The article was met with skepticism. The Associated Press called the headline “sensational” and insinuated that I had written the piece out of an interest in earning “a segment on Morning Joe.” Lipsitch himself received a torrent of concern that his estimate was premature or overly pessimistic. He later worried that his comments could be interpreted to mean that widespread infection was unavoidable, when what he meant to say was that this spread would happen unless we took drastic measures. Lipsitch was confident in his model and what he had told me, but mindful that if people thought this pandemic was inevitable, they would not even try to stop it, and would lose sight of how many lives could be saved by taking precautions and fortifying social and medical systems. “I still don’t know that there’s enough evidence to say that this was inevitable,” Lipsitch told me recently. “But by the time I started mouthing off to you, I thought it was very likely.”
A year later, “I have no illusion that I had the exact right calibration,” Lipsitch said, although he did have, essentially, the exact right calibration: The virus has now infected roughly 40 percent of Americans, killed more than 500,000, and is likely to become endemic. “But I think as early as I was able to put together the evidence, I said what I thought it meant. And I don’t know how to do better than that.”
Part of the reason Lipsitch was ultimately so correct is that he underestimated two major things. First was the extent to which, he told me last month, “bad leadership can screw up a response.” Meanwhile, he said, “the more positive surprise is the story of the vaccines, and the fact that, thanks to super-insightful planning, we had the infrastructure to build vaccines that work.” Ultimately, the extraordinary vaccine development may offset some of the Trump administration’s damage, and leave the world close to the worst-case scenario Lipsitch depicted a year ago.
In response to critics, Lipsitch has cited the work of the immunologist Peter Medawar, who warns in his book, Advice to a Young Scientist, of people who “affect the possession of a mind so finely critical that no evidence is ever quite good enough.” This position is always rhetorically defensible, because no hypothesis or scientific theory ever achieves certainty, by definition. Being proved wrong is hard if you say that you’d like to wait for more evidence before commenting. But that is, at some point, dishonest. Taken to its extreme, the insistence on waiting for more evidence can be malignant: climate denialism, anti-vaccination campaigns. It can also be paralyzing, which is especially dangerous in moments of crisis.
“You don’t ever want to let your desire not to panic people hold you back from something that you definitely know,” Fauci told me. “But when you just don’t know, you’ve got to walk a delicate balance.” You say and act on what you know, and you accept that some people will accuse you of flip-flopping when you later know more. “When people want to stick it to you, they say, ‘Oh, you said in the beginning that there isn’t anything that you do any different,’” Fauci said. “Tell me what you would have thought if we said, when you had the first case here, that we should absolutely shut the country down? They would have thrown me in jail.”
