with Alexandra Ellerbeck

As the first big wave of coronavirus books arrives, it's shedding new light on the outbreak — and raising questions when those stories conflict.

The pandemic literary moment is hard to miss, with reporters, pundits and politicians afflicted by book contracts. Former Biden official Andy Slavitt, author of the just-published "Preventable," will be interviewed tomorrow by my colleague Yasmeen Abutaleb — who's co-authoring her own imminent book on the bumbled response, "Nightmare Scenario," with fellow Post reporter Damian Paletta. 

They'll join hundreds of coronavirus books already out or coming soon, including big-picture offerings from former FDA commissioner Scott Gottlieb ("Uncontrollable Spread") and CNN's Sanjay Gupta ("World War C"); narrower scopes like Brendan Borrell's "The First Shots" on the vaccine race or Alina Chan and Matt Ridley's "Viral" on coronavirus' disputed origins; and an entire cottage industry about Anthony S. Fauci, ranging from a children's picture book to "Faucian Bargain," a conspiratorial tome taking aim at the government's top infectious-disease expert. 

(For transparency, today's Health 202 guest author also had discussions about a coronavirus book last year before deciding the timing wasn't right.)

John Barry, author of "The Great Influenza" — the definitive history of the last world-altering pandemic — said he's writing a coronavirus book that he hopes will be published in three years, potentially taking a global perspective. "I haven't really identified precisely what the narrative's gonna be yet," he added. "I think it's still maturing." 

The stakes are real: the right books can shape national policy and collective memory. 

"The Great Influenza" alarmed a parade of Bush administration officials, helping spark a new U.S. pandemic strategy. "Rage," by The Post's Bob Woodward, established that Donald Trump privately knew the severity of SARS-CoV-2, even as he publicly played down the risks.

And the timing is key. There's a risk in writing too early — as New York Gov. Andrew Cuomo might confess, with his triumphant October 2020 memoir now the subject of scorn and probes — or waiting too long.

"If you're only going to read two or three books on the pandemic, which are the two or three you're going to read?" asked prominent epidemiologist Michael Osterholm, who's contracted to co-author his own coronavirus tome.

Set to be judged by history — and potentially millions of readers — top Trump officials involved in last year's bumpy coronavirus response have met to get their stories straight, Politico's Adam Cancryn richly detailed this spring.

Now the pandemic books are here, starting to offer insights as the U.S. outbreak recedes and we move into contemplating what went wrong.

For instance, Michael Lewis' briskly written book, "The Premonition," crystallizes frustrations about the Centers for Disease Control and Prevention that transcend the Trump administration. A master of constructing a narrative, Lewis centers much of his around a California public health official who feels stymied by slow-moving bureaucrats in Atlanta. Another storyline focuses on a scientist who built his own coronavirus testing lab after CDC's test rollout was bungled.

(Lewis, whose daughter tragically died last month, has paused much of his book promotion but was among the authors who spoke with The Post for this piece.)

Slavitt — who stepped out of the White House last week and straight into a book tour — draws upon his own insider access in "Preventable": he was in close conversation with Trump officials and national experts throughout 2020, and then took a job in Biden's coronavirus response. 

It's a unique status that gave him direct access to decision-makers, who appeared to confide in him; Slavitt cites a conversation with then-White House coronavirus coordinator Deborah Birx where he concluded that she wanted Trump to lose re-election.

The books can paint dramatically different pictures of last year's response.

The president's son-in-law is one litmus test.

"Jared Kushner inserted himself into the discombobulated White House response, but he only added to the chaos," according to Lawrence Wright in his new book, "Plague Year," which critiques a Kushner-backed effort to enlist private-sector volunteers to source supplies. That effort prompted a complaint to the House Oversight Committee, filed by one volunteer — the grandson of Robert F. Kennedy — who framed it as a failure, catering to Trump allies.

"Virus" — a slim book by longtime political journalist Nina Burleigh — goes further, mocking Kushner as "Trump's boy wonder" and blaming the administration's "MBA ideology" as one cause of its "murderous decisions." (Burleigh, who leaned heavily on reports from the New York Times and Vanity Fair, says she conducted just seven interviews for the book, none with anyone involved in the government's response; she told The Post that she did not contact some officials because she believed they would not be honest with her.)

But Slavitt, who was in touch with Kushner, describes him as helpful and receptive to advice on the need to delay after Trump called for re-opening businesses by Easter. 

The former White House coronavirus advisor also maintains that Kushner's team of private-sector volunteers were unsung heroes. "I was glad they were there, and I sent a few additional talented people their way," Slavitt writes, detailing how one volunteer — data scientist Blythe Adamson of Flatiron Health — ended up shaping efforts to better track the virus' spread.

And in some places, the narratives explicitly conflict. 

In his bestseller, Lewis relays an episode where his protagonist, a California public health official named Charity Dean, drafted a secret national coronavirus management plan that circuitously ended up in the hands of Slavitt, thanks to mutual connections. In Lewis' telling, Slavitt took Dean's plan, renamed it and "presented it to Kushner as his own" in the effort to delay Trump from re-opening the nation by Easter.

But Slavitt's book offers a different, more robust origin story for the plan he gave Kushner: it was the product of several days of working with experts like epidemiologist Larry Brilliant and health care venture capitalist Beth Seidenberg, and he told The Post that it was modeled on existing plans overseas. Dean isn't mentioned at all in Slavitt's book, and contemporaneous emails show that she was among several people who reviewed a draft plan that Slavitt sent her. 

It's a reminder of journalism reality: the narrative can be held captive by who's willing to talk. 

"The Premonition" tells the now-famous tale of the "Red Dawn" group of infectious-disease experts, who peppered government officials by phone and email with their prescient insights on coronavirus. 

"The names at the top of the Red Dawn emails grew in both number and importance," Lewis writes, citing recipients like former Surgeon General Jerome Adams and Fauci, and implying that one conference call even influenced CDC policy on coronavirus testing.

But Adams told The Post that he didn't ask to be added to the emails nor recalled the contents being discussed by fellow White House coronavirus task force members. “Just because someone CC’d you on an email doesn’t mean you actually read or responded to it,” Adams said, adding that the officials were being deluged with messages. Four other former officials directly involved in the White House response said the influence of the Red Dawn group had been exaggerated in the popular press. 

Meanwhile, Wright's book tells the oft-riveting story of Matthew Pottinger, the national security official and former China-based journalist whose own premonitions helped shape the Trump administration's response in January 2020. But Pottinger's journey comes at the exclusion of many key Trump officials like FDA commissioner Steve Hahn or domestic policy chief Joe Grogan, who are scarcely or never mentioned, while other forthcoming books rely on their perspectives.

The authors' takeaways already are sparking robust debate in the health policy world. 

Current and former CDC officials are pushing back on Lewis' contention that the agency was inevitably damaged when Ronald Reagan first picked a political appointee to lead it, rather than a career civil servant.

Lewis defended the theory to The Post — "The difference between Redfield and [Fauci] is the difference between an appointee and a career official," he wrote in an email — but told The Post in a follow-up phone call that he knows more stories are coming to shade in the gaps.

"There is a book to be written, I have no doubt, about what actually happened inside the CDC and why," Lewis said. "That wasn't the book I was writing."

But there's a chance that future waves of books reach an audience that's increasingly immune to reading them.

Barry's book detailed how Americans in the 1920s quickly lost interest in dwelling on the flu outbreak, and the author acknowledged that it was "very possible" that interest in the pandemic may wane before his own book is released years from now.

"But I don't write for an audience — I write for myself," Barry added. "So that may concern the publisher, but it doesn't concern me."

Ahh, oof and ouch

AHH: Coronavirus cases are dropping in states with high vaccination rates.

But they are rising in places where most residents are not immunized, a Post analysis found. States with lower vaccination also have higher hospitalization rates.

“As recently as 10 days ago, vaccination rates did not predict a difference in coronavirus cases, but immunization rates have diverged, and case counts in the highly vaccinated states are dropping quickly,” The Post’s Dan Keating, Naema Ahmed, Fenit Nirappil, Isaac Stanley-Becker and Lenny Bernstein report.

The Post also looked at vaccination rates at the local level and found that in counties where few people are vaccinated, not only are there higher infection rates, but cases are going up.

The U.S. is averaging less than 15,000 cases per day, according to The Post’s coronavirus tracker. It’s the lowest rate since March 2020, in the early days of the pandemic.

“But experts worry that unvaccinated people are falling into a false sense of security as more transmissible variants can rapidly spread in areas with a high concentration of unvaccinated people who have abandoned masking and social distancing,” our colleagues write.

OOF: Former president Donald Trump’s FDA chief is joining the venture capital firm that launched Moderna.

Former Food and Drug Administration commissioner Stephen Hahn will serve as the chief medical officer at Flagship Pioneering, which incubated Moderna more than a decade ago and continues to share ties with the vaccine maker, The Post’s Dan Diamond reports.

“The former commissioner’s move is the latest by a federal official to a company that is regulated by the government or that might profit from firms regulated by the government — what critics call a revolving door that they say undermines trust in federal decisions,” Dan writes.

There are no rules barring Hahn from taking the role with Flagship, although he will be limited in communicating with the FDA on particular matters that he worked on. 

He's not the only former official to take a prominent role in the biotechnology sector. Scott Gottlieb, who preceded Hahn as FDA commissioner during the Trump administration, joined the board of Pfizer after stepping down from government in 2019. Amy Abernethy, the FDA’s top career official under Hahn, joined Verily, Google’s health-care spinoff.

“Is it concerning whenever a high-level government official who was instrumental in actions that may have profited a company turns around and goes to work for that company soon thereafter? You bet it is,” said Walter Shaub, a senior ethics fellow at the Project On Government Oversight and the former director of the Office of Government Ethics.

OUCH: The largest hospitals are making money from massive markups.

A new analysis from Axios found top hospitals are charging inflated prices and engaging in predatory billing practices.

“Most hospitals charge more for a procedure than what it costs them. The top 100 hospitals, on average, charged patients 7x the cost of service, with markup calculated from the American Hospital Directory's cost-to-charge ratio. And private, for-profit hospitals average nearly a 12x markup,” Axios’s Michelle McGhee and Will Chase report.

Hospitals say patients rarely get charged the list price, which industry officials dismiss as a tactic to negotiate with insurers. But there are incentives for higher markups. A 2017 study found that hospitals gain an extra 15 to 20 cents in revenue for each additional dollar of list price. And uninsured patients and those with high deductibles can find themselves responsible for bloated prices. 

When patients can’t pay, they sometimes run into predatory billing practices. Just 10 hospitals are responsible for 97 percent of court actions against patients who are unable to pay.

An epidemic of gun violence

Last year was the deadliest year for gun violence in two decades. This year could be worse.

“Through the first five months of 2021, gunfire killed more than 8,100 people in the United States, about 54 lives lost per day, according to a Washington Post analysis of data from the Gun Violence Archive, a nonprofit research organization. That’s 14 more deaths per day than the average toll during the same period of the previous six years,” The Post’s Reis Thebault, Joe Fox and Andrew Ba Tran report.

This year’s gun violence toll already exceeds that of the first five months of 2020, which was the deadliest year of gun violence in the last two decades.

“Experts have attributed the increase to a variety of new and long-standing issues — including entrenched inequality, soaring gun ownership, and fraying relations between police and the communities they serve — all intensified during the coronavirus pandemic and widespread uprisings for racial justice. The violence, its causes and its solutions have sparked wide-ranging and fierce policy debates,” our colleagues write.

More in coronavirus news

Hygiene theater persists even amid plummeting coronavirus cases.

Ice cream shops use cups instead of cones. New York power washes the outside of its subways. Baseball fans at the Nationals’ stadium must order off a digital menu.

“None of these precautions provide meaningful protection against the spread of the coronavirus, safety experts say. Instead, they are examples of what critics call ‘hygiene theater,’ the deployment of symbolic tactics that do little to prevent the spread of the coronavirus but may make some anxious consumers feel safer,” The Post’s Marc Fisher writes.

Many of these practices were adopted in the early days of the pandemic, when scientists thought the coronavirus might linger on surfaces and be transmitted via touch. In April, the Centers for Disease Control and Prevention said the risk from infected surfaces is extremely low. Yet, months later, amid rapidly dropping infection rates, much of the hygiene theater continues. 

Vatican divisions

The Vatican warned bishops not to deny Communion to President Biden over abortion.

Pope Francis’s top doctrinal official, Cardinal Luis Ladaria, sent a letter to American bishops warning them not to push forward with a vote over denying Communion to politicians who support abortion. The issue could directly impact Biden, the first Roman Catholic to occupy the White House in six decades.

“But despite the remarkably public stop sign from Rome, the American bishops are pressing ahead anyway and are expected to force a debate on the communion issue at a remote meeting that starts on Wednesday,” the New York Times’s Jason Horowitz reports. “Some leading bishops, whose priorities clearly aligned with former President Donald J. Trump, now want to reassert the centrality of opposition to abortion in the Catholic faith and lay down a hard line — especially with a liberal Catholic in the Oval Office.” 

Elsewhere in health care

Americans for Prosperity is running a fresh round of ads against H.R. 3.

The libertarian advocacy group is pressuring members of Congress to vote against the measure, which is Democrats’ flagship legislation to let the federal government directly negotiate lower drug prices in the Medicare program. Advocates on the political right have been arguing the bill would lead to drug rationing and quash new drug innovation.

The digital ads target moderate Democrats who may be willing to side with Republicans against the bill if it comes to the House floor again. They include: Rep. Kurt Schrader (Ore.), Rep. Scott Peters (Calif.), Rep. Lisa Blunt Rochester (Del.), Rep. Tom O’Halleran (Ariz.) and Rep. Kathleen Rice (N.Y.).

A bipartisan group of senators introduced legislation to boost rural ambulance services.

The legislation aims to ensure that ambulance providers are reimbursed by Medicare at a rate that covers the cost of the service. It was introduced by Sens. Bill Cassidy (R-La.), Catherine Cortez Masto (D-Nev.), Susan Collins (R-Maine), Debbie Stabenow (D-Mich.), Patrick Leahy (D-Vt.), and Bernie Sanders (I-Vt.).

Sugar rush