By now, it’s clear that the novel coronavirus will be with us for a long time.
Marc Lipsitch, an infectious disease epidemiologist at Harvard’s TH Chan School of Public Health, said “Exactly how long remains to be seen, it’s going to be a matter of managing it over months to a couple of years. It’s not a matter of getting past the peak, as some people seem to believe.”
Do you think, the single round of social distancing — closing workplaces, schools, and malls, limiting the social gatherings, lockdowns of varying durations and intensities — will be sufficient in the long term? What about the economic meltdowns?
To manage and govern ourselves and our expectations, the so-called soliton wave of social distancing might be helpful, at least for our pandemic state of mind, and to envision the current predicament, existentially; the wave just keeps rolling and rolling under its own power for a great distance.
The pandemic wave is similar to water waves that are, according to a Report on Waves by Scottish engineer and naval architect John Scott Russel, “Its height gradually diminished, and after a chase of one or two miles I lost it in the windings of the channel.” will be with us in the future before it diminishes. But not the same, it means the magnitude of COVID-19 waves vary between location and the respective policies in place, exhibiting multitude of dynamics and dimensions through time and space.
“There is an analogy between weather forecasting and disease modelling,” Lipsitch said; for him, both are simple mathematical descriptions of how a system of any country works: drawing upon its physics and chemistry in meteorology; and in case of infectious disease modelling, the respective behavior, virology, and epidemiology will affect. He said, “we can’t change the weather.” But the course of the pandemic, to an extent — with our behavior, or in other words by balancing and coordinating the sociological, psychological, political, and economical factors.
Lipsitch is a co-author of two recent analytical works — one from the Chan School published in Science and the other from Centre for Infectious Disease Research and Policy at the University of Minnesota — describing different shapes the pandemic wave might take in the coming future.
According to their study conducted at the Minnesota, there are three probable futures:
- The first will reveal the initial wave of cases — like the current situation —followed by a bumpy ride of consistent peaks and valleys, and these waves will gradually diminish in a year or two.
- The second possibility shows that the current wave may be followed by a larger fall or perhaps a winter peak, then followed by smaller waves, just like the 1918-19 flu pandemic.
- The third supposes an intense spring peak followed by a “slow” yet less-exaggerated ups and downs.
According to the authors, whichever reality materializes (assuming current containing measures, and the wait for a vaccine), “we must be prepared for at least another 18 to 24 months of significant COVID-19 activity, with hot spots popping up periodically in diverse geographic areas.”
Another Science paper, created by the Harvard team, also took a closer look at different possibilities by incorporating the current transmission dynamics and the latest COVID-19 data and related viruses. Their results also project a similarly wavy future loaded with peaks and valleys.
One figure from the paper also shows the trajectory of COVID-19 infections due to “intermittent social distancing.”
It means social distancing will turn “on” if the number of COVID-19 cases reaches a certain locally set threshold – for instance, 35 cases per 10,000 – followed by strict monitoring with widespread testing. Similarly as the cases drop to a lower threshold – let’s say 6 per 10,000, the social distancing will turn “off.” This strategy is aimed to reduce the economic meltdowns and to prevent the healthcare systems from being overwhelmed, as critical cases that require hospitalization more than the general prevalence.
Another iteration also shows the effects of seasons over the spread of COVID-19 — a slower spread during warmer months, if this is the case then the seasonal effects expand the intervals between periods of social distancing.
However, the seasonal effects of this year will likely be minimal, as a large population will still be susceptible to the virus in the coming summers. And yes, we cannot ignore the other unknowns that are underlying in the mechanisms of seasonality — like temperature, humidity, school schedules, etc. — that also has been studied for some other infections, like influenza, but not for coronaviruses.
So, sadly, seasonality alone is not a foolproof way to control the waves of outbreak in the coming summer months.
Yet another scenario, other than seasonality, is the expansion of critical-care capacity in hospitals, which in turn, takes the social distancing at a higher threshold — say, if the general prevalence will reach 80 cases per 10,000 — the social distancing periods will increase.
One thing is clear that a one-time social-distancing effort is not sufficient to control the pandemic in the long run, more months – maybe years – for this world to reach an acceptable herd-immunity threshold.
Tedijanto said, “This is because when we are successful in doing social distancing — so that we don’t overwhelm the healthcare system — fewer people get the infection, which is exactly the goal, but if infection leads to immunity, successful social distancing also means that more people remain susceptible to the disease. As a result, once we lift the social-distancing measures, the virus will quite possibly spread again as easily as it did before the lockdowns.”
So, in the wake of lacking a vaccine, our pandemic state of mind will possibly persist well into the coming years – 2021 or 2022 – which will be surprising even for the experts.
World leaders bickering like children – who is responsible and who is to blame – instead need to start taking this pandemic seriously. Abiding by the protocols set by the WHO, strict social-distancing, and awareness are the only way to prepare citizens for the worst that the coming future seems holding.
So, get ready for any new normal, as we never know when the pandemic will reach a peak and a sudden – maybe more than this one – would prevail; and yes, maintain peace in the meantime.