Informed by study of the history of natural and unnatural outbreaks, MacIntyre wades in fearlessly. Rather than debate the evidence for a natural origin, she details the evidence pointing to the possibility of an unnatural one. She even examines other recent epidemics including MERS and mpox (formerly known as monkeypox) through this lens, and raises some disturbing questions about just how “natural” those outbreaks were.

There is no smoking gun here, just as there isn’t for the natural origin. But MacIntyre’s research suggests the possibility of an unnatural pandemic is far greater than of a natural one. History also indicates that if the source of SARS-CoV-2 was an accidental lab leak, “we won’t be told for a very long time”.

In the meantime, humanity has its work cut out for it dealing with the ongoing consequences of SARS-CoV-2’s emergence, and preparing for more incidents like it while also working to prevent more incidents like it.
In MacIntyre’s reckoning, the latter should include greater scrutiny of so-called “dual use” research on viruses – research that is intended for good, but could cause harm if it fell into the wrong hands – such as gain-of-function research.

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She also calls for greater preparation for the information warfare and cultural warfare that has made it so much more challenging for governments and communities to respond effectively to the threat of COVID-19. At the same time, MacIntyre challenges the scientific and medical community to consider the role it has played in muddying the waters around issues such as mask-wearing, COVID-19 in children, and even vaccines.

This book is as gripping as any fictional spy thriller, but there is no escapism to be had here. Instead, there are plenty of warnings – and some advice and guidance – about a present and future in which there is a very real threat of life imitating art.

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