By Paul Meade, M.Sc, MPH

Those of us in the healthcare community always believed that there was going to be another pandemic. But the pandemic we’re experiencing now, COVID-19, is a different kind of bug to what we’ve studied historically. Two major factors set this virus apart: first, it’s a coronavirus rather than an influenza strain; and second, viruses of this type tend to mutate.

Following the devastation of the Spanish Flu of 1918, the Asian Flu of 1957, and the Hong Kong Flu of 1968, everyone in the healthcare sector and beyond was anticipating another influenza pandemic. Then, along comes this novel coronavirus, COVID-19, and it acts very differently from anything we’ve seen before.

To begin understanding COVID-19, you need to know that it’s related to Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and even the common cold virus. A lot of people get confused and still refer to this virus as “the flu,” and you’ll even see signs at some hospitals that say “flu patients here.” But it’s not a flu; a flu is caused by a variety of influenza viruses, and while both influenza viruses and coronaviruses affect the respiratory system, they behave quite differently.

Because COVID-19 is a novel virus, it’s creating all kinds of problems. We have no history, we have no herd immunity, we have no previous vaccines, we initially had no tests, and we have no effective treatments. We don’t yet understand with any level of certainty how this virus works. We don’t understand whether people who get it and recover have developed lasting immunity, or whether they’re still vulnerable to reinfection.

We don’t know if we can create an effective vaccine because COVID-19 is new, and a lot of work will need to be done to show effective and lasting immunity. We might spend the next 12 to 18 months developing a vaccine, only to find that the virus has mutated and we have to start all over again. There are many different treatments being tried, and we don’t yet know which ones work or don’t work. To boil it down, we’re still trying to understand this virus. That makes it incredibly difficult compared to pandemics we’ve seen in the past with influenza viruses.

Will the novel coronavirus go away forever? I doubt it. I think this is going to be a recurring problem that we all must reckon with. It may come around every Fall, riding the coattails of the influenza virus. This could make it even more potent, as people may start to get the flu as well as COVID-19 during flu season. We simply don’t know.

All of the measures that we put into place to try to prevent an influenza pandemic have essentially gone out the window. We’re having to learn everything for the first time as this virus progresses. It can be frightening; there are high-risk individuals who, if they contract this virus, have serious reason to be concerned. But there are also people who get it and recover without ever knowing they had it. It’s a different bug, for sure. But as far as viruses go, it a very clever one, characterized by the concept of asymptomatic carriers, since it can make its host contagious without symptoms for up to two weeks – if at all – thereby giving it a chance to spread before we try to contain it.

So, what’s going to happen over the next 3-5 years? I’d like to explore some very possible scenarios for our country and our world, as we see the spread of coronavirus, as well as our attempts—and those of other countries—to contain the virus play out. Stay tuned to this space, for our look at four scenarios for our world and COVID-19.

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