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The Covid-19 pandemic: what can we expect?

Posted on 30th March 2020

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Although there is quite a lot of information available about the Covid-19 coronavirus, there is also a lot of disinformation (not least from President Trump), and quite a few scams. Also the consequences of the information are not being explained by governments and health experts. So I am going to try and list some key facts, and the results on us of those facts.

There is also a useful article here on The Atlantic, on what the future holds regarding Covid-19.

Treatments

As I write this, there are no proven treatments for Covid-19. There are some rumours, but nothing yet that has been shown to work. Many scientists are busily searching for existing drugs that are effective against it, and trying to invent new drugs to treat it.

We should expect that this will take some time, partly because it is a large and complex task, and partly because the approval process for new drugs takes time, although it is reasonable to assume that this process will be fast-tracked. Therefore don’t expect an approved treatment before the end of 2020, or mid 2021 at the very earliest.

Also, if and when one or more treatments are found and approved, expect the drugs to be in short supply at first. This is true even for any existing drugs found to be effective against Covid-19, but even more so for any totally new drugs.

In the meantime, treatments are all symptomatic: treating the symptoms so that they don’t kill the patients, thus giving their bodies time to defeat the virus. This is no different to the situation with many endemic viruses such as ‘flus and colds.

An immunisation

Many scientists and drug companies are working flat out on an immunisation, and at least one has already started testing on humans. Although this sounds hopeful, the development of new vaccines is always full of false hopes and failures: shots that don’t work and immunisations that have side-effects so severe as to make them useless.

We should expect that the first approved immunisations will give only partial and/or short-term protection against the virus. We should also expect that any approval may have exclusions: parts of the population for whom the vaccine is not deemed safe (most likely the people who need it most).

As with treatments, immunisations will take time, for the same reasons, so don’t expect them to be available before mid to end of 2021.

What is all this talk about flattening the curve?

There has been lots of talk about flattening the curve, and it is the justification for the lockdowns and travel bans that have been put in place.

Basically, self-isolation is a way of slowing down the spread, so that hospitals are not overwhelmed by the numbers of patients, so that people who need to be hospitalised can be, thus increasing their survival rate. In other words, lockdowns and travel bans will reduce the proportion of infected people who die, by a small amount.

There is no justification for believing that flattening the curve will reduce the total number of people who get infected. It just means that it may take longer for you to get infected: in some isolated communities maybe 3 to 5 years instead of 3 to 6 months.

Through their strategy of flattening the curve, your government is not trying to prevent you from catching the virus; they are only deferring when you will catch it. That means that not only are your chances of survival improved, but also there is a chance that treatment or a vaccine may be available when you do catch it.

Will you catch it?

Current projections are that at least 50% of the world population will become infected with Covid-19 eventually. It could be more. So yes, expect at some point to catch it.

You might have no symptoms at all, or you might have only mild symptoms. At risk people (people with existing conditions like heart disease, cancer and diabetes, and older people) are likely to have more severe cases, and may need to be hospitalised.

How long will the lockdown last?

One of the results of successfully flattening the curve is that the danger period will be lengthened. You should therefore expect lockdowns to last 3 months or more (the lockdown in Wuhan has already lasted 3 months and is not completely over (being eased, but not over), and that lockdown was severe and very strictly enforced by Chinese authorities).

Will it come around again, and will I catch it again?

Most coronaviruses are prone to mutation. This coronavirus is already mutating. Scientists are currently tracking 8 variants around the world (see here).

What that means is that any immunity that you gain, by catching it, or by vaccination, may not be effective against a new strain resulting from mutation. Immunity from having been infected is likely to be more effective against such new strains than an immunisation.

Also, it is not yet clear how long immunity from infection lasts (see paragraph 8 in this BBC article).

Colds and ‘flus come around regularly, also due to mutations, and these viral diseases are now endemic. Expect Covid-19 to also become an endemic disease, but so far there is no factual scientific basis for believing that Covid-19 will be seasonal like colds and ‘flu (see paragraph 6 in this BBC article).

So yes, it would be reasonable to assume that Covid-19 will come around again, and that some of you will catch it again. If you have some partial immunity from a previous infection or vaccination, a second infection should be less severe (but there are no guarantees).

Will it ever be completely stamped out?

It seems unlikely that we will ever completely eradicate Covid-19.

We have only been partially successful in limiting ‘flu, and even less successful in limiting the common cold (also caused by a coronavirus). In the case of influenza, new vaccines have to be developed every year for the new strains.

There are some notable success stories with immunisation (such as smallpox – now completely eradicated), but other diseases such as polio (caused by a virus) have not been completely eradicated, and TB (caused by a bacterium) is making a comeback, with drug resistant strains.

What about the impact on the economy?

The economy has taken a huge hit all around the world (see here). Currently stock markets are about 30% down. Oil prices are down to around $20 for a barrel, due to reduced demand, due to the lockdowns and travel bans.

It currently looks like China will be the first economy to recover.

Economies will not recover until everyone can return to work and spending patterns return to normal, so not until after the lockdowns are over.

Things may not get as bad as during the great depression, but they might.

What about my job?

Many people have been fired, put on reduced hours, or temporarily laid off.

Governments are offering bail-outs to some industries and financial support to some conventional full time employees, but understand that they cannot afford to do this long-term. Most of the government support is going to large high-profile companies. Worker in the gig-economy, and freelancers, are getting no help. This means that many people and small firms can expect hard times and possible bankruptcy.

Some people are able to work from home. If you are one of these, as am I, you are lucky. Other people are in professions that are critical to keeping things working and keeping people alive (police, fire-fighters, medical workers and the like) continue to work and get paid.

The longer the lockdowns continue, the more people’s lives and livelihoods will be destroyed.

What about travel?

Most flights have been cancelled. Many borders are closed. The Czech Republic has barred its citizens from leaving the country.

So at the moment, international travel is all but impossible, except for people returning to their country of citizenship.

My father in New Zealand is expected to die this year, and I am expecting to be unable to attend his funeral.

Eventually, flights will resume, and borders will reopen. By then, many airlines, bus companies and travel agents may be bankrupt, so travel choices will be reduced.

You should probably not be planning a vacation trip this year, not even in-country. If you are sensible, next year you should probably vacation in-country.

People returning from ski trips have been a major cause of inter-country spread of Covid-19, and should probably be avoided for a while. I love to ski, but I think I will defer it until the winter of 2021/2022.

What about social and business gatherings?

For the time being, pretty much all events are cancelled: concerts, music festivals, conferences, exhibitions, beer festivals and sporting events. This will probably remain the case for the next 3 to 4 months. After that, there should be a gradual easing off of the lockdowns, and some (but not all) social and business events will probably start again. Other higher risk events such as music festivals and beer festivals may remain cancelled for the remainder of 2020.

Apparently this year's Oktoberfest in Munich has been cancelled, although I have no confirmation of that yet. Every year, many people get sick from attending the Oktoberfest, after catching a virus (called the Wiesenkrankheit) from glasses that are not washed well enough before reuse, so it is pretty clear that this year the coronavirus would be spread by the same means if the Oktoberfest goes ahead.