Corona Daily 055: How will the Covid Pandemic End? When? Part Two

One way to predict the end of the current pandemic is to analyse how the earlier pandemics ended.

Infectious diseases have threatened humans since the Neolithic revolution 12,000 years ago, when human hunter-gatherers settled in villages to domesticate animals and cultivate crops. Animal domestication was man’s earliest systematic and large scale manipulation of nature. The man-animal interaction was the cause of several pandemics. Justinian plague (541-549 AD) wiped out half the world’s population, Black Death (1346-1353) killed over 50 million. Not enough reliable documentation exists to know how they ended. Probably everyone who was not dead had developed immunity through natural infection.

The current pandemic raised awareness about the Spanish influenza of 1918. Without vaccines and medicines how did the virus disappear? Does Wikipedia offer the end-date of that pandemic the way it mentions the dates of individual deaths?

Readers may be shocked to learn the Spanish flu virus never disappeared. It caused minor pandemics in 1957, in 1968 and in 2009. The H1N1 virus gave rise to swine flu in 2009 killing 284,000. During the Spanish influenza, the same virus was far deadlier killing 50 million people.

The AIDS pandemic continues for forty years, and has killed over 37 million. We are just less afraid of HIV because it doesn’t spread through sneezing and coughing. Chikungunya (2014), Zika (2015), Ebola in Africa (1976-2021) are all around us and can cause outbreaks at opportune times.

If some of these viruses are not widely experienced, take the case of the more familiar malaria. Transmitted via parasite, it is as old as the human race. In 2018, there were 228 million malaria cases and 405,000 deaths worldwide. But malaria didn’t ever shut schools or restaurants.

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No doubt vaccinations help reduce hospitalizations and the death toll, but not a single epidemiologist would think vaccines will eradicate the covid-19 virus.

In human history, the only disease eradicated through vaccination was smallpox. The last person to naturally contract it was Ali Maow Maalin, a hospital cook in Somalia. (In 1977, he recovered from small pox, but eventually died of Malaria in 2013). Smallpox was exceptional in many respects. Its vaccine offered lifelong protection. More importantly, its virus, Variola major, had no animal host. Eliminating it in humans really meant its end. Smallpox symptoms were so unusual, it was easier to trace and isolate patients.

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That is also probably the reason why SARS-I (2002) ended so quickly, claiming only 813 lives. The symptoms appeared together with infection. The infected person could immediately isolate. SARS-2, better known as Covid-19, has a gap of a couple of days between infection and symptoms. Worse, it is possible to attract and spread infection without having any symptoms. The strategies that worked with SARS can’t work with covid-19.

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In short, the end of the pandemic can’t be associated with the disappearance of the covid-19 virus. It will stay with us for many decades, perhaps for ever, just like influenza. Of course, it is expected to turn into a seasonal flu virus, emerging every year in a mild form probably in winter months. Winter because children are at school, and everybody spends more time indoors.

It will be a sort of truce agreement between humans and the corona virus.

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Historians talk of two types of pandemic endings, the medical ending (like for smallpox) and the social ending, when fear recedes, panic disappears, life returns to normal. When people ask: ‘when will the pandemic end?’, they are asking about the social ending, says Dr Greene, a historian at Johns Hopkins.

Tomorrow, I will share the latest thinking about when this social ending may happen. It means in-person classes at schools and universities, opening of businesses, offices, restaurants, theatres, malls, large gatherings and inter-regional and international travel as it was pre-pandemic.

(Continued tomorrow)

Ravi