Seven months into the pandemic, we continue the mystery that is COVID-19. Critical questions remain that remain unanswered.
Experts interviewed by ABC News shared five scientific mysteries that persist amid the race to end the pandemic.
When will we have a safe and effective vaccine?
This can be one of the biggest questions on the minds of many. Vaccination is perhaps the most effective way to develop herd immunity so that the virus cannot spread effectively.
Nearly 170 candidates for vaccines are followed by the World Health Organization. Six of these are in key phase three trials, where thousands of facsimile doses are given.
Most vaccines take years to develop. However, optimistic projections suggest that a SARS-CoV-2 vaccine could be available by the end of 2020 as early as 2021, but broad distribution will take time.
“I believe we will be able to know if one or more vaccines are effective against COVID-19 by the end of the year,” Drs. Anna Durbin, professor at John Hopkins Bloomberg School of Public Health, at ABC News. “I am less confident that by the beginning of 2021 there will be enough doses of vaccine to reach the population at risk … How this is distributed needs to be carefully planned.”
In order for the vaccine to be effective, the public should also be prepared to be vaccinated, especially in the case of rapid “emergency use authorizations”, Drs. Joseph Sakran, a trauma surgeon and public health expert at Johns Hopkins Hospital, told ABC News. “The public needs to know that the vaccine being produced is safe and effective. It will be critical that the cornerstone pieces of the normal process are incorporated before issuing an emergency use authorization for a vaccine product.”
Fax confidence is essential because enough people need to be vaccinated – estimates vary between 40-70% of the population – to enable herd immunity. Even with a perfect vaccine, spreading it to billions of people is no small feat.
In addition to supply problems, many countries will not be able to provide sufficient vaccinated doses.
Are children as sensitive as adults?
Our understanding of coronavirus infection in children has evolved during the pandemic.
Scientists interviewed by ABC News suggest that children are not as much infected as adults and with less intensity, but data come from the Centers for Disease Control and Prevention. A recent report on COVID-19 infections in children by the CDC says that children can spread the virus effectively in certain settings. The number of virus children who are fired seems to be even higher than adults.
“It is safe to say that this research complicates back-to-school plans,” said Drs. John Brownstein, an ABC and epidemiologist at Boston Children’s Hospital, added that the CDC study, and another recent study from Massachusetts General Hospital, “confirms deficiency as non-specific symptoms in infected children, making control strategies difficult” and ” poses a challenge for school reopening and puts strain on testing (instead of screening for symptoms). “
There is also a risk that some children develop an idiosyncratic, severe inflammatory reaction called multisystem Inflammatory Syndrome in children (MIS-C). In a small number of children, the immune system goes into overdrive and can damage the heart.
According to the CDC, we do not yet know why MIS-C occurs in some children. The organization notes that “MIS-C can be serious, even fatal, but most children diagnosed with this condition have recovered with medical care.”
Why do some people get really sick, and others not at all?
It is thought that a significant number of people with coronavirus do not get symptoms, with some studies suggesting that up to 80% of people are asymptomatic.
We know that there are risk factors for developing severe COVID-19: age, obesity and other co-morbidities. Ethnic minorities, especially Blacks and Hispanics, are also at significantly higher risk.
“I think this is still such a mysterious virus … the ability to greatly influence certain people, while sparing others makes this virus difficult to understand, diagnose and treat,” Drs. Ashish Jha, professor of global health and director of the Harvard Global Health Institute, told ABC News.
There may be a genetic element involved. One study suggests that two major gene variants increase the risk of severe respiratory complications, one of which is blood type. But this evidence is controversial, as a recent study by Harvard Medical School suggests there is no relationship. Genetic effects are likely to be modest compared to the well-established risk factors.
Can people re-infect?
There are two things that can affect reinfection rates; the duration of immunity to coronavirus and how much the virus mutates.
However, we do not yet know how long immunity lasts.
Re-infection is possible with coronaviruses that cause the cold, but it does not seem to happen with SARS or MERS, which are the two other notorious coronaviruses that are closely related to the virus that causes COVID-19.
There have also been cases of SARS-CoV-2 infection where people test positive, then test negative, only to be tested positive again. This may be due to re-infection, but may also be due to a false-negative test result.
Experts say that given enough time, people who are infected with the novel coronavirus will eventually be able to be re-admitted. But our experience with this virus has been so brief that they say it is unlikely, as very rare, that someone who has survived is infected again.
Will the virus ever go away?
The unfortunate answer is probably no.
The pandemic – the rapid, uncontrolled spread of the virus – could end, but experts think it will continue at lower levels. This is called endemic spread. Over time, endemic viruses typically become less harmful.
The future trajectory of SARS-CoV-2 remains uncertain, but many experts predict a second elevation later in the year before the virus becomes endemic.
Our slow return to normalcy must take into account that the virus will be with us for the time to come, and we must support ourselves for things that get worse before they get better. They will get better, but just as remains unclear.
One way that scientists suggest we can adapt to the new normal is to consider the risk that poses when we do it in public or in homes. Is it a situation with low, moderate or high risks, and what is the positivity rate in your community? Camping, shopping, eating in your favorite restaurant and cuddling take on a different meaning. That being said, we know one answer to the question of how to defeat the virus, live our lives and save much more is clear: wear our masks, see our distance and wash our hands.
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