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On Monday, March 16, President Trump predicted that the COVID-19 outbreak could go on until July or August, prompting a collective gasp among Americans who had been hoping for a quicker resolution. While there are too many variables at play to know for sure when this will end, experts are looking for clues and suggesting possibilities. Spoiler alert: It’s somewhere between June 2020 and September 2021.
Predicting the Peak. The course of the outbreak depends largely on when the United States hits its peak. Cases will increase exponentially until that time and then will slow with fewer infections each day until there are no new cases. China and South Korea both appear to have reached their peaks, but in very different timeframes. In China, it took about two months from the start of the outbreak. In South Korea, it was only about two weeks. Scott Gottlieb, MD, former U.S. Food and Drug Administration (FDA) commissioner, estimates that the United States will hit its peak in late April or early May—about three months from the first case.
In both China and South Korea, cases are decreasing at about the same speed at which they rose. If that holds true for the United States, we could expect to see cases winding down significantly around July or August. If warm weather slows the virus, it could shorten the time frame, suggests Zhong Nanshan, MD, China’s senior medical adviser. If all countries follow the World Health Organization’s guidelines, “it could be over by June,” he predicted in a news conference.
Heat and Viruses. Scientists don’t yet know if SARS-CoV-2 (the virus that causes COVID-19) will weaken in warmer weather. We can see from past outbreaks that coronaviruses often do display what’s called seasonality.
“Viruses in the same coronavirus family, including SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome), did occur more commonly in winter months, but no clear seasonal pattern was ever established,” explains Thomas Bashore, MD, Professor of Medicine-Cardiology at Duke University Medical Center and editor-of-chief of Duke Medicine Health News. “For a novel virus like COVID-19 that has only been known since November 2019, there are simply no data at this time to know whether it will be seasonal, like influenza.”
If the virus is indeed seasonal and we see a slow-down in the summer, it does not mean we are in the clear: It could return in the fall and affect an even larger number of people. Researchers speculate that it could even become a permanent part of our lives, like a more-lethal version of the common cold or flu. If that is the case, our best hope lies in a vaccine.
Vaccine Progress. The first potential vaccine is already in a phase 1 trial, but it will take about 12 to 18 months for it to wind its way through all of the safety, efficacy, and dosing studies, says Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases. That would take us to between March and September 2021.
Researchers are also scrambling to test the effectiveness of existing drugs and antivirals that could provide quick treatments.
- The Oklahoma Medical Research Foundation reports that the FDA-approved malaria drug chloroquine phosphate shows promise. If proven effective, it could be used immediately.
- In China, a fixed-dose combination of two antiviral drugs, lopinavir and ritonavir (Kaletra; AbbVie), is being used to treat pneumonia caused by SARS-CoV-2.
- Remdesivir (Gilead Sciences), a failed Ebola drug, is being tested in five clinical trials. Some early results suggest limited efficacy and a high risk of side effects.
This Will End Faster if We Take it Seriously. The top threat to a timely resolution right now is human behavior. Many public venues remain crowded as a significant number of Americans insist that the threat of COVID-19 is overblown. In fact, a new NPR/PBS NewsHour/Marist poll published on March 17 reported that only 56% of Americans consider the coronavirus a “real threat.”
“Without separation of people to reduce person-to-person spread, the issue is not only one of how long the virus will be around, but the potential for the number of serious cases to overwhelm our hospitals and health systems,” says Dr. Bashore. “This is why a delay in acting quickly put Italy into such a bind. Our initial trend suggests we are indeed on the same trajectory as Italy unless we seriously clamp down now and blunt this curve.”
While it is inconvenient for everyone, practicing strict social distancing and staying at home as much as possible can dramatically reduce the duration and severity of COVID-19. As voluntary measures fail to attain sufficient social distancing, several states are stepping in with mandatory restrictions. The federal government hasn’t ruled out doing the same on a national scale.