The Future

pltrgyst

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... is looking mighty grim for meetups.

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The Four Possible Timelines for Life Returning to Normal
The coronavirus outbreak may last for a year or two, but some elements of pre-pandemic life will likely be won back in the meantime.

JOE PINSKER, The Atlantic, MARCH 26, 2020

The new coronavirus has brought American life to a near standstill, closing businesses, canceling large gatherings, and keeping people at home. All of those people must surely be wondering: When will things return to normal?

The answer is simple, if not exactly satisfying: when enough of the population—possibly 60 or 80 percent of people—is resistant to COVID-19 to stifle the disease’s spread from person to person. That is the end goal, although no one knows exactly how long it will take to get there.

There are two realistic paths to achieving this “population-level immunity.” One is the development of a vaccine. The other is for the disease to work its way through the population, surely killing many, but also leaving many others—those who contract the disease and then recover—immune. “They’re just Teflon at that point,” meaning they can’t get infected again and they won’t pass on the disease, explains Andrew Noymer, a public-health professor at the University of California at Irvine. Once enough people reach Teflon status—though we don’t yet know if recovering from the disease confers any immunity at all, let alone lifelong immunity—normalcy will be restored.

Unfortunately, both of these paths could be a year or two long, but degrees of normalcy will likely be won back in the meantime: Come summer, Americans might get restaurants but no music festivals, offices but no crowded beaches, bars with spaced-out seating. Projecting when each facet of daily life will be restored would be easier if public-health authorities had an omniscient view of who is infected, who has recovered and become immune, and who is still susceptible—this is the information that would emerge from widespread testing, which the United States is terribly behind on deploying.

As such, America is currently left with self-isolation, a blunt tactic that can slow the spread of the virus, potentially sparing the country’s hospitals from a catastrophic overload of patients, but that comes at the cost of freezing daily life. Epidemiologists I interviewed stressed that they have no idea when life will be unfrozen, but they walked me through a series of possible timelines on which Americans might be able to safely start leaving the house to make money or do fun things again. Below are those timelines, including some turning points to look out for in the coming weeks, months, and years.

No matter what, staying safe means staying home for a while yet, despite Donald Trump’s desire, expressed at a Fox News town hall on Tuesday, “to have the country opened up, and just raring to go, by Easter.” Moving back toward normalcy at this early stage could be disastrous. “Prematurely ending severe social distancing would be an incredible blunder that would have major human consequences,” Noymer told me. “What is ‘prematurely’? The truth is, we don’t know yet, exactly, but it’s longer than a fortnight. It could be eight to 12 weeks.”

TIMELINE ONE: ONE TO TWO MONTHS

I should note that the experts I spoke with think this timeline is highly unlikely. But America could be through with most of its social distancing in a month or two if the coronavirus turns out “to not be a serious pathogen, suddenly,” said William Hanage, an epidemiology professor at the Harvard T. H. Chan School of Public Health. “All of the people who are now infected, instead of behaving like the infected people we’ve seen [before], have very mild disease, and we realize that immunity is being generated.” This “false alarm” outcome would of course be fantastic, but also produce “a lot of head-scratching” among public-health experts, Hanage said.

Another path to a short-term resolution is much grimmer: Too-lax social distancing could produce what Noymer calls a “big, short, sharp shock” of infections sometime in the next few months, overwhelming the health-care system and killing enormous numbers of people. After such a catastrophe, it’s conceivable that lots of people infected with the virus would recover, bringing the broader population closer, if not all the way, to immunity.

Both of these eventualities would make it okay to go out again in a couple of months, but even if Americans are still mostly cooped up at home in late spring, public-health experts will have learned more about the virus by then. Perhaps most important, they should know how much strain this first wave of infections will have put on America’s hospitals, and thus how effective containment efforts have been. This information isn’t readily available now, Hanage explained, because people who get infected today generally won’t require intensive care until several weeks from now. Also in a month or two, public-health authorities and researchers will likely have a better sense of whether those who recover from an infection are immune to future infections, and if so, for how long. That information will come in handy for containment efforts.

TIMELINE TWO: THREE TO FOUR MONTHS

In this timeline, Hanage speculated, “we learn some things about the virus that make us much more confident about being able to resume various activities. One of them might be that we actually have substantial immunity already, through mild infections” or even asymptomatic ones.

These are the sorts of things that could be learned from months of testing both people who have symptoms and people who don’t. Two types of tests matter here: one that detects the presence of the virus itself, and one that detects the antibodies that people develop when they’re immune to it.

With this new information, Hanage said, it might be possible to isolate contagious or more vulnerable people, while a large portion of the population returns to something resembling normal life. “You can have fewer tables to a restaurant, for instance, or a smaller number of people at a bar,” he said. Meanwhile, if some places have much higher incidences of the disease than others, people in some states and cities might leave home sooner or during different periods than people elsewhere in the country.

Michael Stoto, a professor of health-systems administration and population health at Georgetown University, told me that three variables dictate the spread of a disease: “how many people the average person encounters in a day when transmission could take place” (whether through face-to-face interaction or from touching the same surface), “the chance that the virus will be transmitted in each of those interactions,” and “the proportion of people that you encounter who are themselves infected.”

If more and better-targeted testing started to yield a fuller picture of the spread of the virus, Stoto said, public-health authorities might choose to focus on one variable more than another. For instance, if testing data indicated that reducing people’s number of encounters (the first variable) would be highly effective, maybe restaurants and small businesses would reopen, but large, crowded events would be canceled or remain postponed. “Some of the extreme things we’re doing now, we might be able to drop sooner rather than later,” he said.

And in three to four months, researchers might have identified a treatment for COVID-19—not a cure, but something that could quickly and reliably ease symptoms and prevent deaths. This wouldn’t eliminate the continued need for social distancing, since large-scale outbreaks would still be possible, but it could reduce the risk of overburdening the country’s hospitals if an outbreak arose.

To Hanage, this timeline is likelier than the false-alarm scenario, but “all of this is Who knows exactly?”

TIMELINE THREE: FOUR TO 12 MONTHS

One big unresolved question about COVID-19 is whether, like the flu, its spread will slow substantially during the summer. Researchers have a few theories for why summer is a season unfriendly to the flu—it could be that higher temperatures and increased UV radiation are inhospitable to some viruses, and/or that most schools are out of session, depriving viruses of a crucial breeding ground. But whether either of those theories applies to the coronavirus is not yet known.

Noymer guesses that we’ll find out if COVID-19 is seasonal sometime in the next two to three months, and here is where Timeline Three splits in two: In one possible universe, the virus recedes in the summer. In the other, it doesn’t. In both, at least some of the social distancing measures now in place continue into the second half of the year.

In the first universe, Noymer said, summer will be a bit more fun than spring was, at least in the Northern Hemisphere. Outdoor activities in small groups would probably be fine. Maybe bars and restaurants would reopen. But large gatherings would likely be out: “No Lollapalooza, no Major League Baseball, no crowded beaches,” Noymer guesses.

Hanage thinks that sports leagues might resume in the summer but without crowds, and that TV shows might forgo studio audiences. Meanwhile, stores might cap the number of shoppers allowed in at once. “I really don’t think that large crowds are going to be a thing for quite some time,” he said. But the smaller-scale units of American life might be phased back in.

It might even be (relatively) safe to travel to see loved ones. “Once it’s everywhere, and you are as likely to get infected in your local convenience store as anywhere, travel restrictions make very little sense,” Hanage said. “That said, there would need to be some responsible measures to help people not get too crowded in the airports.”

The downside of this closer-to-normal summer is that a resurgence of the disease in six months or so is a strong possibility (though not guaranteed). This “fall wave” of infections might arrive in September or October, reintroducing the need for social distancing. That social distancing might be on par with what’s happening now, or it might be eased a bit: By then, many people could have developed immunity, and could theoretically go out without risking infection. And we’ll know more about the virus too. If we’ve learned by the fall that children don’t spread it, schools might even reopen.

Also, the country would hopefully be in a better position to absorb another wave of infections. The summer would be a good time to produce more ventilators, hospital beds, and the protective equipment that health-care workers wear to prevent infection. “If we get seasonality, saving our bacon in the short term … we need to use the summer lull to steel our response” in the fall, Noymer said. With the proper steeling, social distancing might be able to be scaled back further.

In the second possible universe, we don’t get a summer reprieve. The current oncoming spike in cases would, hopefully, subside as a result of isolation measures taken now, but the risk of a resurgence would remain high in the warmer months. If the number of cases isn’t falling significantly by early to mid-June, Noymer said, that’s how we’d probably know the virus isn’t seasonal.

At that point, social-distancing measures could be modified according to the situation. If another onslaught of infections appears to be approaching, Americans could be stuck where they are now. But if there’s good enough data indicating that hospitals shouldn’t be overwhelmed, social distancing could be scaled back.

“Once the [current] wave is dealt with, then some things might relax—a little,” Hanage said. More out-of-the-house working and socializing might take place, but this would still be a world with rigorous hand-washing, well-smothered sneezing, and generous amounts of hand sanitizer (and suspicion of anyone who disregards these public-health norms). In all likelihood, people who can work remotely or order food via delivery would still do so instead of leaving the house.

The fall could introduce some chaos, regardless of the virus’s seasonality. “There’s the small matter of an election, which is a potentially huge superspreading event,” Hanage noted. (He also worries that social-media rumors of, say, people coughing near a certain polling place could cause turnout there to plummet.) And of course, the flu will return around the time of the election too, making it hard to tell, without a test, if any given person has COVID-19 or the flu—an ambiguity that isn’t as onerous now, during the tail end of flu season. The election and the flu are reminders that all of the things that happen under normal circumstances—including natural disasters (summer and fall are hurricane and wildfire season too, don’t forget)—won’t necessarily be put on hold during this highly abnormal time.

TIMELINE FOUR: 12 TO 18 MONTHS (OR LONGER)

Amid everything I’ve described so far—the crowd-free baseball games, the bars and restaurants with spaced-out seating, and so on—researchers around the world will have been scrambling to develop a vaccine. Spring 2021 is about the earliest anyone expects one to be available. “Anything faster would be world-record, lightning speed,” Noymer said. If it’s a “rough draft and needs to be polished,” it would take longer, possibly another six months or a year after next spring.

Vaccines take so long to make because they are difficult to perfect. There are a series of methodical trials done to make sure they don’t harm healthy people, to make sure they generate the desired antibodies, and to make sure those antibodies actually defend against the disease. These aren’t overcautious bureaucratic safeguards; if researchers are making something that’s going to be pumped into the arms of hundreds of millions, probably billions, of people, they want to make sure it’s just right.

And if it’s just right, normal life will resume, but not immediately. “The logistics of vaccinating [nearly] 350 million people is no mean feat,” Stoto said. He also noted that, “assuming that it doesn’t all arrive in one big batch,” some sort of system would need to be in place for determining who gets the first doses: the people most vulnerable to the disease? Health-care workers?

It’s also possible that no one is able to develop a safe, effective vaccine. This would be a disappointment, but even then, America could be well on its way to population-level immunity, perhaps reaching a Teflon critical mass by the fall of 2021. And the journey from now to then would probably not mean being cooped up indoors continuously for more than a year. “If we can’t come out of our groundhog holes for more than 12 months,” it’s because the coronavirus is about as ferocious and noncompliant as it could possibly be, producing “some perfect storm of viral epidemic in which we can never relent,” Noymer said.

Even in a vaccine-less world, reaching population-level immunity means that future outbreaks of COVID-19 should be far less damaging than the one the U.S. is currently confronting. The virus might, however, remain threatening and continue to circulate, infecting people like the cold or flu does. This wouldn’t be ideal, but by then, life would be back to normal—though at the same time, completely changed.
 

FordPickup92

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Thank you for posting this Larry. Definitely provides valuable insight to somethings people likely aren't considering. And as silly as it may seem, the bleak possibilities of a vaccine almost make it sound as though if one is healthy enough to recover from covid, it may be a better interest to actually get the disease and recover from it, rather than trying to hide from it. Provided, as mentioned, that one can become immune to it. I find it amazing how powerful one small virus can be on such a large scale. I also really would love to know if scientists are ever able to determine what made it, or how it mutated (if originated from a flu virus) into something so aggressive..
The timelines provided are all very well thought out, and sadly without knowing key points of information we are all only stuck waiting to see the result. With time, I'm confident our scientists can break ground on how to fight covid, however that leaves so many people vulnerable in the meantime. Hospital workers, health care providers, and the scientists working hands on with the virus, if infected and begin suffering large numbers not able to work, could potentially cause a heartbreaking situation for all of us. One can only hope that we see improvements before then, and not an opposite affect where the virus can adjust and mutate further to something we can never control.
 

FordPickup92

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I just read this article myself and thought about posting it. I was afraid that the jack asses in the politics thread would ruin it.
Did I do a good job not doing that? I started typing a section about the economy etc but deleted that section thinking, nah dont want that mess in here lol
 

Hornet

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I just read this article myself and thought about posting it. I was afraid that the jack asses in the politics thread would ruin it.
Guaranteed someone will ruin having a legitimate discussion about this, but I very much appreciate having the information in the article. I haven’t seen much written on the subject.
 

BarrieJ3

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It's quite sobering. Hard for me to have other thoughts past that simple aspect right now.

We were just handed an extra couple weeks of legally implemented quarantine, and we obviously expect it to go on for quite a bit more, but hadn't really thought about how long it *could* go.
 

Burke

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Thank you for posting this Larry. Definitely provides valuable insight to somethings people likely aren't considering. And as silly as it may seem, the bleak possibilities of a vaccine almost make it sound as though if one is healthy enough to recover from covid, it may be a better interest to actually get the disease and recover from it, rather than trying to hide from it. Provided, as mentioned, that one can become immune to it. I find it amazing how powerful one small virus can be on such a large scale. I also really would love to know if scientists are ever able to determine what made it, or how it mutated (if originated from a flu virus) into something so aggressive..
The timelines provided are all very well thought out, and sadly without knowing key points of information we are all only stuck waiting to see the result. With time, I'm confident our scientists can break ground on how to fight covid, however that leaves so many people vulnerable in the meantime. Hospital workers, health care providers, and the scientists working hands on with the virus, if infected and begin suffering large numbers not able to work, could potentially cause a heartbreaking situation for all of us. One can only hope that we see improvements before then, and not an opposite affect where the virus can adjust and mutate further to something we can never control.

Hey Brie, there is pretty extensive research out there regarding the origin of the virus. I feel like this article does a good job summarizing the theories of the origin. It is based off a Nature (huge scientific journal) article that is linked at the bottom.

https://www.sciencedaily.com/releases/2020/03/200317175442.htm

It didn’t mutate from an influenza virus. The family of coronaviruses are separate from influenza viruses. While coronaviruses are often causes of a common cold, SARS, MERS, and COVID all have the SARS-CoV-2 genome. I’ll edit this post to add a little schematic when I get back to my computer.

It is zoonotic meaning that it made the jump from non-human hosts to human hosts at some point. For COVID-19 lots of the genome (which has been sequenced) is very very similar to bat coronaviruses. That is why bats have been a popular theory as to the natural reservoir.

If you guys already knew all this I’m sorry for wasting your time.
 

FordPickup92

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Hey Brie, there is pretty extensive research out there regarding the origin of the virus. I feel like this article does a good job summarizing the theories of the origin. It is based off a Nature (huge scientific journal) article that is linked at the bottom.

https://www.sciencedaily.com/releases/2020/03/200317175442.htm

It didn’t mutate from an influenza virus. The family of coronaviruses are separate from influenza viruses. While coronaviruses are often causes of a common cold, SARS, MERS, and COVID all have the SARS-CoV-2 genome. I’ll edit this post to add a little schematic when I get back to my computer.

It is zoonotic meaning that it made the jump from non-human hosts to human hosts at some point. For COVID-19 lots of the genome (which has been sequenced) is very very similar to bat coronaviruses. That is why bats have been a popular theory as to the natural reservoir.

If you guys already knew all this I’m sorry for wasting your time.
Cool, I do recall the info about originating in bats. Thank you for the additional link!
 

pltrgyst

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If you guys already knew all this I’m sorry for wasting your time.

AFAIK, anything from authoritative sources or people who take it seriously and know what they're taking about is welcome information.

A complementary article from today's Washington Post:
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Three months into the pandemic, here is what we know about the coronavirus

The Washington Post, Joel Achenbach March 28, 2020 at 10:46 a.m. EDT

Three months into this pandemic, scientists are coming to understand the novel coronavirus. They know, for example, that as horrible as this virus is, it’s not the worst, most apocalyptic virus imaginable. Covid-19, the disease caused by the virus, is not as contagious as measles, and although it is very dangerous, it is not as likely to kill an infected person as, say, Ebola.

But there is one critically important, calamitous feature of SARS-CoV-2: the novelty. When it jumped from an animal host into the human population sometime late last year, no one had immunity to it. That’s one reason the new coronavirus isn’t comparable to a harsh strain of the flu going around.

The first cluster of mysterious, pneumonia-like respiratory illnesses was reported in Wuhan, China, at the end of December, and in the days that followed it spread explosively. With astonishing speed this submicroscopic pathogen has contaminated the planet, infecting more than 600,000 as of Saturday and killing at least 28,000, grinding global commerce to a near standstill and rattling the nerves of everyone brave enough to be following the news.

“This is a new virus that has landed in the human community. We are a brand new, naive population. We’re kind of sitting ducks, right?” said Ilhem Messaoudi, a virologist at the University of California at Irvine.

Most viral contagions in circulation face obstacles in the form of people with at least partial immunity. But this coronavirus is a bulldozer. It can flatten everyone in its path.

When the virus infects people, they don’t get sick right away. Researchers believe the incubation period before symptoms is roughly five days on average. In studying the pattern of illness, epidemiologists have made the dismaying discovery that people start shedding virus — potentially making others sick — in advance of symptoms. Thus the virus has a gift for stealth transmission. The virus seeds itself in communities far and wide, where vulnerable human beings represent endless fertile terrain.

At the genetic level the new virus is not terribly different from the SARS virus that emerged in China in 2002-2003 — which is why the new one has the derivative name SARS-CoV-2. SARS killed nearly one in 10 patients. But people with SARS infections did not shed virus until they were already quite sick, and victims were typically hospitalized. SARS was snuffed out after causing about 8,000 infections and 774 deaths worldwide.

That successful fight may have led to some complacency; researchers say funding for SARS research dried up in recent years.

“We thought we cured it. We thought the virus disappeared. Well, the virus didn’t disappear, did it?” said Michael Buchmeier, a UC-Irvine virologist who has studied coronaviruses for three decades.

Because this is such a contagious virus, a large percentage of the world’s population, potentially billions of people, could become infected within the next couple of years. Frantic efforts to develop a safe and effective vaccine are likely to take a year or more.

President Trump and others have repeatedly downplayed the threat of covid-19 by comparing its lethality to seasonal influenza, which claims tens of thousands of lives in the U.S. every year. But covid-19 may be many times as lethal for an infected person as seasonal flu.

Messaoudi noted that the health system is set up to deal with the seasonal flu, but not with a new, pandemic disease.

“We have a vaccine for the flu. And antivirals. It’s seasonal, we prepare for it, we try to get vaccination coverage, this is already what our system is dealing with,” she said. “This is the wrong time to deal with another surge of a respiratory disease that causes a lot of morbidity and potentially mortality.”

The bulldozer nature of coronavirus means widespread severe illnesses and deaths from covid-19 can happen with terrifying speed. This happened in Northern Italy, where hospitals become overwhelmed and many patients couldn’t get standard lifesaving treatment.

The pandemic appears to be largely driven by direct, human-to-human transmission. That’s why public health officials have told people to engage in social distancing, a simple but effective way to drive down virus’s reproductive number — known as R0, pronounced “R naught.” That’s the average number of new infections generated by each infected person.

The R0 is not an intrinsic feature of the virus. It can be lowered through containment, mitigation and ultimately “herd immunity” as people who have recovered become less susceptible to infections or serious illnesses. For the epidemic to begin to end, the reproduction rate has to drop below 1.

In the early days in China, before the government imposed extreme travel restrictions in Wuhan and nearby areas, and before everyone realized exactly how bad the epidemic might be, the R0 was 2.38, according to a study published in the journal Science. That’s a highly contagious disease.

But China on Jan. 23 imposed extreme travel restrictions and soon put hundreds of millions of people into some form of lockdown as authorities aggressively limited social contact. The R0 plummeted below 1 and the epidemic has been throttled in China, at least for now.

The virus does have an innate infectivity, based on how it binds to receptors in cells in the respiratory tract and then takes over the machinery of those cells to make copies of itself. But its ability to spread depends also on the vulnerability of the human population, including the density of the community.

“If you have a seriously infectious virus and you’re sitting by yourself in a room, the R naught is zero. You can’t give it to anybody,” says Jeffery Taubenberger, a virologist with the National Institute of Allergy and Infectious Diseases.

Without a vaccine or a drug to stop infections, the best hope is to break the chain of transmission one infection at a time. There is no way to combat the virus through aerial spraying, dousing the public drinking water with a potion or simply hoping that it will magically go away.

“Social distancing is building speed bumps so that we can slow the spread of the virus. We have to respect the speed bumps,” Messaoudi said.

Melissa Nolan, an epidemiologist at the University of South Carolina, said the efficacy of social distancing “is the million-dollar question right now.”

She compared the current public measures to what happened during the 1918 influenza pandemic that killed an estimated 675,000 people in the U.S., and in which some cities were more careful than others about enforcing social distancing.

“The USA is currently in a natural experiment of sorts, which each state implementing their own version of social distancing,” she said. “We will be able to compare the efficacy of these various public health policies, but not until more time has passed.”

The social distancing effort requires individual participation on behalf of a collective need. But it’s self-interested first and foremost: No one wants to catch this virus. It can be deadly, and even if not, many victims are miserable for days or even weeks on end.

Not only must people limit their direct contact, they need to limit the amount that their paths overlap, because the virus can linger on surfaces.

Virus degrades outside a host due to exposure to moisture, sunlight, or from drying out. But a study published in the New England Journal of Medicine showed that, in pristine laboratory conditions, some SARS-CoV-2 particles can remain potentially viable on metal or plastic for up to three days.

It’s unclear to what degree contact with contaminated surfaces is playing a role in the contagion. This is obviously something everyone would like to know when they handle the pump at a gas station or go to a grocery store. Absent hard data, limiting contact with shared surfaces such as door handles or checkout machines and frequent hand-washing is highly advisable.

Even though we don’t have a vaccine, and no one had immunity to this novel pathogen, people have some innate, mechanical defenses against viruses just like they do against pollen and dust, Taubenberger noted. Cells in the respiratory tract have tiny hairlike projections, called cilia, that move mucus toward the throat in a manner that helps clear invasive particles. This is not our body’s first viral rodeo.
----------------------
 

Burke

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AFAIK, anything from authoritative sources or people who take it seriously and know what they're taking about is welcome information.

A complementary article from today's Washington Post:
---------------------------------------------------------------------------

Three months into the pandemic, here is what we know about the coronavirus

The Washington Post, Joel Achenbach March 28, 2020 at 10:46 a.m. EDT

Three months into this pandemic, scientists are coming to understand the novel coronavirus. They know, for example, that as horrible as this virus is, it’s not the worst, most apocalyptic virus imaginable. Covid-19, the disease caused by the virus, is not as contagious as measles, and although it is very dangerous, it is not as likely to kill an infected person as, say, Ebola.

But there is one critically important, calamitous feature of SARS-CoV-2: the novelty. When it jumped from an animal host into the human population sometime late last year, no one had immunity to it. That’s one reason the new coronavirus isn’t comparable to a harsh strain of the flu going around.

The first cluster of mysterious, pneumonia-like respiratory illnesses was reported in Wuhan, China, at the end of December, and in the days that followed it spread explosively. With astonishing speed this submicroscopic pathogen has contaminated the planet, infecting more than 600,000 as of Saturday and killing at least 28,000, grinding global commerce to a near standstill and rattling the nerves of everyone brave enough to be following the news.

“This is a new virus that has landed in the human community. We are a brand new, naive population. We’re kind of sitting ducks, right?” said Ilhem Messaoudi, a virologist at the University of California at Irvine.

Most viral contagions in circulation face obstacles in the form of people with at least partial immunity. But this coronavirus is a bulldozer. It can flatten everyone in its path.

When the virus infects people, they don’t get sick right away. Researchers believe the incubation period before symptoms is roughly five days on average. In studying the pattern of illness, epidemiologists have made the dismaying discovery that people start shedding virus — potentially making others sick — in advance of symptoms. Thus the virus has a gift for stealth transmission. The virus seeds itself in communities far and wide, where vulnerable human beings represent endless fertile terrain.

At the genetic level the new virus is not terribly different from the SARS virus that emerged in China in 2002-2003 — which is why the new one has the derivative name SARS-CoV-2. SARS killed nearly one in 10 patients. But people with SARS infections did not shed virus until they were already quite sick, and victims were typically hospitalized. SARS was snuffed out after causing about 8,000 infections and 774 deaths worldwide.

That successful fight may have led to some complacency; researchers say funding for SARS research dried up in recent years.

“We thought we cured it. We thought the virus disappeared. Well, the virus didn’t disappear, did it?” said Michael Buchmeier, a UC-Irvine virologist who has studied coronaviruses for three decades.

Because this is such a contagious virus, a large percentage of the world’s population, potentially billions of people, could become infected within the next couple of years. Frantic efforts to develop a safe and effective vaccine are likely to take a year or more.

President Trump and others have repeatedly downplayed the threat of covid-19 by comparing its lethality to seasonal influenza, which claims tens of thousands of lives in the U.S. every year. But covid-19 may be many times as lethal for an infected person as seasonal flu.

Messaoudi noted that the health system is set up to deal with the seasonal flu, but not with a new, pandemic disease.

“We have a vaccine for the flu. And antivirals. It’s seasonal, we prepare for it, we try to get vaccination coverage, this is already what our system is dealing with,” she said. “This is the wrong time to deal with another surge of a respiratory disease that causes a lot of morbidity and potentially mortality.”

The bulldozer nature of coornavirus means widespread severe illnesses and deaths from covid-19 can happen with terrifying speed. This happened in Northern Italy, where hospitals become overwhelmed and many patients couldn’t get standard lifesaving treatment.

The pandemic appears to be largely driven by direct, human-to-human transmission. That’s why public health officials have told people to engage in social distancing, a simple but effective way to drive down virus’s reproductive number — known as R0, pronounced “R naught.” That’s the average number of new infections generated by each infected person.

The R0 is not an intrinsic feature of the virus. It can be lowered through containment, mitigation and ultimately “herd immunity” as people who have recovered become less susceptible to infections or serious illnesses. For the epidemic to begin to end, the reproduction rate has to drop below 1.

In the early days in China, before the government imposed extreme travel restrictions in Wuhan and nearby areas, and before everyone realized exactly how bad the epidemic might be, the R0 was 2.38, according to a study published in the journal Science. That’s a highly contagious disease.

But China on Jan. 23 imposed extreme travel restrictions and soon put hundreds of millions of people into some form of lockdown as authorities aggressively limited social contact. The R0 plummeted below 1 and the epidemic has been throttled in China, at least for now.

The virus does have an innate infectivity, based on how it binds to receptors in cells in the respiratory tract and then takes over the machinery of those cells to make copies of itself. But its ability to spread depends also on the vulnerability of the human population, including the density of the community.

“If you have a seriously infectious virus and you’re sitting by yourself in a room, the R naught is zero. You can’t give it to anybody,” says Jeffery Taubenberger, a virologist with the National Institute of Allergy and Infectious Diseases.

Without a vaccine or a drug to stop infections, the best hope is to break the chain of transmission one infection at a time. There is no way to combat the virus through aerial spraying, dousing the public drinking water with a potion or simply hoping that it will magically go away.

“Social distancing is building speed bumps so that we can slow the spread of the virus. We have to respect the speed bumps,” Messaoudi said.

Melissa Nolan, an epidemiologist at the University of South Carolina, said the efficacy of social distancing “is the million-dollar question right now.”

She compared the current public measures to what happened during the 1918 influenza pandemic that killed an estimated 675,000 people in the U.S., and in which some cities were more careful than others about enforcing social distancing.

“The USA is currently in a natural experiment of sorts, which each state implementing their own version of social distancing,” she said. “We will be able to compare the efficacy of these various public health policies, but not until more time has passed.”

The social distancing effort requires individual participation on behalf of a collective need. But it’s self-interested first and foremost: No one wants to catch this virus. It can be deadly, and even if not, many victims are miserable for days or even weeks on end.

Not only must people limit their direct contact, they need to limit the amount that their paths overlap, because the virus can linger on surfaces.

Virus degrades outside a host due to exposure to moisture, sunlight, or from drying out. But a study published in the New England Journal of Medicine showed that, in pristine laboratory conditions, some SARS-CoV-2 particles can remain potentially viable on metal or plastic for up to three days.

It’s unclear to what degree contact with contaminated surfaces is playing a role in the contagion. This is obviously something everyone would like to know when they handle the pump at a gas station or go to a grocery store. Absent hard data, limiting contact with shared surfaces such as door handles or checkout machines and frequent hand-washing is highly advisable.

Even though we don’t have a vaccine, and no one had immunity to this novel pathogen, people have some innate, mechanical defenses against viruses just like they do against pollen and dust, Taubenberger noted. Cells in the respiratory tract have tiny hairlike projections, called cilia, that move mucus toward the throat in a manner that helps clear invasive particles. This is not our body’s first viral rodeo.
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Really good summary - that should be digestible for most everyone here! It's interesting that they touch on the basic reproductive number R0. I think that one concept may be a bit misleading in the article is this quote:

"The R0 is not an intrinsic feature of the virus. It can be lowered through containment, mitigation and ultimately “herd immunity” as people who have recovered become less susceptible to infections or serious illnesses. For the epidemic to begin to end, the reproduction rate has to drop below 1."

I'm absolutely NOT a MPH, epidemiologist, or infectious disease specialist. I simply have a biology major from a liberal arts college where I took virology for a semester (one of my favorite classes honestly) and we discussed public health basics in med school.

But pandemics can end in more than one way. Basically they can end the way an uncontrolled forest fire ends - infect every single host. Or they end when a population has a sufficient immunity. I had previously learned that herd immunity could also occur with this equation:

Herd Immunity = (1 - 1/R0) x 100% of population. So if you assume an R0 of 2.5 with our everyday life, any herd immunity wouldn't occur until 60% of the population can no longer contract the virus.

So if we lower R0, less of the population needs to acquire immunity, BUT we have to keep living like this to maintain that herd immunity.

Any anti-vaxxers out there: the R0 of measles is basically 18 in our society. So it shouldn't be a surprise that when one person gets measles any patient non-immunized is at incredibly high risk because the amount of the population needed for a herd immunity is basically 95%.
 
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BarrieJ3

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I simply have a biology major from a liberal arts college where I took virology for a semester (one of my favorite classes honestly)
1) Dope demeanor. I’ve already learned from your posts, and you have a good way of getting info across.

2) Did you find this to be super common? I feel like a ton of people who went into various other scientific fields had virology as one of their fav all times classes.
 

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@BarrieJ3 you know I’m not sure why. Part of it is that I like learning and school (aka nerd). But I remember that I had pretty low expectations going into that class so that may have been part of it. The lab portion was really fun for me - we “made” an influenza virus wby combining different components which was really cool.
 

BarrieJ3

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@BarrieJ3 you know I’m not sure why. Part of it is that I like learning and school (aka nerd). But I remember that I had pretty low expectations going into that class so that may have been part of it. The lab portion was really fun for me - we “made” an influenza virus wby combining different components which was really cool.
Awesome. I really enjoyed "science", but for some reason chemistry crushed me in college, so I admired from a distance lol.

Can I ask what you do these days with a degree in Bio?
 

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-Medicine fields
-Teacher/Professor

There are other jobs I’m sure, but if not pursuing those I think I’d want a chemistry background (or other STEM fields). If any computer science background there are bioinformatics opportunities I’m told.
 

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Resurrecting this older thread - it seems like OP Timelines 1 & 2 have been left in the rearview mirror, and Timeline 3 is quickly becoming unrealistic. Timeline 4 is a bit optimistic, IMO. It seems more likely that in a year from NOW, the combination of vaccine availability/distrribution, increased exposure amongst the population, and continuing advances in treatments MAY START to result in this virus becoming "under control" (by that I mean similar impact of seasonal Flu - still people dying from it, but at low enough numbers that it is deemed "acceptable"). That scenario depends of course on the virus not mutating into a more deadly form, of which there is no guarantee.
 

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There’s always Option 5: COVID-19 spikes dramatically in the US (already happening) while increasing numbers of people ignore masks and the virus (been happening). Meanwhile, COVID infects minks in Denmark (this already happened), mutates (already happened) and infects humans (already happened) who spread it human-to-human without an 3rd party species reservoir (suspected to have happened) and the new disease (call it COVID-20) can’t be defeated via vaccine like COVID-19 can, making any attempt as a vaccine to address both distances become largely useless (confirmed this is the case - question is can they get COVID-20 under control). At the same time, supply chain issues arrive for the first couple vaccines and their requirement to kept below negative 100F degrees and the vaccine requires multiple vaccinations for effectiveness (both apply to Pfizer vaccines).
 

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It’s like that cat meme with the lady where they say stuff.
 
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