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PARIS (AFP) – The coronavirus has disrupted daily life in the six months since the crisis was declared a pandemic by the World Health Organization (WHO).
While people’s understanding of the new respiratory disease has steadily increased since it was first detected in China last year, what lies ahead over the next half year is unknown.
FEARS OF THE ‘SECOND WAVE’ IN EUROPE
In Europe, where tight closures ended before the summer holiday season that boosted the economy, the reopening of schools and offices has been marred by rising infection rates, especially in Spain, France and Britain.
Although testing is much more widespread now, the number of new daily infections is much lower than in March and April, before the lockdowns were imposed.
Most cases today are among younger people with few symptoms, but many experts fear it is only a matter of time before the virus returns to older and vulnerable people.
England’s Deputy Chief Medical Officer Dr Jonathan Van-Tam said people let their guard down over the summer in fighting the virus.
“We have to start taking this very seriously again,” he told the BBC this week, warning that if not, Britain will have “a bumpy ride for months to come.”
French Health Minister Olivier Veran also said this week that the upward trend is “worrisome”, predicting an increase in serious infections in a few weeks.
Still haunted by the first wave, many doctors fear that hospitals and intensive care units will end up overwhelmed in the coming months, as they did in the spring.
REINFECTION AND IMMUNITY
A handful of recent studies have profiled people reinfected with the virus who have recovered from a previous episode of Covid-19.
This has rekindled concern about the potential for humans to develop long-lasting immunity to disease, either through infection or vaccination.
The first confirmed reinfection was a 33-year-old Hong Kong resident, who tested positive at the airport 4 1/2 months after his recovery.
He had no symptoms the second time around, which some experts have hailed as a hopeful sign that his immune system had learned to defend itself against respiratory illness.
But scientists also caution that it is difficult to draw general conclusions from just a handful of reinfection cases among the millions of people who have contracted the virus.
And it’s unclear how contagious a reinfected person would be.
Human immunity against Covid-19 remains poorly understood.
While much of the attention has been on antibodies, which help fight infection, there is also interest in how T lymphocytes, a type of white blood cell, can build “memory of immunity.”
But little is yet known about how these cells operate against Covid-19.
CHILDREN AND COVID-19
As children return to classrooms, it is not yet clear what exact role they play in the spread of the coronavirus.
Severe illness is very rare in young children with Covid-19, with most developing mild symptoms, or none at all.
But could they remain vectors of infection?
“When symptomatic, children shed the virus in similar amounts to adults and can infect others in a similar way,” said the European Center for Disease Prevention and Control.
“It is unknown how infectious asymptomatic children are.”
Several studies have suggested that children are less likely to transmit the disease, perhaps because with fewer symptoms they would not cough or sneeze, increasing the risk of viral spread.
However, many experts say that a distinction must be made between young children and adolescents, who seem just as contagious as adults.
VACCINE SAFETY
Much depends on the development of an effective and safe vaccine, and this week the WHO listed 35 vaccine candidates that are undergoing human clinical trials around the world.
Nine of them are already in, or preparing for, the final stage, known as Phase 3, which requires thousands of volunteers to measure effectiveness on a large scale.
Big spenders the United States, Russia and China are speeding up the process in a bid to be the first to have a vaccine, even before the end of the year.
But experts urge patience, warning that speed should not compromise public safety or trust.
As an example of the need for caution, the pharmaceutical giant AstraZeneca and the University of Oxford have “stopped” trials of their vaccine after a volunteer developed an unexplained illness.
The European Medicines Agency has said that a vaccine may not be ready until early next year, while the WHO has said it could take until mid-2021 to achieve widespread immunization.
In the worst case, it may be impossible to develop a vaccine.
DEBATE IN MASK
In many places, face coverings went from being seen as unnecessary to a must-have accessory, a quick change in attitude that left many baffled.
The change in opinion from health authorities, including the WHO, was driven by a growing body of research on how Covid-19 spreads.
These studies suggest that it is not only transported in larger virus droplets that can make hands dirty, but also in fine droplets exhaled by patients that can remain airborne – “aerosols.”
The precise role of this mode of transmission in the pandemic is still unknown, but many scientists suggest that it could be substantial.
If that’s the case, social distancing isn’t enough to protect people from infection.
Crowded and poorly ventilated indoor spaces are considered higher risk, although some countries have also made street masks mandatory.
TREATMENT OPTIONS
In clinical trials, only one type of drug has been shown to reduce mortality: corticosteroids, which fight inflammation.
But even these are recommended only for the most severe forms of the disease.
An antiviral, remdesivir, has been shown to reduce the length of hospital stays, but its benefit is relatively modest.
Finally, despite hype from the President of the United States, Donald Trump, the drug hydroxychloroquine has been shown to be ineffective against Covid-19.
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