Inextinguishable

Let us try and wrap our minds around this distinct possibility: this pesky virus may never die.

Until we find a silver bullet to kill it, wherever it might exhibit itself, it will continue its murderous ways. It will keep on resurfacing. Outbreaks will recur in communities that have managed to contain the spread. It will circumnavigate the globe over and over again.

After all, before this virus jumped from animal to human (if that is indeed the genesis of this epidemic), it presumably was always there, jumping from one host to the next. Somehow, the host animals coexisted with the virus. No epidemic broke out among the bats or the pangolins, as the case may be.

The viruses that bring the common cold or the ornery flu have not been wiped off the face of the earth. The virus that causes HIV-AIDS could not be destroyed. There is no vaccine to prevent its spread and various cocktails of drugs developed could only mitigate its effects. Ebola outbreaks continue to recur. 

In the case of malaria, we attacked the mosquito species that transmits it. The best of our science enabled us to destroy that species’ ability to reproduce itself. We will have completely triumphed over malaria the moment the mosquito species becomes extinct.

NCOV-SARS, unfortunately, is transmitted when infected persons exhale. We cannot stop people exhaling. If we ban exhalation, humanity becomes extinct and the virus becomes academic.

When we were told the battle against the coronavirus would be long, we must understand it will be really long.  

Scientists say it will take more than a year to develop a reliable vaccine against this new virus. Add the time needed for mass production and then for deployment. It could take more than two years for that vaccine to get to us.

In the meantime, a viable treatment might be developed for those infected. Several drugs are being experimented on, none yet with reliable results. This is why ventilators have suddenly become so important. It enables a patient to breathe until he is able to build antibodies to fight the infection. It is the antibodies that enable survival.

The realistic scenario is not about this pandemic suddenly evaporating. It is about developing a long-term strategy to manage this infestation. 

This strategy, truly long-term, involves societies rapidly building up their health care facilities, training an army of epidemiologists, prolonged enforcement of physical distancing, and continuous testing especially of the most mobile. Huge investments will have to be poured into expanding hospital capacities and vigilant medical policing at the neighborhood level.

This pandemic will change all our lives profoundly.

After 9-11 happened, extreme security measures were adopted everywhere. We lived under constant threat of terror and accepted such routines as having our bags checked at every entrance. Airports had to be redesigned and re-equipped. 

After this pandemic, masks and distancing will be the norm. Never mind the bags, our temperatures will be checked wherever we go. Large arenas for sports events or collective worship will be a thing of the past. Any large gathering will be an invitation for a viral outbreak. 

Behold our new world. No more large congregations. Even mass transport becomes high risk. Crowded cities are breeding grounds for pestilence.

Extended

All the considerations mentioned above provide context to the decisions to be made about extending the enhanced community quarantine imposed on Luzon. At the moment, it seems there is consensus to extend the lockdown, possibly with some minor modifications.

Extending the lockdown will cause all of us many inconveniences. Our only consolation is that policy formulation in our case is firmly grounded in science and informed by the judgment of experts.

We have heard all the complaints about the lack of food packs for poor communities and the incompetence of some local governments. But this will have to be granted: the lockdown helped us avert (so far) the sort of surge in infections we saw in Italy and, now, in the US.  

Historical information tells us that lockdowns of about six weeks have been most effective. Shorter lockdowns tended to invite resurgence of infections and further lockdowns, resulting in greater economic costs.

Plagues have swept human settlements for as long as we have recorded history. There are Biblical accounts of such events. During the great plague that hit Europe in the medieval period, 40 days evolved as the norm for isolating people and communities – thus the word “quarantine.”

The IATF, the team charged with managing this crisis, has reached out to some of the best minds we have, across many disciplines, in order to arrive at a clearer strategy to deal with the emergency. No single person dictates willy-nilly how the restrictions evolve from day to day.

South Korea just decided to extend for two weeks its physical distancing measures. Combining voluminous testing with strict distancing measures, South Korea appears to have tamed the rate of infections. But each time that country, like China, begins relaxing restrictions, a spike in infections happens.

We have to observe what they do very closely and learn. Some of our businessmen are clamoring for some sort of calibrated easing of restrictions. What exactly that means will have to be threshed out.

We definitely need some time to shuffle mildly infected victims to the new facilities carved out of arenas and convention centers. We need some time to put new testing laboratories in place.

Returning to some semblance of “normalcy” will require very delicate policy adjustments guided by the best science.