What is the new “norm” going to look like? When can we expect it? These are good questions that do not have clear or precise answers. Clearly, as of 4-9-2020, we have not yet reached the peak in cases in Massachusetts or Rhode Island. But, even when we do reach the peak and begin the downward decline, things will never really return to what we used to consider “normal”.
How can we expect the COVID-19 Virus to behave?
Much hope has been placed on the fact that Influenza and other Coronaviruses seem to “disappear” in the warm weather – and return in the fall. The National Academies of Science, Engineering and Medicine, in a report dated April 7th, addressed two issues: the survival of COVID-19 in relation to temperature and humidity and the potential for a seasonal reduction and resurgence of cases.
Researchers have concluded that if transmission is affected by temperature and humidity, that it may not be as apparent as with other respiratory viruses; they also observed that, based upon 10 influenza pandemics in the past 250 years, some started in the winter, some in the spring, some in the summer and some in the fall. Most alarmingly, they also stated that all had peak second waves six months after emergence of the virus in the human population, regardless of when the initial introduction occurred. Thus, the hope that when the warm weather comes, we will see a marked decrease in cases is highly unlikely.
Is There A Risk Of Reinfection From Sources Overseas?
In two very recent articles and communications in the Lancet, the likelihood of a “second wave” of cases occurring in China, and any country, are directly linked to how travel restrictions, social distancing and other interventions are “relaxed” (face masks, contact tracing, surveillance, temperature checks).The risk of re-importing the virus from overseas is and will be a substantial risk.
How The “R0” (R naught) Affects How Many People A Person With The Coronavirus Can Infect
We have to consider the concept of “herd immunity” – what percent of the population needs to have immunity to a disease in order to “protect” those that don’t from getting it. The R0 is important, because we use it to formulate the percent of herd immunity needed. For a R0 of 2.2, 55% of the population needs to have immunity; for a R0 of 5, 80% of the population needs to have immunity.
How Do These Facts Affect What The New Normal Will Look Like?
If we get over the hump, and the appearance of new cases significantly decreases, can we return to ballgames, group gatherings, and large intermingling of people? For those who had COVID-19 and survived, the answer is “Yes”. For those who didn’t contract the disease, the answer is “No.” You see, unless at least 50-80% of the population has had the disease and recovered, those who haven’t are still at risk, and they most likely are at the highest risk of having severe, life-threatening cases.
What Is The Solution?
The only long-term solution will be a vaccine that will protect at least 80% or more from developing the disease. That, unfortunately, is not on the horizon for quite a while. If we look at flu shots, we have rarely had an efficacy that has even closely approached this number. Thus, we can expect as the new “norm” for people at high risk for a severe outcome to continue avoiding large social gatherings, continuing social distancing and frequent hand-washing – and probably continuing face mask use. Those most at risk include those will the following predispositions:
- Marked obesity
- Hypertension
- Diabetes
- Metabolic diseases
- Chronic lung disease [including asthma]
- Cardiovascular disease
- Neurological disorders
- Those over the age of 60
If we let up too quickly on the measures we’ve taken, including international travel, we could very well see a “second wave” of COVID-19 infections. One of the problems is that COVID-19 is not simultaneously affecting every country in the world. Peaks have not yet been reached in many countries, and in some, it has not yet begun. So, we could very well see this virus burning throughout the world for quite a while. The threat of a second wave in the U.S. could only be an airline flight away! In conclusion, the new “norm” will look nothing like what the old “norm” used to be.
What Should I Do If I Suspect I Have COVID-19?
At Truesdale Health we’re here for you. If you should develop any symptoms of COVID-19 (cough, fever/chills/, shortness of breath, muscle aches, diarrhea, nausea and vomiting, sore throat, headache or loss of smell or taste) and are at high-risk for complications, you need to contact your healthcare provider – no matter how mild the symptoms may be!
