The network is pretty healthy at the moment. spam could be a huge problem, but I don't feel like it's unsolvable. There are many proposals by the community. For example, you could have a mode where you can only see posts from people you follow. It could be completely fine if you use it like a signal-like app where only your contacts can send you stuff.

nostr doesn't preclude a particular style of usage. I'm looking forward to many different types of clients that try different spam control techniques.