The Pale Horse

An Interview with John Barry

On the economics: as I said at the beginning, one of the big differences between influenza and COVID-19 is duration. Influenza moves much more quickly, and influenza would hit a community and pass through it in six to ten weeks. Then it was essentially gone. There, in many cases, would be another wave, but that would come months later. In between, the disease was there, but with very little activity of infection.

Plus, the closing orders were not as extreme as what we're doing now. Pretty much everything was considered a war industry. So if it didn't directly relate to an optional public gathering, like a church service or a theater, businesses weren't closed. There was tremendous absenteeism out of fear, so the economy was affected. There was a brief, reasonably intense recession linked to the pandemic, but we came out of it, and things got back to normal pretty quickly economically. We have a much bigger problem today. We've taken much more extreme measures to control the virus. To do that also requires a lot more time, so the economic impact is much greater than it was in 1918.

OR: George W. Bush read your book and was inspired by it. Could you talk about what it’s like to see a work of history — and your own, into the bargain — penetrating the minds of policymaking at the highest level?

Barry: To give you a complete history of that, Tommy Thompson, the former governor of Wisconsin and Bush's first Secretary of HHS, was interested in pandemic influenza. Indeed, on September 11th, 2001, he was in a meeting on it and left very reluctantly. My book didn't come out for three years after that. He had left, but an assistant secretary named Stewart Simonson, who is today Assistant Director General of the WHO, had been alerted to the pandemic and made sensitive to it by Thompson. He read my book and brought it to Mike Levitt, then HHS Secretary, and Levitt brought it to Bush's attention.

Bush did make it a very high priority for his entire administration. Levitt sat down with every member of the cabinet except one, I believe, to get their buy-in. Simonson led the effort on the Hill, and they passed a $7.1 billion piece of legislation, which created the national stockpile, laid out a huge investment in vaccine manufacturing technology and capacity and basic research, and built up a planning process of what to do should a pandemic strike. I did participate in the early conceptual meetings on what to do. The so-called nonpharmaceutical interventions, i.e., what do you do when you don't have drugs? What recommendations to make there?

I was gratified. Any writer is gratified when anybody reads his or her book. That's what you write for. When I wrote the book, I certainly didn't have any purpose in mind, in the sense of affecting policy. I wasn't trying to get anybody's attention to the issue. I actually wrote the book almost by accident. I had intended to write a book on the home front in World War I, culminating in the events of 1919, which I consider one of the most interesting years in American history. That was my initial plan. The book strictly on the pandemic grew out of that, but it was almost an accident. Of course, at the time, I wasn't a great fan of President Bush. In retrospect, I certainly think much more highly of him. But that had nothing to do with partisanship. Preparing for a pandemic is a nonpartisan issue.