The global coronavirus pandemic could be over by June if countries mobilize to fight it, a senior Chinese medical adviser said on Thursday, as China declared the peak had passed there and new cases in Hubei fell to single digits for the first time.
In the world we live in, this has no chance of happening. Even if everybody rolled up their sleeves and acted correctly within their power, it could not happen. China is unique, the world’s first surveillance state, with capabilities of contact tracing unapproached anywhere else. The acquiescence of China’s citizens to strict measures of control is also unequaled.
The headline of earlier CNN article, Will the new coronavirus burn out like SARS … or is it here to stay? poses the wrong question. Like many wrong questions, it has no answer:
- SARS did not burn out. It was contained. Containment was feasible because covert infections were not contagious.
- Flu strains, and common colds, for which many viruses are responsible, do burn out, by the development of herd immunity.
- In the absence of public health interventions, for an historic example, have a look at syphilis. It took about 50 years to convert from a quickly fatal illness to the modern form, which by comparison, is mild.
- COVID-19 will not burn out in a reasonable time frame, unless you consider 65 weeks reasonable.
- Although local containment is possible, COVID-19 cannot be contained globally, because of the prevalence of covert infections, asymptomatic and contagious.
- Containment efforts will prolong the time to “burnout.”
- Containment efforts are nevertheless required, so healthcare systems are not overwhelmed, and to preserve the fabric of society.
Mi Feng, the spokesman for the National Health Commission quoted in the Reuters article, was not intentionally misleading. He simply omitted context for the rest of the world. Messages of hope frequently do this; they should not be condemned. It is up to us to supply the context.
The estimate of How Long Will the COVID-19 Epidemic Last? Napkin Calculation, for true “burnout” is 65 weeks. “Burnout”, a word which tells you nothing, happens when enough herd immunity has developed to change the chain of transmission from growing to shrinking. The estimate is crude, but better than hope.
A painful paradox: Intervention, which presently means quarantine and travel restrictions, without other measures, will prolong the 65 weeks. (You may choose your own number, provided you supply justification other than hope). The fastest way to herd immunity is the cruelest, with unjustifiable loss of human life.
This is the way it will happen in most of the world. Like all the plagues of the past, COVID-19 will “burnout”, with the understanding that plagues end when either
- The concentration of animal vectors has declined.
- Human depopulation has occurred.
- Herd immunity has been acquired.
Since Wuhan bats do not mingle with humans like plague rats, this leaves mostly herd immunity. It would take more than the current lethality of COVID-19 to cause the occurrence of natural selection, the “survival of the fittest.” See COVID-19: A Warning.
Now what about the Third World, when herd immunity is acquired, at the expense of great human suffering? COVID-19 will not vanish. Exiting epidemic, It will go underground, persisting as an endemic, mostly mild disease. The Third World will become a disease reservoir.
This presents a problem for a developed country which has exercised effective measures of travel restrictions and quarantine. It means that the population is “naive” with respect to COVID. Having had no exposure, they are as vulnerable as they were before December 2019. Yet constant vigilance is not feasible with a disease that has covert characteristics. This is constant, imminent catastrophe.
How can the developed countries acquire herd immunity, while avoiding the suffering of the Third World? There are two ways:
- Spontaneous mutation of COVID-19 to a strain that produces mild disease, which out competes virulent strains. Two strains have already been noted in China. See (Oxford Scientific) On the origin and continuing evolution of SARS-CoV-2. Type L produces severe disease; Type S is comparatively mild.
Although selective pressure towards Type S may have been observed, resulting from stringent quarantine, let’s not rely on it. In fact, it appears that Type L evolved from Type S, in the direction of greater virulence.
- Ignoring luck, vaccination is the alternative. Even if vaccination programs have limited duration, there is a fascinating potential benefit: the COVID-19 virus may change to become less virulent. The result: herd immunity that endures beyond a vaccination campaign.
We’ll explore how this could happen in the next post.
It is disturbing how little of the $8B appropriation is for vaccine development. This must be corrected, stat!