The pandemic expert who has been right about COVID-19 all along, especially about how bad it would be, is finally “pretty optimistic” that the worst is behind us. Still, he warns that “overconfidence is always a killer.”
John Barry, the author of the definitive history of the 1918 influenza pandemic and a faculty member of the Tulane University School of Public Health and Tropical Medicine, has been remarkably prescient about the coronavirus. When I interviewed him two years ago this week, a few days before basketball teams began being pulled off courts midgame and sudden lockdowns were ordered, Barry told me the pandemic would be “very, very bad.” Against a number of armchair quarterbacks predicting fewer than 50,000 total fatalities, Barry provided math suggesting more than a million Americans eventually would die from it. He was right: As of today, at least 959,000 Americans have perished from the disease, with death numbers still growing at 10,000 per week.
Exactly 52 weeks later, with numerous prominent commentators pronouncing the pandemic effectively “over,” I summarized Barry’s then-message like this: “Don’t get complacent about COVID-19 because the mutants are coming.” And: “The variants we have seen so far are not the last variants we’re going to see.”
Sure enough, the triumphalists were wrong and Barry was correct: The delta variant began spreading wildly in June of last year, and the omicron variant began its rampage in late November. In the one full year since Barry warned the variants might “outrace” the effectiveness of vaccines, another 432,000 Americans have died from the virus (after 527,000 in the first year).
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That’s why it is encouraging now to hear Barry say, “I think we’re in a good place. If I were under 50, which I’m not, I would be pretty relaxed right now.”
He said that the combination of vaccines, immunities developed by the 80 million Americans who already had COVID-19, and the growing availability of treatments such as Paxlovid mean the disease probably is finally containable. While he said “the next variant could be nasty,” other pandemics have featured later variants that “continue toward mildness.” For example, in the “great influenza” that began in 1918, “by 1921, it lost its ability to bind itself in the lung. At the same time, the immune systems became more adept at dealing with it.” Likewise, although omicron in sheer numbers has continued to be quite deadly, its variant has been significantly less likely to bind itself into our lungs.
“I’m still cautious,” Barry said, “but look at your local situation: If there’s very little community transmission, you can start to relax.”
Still, Barry said the caveats are important. Even for people under 50 who are returning to fully normal life, “I would keep my masks handy” at home, he said, “not cloth masks, but good masks, the N95 or KN95 ones.”
Meanwhile, he said, we should keep producing treatments, just in case. Paxlovid, for example, “has a difficult production process; it’s not easy to scale up to the number of dosages that we need worldwide, but we’re trying.”
After all, tens or even hundreds of thousands of people already “have died who shouldn’t have died,” Barry said, because too many people failed to take proper precautions. This isn’t an argument for or against particular mandates but for personal application of carefulness and common sense.
One might say that Barry’s message is sort of the public health equivalent of diplomacy’s mantra to “trust, but verify.” Forgive the run of cliches, but while the worst may be behind us, it’s better to be safe than sorry.
