When and how will the Coronavirus pandemic come to an end?

If we look at the world today, it would not be overly cynical to conclude that politicians would rather move on and that the societies are distracted to such dysfunctional levels by social media-driven outrage cycles that they often ignore the extant pandemic. Maybe India is already at this point.

The country is inching closer to the 10th month of the Covid-19 pandemic and there seems to be no respite from the highly infectious contagion that is ravaging the world. As of now, the number of coronavirus cases has crossed the 30 million mark across the world and has already resulted in 9,56,881 deaths. What first emerged as pneumonia-like illness in Wuhan, China in December 2019 has engulfed 213 nations across the globe. While scientists and medical experts around the world have been working at breakneck speed to launch a vaccine to contain the spread of Covid-19, there is one question, that is - when and how will the coronavirus pandemic come to an end?

The question is on everyone’s mind and while astrologers and politicians have answers, few scientists want to be drawn into hazarding a prediction. Medical historians recognize two types of endings. The medical ending, when the disease stops spreading and social ending, when people overcome their anxieties and move on. It would be appropriate to add a third type of ending: the political, when the government decides that as far as it is concerned, the pandemic is over. Any of these three endings could occur first, as political leaders and society can decide to move on regardless of whether the cases have peaked. If we look at the world today, it would not be overly cynical to conclude that politicians would rather move on and that the societies are distracted to such dysfunctional levels by social media-driven outrage cycles that they often ignore the extant pandemic. Maybe India is already at this point.

What about the medical ending? It is impossible to put a date on it. If anyone tells you a date, they are starting into a crystal ball. The reality is that it will be with us forever because it has spread now, “Simon Clark” a British Cellular microbiologist offers the scientific establishment’s answer:  prudent and circumspect as this answer is, it is unsatisfying. It is hard for people to grapple with such an open ended answer and is unhelpful for policymakers who need a base case to work on. The conventional way to try to answer the question of “when new Covid-19 cases will start declining “is to look towards the vaccine. The medical elimination of the pandemic stems from the development of an effective and safe vaccine for the novel coronavirus and following the social protocols strictly.

The crisis seems to be unfolding in India in a worse manner than we could have imagined while the official caseload has touched the 5 million mark, experts suggest that the Covid-19 pandemic will peak at different rates in different regions of the country. Hence our response to the pandemic has to be more localized and effective to get rid of the pandemic from the root level. Even when a vaccine reaches us, we would need prioritization and regulation in place to ensure that a covid-19 vaccine reaches all corners.AS of now, more than 165 vaccine candidates are currently in different stages of preclinical and clinical trials and more than 33 of them have reached the critical last leg of human trials. The good news is that even if the vaccine is not completely effective (given the accelerated timeline of its development), it will still be effective in controlling the spread of the pandemic.

According to Dr Anthony Fauci, who is the US’s top infectious disease expert, a vaccine which is safe and 50% to 60% effective will also be acceptable, even though the scientists are aiming to produce a vaccine which is 75% effective. Early data of preliminary studies have shown positive results for several vaccine candidates and we may cautiously expect a moderately effective vaccine by the first quarter of 2021. Once safe and effective vaccines are launched for public circulation begins, the cases will slowly start to go down as well as the mortality rate. Vaccine will arm the World with a good fighting chance against the contagion and take the burden off of the overwhelmed medical care system. This may be considered a step forward in ending the pandemic.

The other ending of the pandemic as observed in the case of the World’s deadliest pandemics, the Spanish Flu, could be the social ending. The deadly pandemic which infected 500 million people across the World and wiped out 1% of the World’s population at that time, ended after two long years when people gained immunity against the virus. This type of ending may play out when a large section of population gets tired of the restriction and starts stepping out of their houses. When people go back to business as usual more and more people will get infected from the disease and develop immunity against the virus. However, herd immunity and the social ending may come at a price which will be beyond our comprehension. It is estimated that 50% to 75% of the population will have to acquire immunity either through infection or vaccination – for herd immunity to kick in. How long will this take? Medical experts have different opinions but it is said that the pandemic will not end before 2022.

Vaccine might not offer permanent immunity, necessitating regular vaccination to keep Covid-19 at bay. But it is suggested that there is another route to herd immunity – when enough people develop immunity to the virus by being exposed to it. Here’s Cynically Optimistic Back-Of-the Envelope (COBOTE) calculation. Let us assume India is undercounting Covid-19 positive cases. This is a reasonable assumption we make. Even a country like Switzerland, estimates that “for every reported confirmed case, there were 11.6 infection in the community”. If we assume that India is undercounting at this order of magnitude, we have over 20 million positive cases in India today, doubling roughly every 20 days. If this holds, over 50% of the population will have immunity by mid-November 2020 and the country will be at the threshold of herd immunity.

The outbreak in Mumbai’s Dharvi area started slowing down when 40% of its residents were infected. This is good news. In fact the more undercounting, the faster we will hit the herd immunity threshold. Even if there is no undercounting at the current doubling rate, half the country’s population will have immunity by Republic Day 2021. There is of course bad news. Very bad news, in fact for the case, the fatality rate is 2%. That’s lower than any other country but for India it still means a lot of deaths. According to health experts, there is no one way of ending the pandemic in sight, instead, we need to bring the focus on controlling the spread of the disease. It can only be achieved through a degree of herd immunity, following the social distancing norms and a safe and effective vaccine. The combination of all three measures will help in slowing down the spread of the disease. But scientists are wise not to offer predictions on, when the coronavirus pandemic will end for there are too many factors at play.

(The views expressed are the writer's own. The author can be reached to:sjugeshwor7@gmail.com)

First Published:Oct. 4, 2020, 7:53 p.m.

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