Former molecular biologist Holm imagines a pandemic much worse than Covid-19 in Child Zero (Mulholland, May).

Was this book conceived before the current pandemic?

Yes. I actually began conceptualizing this book in 2016. I was kicking ideas around with my agent, and I said I’d really love to write a thriller set in a post-antibiotic world. There was this long pause, and then he said, “Tell me more about what that would entail.”

What was your reply?

Most surgeries that we take for granted now would be off the table. There would be no more implants of any kind, or organ transplants. We would no longer be able to use steroids, chemotherapy, or radiation because they decimate the immune system. Since 80% of antibiotics that are produced right now are used largely prophylactically by farms to keep up with the impossible demand we have on them for meat and poultry, we’re going to see a massive crash in the world’s food supply. We’re going to see a resurgence in major killers from the past, like tuberculosis, pneumonia. Childbirth will once again become an incredibly dangerous process. Even something as innocuous as a paper cut could very easily kill you.

What’s the scientific background for such a development?

For years, scientists and medical professionals have been sounding the alarm about the end of the antibiotic era, which I think is something that the average member of the public doesn’t understand very well. It’s actually a really frightening prospect. A 2014 World Health Organization report warned that a post-antibiotic era in which common infections and minor injuries can kill is a very real possibility for the 21st century.

Can you explain the science behind your fictional Harbinger virus?

Bacteria, like humans, are susceptible to viruses. But unlike the viruses that infect humans, the viruses that affect bacteria have this funny habit of picking up genetic material from one bacterium and then depositing it in other bacteria. Any bacterium that bumps into an antibiotic and survives it can teach any other bacteria on the planet, even those of different species, how to do the same thing. And relatively benign bacteria can also learn to become more virulent and even kill. Now, that sounds like science fiction. It’s not. In the bibliography that I’ve included with the book, I cite a paper specifically describing what they call a novel super-spreader bacteriophage that is very, very similar in the way that it operates to the bacteriophage that I create in the book.