Just stay home. The faster we all adhere to this directive, the sooner we can restore normalcy to our lives. This message has resonated widely online amidst the COVID-19 discussions. It sounds appealing, doesn’t it? Shelter in place. Weather the storm. Once it’s all over, we can return to our previous routines.
We often talk about herd immunity. “Flatten the curve,” we say, aiming to spread infections over an extended timeframe—months or even a year—until we achieve herd immunity. However, there are significant issues with this outlook. Firstly, herd immunity isn’t a fixed figure. The percentage of the population that needs to be immune to halt the spread of a disease depends on factors such as how transmissible the virus is and how frequently people interact. For instance, mumps has a reproductive number of 10-12, meaning that in a completely susceptible population, every one infected individual can potentially pass the virus to another 10-12 people. To achieve herd immunity for mumps, around 92% of the population must be immune.
COVID-19, on the other hand, has a reproductive number of approximately 3, which suggests that around 70% of the population needs to be immune.
Let’s break down the numbers:
- The U.S. population is roughly 330 million.
- 70% of that is about 231 million.
- As of this writing, there are approximately 217,000 confirmed cases of COVID-19 in the U.S.
While there are certainly more individuals who are quarantined or asymptomatic, it’s clear that we are far from reaching herd immunity. Attempting to achieve herd immunity without a vaccine is simply unrealistic.
To prevent hospitals from becoming inundated, we need to practice social distancing. There are still cases circulating, some of which remain undetected. Essential workers continue to work, and unfortunately, some individuals blatantly disregard social distancing guidelines, gathering in large groups for various reasons—defiance, political statements, or simply a misguided sense of invincibility.
While we can slow the spread, halting it completely remains elusive. So, what if we were to implement a total lockdown to contain the virus? The moment we attempt to return to normalcy, we risk a resurgence of cases, similar to what is currently unfolding in Hubei, China, where 600,000 individuals have been re-locked down after new infections emerged following the lifting of restrictions.
Without near-total eradication of COVID-19, we will likely face prolonged periods of social distancing. But how can we effectively control its spread?
Experts predict we may have to wait at least 12 months for a vaccine, but a more realistic timeframe could be closer to 18 months. Moreover, for other coronaviruses—like those causing the common cold—previous infections don’t guarantee lifelong immunity, and some individuals are more prone to reinfection. While it’s believed that those who recover from COVID-19 will likely be immune to reinfection, the duration of that immunity remains uncertain. The virus could also mutate yearly, necessitating annual COVID-19 vaccinations, much like the flu. We are still learning about this new virus.
So, should we panic? Absolutely not. It’s crucial to maintain a rational perspective, focusing on science and how we can protect ourselves while striving for a semblance of normalcy, all while supporting the economy. Humans are inherently social beings and we thrive on stability—health, emotional, social, political, and financial.
The reality we need to prepare for is this: while we wait for a vaccine, we will likely be engaged in a surreal game of virus whack-a-mole for the next 18 months or longer. We will experience cycles of social distancing and lockdowns, ideally aided by widespread testing to pinpoint where infections arise, allowing us to strategically impose restrictions in specific areas while enabling some normal activities in regions where transmission is under control.
What can we do?
We must significantly increase our ICU capacity and healthcare workforce to manage the influx of patients requiring acute care. COVID-19 is not merely the flu; unchecked spread can overwhelm hospitals. A substantial portion of those infected may develop acute respiratory distress and pneumonia, necessitating prolonged intensive care.
The pressing question is this: “What level of social distancing is essential to keep our healthcare systems operational and protect our healthcare workers?” Allowing the virus to spread unchecked in hopes of achieving herd immunity would result in catastrophic loss of life. The UK discovered the potential consequences of this approach when they modeled the outcomes of permitting the virus to spread unchecked.
We need social solidarity. As a nation, we must unify in our understanding of social distancing and sheltering in place, recognizing the importance of these measures to safeguard our healthcare workers. This message must come from our leaders. It’s vital for those in power to provide a clear, cohesive plan that inspires trust in doctors and scientists while emphasizing the facts.
We must also prioritize testing. This is our new normal. Even when social solidarity and expanded testing are in place, it remains highly probable that we will experience waves of COVID-19 for an extended period. As the virus can spread easily, particularly through asymptomatic carriers, gatherings significantly contribute to its rapid transmission.
Thus, after enduring lengthy periods of lockdown, the moment we resume work and social activities, reinfections are likely to arise in densely populated areas. Until a vaccine becomes available, a return to what we consider normal is improbable. We can expect periodic school closures and cancellations of events like sports, concerts, and weddings to become routine.
For the foreseeable future—unless we engage in a profound act of social solidarity, taking personal responsibility to maintain physical distance and vastly improving our testing capabilities—what we are experiencing now will be our new normal. For further insights on related topics, please visit this blog post, and for authoritative information on childhood anxiety, check out this resource. Additionally, for excellent information regarding pregnancy and home insemination, you can refer to this article.
Summary:
The COVID-19 pandemic is expected to last for over 18 months, requiring ongoing social distancing measures and increased healthcare capacity. Achieving herd immunity without a vaccine is unrealistic. Leaders must communicate effectively, and society must unite to combat the virus through personal responsibility and testing to manage its spread.