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.

U.S. 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," Brilliant explains.

"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 to [vaccines]."

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."

(Wired.com)


This article was published in

Volume 50 Number 9 - March 21, 2020

Article Link:
What Can We Expect?


    

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