When will the coronavirus pandemic end? Lockdowns crushing economy, lack of vaccine make for grim forecast
Three months ago, no one knew that COVID-19 existed. Now the SARS-CoV-2 virus that causes the disease has spread to almost every country and the world has nearly shut down. People have lost their way of life, their jobs, and home quarantining and social distancing have turned cities into ghost-towns. Economies and healthcare systems have crashed. But the numbers have not stopped.
Over 1,099,380 cases have been reported so far globally and over 58,900 have died, shows the John Hopkins tracker. A question that is on everyone’s mind is when will the pandemic end and when will they be able to return to a ‘normal’ life.
Several scientists MEA WorldWide (MEAWW) interviewed via email attempted to answer these questions. They believe that it may take a while to turn the tide, and it will vary from place to place.
"It isn’t helpful to ask when the current pandemic will end, or when life will return to normal. The course of the pandemic will be different in different countries depending on the health infrastructure, measures to limit transmission, travel patterns, economics, etc. So I think the real question is more specific, when will it come under control in a particular city, country, or region," Dr Tom Koch, professor of medical geography at The University of British Columbia, told MEAWW.
According to Dr Koch, in some ways, life will not return to normal. He explained that economies will need time to recover; some patients will need rehabilitation (lungs); businesses will need to rebuild and in some places, new workers will have to be rehired.
"If you want an optimistic point of view, remember that the great influenza pandemic of 1918-19 was followed, in 1921, by the exuberant 'Roaring '20s.' That is assuming, of course, next year’s epidemics are not as vigorous," said Dr Koch, author of 'Disease Maps: Epidemics on the Ground' and 'Cartographies of Disease: Maps, Mapping, and Medicine', expanded edition.
Dr John Swartzberg, clinical professor, emeritus, UC Berkeley-UCSF Joint Medical Program (Infectious Diseases & Vaccinology Division), predicts that the pandemic will not end for at least 12 to 16 months from now.
Another likelihood is that if in any given area no new cases are occurring for three to four weeks, that would indicate that the epidemic there has ended and things could gradually return to normal, said Dr Lee W Riley, chair of the Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley. By normal, he implies that lockdowns and other restrictions could begin to get relaxed in a staged manner.
Dr Steve Austad from the Department of Biology at the University of Alabama at Birmingham, also emphasizes that currently, no one can predict when life will return to normal. He said it depends on whether the virus abates in the summer months like colds and flu do or whether it persists. "We do not know enough about the virus's behavior yet. Life will return to normal eventually, certainly once we have a vaccine available. There are at least 11 vaccines currently in development, but it is likely to be a couple of years before a vaccine can be fully tested and become widely available," Dr Austad told MEAWW.
Life returning to "normal" is a political decision, according to Dr Stefan E Pambuccian. "In most places, it will probably happen within a month, because of the economic impact of the social distancing measures, in addition to their psychological impact," Dr Pambuccian from the Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Loyola University Medical Center, tells MEAWW.
However, Dr Pambuccian cautioned that the coronavirus pandemic can only end if the virus runs out of susceptible individuals, or there are so many individuals who have become immune that the virus cannot spread any longer.
"(It will end) if we will develop a vaccine that works to protect susceptible individuals or a drug that targets the receptor for the virus (ACE2) and blocks the entry of the virus into the cell," he said. The other factors he illustrates that may end the pandemic include social distancing, which is kept long enough to slow down the spread to the point that it dies out. He, however, said this is highly unlikely. Another could be if the virus mutates to a form that is less aggressive or less infective. "This can happen, but it would be a matter of luck. Viruses have been doing this, but usually to become more, rather than less aggressive," says Dr Pambuccian.
With no treatments or vaccines available, interventions have focused on quarantine and social distancing. But experts say shutting down cities is not sustainable in the long-term. The social and economic damage would be catastrophic. "Not even the richest countries can continue to practice any form of containment, or social distancing for the whole population for that long," says Dr Pambuccian.
According to one study, one-time social distancing will not be sufficient to prevent critical care capacities from being overwhelmed. The researchers say once such restrictions are lifted, the virus would, in all probability, come roaring back. The study concludes that on its own, social distancing may need to be maintained intermittently into 2022 to avoid overwhelming critical care capacity.
Also, as long as the virus persists somewhere, there is a chance that one infected traveler will spark an outbreak elsewhere.
A vaccine should give someone immunity, but its development is at least 12-18 months away. There are over 40 different candidate vaccines in clinical evaluation for COVID-19. The discovery of a treatment could also change the situation.
"If testing serologically for antibodies against this coronavirus is done on a large scale, part of the population could start breaking the social distancing, and maybe just the most vulnerable individuals will need to continue. Either convalescent serum — passive transmission of antibodies from people who have recovered from the infection — or a vaccine can be developed during this time to protect the most vulnerable," says Dr Pambuccian.
One study proposes phase-wise re-opening the US — slowing the spread in phase 1, state-by-state reopening in phase 2, establishing immune protection and lifting physical distancing in phase 3, and rebuilding the country’s readiness for the next pandemic in the final phase.
What will the pandemic look like six months from now?
Scientists are unsure if the disease will disappear six months from now, or get into a period of cyclical waves or whether the world will have to deal with low-level endemic disease.
Dr Swartzberg says cases will pop up in different parts of the world regularly, but not the enormous peaks witnessed now.
Two possible outcomes may occur six months from now, says Dr Riley. "It could completely disappear, like the first SARS epidemic of 17 years ago. Or, it could become established and linger in different communities at low levels, like the common cold," he told MEAWW.
According to Dr Koch, in six months, "I imagine the pandemic will have died down" with perhaps a few countries still attempting to control a more or less manageable number of cases.
Experts believe that some countries are taking the right steps, some faster than others, and those that got started sooner will fare better at the end. They stress the key thing is taking protective action quickly on a national scale. "South Korea did that successfully. Italy did not. You can see the differences in the number of deaths," says Dr Austad.
"Western news agencies constantly referred to China’s process of qualified quarantine (different levels at different scales) as 'draconian'. We now know it was intelligent, effective, and is being implemented elsewhere," says Dr Koch.
Can anything more be done to turn the tide?
Experts say that again depends on where one is. "In countries like Italy and hotspots like New York City, everything is not enough. Health services are incapable of handling the current situation. In other areas where the virus began later, stricter measures in effect are turning the tide. In general, in countries like India the great issue is the homeless and semi-migrant or migrant community. They have no homes to shelter in and no money in reserve," says Dr Koch.
Dr Riley says that all countries now need to target the most vulnerable and marginalized populations — people residing in informal settlements, homeless encampments and refugee camps, among others. They need to be provided with the same healthcare resources — both preventive (masks, handwashing facilities, clean toilets) and treatments.
The idea is echoed by Dr Pambuccian. "Various political and social measures have to be taken: there are many categories of people for which 'social distancing' is meaningless: homeless people, inmates in jails and prisons," he said.
According to Dr Austad, the only defense nations have is to reduce the transmission rate through serious restrictions on contacts between people in public places. He, however, said that one thing that will help enormously is when an antibody test is widely available. “That will tell us who was infected and has recovered. Identifying those people will teach us a lot about the virus,” says Dr Austad.
Will the novel coronavirus ever go away?
The answer to this question is also difficult, say experts. Dr Austad says it may never completely go away, but one will be able to control it with vaccinations as health experts currently do in case of polio. Cases should become rare in that event, he adds.
Coronaviruses, say experts, have been around for a long time. Scientists have dealt with them for years, and the novel coronavirus is newest member of the family. “This pandemic will end, surely. But the question is whether this virus, SARS-COV-2 will return and if so in what form. And that we do not know,” says Dr Koch.
Dr Riley also says that while this particular coronavirus may go away like SARS-CoV, there will definitely be another one that will emerge someplace in the near future. He said it is not known currently if that will happen next year, two years or 10 years from now. “If the world is not prepared and has not learned its lesson from this coronavirus pandemic, it will face the same situation then,” he cautions.