Book Review “How to survive a Pandemic” by Dr Michael Greger, MD

Dr Michael Greger is a physician, author and internationally recognised speaker on health and nutrition and runs the popular website He is well known for a series of books written on health and diet including “How Not to Die” and “How Not to Diet”. Before any of those books were published he wrote “Bird Flu: A Virus of Our Own Hatching” in 2007 collating much of his infectious disease work that was a primary focus at the time.

To start it’s important I make my position clear on a number of matters that have arisen in the course of reading this book. Firstly, like many readers would attest to, I first came to know Dr. Greger through the documentary “What the Health”, around the same time I started familiarising myself with the animal rights movement. At the time, I was formulating my views about animal rights by subscribing to the dominant ideologies of the big animal charity corporations and the confrontational style of activism pioneered by the likes of Gary Yourofsky and street theatre using graphic slaughterhouse footage. Like most people, I found myself adopting their discourse and arguing the viewpoints that I had been recruited to, without questioning the approach I was taking. This also meant prophesising individuals and putting on a pedestal select people to aspire to and learn from.

It wasn’t until a little over a year of being vegan that I asked myself the question; there must be more and surely I am missing a big part of the picture? This led to a day searching the web on ethical veganism and this is where I came across Gary L Francione. From this moment my entire outlook, not only on animal rights, but on morality in a broader sense was awakened and the animal rights movement and all its flaws and problems was revealed from the shadows. This is also where my romanticism and one way bromance with Dr. Greger started to erode and it become clear that he also had his flaws in regards to animal rights issues and was echoing the rhetoric of all the major animal charities who are happy to settle for welfare reform measures and so-called ‘humane treatment’.

To Dr. Greger’s credit he openly acknowledges that he is not an animal rights activist but is in fact an animal protection advocate and he does not promote veganism, but promotes an evidence based diet and that happens to be a “whole food plant based diet (WFPB)”. In the preface of “How Not to Die” he claims to be “quite the animal lover” and “like many people, I care about the welfare of the animals we eat, but first and foremost, I am a physician”.

I think it’s clear that people idealize public figures like Dr. Greger and place them in positions of leadership in the animal rights movement, but foolishly miss the fact that they do not actually promote animal rights or veganism. Dr. Greger is actually opposed to promoting veganism as he states here in one interview; “there is this baggage that comes along with it (veganism), whereas like for your health it doesn’t matter whether you have a leather belt or not”.

Dr. Greger is not opposed to humans using animals for unnecessary purposes, such as for food. He is frequently arguing for better treatment and practices that minimise suffering, but of more importance to him, to lessen health risks for humans. In a recent interview he promotes animal welfare views such as straw bedding for pigs, reducing intensive animal production and giving chickens more breathing room. These are problematic positions, because they still result in ongoing animal exploitation and are not consistent with the one basic right animals should not be treated as property.

Dr Michael Greger, MD

The book “How To Survive a Pandemic” is dedicated in honor of Dr. Li Wenliang, who was the medical specialist at Wuhan Central Hospital, responsible for raising the alarm of COVID-19 (and reprimanded for “spreading rumours”) who died a month after becoming infected. This was very respectful of Dr. Greger to acknowledge this and it does highlight the genuineness and heartfelt characteristics that are instilled in him.

The first two chapters had me clinging to every word as Greger summarised the history of zoonotic diseases, right from the original source, some 4500yrs ago when waterfowl were first domesticated in China. This provided a novice like me a masterclass in infectious diseases and how a virus can actually breach our bodies defense systems and can trick it into self-destructing. This section in itself should be read not only for the wealth of information but it also gives rise to Dr. Greger’s trademark entertaining and engaging communication style. He lays the groundwork early for his main objective, which is to expose the risks associated with the intensive chicken industry and introduces readers to the avian bird flu, H5N1, which I might add becomes the leading character in the book from that point forward.

For someone like me not familiar with the magnitude of the 1918 influenza pandemic, it was an engaging presentation on a seemingly understated event in our history. He included media reports and scientific research from the time and took you on the journey from the trenches of WW1 to the spread of the flu, which is estimated to have infected half the world. He lay bare horrific details about the symptoms and how most victims bled from their nostrils, ears, eye sockets, vomited up blood and purple blisters appeared on their skin. It also affected children and healthy people in their 20s and 40s, unlike our current coronavirus pandemic favoring the elderly and those with predisposing health risks.

During this section Dr. Greger really starts to hone in on the ‘golden goose’ (pun intended Greger style) and continues building his main argument; that the intensive production of poultry, primarily chicken, in the past 50yrs is the single biggest threat to the next major pandemic, which would make COVID-19 look like a dress rehearsal and the prospect of survival could be a matter of flipping a coin. The argument is compelling and this section is bristling with a comprehensive examination of not only the H5N1 virus which emerged in 1997, but other viruses such as swine flu pandemic in 2009, SARS, MERS, Bovine Tuberculosis, Measles, smallpox, AIDS and the good ol’ common Cold virus which jumped to humans from either horses or cattle.

Dr. Greger has a way of telling the H5N1 story as if the virus is the main character and we are on a journey alongside it. We go along for the ride as it discovers clever ways to infiltrate and breach our systems. We are there when it hitches rides on transport trucks or with migratory birds flying from China to the Middle East; when it goes full stealth mode as it waits in minced up contaminated chickens and fed to zoo animals; whilst it hides in uncooked poultry at our supermarkets or in eggs used in processed foods; and finds itself in our down feather sleeping bags and puffer jackets. It is the James Bond of the virus world, and what he makes clear is it’s just starting to get to know us. He also argues that vaccines are going to prove useless due to the rapid rate a virus mutates and that feeding antibiotics to animals as a growth hormone will ultimately lead to antibiotic resistance and serious implications and public health risk.

We are taken on many around the world trips, exploring different virus stories and the impact on the human populations over the centuries. During one rotation he goes from continent to continent reeling off many examples of the impact of the agricultural and logging practices which have also invited opportunities for zoonotic disease to emerge. For example, how AIDS derived from such a practice which saw bushmeat trade in Africa (apes and gorillas) become the cheaper option to feed the loggers, than shipping in meats from other areas.

“Increasing consumer demand for animal products worldwide over the past few decades has led to a global explosion in massive animal agriculture operations which have come to play a key role in the Third Age of emerging human disease.” (Michael Greger 2020)

The book delves into concerning issues with food borne illness and disease and highlights the staggering amount of deaths per year from food contamination. His criticism towards the big pharmaceuticals and agriculture industries is well supported by scientific research as he makes a strong link between industry attitudes and serious public health issues. He highlights the ‘putrid’ conditions of animals in intensive practices on a global scale, comparing it to the dark ages, all for the purpose of minimising the costs of production in order to maximise profits.

A 12-story pig farm in China (Source: The Guardian)

Besides chickens, the support act goes to pigs and this is also explored through an eye opening venture around the intensive farming globe. He shines a light on the US swine flu which originated in 1999 and then slowly smoldered over the years with a few flare ups eventually leading to the pandemic of 2009 in North America. Transporting pigs over large distances, in connection with the stress this causes the animals, helped accelerate the spread. Pigs are capable of carrying both avian flu viruses and human flu viruses, they became a mixing vessel for flu mutations as what caused the pandemic in 2009. He predicts that besides the bird flu, the next pandemic could arise out of Europe's crowded pig farms.

The evidence of animal stress, particularly in confined spaces and the weakening of the animals immune system is given a thorough inspection in the book. Likewise, intensive farming practices that seem to exacerbate virus spreading, such as exhaust fans blowing infectious particles from poultry farms to neighbouring pig operations. He even highlighted the issues with wild bird and animal trafficking in the US, who import thousands of stressed and infected animals annually. Even if birds are stopped at quarantine stations at various points along the way, he provides evidence of birds becoming infected due to other quarantined animals from other parts of the world.

Dr. Greger barely bats an eye when discussing the multiple animal laboratory studies he draws from to make his points. It is difficult to stomach much of the science that involves animal exploitation, especially from an ethical point of view, and he definitely does not raise any concerns about the ethical dilemmas of using animals in scientific research or the stress that these animals also endure as they are exploited by humans.

Dr. Greger takes a well deserved break from exposing the incomprehensible treatment of animals in confined and intensive farming systems and then turns his focus to the practical and less triggering discussion around pandemic preparedness and management. I will admit these sections were less engaging and I struggled to maintain interest. The focus was on why pandemics have been poorly managed in the past and what we need to do to ensure we are prepared for the next ones. The chapter on what to do in a pandemic is like a survival kit checklist which I breezed over, however as I sit here writing this review, Adelaide has gone into total lockdown again and I am wishing I had gone shopping beforehand and had my survival box under the bed ready to go.

The final chapter was disappointing for me as the book had presented up to this point such a strong argument for animal rights but he decided to play it safe. He kept animal consumption and exploitation alive and was content to settle for a much smaller ambition of reducing our demand for chickens. He rarely focused on any other animal other than chickens in his conclusion, which is as speciesist as one can get and even in regards to chickens, the best he felt we would be capable of achieving was to reduce intensive poultry operations.

‘Megafarms’ are on the rise in all animal agriculture industries due to increased public demand for cheaper meat

Why chickens (intensively raised) were isolated and given more weight than other animals is questionable, given the past four zoonotic diseases have also emerged through other animals, not just birds; SARS 2003 (bats and palm civets); Swine flu 2009 (pig); MERS 2013 (bats and camels); COVID-19 (bats and pangolin). Dr. Greger himself pointed out in an earlier chapter that swine flu from Europe may well be our next biggest threat. It has left me wondering what other interests or influences were at play in publishing this book and why it became so heavily focused on animal (chicken) welfare reform issues.

A key argument presented throughout the book is that free range poultry operations are a lower risk of causing highly pathogenic avian influenza and the world needs to curb its demand for ‘cheap chicken’. Whilst reading his persuasive arguments about factory farming and battery cages, it was only in the state of Victoria in Australia that multiple free range poultry operations started killing hundreds and thousands of chickens, turkeys, emus and ducks due to a H7N7 strain infecting its flocks, by migratory ducks flying around in the area. Is Dr. Greger dismissing other research, in order to strengthen his argument about intensive poultry farming? I would not be the first critic to suggest this about his work.

If you read his preface in “How Not to Die” Dr. Greger admits himself to having certain biases that he needs to reign in. Maybe he has just set the bar for human change considerably low as suggested in this passage;

“ending chicken consumption may be little more than a hypothetical, but ending the riskiest practices, the most intensive forms of industrial poultry production, seems an attainable goal”. (Michael Greger, 2020)

And this is where it was confirmed to me that Dr. Greger has been recruited into the animal welfare and protection ideologies that do not promote veganism as a moral imperative, but prefer to settle for more “humane” and “compassionate” forms of animal exploitation. I guess being the public health director for the Humane Society of the US, should have been enough of a warning to me that he was peddling the same old animal welfarist, revenue raising, speciesist and confusing crap, corporate charities and animal protection/justice organisations are famous for.

I admire Dr. Greger for his work and contributions to healthy eating and he has inspired in me songs, writings and a healthy thirst and hunger for knowledge. I am happy to hold him in the space as being one of the leading experts in WFPB nutrition. However, it is a mistake if vegans or animal rights groups continue to promote Dr Greger as some kind of leading animal advocate because he clearly doesn’t claim to be and most definitely does not promote a clear and consistent vegan message, nor does he acknowledge in his work the intrinsic value of ‘all’ animals who are ‘used’ for unnecessary purposes such as for food, clothing, entertainment and scientific research.

Dr. Greger however always maintains that as a physician, health is the paramount focus with his work and his quest is to promote a WFPB diet where resources are free and accessible. He has stated that “veganism is nothing more than an identity that doesn’t tell you much about a person and comes along with all this baggage”. On the contrary there are other physicians and renowned nutritional experts, such as Dr. Michael Klapper, Bill Tara and Marlene Watson-Tara, who explicitly promote veganism and are strong advocates for animal rights and ending non-violence.

I would recommend this book as a comprehensive and engaging way to learn about infectious disease in our current global situation and to consider how our relationship with animals has lead to an extremely contagious and risky situation within our public health. It is also offers practical ways to survive in emergency situations, which, will no doubt become a norm in our society. However, in regards to the ethical issues around our use of animals, this book will not fulfill expectations and if anything just gives more support to the animal corporate charities who continue to fund animal exploitation under the guise of “happy exploitation” and animal protection nonsense.

Vegan ethics, abolitionist approach to veganism , vegan songwriter

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