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They recommended that the United States prepare for the worst-case scenario that includes a second big wave of coronavirus infections in the fall and winter. Even in the best case, people will continue to die from the virus, they predicted.
“This will not stop until it infects 60 to 70 percent of people,” Mike Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, told CNN.
Osterholm has been writing about the risk of pandemics for 20 years and has advised several presidents. He wrote the report in conjunction with Harvard School of Public Health epidemiologist Marc Lipsitch, who is also a senior pandemic expert; Dr. Kristine Moore, former epidemiologist at the Centers for Disease Control and Prevention who is now CIDRAP’s medical director; and historian John Barry, who wrote the 2004 book “The Great Flu” about the 1918 flu pandemic.
Waiting for herd immunity
Because Covid-19 is new, no one has immunity, they said. “The duration of the pandemic will likely be 18 to 24 months, as collective immunity develops gradually in the human population,” they wrote.
Their predictions are different from the models presented by groups such as the Institute of Health Metrics and Assessment (IHME) at the University of Washington or the models produced by Imperial College London, whose report predicts millions of deaths in the US. USA And the UK helped drive responses from both governments
The CIDRAP-led team used those reports, historical data on past pandemics, and released reports on Covid-19’s medical details to make its prognosis.
“I have long said that when you try to understand how infectious disease will develop, you must trust history and models,” Lipsitch told CNN. For example, pandemic infections don’t tend to go away in the summer, like seasonal flu does, he said.
Covid-19 is more comparable to a pandemic strain of influenza, they said.
“Due to a longer incubation period, a more asymptomatic spread, and a higher R0, COVID-19 appears to spread more easily than the flu,” they wrote in the report. R0 is the average number of other people infected by each patient.
“A higher R0 means that more people will need to become infected and become immune before the pandemic can end,” they added. “Based on the latest flu pandemics, this outbreak is likely to last 18-24 months.”
Preparing for the worst
They said government officials should stop telling people that the pandemic may be ending and instead prepare citizens for a long journey.
Three scenarios are possible, they said:
Scenario 1: The first wave of Covid-19 in the spring of 2020 is followed by a series of smaller repetitive waves that occur during the summer and then consistently over a period of one to two years, gradually decreasing at some point in time. 2021
Scenario 2: The first wave of Covid-19 is followed by a larger wave in the fall or winter and one or more smaller waves in 2021. “This pattern will require reinstatement of mitigation measures in the fall in an attempt to reduce the spread of infection and preventing health systems from being overwhelmed, “they wrote. “This pattern is similar to what was seen with the 1918-19 pandemic.”
Scenario 3: A “slow recording” of broadcast in progress. “This third scenario probably would not require the reinstatement of mitigation measures, although cases and deaths will continue to occur.”
States and territories should plan scenario 2, the worst case scenario, they recommended.
“Government officials should develop concrete plans, including triggers to reinstate mitigation measures, to deal with spikes in disease when they occur,” they advised.
Lipsitch and Osterholm said they are surprised by the decisions that many states are making to lift restrictions aimed at controlling the spread of the virus.
“I think it is an experiment. It is an experiment that is likely to cost lives, especially in places that do it without careful controls to try to figure out when to try to slow things down again,” Lipsitch said.
Also, he said, some states are choosing to lift the restrictions when they have newer infections than when they decided to impose the restrictions.
“It’s hard to even understand why,” said Lipsitch.
A vaccine could help, according to the report, but not quickly. “The course of the pandemic could also be influenced by a vaccine; however, a vaccine will probably not be available until at least sometime in 2021,” they wrote.
“And we don’t know what kinds of challenges might arise during vaccine development that could delay the schedule.”