Reported new coronavirus global numbers have continued to stagger — cases, deaths and recovered — deepening the state of suspense the worldwide community and economy is under.

Even after the initial and most severe pandemic wave, the ongoing response plan must continue to focus on two core areas. First, to not exceed critical care capacities. Second, the study and approval of an effective therapeutic as analysis suggests that a one-time lockdown will not be enough to tame the pandemic. Considering there could be resurgences of COVID-19 for years to come.

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Reported new coronavirus global numbers have continued to stagger — cases, deaths and recovered — deepening the state of suspense the worldwide community and economy is under. The transmission of the novel coronavirus shows different trends in different countries depending on the virus incidence, as well as the response and measures put in place by sovereign governments to combat SARS-CoV-2. Yet the question of how many people worldwide are at increased risk of severe COVID-19 disease still tops the international agenda.

Even as progressively lockdowns are extended with others eased, nations and the world enter a new stage in tackling the Coronavirus pandemic with the ever-present question: How will the pandemic continue? “If immunity to SARS-CoV-2 wanes in the same manner as related coronaviruses, recurrent wintertime outbreaks are likely to occur in coming years” (Stephen M. Kissler 2020), is one finding of a model of SARS-CoV-2 transmission. It is covered in a new report published in the peer-reviewed journal, Science, titled “Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period”.

In blue, reducing the risk and reducing the peak intensity of the epidemic, in red

Governments and international organizations such as the World Health Organization seek a path forward that reins in the health of citizens worldwide. Through strategies focused on reducing the peak intensity of the epidemic (“flatten the curve”), reducing the risk of overwhelming health systems and buying time to develop treatments and vaccines. However, those objectives must be part of the long term strategy given that, according to the authors, a one-time lockdown will not be sufficient to bring the pandemic under control.

The scientists’ findings indicate vital data required to know how the current SARS-CoV-2 outbreak will unfold, including the fact that physical distancing measures could be needed intermittently until 2022. The same scenario predicted a resurgence could occur as far in the future as 2025 in the absence of a vaccine or effective treatment. “The total incidence of SARS-CoV-2 through 2025 will depend crucially on this duration of immunity” as the research cautions that secondary peaks could be larger than the current one without continued restrictions. The possibility of resurgences of SARS-CoV-2 infection could take place even after a prolonged period of apparent elimination.

“The total incidence of SARS-CoV-2 through 2025 will depend crucially on this duration of immunity”

The research paper argues that “regardless of the post-pandemic transmission dynamics of SARS-CoV-2, urgent measures are required to address the ongoing epidemic”. Given that background, “new therapeutics, vaccines, or other interventions such as aggressive contact tracing and quarantine — impractical now in many places but more practical once case numbers have been reduced and testing scaled up — could alleviate the need for stringent social distancing to maintain control of the epidemic”.

Any exit from this crisis will have to involve the large-scale deployment of a vaccine. Accelerate the accumulation of immunity in the population. Reduce the overall length of the epidemic. Avert infections that might have resulted in a need for critical care. In other words, until there is no vaccine, it’s improbable we will be able to prevent COVID-19 infections at the rate which is needed. A challenge in itself as very little evidence-based is continuous in the fight against coronavirus. The search for a vaccine against coronavirus is a race against time, and the quest continues. As of April 8, there are over 100 COVID-19 vaccines in development according to the Coalition for Epidemic Preparedness Innovations (CEPI) who is part of the global response, led by health authorities and vaccine developers, to support the materialization of vaccines against COVID-19 (Tung Thanh Le 2020).

“As of April 8, there are over 100 COVID-19 vaccines in development according to the Coalition for Epidemic Preparedness Innovations”

However, Science also published another article that suggests that “the number to watch in the next phase may no longer be the actual number of cases per day, but what epidemiologists call the effective reproduction number, or R, which denotes how many people the average infected person infects in turn. If R is above 1, the outbreak grows; below 1 it shrinks. The goal of the current lockdowns is to push R well below 1”. (Kupferschmidt 2020)

Yet there is one area that still is critical, according to the paper, which could indicate the extent of population immunity, whether the immune system wanes, and at what rate. Meanwhile, serological testing (that measure the amount of antibodies or proteins present in the blood when the body is responding to a specific infection, like COVID-19) is required to understand the scope and duration of immunity to SARS-CoV-2, which will help determine the post-pandemic dynamics of the virus. Many questions remain concerning how long will this pandemic continue or how it will evolve. Yet the science agrees that as response plans are placed in the short term, they will begin to take a long term view as there could be resurgences of COVID-19 for years to come. Furthermore, how to scale up existing technologies on the two core areas of focus? How to boost more testing? What new technologies are available?

By Alex Erquicia

A contributor and member of the Cov360 team

24 April 2020

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