ML: Can you think of any American government mechanism that has that capacity?
RH: I would point to the Biomedical Advanced Research and Development Authority. Barda is focused exclusively on biodefense. It doesn't have to worry about maintaining its credibility for public-health interventions. It exists to develop countermeasures against biothreats to the United States. This model morphed into [Operation] Warp Speed, and the one part of the U.S. response that really succeeded in my mind was Warp Speed. You had the military and the technical experts and folks from NIH, and all they cared about were these kinds of threats. That shaped their thinking, it shaped their behavior and it shaped their response.
The problem is that if this is the once-in-a-century problem, an organization that's designed to address a bunch of other problems and has other incentives that drive its culture is not going to be well-adapted to this problem.
Except we’re now in a different world. This is definitely not a once-in-a-century problem. Covid-19 is the seventh global infectious-disease crisis of the 21st century: SARS, avian influenza, swine flu, MERS, Ebola and Zika preceded it. It looks like roughly every three years you're going to have a global infectious-disease crisis, and that tempo is probably increasing. Creating dedicated biodefense organizations might have sounded crazy 30 years ago. It's not crazy now.
ML: The nearest analogy I can think of is climate risk, catastrophic climate events.
RH: I think cyber is also a good example, because threats have increased and changed and become diversified over the last 40 years. Forty years ago, you had to take an infected floppy disk and put it into your computer. Now that we live in, and want to live in, a digitally interconnected world, you've got to invest in security arrangements. Nobody would dream of going onto the internet without an antiviral program.
ML: What do you think the likelihood is that Covid peters out and we forget about it and think this is a once-in-a-century thing?
RH: I think it's much more likely that Covid is going to be like flu and we're going to have annual Covid seasons. Periodically we're going to have mutations emerge and these may give rise to new Covid pandemics. I don't know how often that's going to occur, but I think that's a more likely scenario than it petering out and disappearing from the landscape. So we need to develop the tools to coexist with Covid for the long term.
ML: If a variant emerges that is not severe, that’s like a cold—a version of the escape fire you light to save yourself from a fire—could you think of that as a vaccine?
RH: It's what we do with live attenuated vaccines. We started fighting polio this way. The Sabin vaccine was a live attenuated vaccine, where people who were vaccinated could actually infect other people. In fact, we speculated early in the pandemic about looking for an escape fire. Some were speculating that kids might be protected from the virus because they were exposed to other non-Covid coronaviruses all the time. If that were the case, should we be squirting non-Covid coronaviruses up people's noses because that would be easy to do, give everybody a cold? But we didn't have enough evidence that it would provide any kind of enduring immunity.
ML: We'd be able to give it to each other instead of the health-care system delivering it. If you could create something that was stable, highly transmissible, not lethal that essentially displaced the current strain of Covid, that might be the most efficient way to create immunity.
RH: That's essentially what happened with the 2009 pandemic flu virus. It was a super-mild flu virus. It had a higher reproductive number than the other flu viruses that it displaced and had a comparatively minimal impact. It knocked the other, more severe flu viruses out of play for a couple of seasons. But I'm not aware of us ever adopting that strategy deliberately.
Michael Lewis is a Bloomberg Opinion columnist. His books include Flash Boys: A Wall Street Revolt, Moneyball: The Art of Winning an Unfair Game, Liar’s Poker and The Fifth Risk. He also has a podcast called Against the Rules.