Marin County-based epidemiologist Dr. Larry Brilliant, who offered some prescient warnings last April about not letting up the Bay Area's strict lockdowns for fear of subsequent COVID surges, is back with some dour predictions and words of caution.

"What we say in epidemiology, it's not a very nice thing, but when the virus is in decline, you have to put your foot on the neck," Dr. Brilliant said last year, speaking to KQED's Michael Krasny early on in the pandemic, just as the earliest surge in cases appeared to be on the wane locally. "That's not a nice way to describe it, but it's true."

At the time he was warning the public not to get complacent and advising government leaders not to let up on the economically devastating public health measures which at that point were only several weeks old. Also at the time, the Bay Area had just begun discussing transmission mitigation efforts, versus early containment strategies like forced quarantines for infected people, and he was advising against the change.

Now Brilliant has given another rare interview, this time to the Chronicle, in which he expresses some cautious optimism about the vaccine rollout but still doesn't have anything especially encouraging to say. (You can stop reading now if you're not in an emotionally stable or strong place today.)

"I think there’s a lot of good happening," he said. "I would prefer to think that things will get better, but the scientist in me worries we’re too perilously close to things going the other way."

He goes on to explain that without mass-vaccination efforts like we are seeing locally going on at a global scale, in rich countries and poor, and quickly, we will be stuck in ongoing cycles of this pandemic with potentially worse and vaccine-resistant variants.

"Until everybody in the world is safe, no one is safe," Brilliant tells the Chronicle. And, most disturbingly, he says, regarding the last three surges we've seen across the country, "There’s a nonzero probability that we’ll look back and all those three bumps will all together just be the first wave, and what’s coming next could be worse. I think the future is really complicated."

There's a growing public perception that once a lot of us have both our vaccine shots, there will be a familiar degree of normalcy returning to everyday life. And Dr. Brilliant suggests that if public health officials allow this, it will be to our detriment, especially when we don't know whether vaccinated people can still spread the virus and allow it to keep mutating.

"Today’s vaccines are good enough to stop today’s variants," Brilliant says. "The problem is tomorrow’s variants. We’re just on the cusp."

Brilliant knows what he's talking about, so he's probably someone we should listen to. He spent a good part of his career bringing an end to smallpox on the planet — something he talked about in a 15-year-old TED talk — and he served as a consultant on the 2011 film Contagion that many of us rewatched last March in a fit of panic and doom-wallowing. In the film, he correctly foresaw that a new global pandemic would lead to panic-buying in stores, epidemiologists becoming TV stars, and stadiums (in the case of the film, Candlestick Park) becoming mass-vaccination sites. (The Chronicle also spoke to some people who worked on the film last week just as stadiums across the state were being put to use for this purpose.)

And his thoughts are echoed in a New York Times opinion piece today penned by a trio of experts who were part of President Biden's advisory committee on COVID — in short, they say beware of even the tiniest rise in case numbers, and remember that this virus "is not done with us," no matter how much we might feel done with it.

So, we need to keep wearing two masks, keep distancing ourselves and staying home more than not, and not assume that it's all going to be a great big party by spring or summer. Likely, as many experts like Brilliant have been quietly trying to say, it's going to be a very long and slow road back to "normal," and we need to brace ourselves for things to take at least another bad turn before it's all good news.

Related: Infectious Disease Expert Says Bay Area Should Go Back to Containment and Contact-Tracing

Photo by Paul Zimmerman/Getty Images for HBO