What Can We Expect?
The government has thus far given little
orientation of what Canadians can expect next, after they complete
their 14-day self-isolation and their children's scheduled time away
from school comes to an end. The fact is that life will not go "back to
normal" after the self-isolation ends and everyone will have to start
taking stock of what comes next.
epidemiologist Larry Brilliant explains what we are facing in terms of
bringing the coronavirus under control. The first step is to flatten
the curve. This means that first we want to spread out the disease over
time. "By slowing it down or flattening it, we're not going to decrease
the total number of cases, we're going to postpone many cases, until we
get a vaccine -- which we will, because there's nothing in the virology
that makes me frightened that we won't get a vaccine in 12 to 18
months. Eventually, we will get to the epidemiologist gold ring,"
"That means, A) a large enough quantity of us have
caught the disease and become immune. And B) we have a vaccine. The
combination of A plus B is enough to create herd immunity, which is
around 70 or 80 per cent." He adds:
"I hold out hope that we get an antiviral for
COVID-19 that is curative, but in addition is prophylactic. It's
certainly unproven and it's certainly controversial, and certainly a
lot of people are not going to agree with me. But I offer as evidence
two papers in 2005, one in Nature and one in Science.
They both did mathematical modeling with influenza, to see whether
saturation with just Tamiflu of an area around a case of influenza
could stop the outbreak. And in both cases, it worked. I also offer as
evidence the fact that at one point we thought HIV/AIDS was incurable
and a death sentence. Then, some wonderful scientists discovered
antiviral drugs, and we've learned that some of those drugs can be
given prior to exposure and prevent the disease. Because of the intense
interest in getting [COVID-19] conquered, we will put the scientific
clout and money and resources behind finding antivirals that have
prophylactic or preventive characteristics that can be used in addition
Brilliant points out that increasing the amount of
testing is crucial. "Tests would make a measurable difference. We
should be doing a stochastic process random probability sample of the
country to find out where the hell the virus really is. Because we
don't know. Maybe Mississippi is reporting no cases because it's not
looking. How would they know? Zimbabwe reports zero cases because they
don't have testing capability, not because they don't have the virus.
We need something that looks like a home pregnancy test, that you can
do at home."
He points out that, "The world is not going to
begin to look normal until three things have happened. One, we figure
out whether the distribution of this virus looks like an iceberg, which
is one-seventh above the water, or a pyramid, where we see everything.
If we're only seeing right now one-seventh of the actual disease
because we're not testing enough, and we're just blind to it, then
we're in a world of hurt. Two, we have a treatment that works, a
vaccine or antiviral. And three, maybe most important, we begin to see
large numbers of people -- in particular nurses, home health care
providers, doctors, policemen, firemen, and teachers who have had the
disease -- are immune, and we have tested them to know that they are
not infectious any longer. And we have a system that identifies them,
either a concert wristband or a card with their photograph and some
kind of a stamp on it. Then we can be comfortable sending our children
back to school, because we know the teacher is not infectious. And
instead of saying 'No, you can't visit anybody in nursing homes,' we
have a group of people who are certified that they work with elderly
and vulnerable people, and nurses who can go back into the hospitals
and dentists who can open your mouth and look in your mouth and not be
giving you the virus. When those three things happen, that's when
normalcy will return."
This article was published in
Volume 50 Number 9 - March 21, 2020
What Can We Expect?