It feels a little ironic that the week that Devi Sridhar and I are meant to meet in person, I come down, for the first time, with Covid. And so, rather than a coffee near the University of Edinburgh, where she works, we resort to the tool of the pandemic, Zoom.

In her new book, Preventable, the global public health expert wrote that, as of January, she had still not yet had Covid. I’m curious to know if, with infection rates at somewhere around one in twelve, as we speak, she has still managed to swerve it.

“I had it!” she declares. “I knew I’d eat my words. My editor was like, ‘People will want to know if you’ve had it and what your experience of it was.’ But I hadn’t had it. And actually I found it hit me pretty hard. I was hoping I’d be asymptomatic. But it took me a few weeks to recover.”

The 37-year-old was in bed for three or four days. She cancelled her PhD meetings, answered very few of her emails. “Having had it,” she says. “I don’t want to get it again. Even if it makes you unwell for a week or two with exhaustion, to have productive adults out of the workforce for two weeks or a month, isn’t good.”

Omicron, Sridhar observes, is very transmissible. “It makes the wild type [original strain] look easy to control in comparison. I think in some ways looking back, we can see that probably if countries had worked together, we could have probably stopped the development of very many variants at the start. It got so much more transmissible with each variant, that now we’re seeing that it’s pretty much uncontrollable – which is what China discovering.”

How we came to this point where we have an uncontrollable virus circulating across the planet is part of the story she tells in Preventable. It’s a memoir of her experience as an expert giving advice to government, but also an examination of what, globally, we could have done differently, touching on the many points at which we could have prevented the spread of Covid-19, and deaths, right back to the virus’s emergence in China – including the question of whether it was the result of a ‘spillover’ event of a disease from wild animals in wet markets in Wuhan, or a lab leak. Sridhar, by the way, does not discount the latter. In fact, she examines it quite seriously.

The story for Sridhar begins with a moment in January 2020, in which she, a keen fitness lover (as a “hobby” she is currently studying to be a personal trainer) was working out at her gym and reading on her phone about China’s lockdown of Hubei Province. Already alert to the gravity of this, she recalls, “I stared at the people surrounding me on treadmills, spin cycles and elliptical machines, all blissfully unaware about how their lives, and those of the entire world, would change in the coming weeks and months.”

At this point few in the UK outside those interested in global public health would have known the name Devi Sridhar. Nor would they have predicted that she would soon gain the ear of the First Minister – and even, as she notes in her book, gain the offer from Nicola Sturgeon to be one of her first personal trainer clients when she qualifies as coach.

Though in 2020 she was already The Chair of Global Public Health at the University of Edinburgh, highly respected in her field, with already a high-flying career behind her, she was not yet the kind of person to cause a Twitter storm and appear regularly on television. That was all about to change.

Just as the virus would alter all our lives, it did hers. In her book, she reflects, “I’m not sure when it hit me that life had changed irrevocably. Was it when a local officer rang my doorbell after an anti-masker social media influencer sent out a request for my address on Facebook, so the police had to mark my home as a high-risk target?”

“That was a moment, “ she says, “where I thought, ‘What has my life become?’ To get to that point where you’re speaking to your neighbours and saying, ‘In case, anyone’s looking for me could you not mention that I live here? And also call the police.’”

After eight years of living in this country, in a relatively quiet way, she became both a target of threats, and figure of admiration, such that she even gets marriage proposals from strangers and puppies named after her. Why did this happen? Because from very early on Sridhar said quite publicly exactly what she thought. It’s a principle she still lives by.

Even the publication of Preventable says a great deal about her emergence as a public figure. Before Covid, this high-profile academic had been working on a book about the animal-human nexus and infectious diseases, its chief foci Ebola and Zika. Her last book, Governing Global Health, co-written with Chelsea Clinton, was, she says “quite technical, for an academic policy audience”.

But in Preventable she has written something broader and more popular, with a little of her own story. “It’s almost been a bit cathartic. Because I feel like I’ve downloaded my brain, I’ve given my input on how it was for me and what happened. Now I can walk away.”

Right at the beginning of the pandemic, her team at Edinburgh University shifted to tracking policies, keeping an eye on East Asia, and low and middle income countries.

Their work was “very international and comparative”. She already believed “the only way to really learn about this virus was by looking at other countries where it was spreading and understanding what is happening there.”

This meant they saw other stories from the ones being told here. It meant they were watching and studying. They saw the rapid testing response that took place in South Korea. They watched the news from the Diamond Princess, the cruise ship where passengers and crew were quarantined with the disease for weeks.

What’s clear from Preventable is that, along the way, this is a story, again and again, of vital time being lost. That loss of time begins with China’s delaying notifying the world about this terrifying new virus. “We lost weeks there,” says Sridhar. “Then we saw the spread in other countries and the widespread seeding.”

In those early months many countries were too slow to wake up to the significance of this disease – and the UK was among them. “My book looks at the way deaths could have been preventable. One way is that many governments didn’t wait for vaccines and didn’t anticipate vaccines. They said, okay, we’ve got to take this wave of infections. Perhaps if the British government had known that we were going to have a vaccine in a year, their strategy would have been different. If they had known there were going to be reinfections, it might have been different. At different stages we fumbled, and the virus took advantage of every one of those.”

For Sridhar, a big moment, early on in the pandemic, was when she stuck her head well above the parapet with a response to Boris Johnson’s announcement on March 12, 2020, that the UK was adopting a herd immunity strategy, endorsed by “best science”. In a tweet the following day she wrote, “Part of my job is speaking truth to power. And the UK govt is (in my view) getting it wrong.” She also wrote an article titled Britain’s Gamble, and in that flagged the issue of reinfections, which, as we have since discovered, have made it impossible for us to gain herd immunity.

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“I was worried,” she recalls. “And I was very confused. They were talking about herd immunity, saying that we were going to get to 60-70 percent infection.

“It just made no sense to me or my team, because we had been studying other places. And by that point, in March, we had had the Diamond Princess cruise ship. We had already seen Wuhan. We’d seen South Korea, we’d seen Taiwan. There was a lot of knowledge at that point, so it didn’t make sense.”

In the months that came she would become a familar face on television. She would become a member of the DELVE (Data Evaluation and Learning for Viral Epidemics) team, giving advice to SAGE, the UK’s Scientific Advisory Group for Emergencies, as well as the Scottish Government’s “time limited expert group”.

Her positions didn’t always make her popular. Frequently Sridhar got what she describes as pushback. “Right from the start there were a lot of people criticising me. But I wasn’t trying to be difficult. I was just saying if they are following the science, show us the science, publish it. Sage wasn’t publishing their minutes then.”

That often vitriolic reaction surprised her. “It was really weird because in public health, we’re usually the good guys. I work with Save the Children and the Scotland Office. We would go to the poorest schools and try to help and we’re there to help, right?

“It’s not a glamorous profession, and you’re never really accused of being the bad guy. To go from that to becoming a villain!”

She lists the various groups that over the past few years have attacked her: the anti-vaxxers, anti-maskers, anti-lockdowners. On one occasion, she recalls, she even received an envelope in the post containing a surgical facemask, with the words ‘I am done’ written in black Sharpie, as well as traces of white powder.

She froze, caught between the possibility that it was a hoax or anthrax – fortunately it turned out to be harmless. But she’s keen to emphasise that many scientists around the world were attacked in even more terrifying ways.

She explains, “My experience is much less difficult, for instance, than that of the Florida whistleblower, Rebekah Jones, who was sacked for refusing to hide Covid-19 data and later had her house raided by armed police and computers confiscated. Or the Chief Scientist from the WHO Dr Soumya Swaminathan, who had a lawsuit filed against her, or the Belgian scientist, Profesor Marc Van Ranst who had to go into hiding with his family after threats.”

From the start she was critical of SAGE – not just of its initial advocating of herd immunity, but of its opacity. “Think of March 2020, we didn’t know who was on it. We didn’t know what they were advising. We didn’t really understand when the government said it was following the science, what the science was, which is why a group of us academics wrote a letter, saying who’s on it.

“When the minutes were released you saw how it was almost like a group think where they all didn’t see a way out because they weren’t looking at other places. They were just saying, we’re just going to all have to get it. East Asian suppression was not discussed. Mass testing wasn’t really discussed. And I think it comes down to the lack of diversity at the table of who was sitting there.”

One of her criticisms has been their emphasis on the use of modelling. “Modelling,” she says, “is really useful, in terms of a scaffolding for scenarios, but in the end it’s just scenarios, right? And you also have to have really good data going in and we didn’t have great data going in on the hospitalisation rate or the IFR infection fatality rate. It’s very hard to model something when you don’t have the basic data to put into your model. And I think the other thing that sometimes numbers can miss is what you find out actually talking to frontline staff.”

Her other gripe about SAGE was, quite simply, its narrow vision. “It was largely male, and that’s generally true of professors, even today. It was very UK focused and it had a lot of scepticism towards looking at other countries that maybe are considered poor, or less smart like Senegal or South Korea, instead of thinking, well, actually, they have a lot of experience in infectious disease management.”

Sridhar is an American, who grew up in Miami, in a family from India. She lives alone, and has done throughout the pandemic, with only her pet tortoise as company – a companion which she heartily recommends, as “very low maintenance”.

Her chat about her daily non-work life over the past few days is surprisingly uplifting, frequently emphasising the joy of simple pleasures, spotting an otter on Dunsapie Loch, the pleasures of paddleboarding at Wardie Bay.

Her father, Kasi Sridhar was a lung cancer specialist who would die of leukaemia and lymphoma at 49 years old, while Devi was in her last year at school.

"Seeing him get cancer when I was quite young,” she says, “made me realise that health is so important, being able to live your life without suffering. Medicine often intervenes when it’s too late. So how can we get there earlier and help people as a society? How we make it so people can avoid infections, avoid chronic illness and live healthy, happy lives? ”

Her father passed his passion for health on to her. “I also saw,” she reflects, “when he died, that so many people spend their lives accumulating wealth, and there’s so much greed and materialism, but when you die, you don’t take it with you. It’s not like you’re buried with your five yachts and your three Mercedes. You go with what your legacy is and how you’ve improved people’s lives. It’s their memory of you and what you’ve done.”

She recalls watching him get sicker and sicker as he got closer to death. “It’s quite awful to watch a loved one go through that. But I think in some ways it helped me realise what it’s important in life. Trying to live your life with integrity and, in the end, a simple life is much better, lived well. People over-complicate it.”

Among the ways in which the pandemic has impacted on her personally, has been the death of her grandfather, in India.

“It’s really hard because in normal times I would have flown out to India, would have been there with my grandmother when that happened, but I wasn’t able to. Also I know they’d had a really difficult time being imprisoned in their homes because of their age and their frailty.”

Values are clearly important to her. At one point in Preventable, she observes that it’s not so much that the pandemic changed us, it revealed who we really are, our own values and those of others. “I guess for all of us,” she observes as we talk now, “there’s the question of who did we get closer to, who did we kind of look at in terms of decisions made? I think it did reveal people’s values and what they stood for.’”

She has little regard for the conduct of the UK Prime Minister. Amongst her complaints is that, early on, Johnson missed “so many, many” COBRA meetings. “Your job, if you’re going to be Prime Minister, is to show up to the meetings.”

She was also horrified to see the example he set when he was in a Covid hospital shaking the hands of everybody, some of whom had Covid.

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“I think now,” she observes, “what’s really painful is the parties, to learn it all happened when so many people weren’t able to be there funerals and weren’t able to be there at the birth of their child. People made enormous sacrifices. And the idea that leadership didn’t make similar sacrifices is quite a difficult one.”

By contrast, she speaks of Nicola Sturgeon, the woman whose ear she had, in glowing terms. She didn’t know the First Minister before the pandemic, but, she says, came to “really like her”.

“I think it’s because she always wanted from me the direct, blunt analysis. She didn’t want to hear sugarcoating. She didn’t want spin on it. She was really like, ‘What do you think?’ Or, ‘What is Hong Kong doing?’ Or, ‘What do you think about the United States’ position on this?’ And I would just say it and then put the analysis behind it and offer the logic.”

“I found with her, she wanted to do the right thing. I think she very much wanted to protect life. And she understood the cost of restrictions to the economy, so it had to be proportional. That what you were doing was proportional to the risks associated with what spread. I think I feel quite lucky that we had a leader who wanted that kind of direct expert input. There was never an idea of, ‘Tell me what I want to hear. It was quite the opposite.’”

The pandemic also delivered Sridhar a crash course in how power is distributed across the UK. “Health is devolved,” she summarises, “education is devolved. But other things are reserved, so you kind of do some stuff, but can’t do other stuff. So when our rates are going up, and we’re thinking, Oh, we really need to shut, let’s say, nightclubs or bars. You can’t just do that if you can’t provide furlough or economic support. You’re condemning people to impoverishment, right?”

A “lost moment” was, she says, the summer of 2020. “We had this really difficult lockdown. We got numbers negligible. There was the idea of vaccines hopefully arriving by Christmas. So the question should have been, how do we seal off and protect those gains until we can vaccinate widely? But Scotland couldn’t control tourism in and out of the country. And we know from the sequencing work that the first strains were largely eliminated. And that we reimported and got new strains through holiday travel.”

A few months of no, or very limited, international travel, she believes, would have made a great deal of difference in terms of the deaths that following winter. “How many of those deaths were preventable had we taken different policy options? As I say in the book, for Scotland to be an island. I think every place wanted to be an island.”

Does she think we could ever have behaved as New Zealand did, keeping the virus out until vaccines were available? “Because of our geography, we weren’t going to be a New Zealand. Heathrow is extremely connected, Scottish airports, not as much. You could envision, if we were in another universe, a little island in the North Sea, we would have been similar to other little islands, who all kind of bubbled off. But we are still connected at Heathrow and that would have pretty much been impossible.”

The other crash course she got was in the vitriolic politics around independence.

“I learned,” she says, “that anything you say positive about Scotland becomes a soundbite for Scottish independence. If you say anything positive about Nicola Sturgeon, even if you’re just talking about her as an individual, that’s seen as pro-independence. The bizarre thing is people in England in polls really like her, and it’s not like they are for Scottish independence. So you can admire a person and their qualities without necessarily aligning with their politics.”

What does she think the future is for humankind and this particular virus? “We got lucky with Omicron. Imagine if it was this transmissible but even more severe than Delta. It would have been an impossible situation. We would have had NHS collapse. But we don’t know what’s going to happen with future variants. We hope we will get lucky again and this gets more innocuous. But this is so unpredictable as a virus.”

For her, the still bigger question, is what we have learned from all this. “We’ve made the mistakes we’ve made. What do we do better the next time? And I think we will do better next time. There is an awareness now that we have to act quickly.”

Preventable: How A Pandemic Changed The World And How To Stop The Next One by Devi Sridhar is published bv Penguin, £20