Indiana Univ. professor explains why covid-19 will be with us well into 2021: 'We need to accept this reality and take steps to meet it'

Photo: MedpageToday

Aaron E. Carroll writes in an opinion piece for The New York Times that Americans need to stop expecting life to go back to normal next year, and shows why. 

Carroll opens by reminding us that Dr. Anthony Fauci, the director of the National Institute of  Allergy and Infectious Diseases, warned last week that covid-19 is likely to be hanging over our lives well into 2021. 

"We need to accept this reality and take steps to meet it rather than deny his message," Carroll writes. "Many Americans are resistant to this possibility . . . Unfortunately, their resolve is weakening right when we need it to harden. This could cost us dearly."  

He says this "unrealistic optimism" stems in part from the hope of a medical breakthrough --like Remdesivir or convalescent plasma or antibody treatments, but "most cases don’t benefit from these treatments. Further, none of these therapies can prevent infections or hospitalizations on a broad scale."

He reminds us that concerns about an unflattened curve isn't just about death, but is also about overwhelming the health-care system, which would lead to a situation where people would not have access to care for other life-threatening conditions. That is more of a threat in the flu season to come.

He says Americans are overestimating what a vaccine might do, cautioning that while it seems likely a vaccine will be approved this fall that will be "effective . . .  it’s very unlikely that this vaccine will be a game changer." 

He explains that while some vaccines provide nearly lifelong benefits, like the measles-mumps-rubella vaccine, the flu vaccine and others have to be taken every year -- and we still don't know what type the coronavirus vaccine is. He also points out that we still don't know what type of immunity it will provide, or if it will be more beneficial to certain populations than others. 

"Because of all these unknowns, we will need to continue to be exceedingly careful," using masks, social distance and restraint. "Too many of us won’t," he writes. "Too many will believe that the vaccine has saved them, and they will throw themselves back into more normal activities. That could lead to big outbreaks, just as winter hits at its hardest."

"We still need to figure out how to live in this new world, now, and that means embracing, finally, all the strategies for fighting the virus that many of us have resisted," he writes. "It’s not too late to invest in testing both symptomatic and asymptomatic people." 

 

He says the nation has failed to provide adequate testing and because it let shelter-in-place strategies go to early, "we can no longer rely on just symptomatic testing and contact tracing." 

He calls for more than a million tests a week and says the only way to do this is through "ubiquitous, cheap, fast tests that can be distributed widely to identify those at risk who don’t even know it." 

Further, he writes, "Those who are infected need to isolate, and their close contacts need to quarantine," noting that this is a challenge for many " because they need to work, or their housing is inadequate, or they need food and supplies delivered to them. We have failed to address these gaps."

He adds, "Those who need the most assistance are often those at highest risk for getting and spreading the coronavirus and for having the worst outcomes, and our government has not provided for them."

Carroll expresses doubt that the vaccine can be distributed widely and quickly, that "most people will get it (many won’t) and that we will succeed in prioritizing distribution so that those most at risk will get it first (flying in the face of decades of disparities in the way health care is distributed)." 

Further, he writes that the vaccine is just the beginning of a real coronavirus response and likely won't be the end" "Those who think that we have just a few more months of pain to endure will need to adjust their expectations." 

He also writes about the importance of masks. " We need to normalize mask-wearing. It’s a tragedy that this has become politicized and that this simple, safe and effective measure is in dispute. It’s about protecting others even more than ourselves. That such an action is now viewed as weakness is horrific."

And finally, he says, "We need a functioning scientific infrastructure to provide detailed and specific plans on how schools, businesses and institutions can open and operate safely. We also need a functioning Congress to fund whatever it takes to put those plans into practice."