We are more than two years on from the Wuhan outbreak. Did the COVID-19 pandemic play out as you anticipated?‍

On the academic side, it’s probably bigger than any of us had imagined, with wave after wave and, of course, over a quarter-billion people infected and five million dead. I think the other thing is [that] we knew there was enormous scientific investment in solving this problem, but the solutions came faster than we anticipated, exemplified by the very rapid development of highly efficacious vaccines and antibody therapies and more recently, the emergence of treatment drugs. I think that’s beginning to change the equation. We now have more tools at our disposal to combat this virus.

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The global health system did a pretty good job of containing SARS and MERS. What was so different about COVID-19?‍

Both MERS and SARs were actually more deadly. But there’s one very fundamental difference with COVID-19, and that is people who are infected can have no symptoms at first and so go about their business and spread the virus. That’s a particular feature that allows it to spread so rampantly.

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In August 2020, on a podcast, you said the country was doing very poorly confronting the pandemic. More than a year from that statement, what’s your assessment? Did we get better?

I think we did get better but we could always improve. Witness the period following the summer of 2020—the situation got a lot better until the winter months arrived. That’s because I think much of the country was hit hard and was devastated and everybody learned the lesson the hard way. Then the winter months and the holidays and the increased indoor contact caused another peak. Once the situation was better, everyone let their guard down. Now, you could say nearly two- thirds the country is vaccinated, so the pool of susceptible individuals has decreased substantially, so the expectation was that we may not hit the same type of peaks that we have seen in the past. But the omicron variant has proven that wrong because its infectiousness is several fold greater than previous variants. I think we need to sustain our efforts much longer than what we have done with each previous wave of the pandemic.

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What made such a difference this time in the extraordinarily rapid development of multiple vaccines and now-promising treatments?

After China shut down in January 2020 and we pretty much shut down here in March, everyone appreciated the enormity of the situation. There was a massive infusion of talent to address this problem from a diagnostic, treatment, and prevention perspective. And the FDA should get credit for responding very quickly to fast-track the development of antibody drugs and vaccines.

But these developments don’t come out of nowhere. There was a lot of scientific progress made on various vaccine platforms, most notably the mRNA vaccines administered by Pfizer and Moderna. Some of that technology had been worked on for over a decade. In terms of antibodies and drugs, the massive effort spent on HIV and hepatitis C really formed the foundation for rapid development. Take the Pfizer drug: It is a protease inhibitor that was first developed in the 1990s for HIV and then applied to hepatitis C and now effectively applied to COVID-19.