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New York: Now we know that the novel coronavirus will be with us for quite a long time.
“Exactly how long remains to be seen,” said Marc Lipsitch, an infectious epidemiologist at Harvard’s T.H. Chan Public Health School. “This will be a matter of managing it for months to several years. This is not a matter of crossing the peak, because some people seem to believe. “
One round of social exclusion – closing schools and workplaces, limiting the size of meetings, locking in various intensities and durations – will not be enough in the long run.
For the sake of managing our expectations and organizing ourselves, it might be beneficial, for our pandemic state of mind, to imagine this difficulty – existentially, at least – as a soliton wave: a wave that continues to roll and roll, continuing under its own strength for great distances. .
First seen in 1834
Scottish naval engineer and architect John Scott Russell first discovered a soliton in 1834 when he traveled along the Union Canal. He followed him on horseback and, when he wrote in “Report on Waves,” followed him rolling around 8 mph, 30 feet long and about one foot high. “His height gradually decreased, and after a mile or two of the chase I lost it in the windings of the channel.”
A wave of pandemics, too, will be with us for the foreseeable future before diminishing. But depending on location and policies, it will show a variety of dimensions and dynamics through time and space.
Simple mathematical description
“There is an analogy between weather forecasting and disease modeling,” Lipsitch said. Both, he notes, are simple mathematical descriptions of how the system works: describe physics and chemistry in the case of meteorology; and about behavior, virology and epidemiology in the case of infectious disease modeling. Of course, he said, “we cannot change the weather.” But we can change the direction of a pandemic – with our behavior, by balancing and coordinating psychological, sociological, economic and political factors.
Lipsitch is the co-author of two recent analyzes – one from the Center for Research and Policy on Communicable Diseases at the University of Minnesota, the other from the Chan School published in Science – which describes various forms of pandemic waves that may occur in the coming months.
The Minnesota study illustrates three possible futures:
The first describes the initial wave of current cases – followed by consistently wavy peaks and valleys that gradually decrease over a year or two.
The second presupposes that the current wave will be followed by a larger autumn peak, or perhaps a winter peak, followed by the next smaller wave, similar to what happened during the 1918-19 flu pandemic.
The third shows the peak of intense spring followed by “slow burns” with ups and downs that are not too pronounced.
The authors conclude that any reality is realized (assuming mitigation measures are taking place, as we wait for the vaccine), “we must prepare for at least 18 to 24 months of significant COVID-19 activity, with hot spots popping up periodically in various diverse geographical areas. “
In the Science paper, the Harvard team – epidemiologist of infectious diseases, Jonathan Grad Grad; his postdoctoral colleague, Stephen Kissler; Lipsitch; her doctoral student, Christine Tedijanto; and their colleague Edward Goldstein – take a closer look at the possibilities by simulating transmission dynamics using the latest COVID-19 data and data from related viruses.
Peaks and valleys
The authors present the results in a series of graphs – compiled by Kissler and Tedijanto – that project a similar undulating future marked by peaks and valleys.
What is clear overall is that a one-time distance social effort will not be enough to control the epidemic in the long run, and that it will take a long time to reach an acceptable percentage of herd immunity.
“This is because when we succeed in making social distance – so we do not overwhelm the health care system – fewer people are infected, which is the real goal,” Tedijanto said. “But if infection leads to immunity, success in maintaining social distance also means that more people remain vulnerable to disease. As a result, after we take the steps away from the social, the virus is very likely to spread again as easily as before locking. “
So, because we don’t have vaccines, our pandemic state of mind can last until 2021 or 2022 – which is surprising even to experts.
“We anticipate a period of prolonged social distance that will be needed, but at first didn’t realize that it could be this long,” Kissler said.
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