By Dave B.
I’ve mostly avoided talking publicly about novel coronavirus for the same reason that I’ve avoided discussing politics recently: they’re both topics in which reasoned public discussion is extremely unlikely and dealing with people’s emotions, when I’m much more interested in their thoughts, is very frustrating for me. That said, Covid-19 is important enough that I’ll share a few things for you to consider regarding a vaccine, immunity, and a long-term societal impact. But first, I want to share the perspective of a good friend of mine, Caterina V. She’s a doctor in Italy and she has a frontline perspective on what America, and much of the world, could likely be facing in the next couple of weeks (The message below has been lightly edited for clarity):
My name is Cate V. I am an Italian general practitioner: I am pretty scared and I work without PPE (personal protective equipment).
It all really started about 3 weeks ago... I was extremely reluctant (to accept what was happening). People would go to the hospital for troubled breathing and all I thought was "All this fuss for a seasonal flu...".
I was wrong, I was extremely wrong.
Here, we are fighting a battle, an extremely crazy one... we know the name of the enemy, COVID-19, but we have no clue what the weapons he is using are...
When I go to work in the morning everything is closed: no shops, no cafes, no hairdresser...nothing but the big grocery stores.
Almost no one is walking in the streets: probably this weekend, it will be declared illegal to go outside even to go for a run... only people with dogs can go for walks!
Yesterday I went grocery shopping.... I had to wait in line for 15 minutes to get in. Luckily there were still almost all of the products, so we are filling our fridge as if tomorrow everything will close.
On the 16th in Italy we had something like 470 deaths in one day... there are pictures of soooo many coffins without a family around them: funerals are forbidden; so are marriages. It’s surreal.
With Covid-19 people die alone: the relatives are not allowed in the hospitals due to how contagious the disease is... the patients die with their loved ones on the phone.
Italy has been great: new medical units have been built in no time, doctors are working 24/7... we are so madly tired... thankfully the system is public so everyone can be treated... or at least can have access to the treatments. But there are so many patients...
Stay home, stay safe!!!
As you can see, and probably already know, Covid-19 has changed the way that we live our lives. And because of the impact that it’s had on ourselves personally, we may not have taken the time to think about the bigger picture. So here are a few things to consider while you’re in isolation:
Experts say that we’ll have to wait 12-24 months for a vaccine to novel coronavirus. Maybe that’s true. But the evidence suggests that it will take much longer, assuming that a vaccine is possible at all. Think about it. There are six other coronaviruses that infect and are transmitted by humans. Four of them are responsible for a lot of cases of common cold and the other two are SARS and MERS (both more deadly, but less infectious than Covid-19). Guess how many of these six coronaviruses have vaccines? ZERO! Yep. As a species, we’ve never developed a vaccine for a human transmissible coronavirus. That doesn’t mean that we can’t. But it does mean that putting any sort of timeline on doing so is probably irresponsibly optimistic.
There’s a belief among many that novel coronavirus will be like the flu, where once you catch it and recover from it, you’ll be immune to that particular strain for most of the rest of your life. Well, coronavirus is NOT the flu. We have no idea if it will generate a lifelong immune response or not. But if we use other coronaviruses as a guide, it’s quite possible that immunity will last, at most, a season. The four coronaviruses that cause common colds have been around for many, many generations and we catch them again and again throughout our lifetimes without developing a permanent immunity. At this point, with our extremely limited knowledge of novel coronavirus and how our immune systems respond to it, it’s safer to assume that this virus will be a permanent pandemic.
While my first two points are blunt and seem rather dire, this one is a bit more nuanced. It’s obvious to everyone that permanent isolation and quarantine are unsustainable. The good news is that these measures are not designed to be indefinite. They’re designed to buy time for healthcare systems to establish a new equilibrium. Currently, our healthcare systems are designed for an expected number of patients at expected times of year. Covid-19 has thrown those expectations completely out of whack. Social distancing isn’t intended to prevent you from catching this disease forever. It’s designed to prevent you from catching it RIGHT NOW. You will get it at some point. And you’ll probably be alright. Or you might not. But what’s vital, from a public health perspective, is that healthcare institutions have time to adjust to a new normal. That means having adequate supplies, sufficient staff, and a viable funding model. For better or worse, the lasting impact that novel coronavirus is likely to have on our global society is an increased emphasis on healthcare systems (I say for better or worse because emphasis on a problem is not the same thing as successfully addressing it).
My point is that if you are expecting your life to go back to “normal” once the worst of this crisis abates, you’re likely in for some big surprises. But if we all work together, we can get through this stronger and more prepared than when this outbreak began. That’s the least we can do, so that all of the lives lost and sacrifices made, won’t have been in vain.