April 17, 2021
3 min read
Barry JM. Pandemics — What the Past Tells Us About Our Current and Future of COVID19. Presented at: Interdisciplinary Autoimmune Summit. April 15-18, 2021 (virtual meeting).
Barry reports no relevant financial disclosures.
The U.S. public health community was unable to foresee the rampant politicization of the COVID-19 pandemic, and was shocked by the initial federal response, according to New York Times bestselling author John M. Barry.
Barry, whose book, The Great Influenza: The Epic Story of the Greatest Plague in History, won the 2005 Keck Communication Award from the United States National Academies of Sciences, Engineering, and Medicine, was asked during a virtual Q&A session at the 2021 Interdisciplinary Autoimmune Summit what shocked him most about the United States’ response to the COVID-19 pandemic.
“Probably the same as you and everyone watching — that you have a public health crisis that has been politicized, that you have measures that can save people’s lives, and they become political,” Barry said.
“Nobody in the public health community, I can guarantee you, or in the preparedness community ever imagined that the response of the White House would be what it turned out to be, or that, in any national crisis, the president of the United States would stand at the podium and say, ‘The federal government is a back-up,’ not just once but on several occasions,” he added. “‘The federal government is a back-up,’ in a national and international crisis. Who could possibly imagine that? It was not just the biggest surprise to me, but probably to everybody.”
John M. Barry
Barry, who is also a distinguished scholar at Tulane University’s Bywater Institute, and a professor at the Tulane School of Public Health and Tropical Medicine in New Orleans, also reflected on the early days of the COVID-19 pandemic in the United States, in which there was a “frustrating” lack of testing.
Specifically during early- to mid-February, he recalled that the dearth of known cases in the United States — mostly likely due to the lack of testing — had lead both public health officials and the public into a false sense of safety.
“We had the sense that it was here,” he said. “I live in New Orleans, and Mardi Gras, in retrospect, was probably a big spreader. However, there were no reports of cases at the time — so no reason to close it down. The last time I got off an airplane was, I think, on Feb. 23, to give a talk on the coming pandemic, and I remember thinking, ‘Well, I will adjust my personal habits when it arrives, but it’s not here yet.’ But I knew it was coming. And of course, I was mistaken — it was here, and spreading.”
Lead during the Q&A session by moderator Joel M. Gelfand, MD, MSCE, of the University of Pennsylvania Perelman School of Medicine, Barry provided a history lesson of the state of medicine prior to, and during, the 1918 influenza pandemic in the United States. He also described the measures that were taken to help curb its spread.
At that time, medicine in the United States had only recently become scientific, following the opening of Johns Hopkins School of Medicine, the first such school to establish scientific requirements, in 1893, Barry said. In addition, the idea that influenza was a viral-based disease was largely unknown.
“Physicians at the time tried everything, including injecting hydrogen peroxide intravenously,” Barry said. “Someone wrote an article in JAMA on that and, of the 25 patients, if my memory if correct, 12 of them died — and he claimed success.”
“However, they were familiar with vaccines, and they developed vaccines, but it was against a bacterial pathogen, so they didn’t do much good unless you happened to be infected by a secondary bacterial pneumonia,” he added. “They did use transfusions, essentially what would be developed into monoclonal antibodies. That had some impact, but basically all you could do back then was keep people hydrated.”
In terms of public health measures, officials at the time turned to a familiar strategy — masks and social distancing.
“Of course, one of the oldest interventions is quarantine,” Barry said. “They knew it was an infectious disease, they knew it was respiratory, and they had actually run pretty good experiments on masks for other respiratory diseases, and they knew that if you put a mask on someone who is sick, it was useful for protecting people who were well. So, masks were quite commonly used in cities, but the keys were social distancing and closures.
“There was a tremendous amount of fear,” he added. “This was a deadly disease. Nobody thought anything but that. Nobody was dismissing that. You couldn’t, when the numbers of the dead are rising, your neighbors are dead in 24 hours, and so forth. So, even if they had not imposed any social distancing measures, the streets would have been empty.”
Asked by Gelfand what historians will be writing about the COVID-19 pandemic 100 years from now, Barry said future scholars will have to look at the planet as a whole, and recognize that “Some countries did it right, and some did not do it right.”
“Unfortunately, we are not one of the countries that did it right,” he continued. “And they will be able to figure out just how important politics is to a public health response.”