Lessons from history: A conversation with author John M. Barry

Barry pointed out that there were serious efforts by Russia and other countries to spread disinformation during the COVID-19 pandemic, while the White House itself routinely undercut public health messaging. In Canada and the U.S., these efforts sowed discord among the public and undermined trust in institutions. 

“I used to believe that the truth could stand on its own, but it turns out that even the truth needs support,” Barry said. “Officials and medical communicators need to get ahead of a crisis early because you have to build and maintain a reservoir of trust. During the pandemic, I think communication teams assumed they would automatically be trusted, but that wasn’t the case.”

Barry added that some of the wounds were self-inflicted. The Centers for Disease Control and Prevention, he suggested, fumbled the roll-out of testing systems and failed to recognize the reality of secondary, post-vaccine infections. “Some of the problems that emerged could have been avoided,” he said. “They happened because people simply weren’t paying enough attention.”

Spencer described working as a physician in emergency rooms during the early days of the COVID-19 pandemic. “It felt like walking through the apocalypse,” he said. “I’ve worked in wars and pandemics but nothing felt as heavy as April 2020. In many ways, it’s surprising how little coverage there is of that period now. Do you think this apathy is an inevitable part of the aftermath of a pandemic?”

Barry suggested that we are inclined to assign traumatic events like pandemics and natural disasters to short-term memory. “I live in New Orleans and it’s not that people have completely forgotten Hurricane Katrina, but when it comes to conversations about flood protection—it’s like they’ve forgotten,” he said. “Yes, the apathy can be real.”

Should public health start investing and preparing now for the next emergency? Spencer asked.

Undoubtedly, we should try, Barry suggested. But political circumstances will determine which investments are possible at what time. “Several years ago, I thought pandemic preparedness was well-funded, but I was overly optimistic.”

Barry stressed that each outbreak is unique. Young people died in large numbers in the pandemics of 1918 and 1957 but fared relatively well during the COVID-19 pandemic. “Schools played a role in spreading the 1957 pandemic, so the decision to close schools in 2020 involved a complex cost-benefit analysis. It was not an easy decision. But the data I’ve seen suggests that school closures were one of the most effective interventions during COVID-19.”

Hence the importance of integrating the study of history into public health training. “You have to know the history but you can’t let it blind you to one moment,” he said. “Studying multiple pandemics gives insights into the variety of possible outcomes, helping us understand that no two situations will unfold in the same way.”

In addition to The Great Influenza, Barry has authored The Great Mississippi Flood of 1927 and How it Changed America, which was named one of the best 50 books in the preceding 50 years by the New York Public Library. A native of Providence, his latest book is Roger Williams and the Creation of the American Soul: Church, State, and the Birth of Liberty.

This Public Health in Practice Seminar was sponsored by the Dean’s Office and Pandemic Center at the Brown University School of Public Health.