After a rocky start, summer finally seems to be upon us.
Of course, the current circumstances preclude us from taking advantage of most of the things that warm weather affords. With respect to the COVID-19 pandemic, things are slowly beginning to improve but not on all fronts. Adjacent illnesses are appearing more frequently as a result of overwhelmed medical facilities and some workers are being nudged back into high-risk scenarios without the necessary precautions.
Even still, the research is unmistakable. Quarantine sucks, but the contrary is unfathomable.
For the informed, the question isn’t does social distancing work? It’s how long do we need to adhere to it before it can work optimally? Two new research papers have provided a potential answer.
According to models projected by The Harvard Chan School of Public Health and The University of Minnesota, we may need to shelter in place until 2021 or even 2022 to sufficiently suppress COVID-19’s exponential growth curve.
“It is urgent to understand the future of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) transmission. We used estimates of seasonality, immunity, and cross-immunity for beta coronaviruses OC43 and HKU1 from time-series data from the USA to inform a model of SARS-CoV-2 transmission,” the authors explained in the Harvard report. “We projected that recurrent wintertime outbreaks of SARS-CoV-2 will probably occur after the initial, most severe pandemic wave. Absent other interventions, a key metric for the success of social distancing is whether critical care capacities are exceeded. To avoid this, prolonged or intermittent social distancing may be necessary into 2022. Additional interventions, including expanded critical care capacity and an effective therapeutic, would improve the success of intermittent distancing and hasten the acquisition of herd immunity.”
The University of Minnesota researchers assessed their estimations based on three plausible scenarios:
No. 1: An initial wave of cases, followed by peaks and valleys over one to two years.
No. 2: A larger fall peak, similar to what took place during the Spanish flu.
No. 3: A peak in cases now, followed by a slow burn.
Each outcome is made possible, expedited, or prevented by national responses to the crisis in the ensuing weeks.
“These materials would be useful for review by state and local health departments because they reference proposed decision-makers at each level of implementation. This document constitutes a good model for public health organizations that want to be proactive about planning a layered approach to social distancing in a community,” the authors explained. “It may be important to ensure that these materials, especially those pertaining to social distancing thresholds, correspond with federal guidance.”
As pointed out by subsequent literature, social distancing does not eliminate the presence of a virus all on its own, it merely stabilizes it. In other words, if everyone merely stayed indoors except to meet nutritional and medical needs, transmissions would occur at about the same rate as recovery until a vaccine was made available or a windfall phenomenon compromised the coronavirus’ stability.
That isn’t to suggest that a windfall component might not help us along in some way.
In a new report, Qasim Bukhari and Yusuf Jameel, of the Massachusetts Institute of Technology, analyzed global cases of COVID-19, concluding that 90% of infections are transmitted in areas that are between 37.4 and 62.6 degrees Fahrenheit (3 to 17 degrees Celsius) and with an absolute humidity of four to nine grams per cubic meter g/m3 (which is a calculation of moisture in the air irrespective of temperature.
Their findings also posited that SARS-CoV-2 is the most stable at 4°C. At this temperature, its virions are even detectable after two weeks.
Additionally, the SARS virus that caused the epidemic of 2002 and the MERS virus that staffed the outbreak of 2012 both ended up being acutely seasonal, with transmission rates peaking between January and May.
We also have antibodies to consider, concurrently for their utility in antigen research as well as their potential to decrease the number of people naive to the disease thus reducing the need for mass immorality.
However, even if herd resistance theories pan out, it would take a lot of time for it to meaningfully impact hospitalizations and fatalities.
“In the absence of treatment or vaccine, it could take up to 12 to 18 months to build enough immunity in the population to free us from that,” said Dr. Stephen Kissler, a postdoctoral researcher at Harvard Chan School of Public Health in a media release. “It won’t necessarily be this widespread social disruption-social distancing, but I could imagine that people will get a lot more familiar with wearing masks, with sort of keeping their distance from each other in public especially during the winter months.”
On balance, a review of the countries that have successfully neutralized SARS-CoV-2 and those who have not, intimate the same protective measures.
Intensive testing and supportive interventions facilitated dramatic reductions in hospital stays in Singapore and Hong Kong, for instance.
Other nations that were able to keep moralities down employed some version of social distancing or “physical distancing.” Whether by closing schools and workplaces, initiating consumer curfews, or limiting mass gatherings.
These efforts flatten the curve to give epidemiologists, vaccinologists, and elected officials a breathing room to design a course of action.
This can’t happen in a timely manner if health systems continue to be overwhelmed. This is especially true of the development of treatments and vaccines; a process that requires a lengthy list of successful care tactics.
“The best case in the sense that that would be the fastest way that we could get to herd immunity,” Kissler concluded. “If the vaccine development is really much slower than we hope it is, then I think there is a chance that this virus could keep circulating during the wintertime — either every year or every other year — until we do have a vaccine.”
CW Headley is a reporter for the Ladders and can be reached at email@example.com