When Will This REALLY be Over? Part 1 of 4: Three Approaches Overview

When will this terrible coronavirus pandemic situation really be over? I don’t think anyone can answer this with certainty, but in this essay, I’ll share a summary of what most experts agree is probably the answer.

If my local and federal governmental leaders tell me it’s OK to go to the gym again, does that mean it’s over? No. When kids go back to learning together in shared classrooms, does that mean it’s over? No. Lifting stay-at-home orders is not by itself a sign of real progress. If our activities, permitted or not, are stifled by a blanket of worry that we will cause the virus to flare out of control, then it’s not really over.

If we cannot be around other people without handshakes and hugs, it’s not over.

If you cannot visit your grandmother in her nursing home, it’s not over.

If I cannot freely fly to another country for vacation without quarantines, it’s not over.

And so long as the virus is surreptitiously spreading among people who do not even know they are infected, it’s definitely not over.

It will really be over when fear itself is lifted from our collective psyche. When people fear the coronavirus about as much as they fear getting food poisoning or getting in a car accident, then it’ll be over.

But what will it take to get to that point?

I’ve reached my version of an answer, which is based on experts’ opinions. There are three indicators that will signal to me it is OK to stop fearing this coronavirus, that it is really over:

1. The new infection rates show a steady decline beyond the global human mega peak. This is the wait it out approach. When enough time has passed, and enough people have been sick, then humans will have herd immunity.

2. Unlimited affordable testing and tracing are available for all people everywhere. This is the hunt and catch proactive approach. By hunting for every case and isolating each cluster of people until they are virus-free, we can stop the spread.

3. An effective vaccine or another drug that protects people from becoming infected is developed and administered globally. This is an armor and shields approach. These drugs might be able to give us a better biological defense against the virus.

Let’s use the analogy of forest fire prevention to explain why these will show our coronavirus problems are going away, finally.

Imagine a continent with conditions perfect for rampant forest fires. Last year an insect killed half the trees. And the weather has been hotter and drier than anything on record in 100 years. There have been a few fires recently. The forest rangers know the potential for a widespread fire is high. Many cities surround this forest, and if they get too out of control many homes and lives may be lost.

When will the risk of out-of-control fires in this situation really be over?

Wait it out

If we just wait for the fires to burn, the problem will go away on its own. The fires will naturally slow down or stop when all the easy-to-burn wood is used up.

This is like humans getting herd immunity. Once the virus has already “used up” most of the people that haven’t yet got infected, it stops spreading.

Hunt and catch

A team of people could vigilantly monitor the forest and look for signs of fire. They would race to any new fires, no matter how small, and immediately put it out. Then they would block off a perimeter around the fire and wait until the coals are no longer red. They would make sure the wind didn’t blow sparks that could start new fires nearby.

This is like if we had enough human effort and testing supplies to screen everyone. We could find all the positive people and then trace them to figure out who else might be infected. Then the positive and potential-positive people could be separated until they stop shedding viruses.

Armor and shields

People could take steps to protect the remaining unburned wood. For example, they might cut down a wide row of trees to make a firebreak. Or they might soak an area with water, so the wet trees are less likely to catch fire.

This is like vaccinating people so they can’t get the virus. It doesn’t have to be a vaccine. Any prophylactic (preventive or protective) treatment which makes people less likely to get infected would help.

Now, let’s compare these approaches.

Which prevents the most deaths? Assuming we focus on one primary strategy, how many people can we expect to die before the COVID-19 problem is gone?

The wait it out approach would definitely result in the most deaths. If we didn’t do much else, but wait for natural herd immunity to emerge among the human race, nothing would stop the virus from spreading and killing.

The hunt and catch approach, if and only if it is executed well and involves massive testing of almost everyone everywhere, would save the most lives. This approach would shine a spotlight on the virus. We would always know where it was so we could focus our resources on stopping it in the people and places it was hiding.

The armor and shields approach could save as many lives as the hunt and catch approach if we already had a solution deployed today. But, since it will take months or years to find drugs or vaccines to give us protection, people will die while we wait for this. This approach, if it were our only focus, would result in more deaths than the testing and tracing approach, but less than the wait and see approach.

Which is the fastest? The guesses on how long each of these would take differ.

Of the three, testing and tracing could be up and running in the shortest amount of time. It is a matter of producing more of the supplies and deploying enough people to do the work.

The development of new prevention drugs and vaccines will take more time, however. New drugs must be tested thoroughly to make sure they are safe and effective. Some prophylactic ideas (like taking serum from people who already have the antibodies to others who have not yet been infected) are already in trials now. If a prophylactic already being studied today is successful, it is possible something might be available in months. Vaccine development is a bit trickier though. Experts estimate it will probably take a year or more. That assumes one of the early leads already in development works.

Estimating when we might peak globally is difficult. It depends on what happens when it hits the countries that haven’t yet peaked. Models showing probabilities about when any one geographic area will peak have changed drastically over time. Therefore, I expect any current guess at when the entire human race will be over our global mega peak to be unreliable as well. All we can do is watch the world data unfold. We’ll need to see everyone all over the world get past their own peaks. We’ll also need to see the global rates stay down even after everyone returns to gathering, traveling, and behaving normally again.

Which do we already know how to do? Is this something we already have the knowledge to do, or do we need to invent or discover something new to make it happen?

Of the three, the approach to wait for it to burn through the population does not involve us doing anything at all. So there is no technical challenge here! We know how to do this.

Testing and tracing are moderately challenging. We are already doing some of this so it is not a technical challenge, from an invention standpoint. We still need to understand which tests will give us the most useful results. This approach also requires the coordination of an enormous workforce. We need to figure out how to make more tests. Supplies needed to make some of the tests are hard to find. Scientists may have to develop new versions of tests that make do with available materials. (Where’s MacGuyver when you need him?)

Developing a new vaccine or prophylaxis treatment that is proven to be safe and effective is an enormous technical challenge. This requires new-to-world innovation. Scientists know how to develop drugs and vaccines, but the nuances of this new virus need to be understood first.

Which do we have the most control over? If we put lots of resources against it and try our very best, how much of what happens depends on things out of our control versus factors we can control?

We have the highest control over testing and tracing. This is being done in some countries and we would need to figure out the details of how to do it in our country.

We have moderate control over vaccine and drug development, but, there is an element of luck here. Since this is a new virus, as drugs are developed, there may be features of this virus that we don’t yet know. This might make a promising candidate for a new drug end up not working out.

We have the least control over the wait it out approach. We don’t do anything except wait patiently for more and more people to get infected and return to society with immunity.

Which is the least labor-intensive? What resources, people-power, would it take to implement this approach?

There is no labor or effort involved in waiting it out until we have herd immunity approach.

This is where the hunt and catch approach falls short. It is the most difficult to implement from a labor and resource standpoint. In order to implement this, it would take an enormous effort to hire and train tracers, procure massive quantities of tests (some of which are in short supply), and unprecedented coordination among states and federal public health agencies.

The development of vaccines or other protective drugs, in comparison, requires moderate amounts of human labor.

I meant this post to be an overview of the three approaches. But there is so much more to talk about for each of them. That’s why I made this a four-part mini-series. I’ll dive into more information about each of these topics in my next three posts.

When will this really be over? Part 2 of 4: Global Mega Peak

When will this really be over? Part 3 of 4: Testing and Tracing

When will this really be over? Part 4 of 4: Vaccines and Prophylactics

You may have noticed none of these approaches are quick fixes. The coronavirus pandemic is not going to be really over anytime soon. It will be months to years. Yes, we can have social distance. Wear masks. Try to keep crowds to a minimum. But until some of the goals outlined in these three approaches start to happen, it won’t really be over. But, we will get there.

We may not need all three to succeed. “Two Out Of Three Ain't Bad,” to quote one of my favorite songs from Meatloaf. Personally, I’ll relax when 2 of these 3 things happen. Meaningful progress in even one of these areas would help. And progress on all 3, even if each is imperfect or incomplete, taken together might also pull us out from under our suffocating blanket of COVID-19 fear.

Until next time,

COVID Carrie