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"GLOBAL ISSUES, LEADERSHIP CHOICES":

3/18/2020

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What happens after the next two weeks? Or month? Or three months? This article by an epidemiologist at Johns Hopkins considers the future of COVID-19.

"So the virus will traverse the world, probably infecting between 40 and 70 percent of the global population during its first wave. This might occur over a painful six to 12 months, or it might be spread over a more manageable several years. Either way, once the first wave is done, the virus is probably here to stay. ... We don’t know if infection with the novel coronavirus confers long-lasting immunity. If it does, then something similar will happen: Eventually, almost all adults will be immune, and new infections will be concentrated among children. Since the virus causes severe disease almost exclusively in older adults, this shift to a childhood infection would nearly, but not completely, eliminate hospitalizations and deaths from the virus. But none of the coronaviruses currently common in human populations confer lifelong immunity, and there is a very good chance that SARS-CoV-2 [aka, COVID-19] won’t, either. Still, subsequent infections with the virus will almost certainly be less severe than the first, as individuals accumulate partial immunity. This is similar to the incomplete protection you get when the flu vaccine is an imperfect match for circulating strains; you can still be infected, but the resulting illness is far less harsh. ... A buildup of population immunity will also moderate the yearly impact of the novel coronavirus in less obvious ways. Epidemics are like fires: When fuel is plentiful, they rage uncontrollably, and when it is scarce, they smolder slowly. Epidemiologists call this intensity the “force of infection,” and the fuel that drives it is the population’s susceptibility to the pathogen. As repeated waves of the epidemic reduce susceptibility (whether through complete or partial immunity), they also reduce the force of infection, lowering the risk of illness even among those with no immunity. ... So there will be a time after the pandemic when life returns to normal. We will get there even if we fail to develop a vaccine, discover new drugs or eliminate the virus through dramatic public health action, though any of these are welcome because they would hasten the end of the crisis. But a long and painful process may be in store first. The first pandemic wave might infect more than half the world’s population. ... This first wave alone will not get us to the point where covid-19 becomes a disease of children. An infection rate of 50 percent would leave half of adults at risk in the next wave. But a reduction in susceptible individuals would weaken subsequent waves. ... Eventually, we will reach a point where covid-19 deaths in the elderly are virtually unheard of — but this could take a decade or more. Development of a vaccine would vastly accelerate this process. ... Even without a vaccine, improved treatment and new drugs could substantially reduce deaths. There are countless efforts underway to develop vaccines and treatments, but these take time; pharmaceutical solutions may not be available fast enough to blunt the first wave of the pandemic. ... [T]hough it may be years in the future ... this once-dreadful disease will morph into a mild annoyance in the years to come."
https://www.washingtonpost.com/outlook/coronavirus-pandemic-immunity-vaccine/2020/03/12/bbf10996-6485-11ea-acca-80c22bbee96f_story.html

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