Richard Preston’s ‘The Hot Zone’: This book about viruses changed everything

The book was not only a bestseller in the ‘dark biology’ genre, but it changed how the world viewed pandemics

By David Hayes, The National Post, April 8, 2020

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With the COVID-19 pandemic raging, I found myself looking through my bookshelves for a paperback copy of Richard Preston’s 1994 bestseller, The Hot Zone: A Terrifying True Story. It’s worth noting that one of the bio-disaster movies that everyone seems to want to watch these days is 1995’s Outbreak, with Dustin Hoffman and Renee Russo as government scientists trying to save the world from the fictitious “Motaba” virus. It was adapted from The Hot Zone.

The Hot Zone, though, is about a pair of deadly, and decidedly non-fictitious, “thread viruses” called Marburg and its better known, and even more virulent, sibling, Ebola. The book was not only a bestseller in what Preston described as the “dark biology” genre, but it changed how the world viewed pandemics, ramped up interest in bio-terrorism and led to major changes to public health policies. American Scientist called it one of the books that shaped science in the 20th century, along with Rachel Carson’s Silent Spring and The Autobiography of Charles Darwin.

I’m squeamish about medical stories of any kind, but I read this book in the mid-1990s because it had a reputation for being an inspired work of creative nonfiction. (Originally an article in The New Yorker, Preston later expanded it into this book.)

Today, I’m amazed I made it past a description, in the opening pages, of a French naturalist named Charles Monet who lived in western Kenya and was thought to be the first human victim of the Ebola virus:

When a hot virus multiplies in a host, it can saturate the body with virus particles, from the brain to the skin. The military experts then say that the virus has undergone “extreme amplification.” This is not something like the common cold. By the time an extreme amplification peaks out, an eyedropper of the victim’s blood may contain a hundred million particles of virus. During this process, the body is partly transformed into virus particles. In other words, the host is possessed by a life form that is attempting to convert the host into itself. The transformation is not entirely successful, however, and the end result is a great deal of liquefying flesh mixed with virus, a kind of biological accident. Extreme amplification has occurred in Monet, and the sign of it is the black vomit.

I chose a relatively benign paragraph. The rest of this section is far more graphic. How graphic? When Stephen King was asked to blurb the book, he called the first chapter “one of the most horrifying things I’ve read in my whole life.”

The book was written a decade into the AIDS crisis. When a colony of African monkeys housed in a military facility in suburban Reston, Virginia, began dying, Preston describes a U.S. Army operation to wipe out the entire colony. It was a necessary action to spare the population in the greater Washington, D.C. area from a plague far worse than the Black Death of the Middle Ages.

It was a virus, Preston writes, that “does in ten days what it takes AIDS ten years to accomplish.” He also notes that a hot virus from the rain forest, like Ebola or Marburg, “lives within a 24-hour plane flight of every city on earth.” Based on what we know today of the origins of the coronavirus in China’s Wuhan province and how quickly it spread via international travellers, it proves just how prescient Preston could be.

Having taken a course called the Literature of Fact at Princeton, taught by the legendary creative nonfiction master, John McPhee, it’s not surprising that Preston vividly reconstructs scenes, like Charles Monet’s final days and the Army maneuver in Reston. He develops primary characters and allows readers inside the thoughts going through the minds of medical staff, scientists and soldiers.

In a representative scene, a virologist named Tom Geisbert is looking at a slice of a dead monkey’s cell through an electron microscope:

His breath stopped. Wait a minute — there was something wrong with this cell. This cell was a mess. It wasn’t just dead — it had been destroyed. It was blown apart. And it was crawling with worms. The cell was wall-to-wall with worms. Some parts of the cell were so thick with virus they looked like buckets of rope. There was only one kind of virus that looked like rope. A filovirus. He thought, Marburg. Oh, no. This stuff looks like Marburg.

Preston is often guilty of injecting too much testosterone into his writing, as though he knows sensationalism sells. But in his descriptions of people and their thoughts, he’s very effective.

Presenting what people are thinking is still sometimes considered controversial in journalism, but in an Author’s Note to The Hot Zone, Preston explains that he based these passages on interviews with his subjects where he asked them what they recalled thinking at that time, followed by fact-checking sessions to ask them to confirm their recollections. “If you ask a person `What were you thinking?’” he wrote, “you may get an answer that is richer and more revealing of the human condition than any stream of thoughts a novelist could invent.”

A novelist like Stephen King could have invented the Ebola virus. The first known outbreak was in Sudan in 1976, killing half of its victims. Two months later, an even deadlier strain hit Zaire, killing nine out of 10 people in several dozen villages. Zaire’s then-president, Mobutu Sese Seko, called out his army to seal off the entire zone of infected villages and ordered soldiers to shoot anyone trying to come out. But it was already loose and spreading, as Preston dramatically illustrated.

Since then, there have been other attacks on our vulnerable immune systems. H5N1, the Avian (or Bird) flu, mainly killed poultry, birds and waterfowl until 1997, when it suddenly infected 18 people in Hong Kong, killing six. It has flared up several times since then and scientists consider it a significant pandemic threat. From 2002-2004, SARS, a viral respiratory disease traced to horseshoe bats in China’s Yunnan province, and a coronavirus like Covid-19, infected more than 8,000 people from 29 countries and killed approximately 775. (Canada had 251 cases and 43 deaths.) In 2012, MERS (Middle East respiratory syndrome), another coronavirus, appeared. Although, it mainly affected countries in the Middle East with some travel-related cases recorded in Europe and the UK. It has been responsible for around 1,000 infections and 350 deaths. These numbers are part of what makes the magnitude of COVID-19 so staggering. As of this writing, there are nearly 1.4-million known infections in the world and 75,000 deaths, calculated since January 22nd.

To save ourselves we’ve retreated into our caves, an uncomfortable parallel to where the bats that spread COVID-19 live. It’s unsettling, especially when environments become too crowded for too long, or, if one lives alone, so solitary that it disturbs our mental health.

In February, the Literary Hub ran an interview with Preston about the Covid-19 pandemic. In his sometimes hyperbolic way, he said of our present situation, “The Ebola war wasn’t won with medicine. It was a medieval war, and it went down as a brutal engagement between ordinary people and a life form that was trying to use the human body as a means of survival through deep time. In order to win this war against an inhuman enemy, people had to make themselves inhuman. They had to suppress their deepest feelings and instincts, tear down the bonds of love and feeling, isolate themselves from, or isolate, those they loved the most. Human beings had to become like monsters in order to save their human selves.”