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CORONAVIRUS PANDEMIC 2020 | WHEN IS IT GOING TO END?

CORONAVIRUS PANDEMIC 2020 | WHEN IS IT GOING TO END?

The Coronavirus pandemic arose as a result of a newly discovered coronavirus, SARS-CoV-2. This virus is responsible for the disease called COVID-19. The pandemic began its course in December 2019 when pneumonia of unknown cause was detected in Wuhan, China.

Since then, the SARS-CoV-2 has considerably spread so much that the outbreak was declared a Public Health Emergency of International Concern on 30 January 2020 by the World Health Organization (WHO). Currently, there are over 4,101,975 coronavirus cases and 280,451 [1] deaths worldwide.

Further probe is ongoing as to the source of this virus. Studies suggest an animal source with the virus undergoing a change known as mutation. Another rather unpleasant proposition is biochemical engineering.

Regardless of the source, the virus, in most cases, does considerable damage to the respiratory system in animals too.

This virus which has proven itself to be very contagious belongs to a family known as Coronaviridae! Members of this family include Toroviruses and Coronaviruses. Coronaviruses have spawned a wide range of diseases in farm animals and pets.

In hopes of containing the pandemic, countries, and cities continue to enforce social distancing, encourage self-isolation policies, and halt major events around the world.

Similarly, proper use of PPE is the new order as the scientific community works tirelessly in search of a definitive cure or an effective vaccine against this much-dreaded strain of coronavirus.

Amidst the entire event unfolding, one question lingers thus: ‘When will this pandemic actually end?’

When is the coronavirus pandemic ending?

Pandemics have typically lasted between 12 and 36 months. The swine flu is still fresh in our memory; it was declared a pandemic by WHO in June 2009, and by mid-September, there were already four vaccines approved for the virus. The flu pandemic was deemed over in August 2010, according to a timeline from the Centre for Disease Control, CDC.

A close relative of COVID-19 known as Severe Acute Respiratory Syndrome, SARS was about as contagious and certainly more deadly. Even so, it couldn’t hide in mild cases, unlike COVID-19.

Let’s look at a perspective where the SARS-CoV-2 wasn’t so virulent and was living peacefully in its previous natural host until it could survive in a new host (humans). 

In the new host, it’s easy to multiply and spread largely through contact. Unfortunately, a subset of the new host (human) found the virus more uncomfortable leading to significant morbidity and mortality. For the virus to remain relevant it has to mutate and keep the host alive which explains the over 80% recovery rate.

Let’s not forget viruses are microscopic parasites.  As a parasite, there is no point in being so vicious in killing a host when it cannot survive outside the prey.

Though in the case of viruses, without a host they’ll remain dormant till an external condition like heat or chemical destroys it.  This wittingly is an evolutionary trick and follows the rules of survival.

However, several scenarios could emerge; infectious disease specialists and researchers have some views to help put this global health situation into perspective.

What might happen with the coronavirus pandemic in the next few months?

It is most likely that the pandemic would not be formally declared over anytime soon. It will be absurd to model a new pandemic against a past one just to determine how severe or how long it will persist. The causative agents differ and as such, behave and spread differently.

Worse still, some even mutate and adapt as noted by Rishi Desai, MD, a former epidemic intelligence service officer in the division of viral diseases at the CDC.

Remember the Human Immunodeficiency Virus (HIV)? That’s a special case as it mutates rapidly and slips through our immune system. The resultant effect is – any antibodies produced against it by our body today become practically useless in the coming month. This has been a major setback in the development of a vaccine.

The good news however is, the COVID-19 virus is a more stable virus, so the vaccines would probably be effective and ready in the predicted 18-24 months.

As more data emerges about COVID-19, the wild guess is that social distancing would likely be lifted before the end of 2020. In places like the U.S., some parts of the country may end social distancing sooner than others, in contrast to the entire U.S. re-opening all at once. Governments around the world would likely follow suit.

So how would the coronavirus pandemic end?

The WHO Director-General, Tedros Adhanom Ghebreyesus, Ph.D., twote, “we need to attack the virus with aggressive and targeted tactics—testing every suspected case, isolating and caring for every confirmed case, and tracing and quarantining every close contact.

The great expectation is: “As the virus spreads, more and more people will develop immunity to it, so the impact will decline with time,” says  Sandra Kesh, MD, an infectious disease specialist and deputy medical director at Westmed Medical Group in Purchase, New York. Again, no one is really sure just how long that could take. The pandemic might end in several ways.

Will the pandemic end by the “Herd Immunity” strategy?

In history, the world has been plagued many times; take for one the Black Death that struck Europe and Asia in the mid-1300s. The infection kept spreading until a considerable number of the population gained immunity. However, this resulted in  75–200 million deaths in collateral damage before the population reached herd immunity.

According to Wikipedia, ‘’Herd immunity also called herd effect, community immunity, population immunity, or social immunity is a form of indirect protection from infectious disease.’’This occurs when a large percentage of a population has become immune to infection. It could be through previous infections or vaccination, thereby providing a measure of protection for individuals who are not immune.

Consequently, if more than half the world has already experienced and recovered from COVID-19, then the virus will have a hard time spreading because it will hit brick wall immunity in the population.

Invariably, chances of spreading and infecting the vulnerable one would be slim. However, lest we forget, this goes with a huge price. Herd immunity is an extreme scenario as the model usually assumes that we stand back and do nothing at all with regard to treatment or vaccination.

Nonetheless, there’s no doubt that herd immunity would work for COVID-19. In spite of any indications, the scenario played out during the Black Death. In the case of COVID-19, it’ll cost us millions of lives to get there; our health system will definitely be overwhelmed.

The silver lining here is; a vaccine is probably just a year away. Therefore, herd immunity is likely, though not through natural immunity, and with minimal collateral damage.

Can the pandemic go away in the summer?

This is likely if the SARS-CoV-2 behaves like other flu. Geographically, when it’s summer in the Northern Hemisphere, its winter in the Southern Hemisphere. According to WHO evidence so far, ‘the COVID-19 virus can be transmitted in all areas, including areas with hot and humid weather’.

However, there is some evidence coronavirus cases have, for the most part, expressed its virulence in cooler, drier regions such as Italy, Spain, and Switzerland. Similarly, a scientific paper observed 100 Chinese cities with more than 40 cases of COVID-19 and suggested the higher the temperature and humidity, the lower the rate of transmission.

As reported by BBC, researchers at the London School of Hygiene and Tropical Medicine concluded the virus has now spread to every World Health Organization region, “effectively spanning all climatic zones, from cold and dry to hot and humid regions”.

Another enduring problem comes in the form of what epidemiologists term the Basic Reproduction Number – Ro of an infectious disease. This basically represents the average number of secondary cases attributable to infection by an index case after that case is introduced into a susceptible population.

For a regular Seasonal flu, the  Ro ranges between 1.1 and 1.5, this is why the rate of infection grows exponentially and it doesn’t need to be battled head-on for it to deteriorate or be eradicated.

On the contrary, COVID-19 has a Ro of 2 or 3. Although it’s greater than one, it invariably means the virulence would slow down but would continue to expand regardless of the season. Consequently, this is where the implementation of active surveillance, contact tracing, quarantine, and early, strict social distancing really matters.

Would enhanced surveillance and contact tracing eradicate the pandemic?

For governments around the world, the order of the day is to flatten the curve of infection. This is achievable by developing strategies to cut the caseload. Some of the strategies include;

  • Raising awareness about social (physical) distancing, case identification, and hand hygiene.
  • Expand testing capacities – such as putting up drive-through and walk-through test centers in major cities as practiced in the Republic of Korea.
  • Deployment of new technologies in areas such as contract tracing and direct patient management.
  • Pass a law to ensure every hospitalized case of pneumonia is tested for COVID-19 as practiced in Singapore.
  • Massive mobilization of epidemiologists- this set of professionals is knowledgeable in contact tracing.
  • Multi-sectorial approach- setting up task force teams on COVID-19.

Would developing a suitable vaccine end the pandemic?

Eventually, a vaccine will be produced, but the vaccination campaign toward total eradication will be marred by the number of recipients. Widely circulated conspiracy theories about depopulating the world with a vaccine are erroneously holding sway amidst the pandemic.

Developing an effective vaccine against the dreaded COVID-19 will prevent most cases but vaccination might never be 100% effective. RNA (a genetic material) viruses like SARS-CoV-2 are survivors and known to mutate enough to require yearly updates, just like the regular flu shots.

Secondly, as the infection persists, the medical community would have a firm grip on a treatment protocol and the pandemic would eventually become a thing of the past.

Can a ‘treatment protocol’ for COVID-19 end the pandemic?

The antiviral drug Remdesivir gained emergency use authorization (EUA) from the Food and Drug Administration (FDA) on May 1, 2020. The drug has undergone trials and studies and the results have demonstrated a faster time of recovery in hospitalized patients with severe disease.

Similarly, various other antiviral agents, immunotherapies, antimalarial agents, and vaccines continue to be investigated and developed as potential therapies. In the meantime, infected patients would continue to receive supportive care to help alleviate symptoms. This may not eradicate the virus but would reduce mortality and assist the population to develop antibodies against reinfection.

BOTTOM LINE

Ultimately, fighting and surviving this pandemic depends on how we respond to it together.

As the course of the pandemic progresses, staying calm and getting educated will be helpful. Adopting the new-normal lifestyle such as wearing a face mask, physical distancing, and self-isolation will prove effective if backed up by proper hand and respiratory hygiene.

More so, these hygienic practices should not cease after the pandemic has been declared over.

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