1.5 meter society may still be necessary until 2022

Because after this pandemic, the new coronavirus may open the attack again.

We are in the middle of a pandemic, with all its consequences. Hospitals have filled up in recent weeks and months, countries have been locked, we stay en masse at home and keep – if we go out – at least 1.5 meters apart. Last week Prime Minister Mark Rutte warned that we had better get used to this “1.5 meter society”. And a new study, published by the authoritative scientists Harvard University, seems to endorse that. In the magazine Science they outline the near future of SARS-CoV-2 and what it will require from us humans until 2025. It results in a rather bleak scenario in which we may have to (periodically) keep our distance until 2022 to prevent the virus from taking over the world again.

Circulate
It is possible that SARS-CoV-2 follows in the footsteps of that other virus, which is so closely related to it: SARS-CoV-1. That virus, the cause of Severe Acute Respiratory Syndrome (SARS for short) was suppressed after strict but severe epidemics with strict health measures. But it seems increasingly unlikely that we are going to get SARS-CoV-2 in a similar way. In fact, it seems quite possible that this virus will continue to roam after the pandemic and occasionally re-emerge – as the flu virus does.

And if the virus continues to circulate, as models show, we can expect massive outbreaks over the next four to five years, with the virus overwhelming our health system time and time again. In the absence of a vaccine or effective treatment of the virus, we can only prevent such outbreaks in one way: by (periodically) keeping each other away and thus depriving the virus of the chance to spread.

Immunity
The virus can therefore repeatedly appear. The frequency with which we can expect a new attack appears to depend strongly on our immunity to the virus, the researchers write. It is believed that after contracting the virus, people are at least temporarily immune to it. These people can no longer be infected by the virus and can no longer transmit it to others. The more people who have had the virus, the more difficult the virus is to spread and the smaller the chance of a virus outbreak. But now imagine that people who have had the virus are only briefly immune to it afterwards. For example, around 40 weeks – something we also see with two other coronaviruses, namely HCoV-OC43 and HCoV-HKU1 – virus outbreaks could occur annually. And with somewhat longer immunity – for example, two years – you could expect outbreaks every other year.

Seasonal?
The frequency with which SARS-CoV-2 breaks out is also strongly determined by the extent to which it is a seasonal virus. We know about the flu virus that it spreads much more easily in winter and fall when it is a bit colder. In the summer, the virus does not do as well. It is hoped that the new coronavirus will follow the same trend and disappear in the summer. But, the researchers warn, we have not yet won the battle. Because that means that there is a chance that the virus will come back in the fall and overwhelm our healthcare systems again. Whether it is a seasonal virus or not; SARS-CoV-2 remains a challenge.

Periodic
The main thing remains that we avoid overloading healthcare systems. But that comes – as long as the virus continues to circulate and there is no vaccine, nor effective treatment – at a high price. We must then continue to apply the measures that are now being taken to prevent the virus from spreading until 2022. In principle, this is not necessary all year round, the researchers say. You can also choose to apply the measures periodically. The periods of time required will depend, inter alia, on whether there are seasons when the virus spreads more easily. However, periodic application of social distancing measures is only possible if you are able to closely monitor the spread of the virus. After all, it is important that you implement the measures early enough. Otherwise you still run the risk of overloading the health care system. In addition, countries could choose to increase IC capacity, allowing them to provide more people with care and accelerate group immunity. This would shorten both the duration of the epidemic and the period in which social distancing measures are needed.

Sketch
In summary, the overall spread of COVID-19 over the next five years will depend strongly on whether the virus continues to circulate after this pandemic, which in turn depends on the duration of the immunity associated with an infection by SARS-CoV-2. entails, ”said the researchers. “Social distancing strategies can limit the pressure that SARS-CoV-2 puts on health systems (…) Periodic social distancing measures may be needed until 2022, unless IC capacity is vastly increased or a treatment or vaccine becomes available . ” The researchers are the first to recognize that such a long period in which we have to be kept apart – either periodically – has a negative impact on our social well-being and the economy. Their study should therefore not be seen as urgent advice to governments to (periodically) lock their countries in the coming years. It is just a rough sketch – which more research on the virus and its spread requires further elaboration – of what the near future of the virus might look like. And how we can ultimately draw the longest straw in the coming years.

The research also shows that if we want to return to our old lives, it is crucial that a vaccine or effective treatment is introduced. But the development takes months to years, the researchers emphasize. And until then we have been assigned to what they call NPIs: non-pharmaceutical interventions, such as keeping distance and staying home from cold symptoms. And however heavy they may be; it seems sensible to set them to be needed for some time to come.

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