As we commemorate the fifth anniversary of the World Health Organization declaring the novel coronavirus a pandemic, this is the fourth column of a six-part MSNBC Daily series that reflects on the million American lives lost, the political polarization and the declining trust in public health measures that followed the virus’ spread and assesses the country’s preparedness for the next pandemic.
John M. Barry’s 2004 book “The Great Influenza: The Story of the Deadliest Pandemic in History” won the National Academies of Sciences award that year for outstanding book on science or medicine. He later assisted the George W. Bush and the Barack Obama administrations with their pandemic preparedness plans.
We spoke for almost an hour on Feb. 18, 2025, at Barry’s office at the Tulane University School of Public Health and Tropical Medicine where he is a distinguished scholar. This interview has been edited for length and clarity.
Jarvis DeBerry: You wrote an op-ed [for The Washington Post], I think in December 2019, and the question was: Can this [Covid-19] be stopped from reaching the United States? You said, “Probably not.”
The working title was ‘This virus cannot be contained.’ Then I decided to wimp out and change that to a question: ‘Can it be contained?’
john m. barry
John Barry: January 2020. I wasn’t so smart to have done it in December. The working title was “This virus cannot be contained.” Then I decided to wimp out and change that to a question: “Can it be contained?” and said “Probably not.”
My first inklings of it were obviously correct — unfortunately.
JD: What did you see then that worried you?
JB: It was already in Thailand, I think Jan. 13 or Jan. 14, which is right about the day that I wrote it.
And they closed Wuhan. Take the Chinese seriously when they say they can shut things down. But it was clearly too late. It just didn’t seem possible to contain it.
On the differences between the 1918 pandemic and the 2020 pandemic:
JB: I think the real difference is the lethality of the disease and who was dying — and the timing.
JD: What do you mean?
JB: In 1918, 95%-98% of the excess mortality is actually people younger than 65. In the age groups that were most vulnerable, died at the highest rates, No. 1 was kids under 5, and No. 2 was kids under 10. No. 3 was adults in their 20s.
If you had healthy adults in their 20s and young children dropping dead during Covid, I think you’d have had a much different response. And everybody would have been begging the scientists to do something.
When you have primarily the elderly dying —
And plus, people were dying — not all the people in 1918, but enough people — were dying very quickly, in less than 24 hours, sometimes. Sometimes with horrific symptoms, bleeding from their ears, stuff like that.
It’s pretty scary. So if that had been the case in Covid, you wouldn’t have people saying this is just like influenza.
JD: And, yet, it still feels like there has been this movement to minimize it or to memory-hole it.
JB: Yeah. People are rewriting history in a lot of ways, starting with Jan. 6, starting with the 2020 election.
JD: What are the ways that 1918 and ’19 was similar to 2019, 2020?
JB: It’s more dissimilarities than similarities. In 1918, the government lied, period.
JD: In what way?
JB: You had national public health leaders saying this is ordinary influenza by another name. It wasn’t.
The symptoms were totally different, and, again, as I’ve already said, people who were younger were dying. In terms of adults, the most vulnerable population were pregnant women. You were at a very high risk of death if you got influenza in 1918 and you were pregnant.
Trump tried to minimize it. The public health authorities didn’t help themselves by reversing themselves several times.
JOHN M. BARRY
So people at almost the most productive time in their lives are extremely vulnerable in 1918. When the government is telling you this is ordinary influenza by another name, and you see your next-door neighbor drop dead 24 hours after a first symptom, when you see mass graves being bulldozed open and bodies poured in, you know it’s not ordinary influenza by another name. So the result of that is people stop believing anything they’re told.
You know, Covid, Trump tried to minimize it. And he had people who believed him. The public health authorities didn’t help themselves by reversing themselves several times.
There’s a way that you can sort of take back what you said at first — if you set the expectations properly. If you start out by saying, “I’m giving you the best information that I have at this moment, but this is new, and I promise you what I’m telling you today is going to change, but I will always give you the best information I have,” then people expect some shifts.
But if you’re more didactic in what you say early, and you then reverse yourself, you’ve kind of painted yourself into a corner, and then you lose credibility. Once you lose credibility, you ain’t gonna get it back.
JD: What’s an example of that? Masks?
JB: Yeah, masks is No. 1.
I think certainly one of the reasons they initially said masks weren’t useful was to preserve them. I think they may well have felt that if they did anything else, people would hoard the masks, the supply would dry up.
My next-door neighbor is a dentist, and he had masks. He actually gave them to hospitals. He was exposing himself to risk by giving up the masks that he had. So, you know, you may well have had a lot of people that would have acted appropriately.
But to be perfectly honest, I initially also recommended against masks. I had some data that I was backing my recommendation up with.
As early as 1917, the Army had conducted some experiments with masks after a measles epidemic was killing a lot of soldiers in Army camps.
john m. barry
Even as early as 1917, before the pandemic, the Army had conducted some experiments with masks after a measles epidemic was killing a lot of soldiers in Army camps, and they discovered that when you put masks on somebody who’s sick, they’re actually very effective protecting people. (And those masks were obviously nothing like the quality of the masks that we produce now.)
In 1918, there were a lot of cities that required masks. They were not very effective. The conclusion was that, for the general public, they were not worth the effort, because people aren’t wearing them properly, and so forth and so on.
So that was part of my thinking. And, you know, honestly, I was also probably thinking, “Well, let’s not have people hoard them. Let’s preserve them for people who really need them.” So I had mixed motivations behind my own early recommendation, if somebody asked me about a mask — and I guess a few people did.
The other biggest reversal was on the vaccine, because initially it was [said to be] over 90% effective. So you think you get, quote, sterilizing immunity, meaning you can’t transmit and so forth and so on. And CDC reversed themselves on that as the data changed. JD: You mentioned in 1918 the government directly lied. In 2020 maybe the bigger sin is suggesting that they had complete information when they had less than complete information? JB: Well [National Institute of Allergy and Infectious Diseases Director Anthony] Fauci was saying “at this time.” You know, not a threat to the general public at this time — and so forth. But people forget that last part of his sentence. There were always some caveats. I don’t think that they were as definitive as people heard them or interpreted them as being. [Still], they did not present a framework where you, again, you create a kind of infrastructure that allows you to recognize error and correct it. They didn’t really set expectations that they’re going to change the recommendations. Whether they were definitive or not, they didn’t really set expectations that they’re going to change the recommendations. There was a study after Covid of, I think it was 160 countries (it was more than 150, anyway) which concluded that the form of government, whether it was democratic, communist or autocratic, didn’t matter in terms of how well that society performed. What did matter was trust in institutions and trust in fellow citizens. Where that ranked high, that country did pretty well in Covid. Where it didn’t, like the United States, we didn’t do so well. JD: When you say we didn’t do so well relative to other countries, what do you mean? You mean mortality rate? JB: Yeah, total mortality. Before the pandemic, the Global Health Security Index put the United States first in terms of pandemic preparedness. You know, based on resources. There’s very good data that the counties in the United States that were most pro-Trump compared to the counties in the United States that most lean Democratic, there’s enormous differences in the mortality. Enormous, and not all of that is because of vaccination rates. In fact, the people who were most vulnerable, even in pro-Trump counties, the elderly, the majority of them, were vaccinated. So it was more social behavior and vaccination rates of people younger than 65. And the funny thing was, of course it wasn’t Trump’s idea, for the vaccine, to do warp speed. But, you know, he could have said, “No, I ain’t going to do it.” So he certainly deserves some credit. JD: Even if he’s running away from the credit. JB: Yeah, he does and doesn’t take credit for the vaccine. But, again, he could have said no. JD: How do you see America’s preparedness right now for — In 2022, I said I expected public health to be well funded for five years, but after that, forget it. Obviously I was overly optimistic. JB: It’s going backward. JD: In what way? JB: Well, the distrust of public health. You know, it’s not as great as the media might suggest, I don’t think. I think probably most people still trust, but certainly there’s a significant minority that doesn’t. A lot of states have passed legislation that takes authority away from public health. You know, we’re in Louisiana, one of the most backward places in that regard. The state just recently said the Department of Health is not going to promote vaccines at all. I mean, that’s crazy. In 2022, I said I expected public health to be well funded for five years, but after that, forget it. Well, obviously I was overly optimistic. For all the problems CDC has, firing [1,300] people is not the solution. They’ve got great people at the CDC, and I just saw the AI section of the FDA has been canned. What’s that about? It’s stupid. The only thing the Trump administration has done right is they put a guy named Gerry Parker in charge of pandemic response office in the White House. He’s very good. He’s a nice guy on top of being very good, maybe too nice a guy. There are a lot of sharp elbows, and in fact sharp teeth, in that White House. So he needs to get some armor on. JD: I guess it was naive of me to think that something as huge and significant as a pandemic would not become politicized. JB: Who knew? (Laughs) I participated in several pandemic war games. And I know many other people who participated in other pandemic war games, and I can guarantee you, not a single one of them did they ever anticipate or have a move in which the president of the United States undermined the response. What should have happened was Trump should have gotten there with Clinton and Obama and Carter and and Bush and made joint statements. And in fact, there were some of those, as I recall, from everybody but Trump. Frankly, there was your opportunity to take leadership, and he probably would have been re-elected in 2020 if he’d done it. Because people rally around leadership in a crisis. They don’t want people throwing rocks at their leaders. They want to solve the problem. JD: How do you see America’s preparedness right now for —
Jarvis DeBerry is an opinion editor for MS NOW Daily. 
