Coronavirus across the world: What happens next?

More than a billion people are stuck in their homes, wondering when their normal lives will return. When will it end? That depends.

When will it end? That depends …

More than a billion people are stuck in their homes, wondering when their normal lives will return. But European countries have begun extending their demoralising lockdowns for indefinite periods. Why?

Schools are closing. Businesses are shutting. Everywhere is a sense of fear and uncertainty. Life is at a standstill.

Four months ago, who would not have yearned for long weeks of bingeing on favourite shows? Finally reading books you’ve meant to get around to for years? Spending quality time with the kids?

MORE: Follow the latest coronavirus news here

As Australia enters its second week of sporadic self-isolation, the appeal of such an enforced break is rapidly evaporating. It’s no holiday.

Reality’s a beast: It is unemployment, cough cringes, confusion – and cabin fever.

When will normalcy return?

The answer is simple.

We don’t know. But we know what it will take.

We can only hit the streets again in the same way we did back in January once some 80 per cent of the population has resistance to COVID19.

And you only get that once you’ve had the disease and recover.

Or, you get a vaccination.

WHAT’S THE PLAN?

Shutting down society is all about slowing the virus’ spread.

Health experts say widespread social distancing is a measure of last resort. In the face of COVID19, it’s our only choice. Under such emergency circumstances, it’s not a matter of when we can leave our homes again. It’s a matter of under what circumstances.

“Flatten the curve” is the phrase on the lips of every politician and health official.

And that’s good.

It’s the only way we can hope to offer most of those who get sick quality medical care.

But it’s not victory. It’s a lifesaver – for as long as it is maintained. But community-wide shutdown a plan. It’s an emergency response. It’s slamming the door and barring the windows in the face of a wild beast.

But it’s still out there.

Even if the shutdown is perfect and immediate, COVID19’s incubation period will see the numbers of cases and deaths surge for at least another fortnight.

So, epidemiologists must convince the mining and business magnates on our Prime Minister’s emergency committee that viral maths is uncompromising. It has no scientists.

Australia can only open for business once again when the risk can be managed. And that won’t be easy.

It will need all-encompassing testing. Massive contact tracing. Isolating the infected.

This could entail privacy-intruding surveillance and monitoring that goes against our democratic grain.

And it could last up to two years.

BATTLEFRONT

COVID19 is a slow-developing, long-lasting illness.

It takes some five to 14 days to develop symptoms. And such carriers can be infectious.

It means those infected today will appear in intensive care wards in the second week of April.

It means those infected today can be unwittingly infecting others for weeks to come.

Things are going to get much worse before they begin to look better.

Phase one of the fight against COVID19 will be fought on these fronts:

PERSONAL PROTECTION: Australia’s doctors and nurses are already crying out for the high-quality face masks and bodysuits they need to protect themselves. And we’ve only just entered the exponential pandemic ‘curve’. If health workers can’t stay healthy, they cannot care for anyone else.

We do however need scrubs for staff & there just so happens to be a great pattern for scrubs that spotlight have, plus lots of fabric in store and lots of people #stayingathome #SocialDistancing who may have time on their hands, be able to sew and want to contribute 🤷🏻‍♀️💜 pic.twitter.com/PBDu1lvonB

— Dr Bec Szabo 💦🧼✋🏼🤚🏼🛑🦠 (@inquisitiveGyn) March 25, 2020

If you have masks, donate them. If you can manufacture the necessary materials, find others who can help assemble and distribute them.

World War II’s “Dig for Victory” campaign could be the basis of a new “Sew for Salvation” scheme – making gowns for your local hospital.

BROAD TESTING: Some studies put the number of COVID19 carriers without symptoms at an extraordinary 50 per cent of all those infected. This has rendered traditional targeted testing techniques ineffective in slowing its spread. And Australia can assume it won’t be getting new test kits supplied from overseas: They’re desperate to test their populations.

OPINION: To get on top of the #coronavirus, we also need to test people without symptoms, says leading Australian epidemiologist Prof Raina MacIntyre, @UNSW @KirbyInstitute. #COVID2019 #covid19australia https://t.co/YTRreFEUlz

— UNSW Medicine (@UNSWMedicine) March 27, 2020

So, we must tool-up to manufacture homegrown kits. Chemicals must be made, refined and combined, packaged and distributed. On a massive scale. Only once we know who must be isolated can it be considered safe-ish to release an uninfected workforce. And that workforce must be closely monitored for many months to come.

VACCINE DEVELOPMENT: Scientists the world over have been racing to develop a vaccine since the virus was first sequenced in January. But it’s not a quick process. Optimistic estimates put it at between a year and 18 months. Despite anti-vaxxer fears, this is because of rigorous testing to ensure it is safe and effective. Then, it will take time to manufacture. It will take time to roll out across the entire community.

STAY AT HOME: None of the above is possible if COVID19 runs rampant through society. Hospitals will become swamped within days. Our doctors and nurses will quickly become patients themselves. Specialists and experts needed to maintain essential services will fall ill fast. By keeping the virus at your door, you’re buying time for the people and industries who can save your life.

‘It’s appropriate in these strange times to think the otherwise unthinkable. Fast-tracking open-source ventilator designs that can be produced from items we have available is possible’ writes @michael_ASPI https://t.co/L0bkfcDFQe

— ASPI (@ASPI_org) March 26, 2020

Recognise the temptation to socialise or go back to work for what it is: a ticket for the virus to ride. Stay the course. All it takes is one unwitting carrier to reignite this inferno – like China, Singapore and Hong Kong are discovering to their dismay.

“It is likely such measures – most notably, large scale social distancing – will need to be in place for many months, perhaps until a vaccine becomes available,” warns Imperial College Disease and Emergency Analytics Professor Neil Ferguson.

CAMPAIGN

The world of January 2020 will likely never return.

“It is possible that we will eradicate COVID-19 in selected countries or regions, but not necessarily worldwide,” Professors Kleczkowski and Kao write.

“Although there are hopes that a vaccine will be successful within the next year, this is not certain. If it happens, very stringent travel checks may need to be imposed for at least a substantial time.”

In essence, we may “flatten the curve” for now. But it may come back out of nowhere to hit us again in a few months.

“The last thing any country needs is to open schools and businesses only to be forced to close them again because of a resurgence,” WHO director-general Tedros Adhanom Ghebreyesus warned Thursday.

Chances are, some epidemiologists warn, we will face “waves” of lockdowns.

Initially, this could be a dangerous balancing act between return-to-work orders and fresh COVID19 “flare-ups”.

And the virus could mutate on a seasonal basis: we don’t yet know.

“In temperate climates, seasonal influenza spreads rapidly through winter but mostly dies out in summer, only to come back the following year,” Kleczkowski and Kao say.

“In between outbreaks, the flu virus survives in Asia from where it emerges every year.”

Whatever the scenario, only widespread immunity will reduce the threat of the virus.

But it will be a world where rigorous handwashing is the norm, sneezes are instinctively smothered and crowded spaces are looked upon with concern.

That time remains some way off.

“If we all just went right back to how things were before, transmission would start again with the same intensity,” John Hopkins University health security professor Caitlin Rivers says. “It’s hard to experience so many restrictions, and so many hardships, and not feel like it’s not working. We need to recognise that we are doing the right things. You just have to be a little bit patient.”

A WAR WITHOUT END

COVID19 cannot be defeated. It can only be contained.

But this is no mystery.

It’s easy to wind up with mountains of bodies and collapsed societies. Those who win “herd immunity” this way will have to start again.

The social distancing approach takes longer, is complicated and is expensive. In essence, it’s a delaying tactic for a vaccine to be produced, after all.

The World Health Organisation (WHO) and national security agencies such as the Defence Science and Technology Group (DST) have been war gaming scientific models of such epidemic scenarios for decades.

They gleaned one clear lesson: Public morale is the only weapon our politicians have.

It defines how long a population can endure hardship. It hardens resolve. It delays any backlash until after the critical phase has passed.

How to boost that morale is no mystery. Time and time again, history has demonstrated how frank and open honesty carries communities through a crisis. Secrecy only leads the public to invent their own “truths”. And those “truths” rarely bode well for their leaders or each other.

“Mistrust of the government is very problematic because, during an infectious disease outbreak, epidemic, or pandemic, co-ordination across the population is needed,” writes health systems modeller Professor Bruce Lee.

“And such co-ordination is not going to come from Netflix or some other source besides the government.

“Governments need to go out of their way to keep the public apprised of plans and the scientific rationale behind them. They need to make it clear through concrete actions that science and not politics are driving decision making and action.”

Prime Minister Scott Morrison has been saying since February that Australia has “acted quickly” and “we have a plan”. The non-medical National COVID-19 co-ordination Commission (NCCC) was established Wednesday.

Do we have a plan?

“Governments are hoping that a combination of social distancing, border closures, isolation of cases, testing and increasing immunity in the population will slow down the spread of the coronavirus and will hopefully open up successful eradication strategies,” Kleczkowski and Kao write.

“Yet past experiences suggest that we may need to learn to live with the coronavirus for years to come.”

Jamie Seidel is a freelance writer. Continue the conversation @JamieSeidel