COVID-19 Q&A: where might we be in a year’s time?

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Dr Adrian Hyzler
Chief Medical Officer

The current COVID-19 pandemic is an evolving situation and our advice is under regular review. To see our latest recommendations to employers and travellers, click here.

The entire world is reeling from the COVID-19 pandemic. With schools closed and restaurants, theatres and office buildings shut, most of us have settled into some version of a ’new normal‘ and are left to wonder what life will be like on the other side of this ’quarantine fog.’  Dr Adrian Hyzler, Chief Medical Officer at Healix, addresses some of the questions we have been receiving from clients and partners around the globe relating to where we might be in a year’s time in relation to the COVID-19 pandemic.

Q: What do you think the world will look like in a year with respect to COVID-19?

Answer: A year from now the world will have re-opened in varying degrees. Restaurants and theatres will be open again but likely with diminished capacity. Sports may be played with smaller audiences, and we may see people having their temperature taken as they enter arenas. Public places will need to be very stringent in their commitment to disinfecting frequently and thoroughly. Offices may have a rotating schedule of remote work to reduce the number of people in enclosed spaces. There may be ’point of contact‘ rapid diagnostic testing (RDT) prior to entry to healthcare facilities, including nursing homes and other institutions where distancing is problematic – some companies may also choose to adopt this approach. This of course depends on accurate, affordable and simple to use test kits being mass produced. Companies may limit the number of people in meetings or depend more on virtual meeting tools. In turn, we may see less traffic, fewer motor vehicle accidents and less pollution.

It is likely we will still be living with many remnants of the COVID crisis of 2020. Companies will re-evaluate their business continuity plans as a result of lessons learned. Duty of care will become more important than ever before as organisations will need to provide their employees with critical resources to stay well both physically and mentally in the workplace and also where travel is concerned.

There will be many people who remain distanced from society, because they are vulnerable or traumatised by the pandemic experience. Due to the economic turmoil that has occurred as a result of the pandemic, there will be people who continue to experience financial difficulty. There will also be increased numbers of people dealing with mental health issues or living in poverty.

Some of the Southeast Asian countries that tackled the situation early and drew from previous experience of outbreaks in the region will pull forward much more quickly. For the resource poor countries in Africa and Latin America where the pandemic arrived later, there is likely to be a more prolonged course, with the economic and health systems supported by the WHO and countries that have passed the peak and have an excess of hospital equipment, medical professionals and PPE supplies that can be distributed to the most affected countries.

Q: Will social distancing still be in effect a year from now?

Answer: While the world will re-open gradually in the months to come, social distancing will play a continued role to some degree. Until an effective, cheap, safe and well tolerated vaccine is available, there will still need to be episodes of social distancing as measures to control cluster outbreaks and second waves or peaks appear. In areas of low community immunity, where there is an early indication of increasing numbers of cases, there will need to be “freeze-in-place” orders. These orders come in the form of sudden, sharp, short-lived localised lockdown measures to control the rate of spread. Generally, people may be more wary of each other, especially towards individuals who exhibit even mild respiratory symptoms in public spaces. With the confirmation of the extent of asymptomatic spread and the lack of a vaccine, people will likely continue to use masks and gloves in public spaces like stores and pharmacies.

Similar to the cultural shift that resulted from the discovery that dirty water caused cholera in the 19th century, or when we learned about the relationship between HIV/AIDS and unprotected sex, we will adapt to this new reality of a ’post-Covid world’. There may be a reduction in the number of seasonal illnesses in the coming winter seasons as people exercise a heightened level of distancing, hand hygiene and mask usage across the world.

Q: Will we have eradicated this between exposure and treatments?

Answer: There will certainly be a gradually increasing immunity within the populations around the world, but this will not be equal across nations and continents, resulting in an ongoing reluctance to welcome the same level of unlimited travel as before.

If we look at other coronaviruses that have made the leap from animals to humans, the immunity tends to wane over time and the immunity from exposure to SARS-CoV-2 may fade in a similar manner. There will be ’hotspots‘ around the world with cluster outbreaks especially in institutions where social distancing and isolation are so much harder to maintain, such as nursing homes, correctional facilities, armed services and refugee camps/displaced populations. Treatment, though perhaps able to reduce the severity of the disease if taken early in the course of the illness, is unlikely to completely eradicate COVID-19. More potent drugs to treat severe disease may reduce the case fatality rate, but just as seasonal influenza still results in between 400,000 and 600,000 deaths each year, despite treatment and a customised vaccine, it is unlikely that COVID-19, with its multi-organ involvement will be cured or eradicated.

Q: What are the chances of a vaccine being ready in a year?

Answer: Despite the global collaboration between scientists, institutions and governments, we may well still be searching for an effective vaccine in a year. Many vaccine candidates will have fallen by the wayside and even if vaccines reach the final lap in the race for validation, there will be problems with the efficacy of the vaccines and subsequent difficulties in scaling up to the quantities that are needed across the world. In all likelihood, there will be several vaccine candidates that are eventually successfully licensed around the world, and they will take their place alongside the annual seasonal influenza immunisation.

Q: Will universal hygiene remain improved in the years to come as a result of the pandemic?

Answer: The message of how to correctly wash hands and when to do so will be continuously reinforced by informational promotions. There will be alcohol hand sanitiser distributors at the entrances to all office buildings, commercial locations. entertainment venues and public transit stations. If it was not before, it will become the norm to carry portable dispensers wherever we go.

Q: Will people smoke less to minimise their risk of respiratory infection as a whole?

Answer: The drive to reduce the number of smokers is unlikely to be influenced by the effects of COVID-19. There has been a successful campaign over the last 20 years to eradicate the presence of cigarette advertising and promotions and replace that with the devastating effects of cigarettes, to remove packets from view in shops, to levy huge taxation and to restrict smoking in public places. In contrast, the increase in mental health issues that will result from this pandemic is more likely to increase the use of cigarettes as a release from their anxieties and emotional distress, at least in the short term.

Q: Will people and nations take the lessons they’ve learned and become better?

Answer: This is a defining moment in the world. The hope is that nations will come together in the common cause to fight this disease. After all, we need the whole world to do their part to dampen down the spread. Countries cannot just close down their borders and see this through in isolation. The United Nations and WHO, the World Bank and the IMF, powerful nations and powerful unions of nations will be crucial in distributing expertise, PPE, equipment, test kits, medication and eventually vaccines. Worryingly, we have already seen fractures in the relationship between the WHO and at least one major nation, and if this results in funding difficulties for the one unifying force around the world, then the effects of this pandemic will be even more devastating in resource poor countries.

The hope is that the way that humanity has united against this common enemy will bring the world closer and make people realise that we are all vulnerable in a pandemic. As has been said a number of times, this virus knows no borders and needs no passport. We are all involved in a war against an enemy that we can’t see and that attacks, not indiscriminately, but in a way that none of us is entirely safe. These periods of lockdown and a gradual release will make many people realise how lucky they are and appreciate the truly important things in life more than ever before.

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