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In the short term, Nabarro says a vast program of testing and contact tracing would need to be implemented to allow life to function alongside Covid-19 -- one which dwarfs any such program ever established to fight an outbreak, and which remains some time away in major countries like the US and the UK.
"Absolutely critical is going to be having a public health system in place that includes contact tracing, diagnosis in the workplace, monitoring for syndromic surveillance, early communication on whether we have to re-implement social distancing," adds Hotez. "It's doable, but it's complicated and we really haven't done it before."
Those systems could allow for some social interactions to return. "If there's minimal transmission, it may indeed be possible to open things up for sporting events" and other large gatherings, says Hotez -- but such a move would not be permanent and would continually be assessed by governments and public health bodies.
That means the the Premier League, NFL and other mass events could go ahead with their schedules as long as athletes are getting regularly tested, and welcome in fans for weeks at a time -- perhaps separated within the stands -- before quickly shutting stadiums if the threat rises.
"Bars and pubs are probably last on the list as well, because they are overcrowded," suggests Neal. "They could reopen as restaurants, with social distancing." Some European countries have signaled they will start allowing restaurants to serve customers at vastly reduced capacity.
Restrictions are most likely to come back over the winter, with Hotez suggesting that Covid-19 peaks could occur every winter until a vaccine is introduced.
And lockdowns, many of which are in the process of gradually being lifted, could return at any moment. "From time to time there will be outbreaks, movement will be restricted -- and that may apply to parts of a country, or it may even apply to a whole country," Nabarro says.
The more time passes, the more imposing becomes the hotly debated prospect of herd immunity -- reached when the majority of a given population, around 70% to 90%, becomes immune to an infectious disease. "That does to some extent limit spread," Offit says -- "although population immunity caused by natural infection is not the best way to provide population immunity. The best way is with a vaccine."
Measles is the "perfect example," says Offit -- before vaccines became widespread, "every year 2 to 3 million people would get measles, and that would be true here too." In other words, the amount of death and suffering from Covid-19 would be vast even if a large portion of the population is not susceptible.
All of these predictions are tempered by a general belief that a vaccine will, eventually, be developed. "I do think there'll be vaccine -- there's plenty of money, there's plenty of interest and the target is clear," Offit says.
But if previous outbreaks have proven anything, it's that hunts for vaccines are unpredictable. "I don't think any vaccine has been developed quickly," Offit cautions. "I'd be really amazed if we had something in 18 months."
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Posted by Erin Burnett to The Global Outbreak at 3 May 2020 at 08:12
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