Full confession: I’ve been binge reading information surrounding the coronavirus and COVID-19. And while I’ve learned a lot, I’m now realizing that the more I read, the less I know.
Case in point: New research from the Imperial College London highlights the complex interaction of virus transmission, reproductive numbers, herd immunity, and COVID-19. Six weeks ago none of those terms were even on my radar. But, here we are.
By now, many of us have at least a passing understanding of the term, “flattening the curve.” The general idea being that we need to avoid a surge in cases that overwhelms our healthcare system capacity. That’s where a quarantine or social distancing comes into play. By slowing the transmission we keep the number of people who have contracted COVID-19 within the ability of our healthcare systems to manage.
The modeling in the UK report referenced above, however, suggests that even flattening the curve could still overwhelm the British National Health System. In order to avoid this scenario, the British government is now moving close to a full on suppression strategy — an effort to not just slow the transmission of coronavirus, but to suppress it entirely.
That sounds like an appropriate strategy, right? Let’s just stop this thing in its tracks. But, this is where things could get tricky.
A suppression strategy can minimize the risk in the short term. The problem is that we don’t understand coronavirus well enough to know what happens next. There’s a very real chance that once mitigation and suppression measures are lifted (and they will inevitably be lifted) the virus reemerges in a huge way — possibly bigger than if we had done nothing in the first place.
None of us have a natural immunity to SARS-CoV-2 (the official name of the virus). That means that until we have access to a vaccine, most uninfected people (some estimates say up to 80%) are still at risk once measures are eased. We’re pretty much stuck with SARS-CoV-2 until we’ve all been infected (hopefully with minimal symptoms) or vaccinated.
We are all likely to be exposed to coronavirus eventually — none of us started this ordeal with immunity. That means either a very long quarantine period, or other creative solutions. The Imperial College paper and Fiona’s summary give a few examples of what this could look like, including:
- Adaptive suppression strategies where we turn suppression measures on and off in an effort to keep the number of new cases within the ability of healthcare systems to manage. Essentially, like the bouncer at the door letting only a certain number of people into the coronavirus nightclub at a time. Eliminating overcrowding of hospitals would improve our ability to respond to the disease over time.
- Better use of technology to track and monitor those with the disease, those susceptible to the disease, or those immune to the disease. This is certain to raise the hackles of privacy advocates, but may be a necessity to minimize COVID-19 deaths.
Whatever leaders eventually decide, it’s looking like we’ll need to be prepared for some version of quarantines and social distancing to be the new normal for a while. And when the worst is over, we’ll need to continually adapt to unusual preventative measures for the foreseeable future.