‘We will live in masks for years’: COVID-19 through the eyes of a pandemic expert

Eric Toner has been planning a pandemic during years. He has briefed world leaders on outbreaks and how to better prepare entire nations for mass victims. Simulated epidemics in real time and studied the world’s response to major global health emergencies like SARS and the 1918 influenza pandemic.

But nothing could have prepared him for how the COVID-19 pandemic would play out

Toner is a principal investigator at the Johns Hopkins Center for Health Safety and a world leader in pandemic preparedness. The threat of a new coronavirus is not new to him. In fact, in October 2019, Toner and the Johns Hopkins team conducted a simulation of a coronavirus pandemic in New York, months before COVID-19 began to spread worldwide. As part of the half-day tabletop exercise, Toner met with other health professionals to discuss a theoretical coronavirus outbreak and examine how governments and private companies would respond.

Johns Hopkins has been running these simulations for years, with Hollywood-sounding code names like Dark Winter (smallpox) and Clade X (“a biologically engineered airborne pathogen, intentionally released” that caused hundreds of millions of hypothetical deaths). The purpose of the simulations is to help public health experts and policy makers better prepare for the day when a true pandemic arrives.

Now that day has come.

But simulating a pandemic is a far cry from seeing the world handle a real pandemic in real time. On that front, Toner says that some countries are failing the test.

“The response from the United States has been extraordinarily disappointing and wrong,” he told me via Zoom in late June. “Whenever there has been an opportunity to do the right thing, it seems that we have done the wrong thing. The United States has to recognize that it is competing for the first or second position in the most affected country in the world.”

Taken by surprise

It is not the first time that I have spoken to Toner about pandemics.

We met in July 2019, when I traveled to the Johns Hopkins Center for Health Security in Baltimore to interview him about how the world would prepare for a pandemic. The interview was for “Hack the Apocalypse“- CNET’s new documentary series exploring technological solutions that could save us from the events of the end of the world. Naturally, a series about terrible global disasters had to include an episode about pandemics, but for me (and for the rest of the team working on the series)), all of this felt theoretical. A kind of thought experiment that could play out in your head while you watch Contagion on TV.

But then 2020 came. The world began to block and words like “pandemic”, “social distancing” and “quarantine” began to embed themselves in the daily vernacular. Our entire documentary series needed to be rewritten and clipped. Suddenly, none of this was theoretical. And as I went back to watch my original interview with Toner (done in a small room! No facial masks!) I kept rewinding the same part to play over and over again.

“Is there any chance that we could be caught off guard by some kind of horrible, mutant bat flu?” I asked him that day, five months before the new coronavirus cases were first reported.

“Yes,” replied Toner. “And we probably will be.”

I have spoken to Toner several times since then. In April his assessment was grim.

“I think you would have to be clueless not to be scared right now,” he told me, on a Zoom call from his home office. “The current coronavirus pandemic is worse than many we had anticipated in the past … this is going to end up being a truly bad event historically.”

Now, as the world enters the second half of a pandemic-dominated year, the situation remains just as dire.

According to a July 1 update from Johns Hopkins (which has been tracking pandemic statistics and providing regular status reports), the pandemic has affected almost every country in the world, with more than 10 million reported cases and more than half million deaths. Of the more than 200 countries and territories reporting cases, 86 report community transmission, essentially outbreaks that cannot be traced to recent travel, other known cases, or known groups of the disease.

When I speak to Toner in late June, our mood has changed. This is no longer an emerging threat. And unlike our previous conversations, I don’t expect you to tell me about the quick fix that will end this crisis.

It is clear that we are no longer in a sprint. We are in a marathon.

‘There will be no calm’

Many countries have been successful in fighting coronavirus, closing early, taking swift action to adopt the advice of the World Health Organization, and intensifying diagnostic tests to identify and isolate localized outbreaks as they emerged.

But as the northern hemisphere entered summer, hopes of flattening the curve in the United States were soon met with reports of cases continue to rise as states reopened. However, it does not take long for the toner to mention any mention of a “second wave”.

“When you are underwater, it is very difficult to know how many waves pass over you,” says Toner. “I don’t know if it’s a first wave or a second wave. I don’t think it makes any difference. There is a resurgence of cases that, in some states, just seems like a continuation of their outbreaks. In other states, it will look more like a second wave .

“I think the important thing is that there will be no calm in the summer with a big wave in the fall. It is clear that we are having a significant resurgence of cases in the summer, and they will get bigger. And it will continue.” until we close things again. “

Unlike the flu virus, which was behind the 1918 pandemic that claimed 50-100 million lives worldwide, Toner says there is no good evidence of seasonality with COVID-19. Until we have a vaccine, any increase or decrease in cases will be based on social factors: closed communities and refugee families in place. And, as was the case in 1918, people with masks.

There is some good news to come out of the first six months of the pandemic. Hospitals are improving symptom management and intervention before cases reach a point of no return, helping to reduce the death rate. It points to therapies such as remdesivir, which has shown positive effects in trials and has been licensed for hospitalized patients with COVID, and convalescent plasma therapy, which could be used as a way to transfer a level of immunity to sick patients.

But there is no silver bullet. Experts agree that it will be at least a year before we have a vaccine that is accessible to most people. Mass vaccination is not likely to come until 2022, and even then, Toner says vaccination may require a double dose to be effective.

And until then?

“I think that with the use of masks and a certain degree of social distancing, we will live with luck, with luck, for several years,” he says.

For many of us, this long timeline can lead to a feeling of hopelessness. But Toner says there is a way to control our future, and it is not so different from the advice he has given in simulations, advice that goes back more than a century.

“It’s actually pretty straightforward. If we cover our faces, and both you and anyone you interact with are wearing a mask, the risk of transmission decreases. Being outside, having a distance between yourself and others reduces the risk of transmission dramatically.

“There are many things you can do and maintain those conditions. If you stretch, if you keep your distance, if you avoid crowded places, you could go to a beach, go to the mountains, you could go to a lake, you can do things outside without no problem “.

As for those who refuse to wear a mask, Toner does not lose his words.

“They will get through it,” he says. “It is just a matter of how many people get sick and die before they get over it.”