When will it end and will everything return to normal?

The world is paralyzed. The places that were once filled with the hustle and bustle of everyday life turned into ghost towns with massive restrictions.

Factories, schools were closed, travel restrictions were imposed, and tumultuous gatherings were prohibited.

The global response to this disease is unprecedented.

But when will it end and when can we continue with our lives?

United Kingdom Prime Minister Boris Johnson said he believes the country can “turn the tide” of fighting the outbreak in the next 12 weeks and end the coronavirus.

But even if the number of cases begins to decline in the next three months, we will still be far from the end.

The trend can take a long time to disappear, possibly years.

It is clear that the current self-isolation strategy, which many countries have implemented, is not sustainable in the long term because the social and economic damage would be catastrophic.

Exit strategies

What countries that have already reached the peak of the epidemic need is to be clear about what the “exit strategy” will be, that is, how they will lift the restrictions and return to normality, despite the fact that the coronavirus is not going to dissapear.

But if they lift the restrictions that hold back the virus, then cases will inevitably skyrocket.

“We have a big problem as to what the exit strategy should be and how we are going to get out of this,” Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh, tells the BBC.

“It is not just the United Kingdom. No country has an exit strategy.”

It is a great scientific and social challenge.

Basically, there are three ways to get out of this mess.

– Vaccination

– A sufficient number of people develop immunity after contracting the infection

– Permanently change our behavior as a society

Each of these routes would reduce the ability of the virus to spread.

Vaccines: it takes at least 12 to 18 months

A vaccine must give someone immunity so they don’t get sick if exposed to the virus.

If enough people are vaccinated, around 60% of the population, and the virus is not capable of causing outbreaks, what is known as the concept of collective immunity is reached.

This week, the first person received an experimental vaccine in the United States, after researchers were allowed to skip the usual procedure of first testing animals.

Vaccine research is taking place at an unprecedented rate, but there is no guarantee that it will be successful and will require immunization on a global scale.

The best guess is that a vaccine could be ready in 12-18 months if everything goes well.

That period of time is long if we consider the social restrictions adopted and unprecedented during peacetime.

“Waiting for a vaccine should not be considered a strategy. It is not,” Professor Woolhouse told the BBC.

Natural immunity: missing at least two years

The UK and other countries’ short-term strategy is to reduce cases as much as possible to prevent hospitals from being overwhelmed.

It is when a health system runs out of intensive care beds that deaths increase.

Once the emergence of new cases slows down, some measures can be lifted for a while, until the cases increase again and another round of restrictions is needed.

But when all this can happen is uncertain.

UK Chief Scientific Adviser Sir Patrick Vallance said that “it is not possible to establish absolute terms in things”.

Doing this could, unintentionally, lead to collective immunity, as it is a process in which more and more people become infected.

But it could take years to get it.

According to Professor Neil Ferguson of Imperial College London: “We are talking about suppressing transmission to a level where, hopefully, only a very small fraction of the country will become infected.”

“So eventually, if we continued to do this for more than two years, perhaps a sufficient proportion of the country at that time could have been infected to provide some degree of community protection.”

But there are questions about whether this immunity will last.

Other coronaviruses, which cause symptoms of the common cold, lead to a very weak immune response, and people can contract the same virus several times in their lives.

Alternatives: no clear end point

“The third option is permanent changes in our behavior that allow us to keep transmission rates low,” said Professor Woolhouse.

This could include maintaining some of the measures that have been implemented. Or by introducing rigorous testing and isolation of patients to try to stay on top of any possible outbreaks.

“We did early detection and contact tracking the first time and it didn’t work,” he adds.

Developing medications that can successfully treat a covid-19 infection could also help the other strategies.

They could be used as soon as people show symptoms in a process called “transmission control” to prevent them from passing it on to others.

Or to treat patients in the hospital and make the disease less deadly and reduce pressure from intensive care plants.

This would allow countries to deal with more cases before having to reintroduce measures such as quarantine.

Increasing the number of intensive care beds will also help cope with larger outbreaks.

“In the long run, clearly the way out of this is a vaccine, and we all hope it happens as quickly as possible,” says Whitty. And he adds: “Worldwide, science will find solutions.”

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