‘We’ll be living with masks for years’: COVID-19 through the eyes of a pandemic expert

Eric Toner was Planning for a pandemic for years. He has informed the world’s leaders of outbreaks and how best to prepare entire nations for mass victims. He simulated epidemics in real time and examined the world’s response to them major global health emergencies like SARS and the 1918 influenza pandemic.

But nothing could have prepared him for how the COVID-19 pandemic would play.

Toner is a senior scientist at the Johns Hopkins Center for Health Security and a global leader in pandemic preparedness. The threat of a new type of corona virus is not new to him. In fact, Toner and the Johns Hopkins team conducted a coronavirus pandemic simulation in New York in October 2019, months before COVID-19 spread around the world. As part of the half-day table exercise, Toner met with other health professionals to investigate a theoretical outbreak of the corona virus and how governments and private companies would respond.

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Johns Hopkins has been doing these simulations for years with Hollywood-sounding code names like Dark Winter (smallpox) and Clade X (“a biologically developed, deliberately released airborne pathogen” that has caused hundreds of millions of hypothetical deaths). The aim of the simulations is to help experts and decision-makers in the public health system to better prepare for the day when a real pandemic occurs.

Now that day has come.

However, simulating a pandemic is far from watching the world deal with an actual pandemic in real time. In this context, Toner says that some countries fail the test.

“The US response was extremely disappointing and wrong,” he told me about Zoom in late June. “Whenever there was an opportunity to do the right thing, we seem to have done the wrong thing. The US must recognize that it is competing for the first or second position of the worst affected country in the world.”

Rumbles

It’s not the first time I’ve talked about pandemics with toner.

We first met in July 2019 when I traveled to the Johns Hopkins Center for Health Security in Baltimore to interview him about how the world would prepare for a pandemic. The interview was for “Chop the apocalypse“- CNET’s new documentary series that deals with the technical solutions that could save us from doomsday events. Of course, a series of terrible global disasters had to include an episode about pandemics, but for me (and the rest of the team working on the series )), it all felt theoretical, a kind of thought experiment that could happen in your head while you watch Contagion on TV.

But then came 2020. The world started to block and words like “pandemic”, “social distancing” and “quarantine” began to be embedded in everyday colloquialism. Our entire documentary series had to be rewritten and edited. Suddenly none of this was theoretical. And when I saw my original interview with Toner (in a small room! Without face masks!), I kept rewinding the same role to play again and again.

“Is there any chance that we’ll be surprised by a terrible, mutated bat influenza?” I asked him that day, five months before cases of the novel coronavirus were first reported.

“Yes,” replied Toner. “And we will probably be.”

I have spoken to toner several times since then. Back in April, his assessment was grim.

“I think you would have to be clueless so as not to be afraid at the moment,” he told me over a zoom call from his home office. “The current coronavirus pandemic is worse than many that we expected in the past … this will be a really historically bad event.”

Now that the world is entering the second half of a full year that is dominated by the pandemic, the situation is still just as serious.

According to a July 1 update by Johns Hopkins (who has tracked pandemic statistics and has made regular progress reports), the pandemic has hit almost every country in the world, with more than 10 million reported cases and more than half a million deaths. Of the more than 200 countries and areas in which cases have been reported, 86 report community transmission – essentially outbreaks that are not due to recent travel, other known cases, or known clusters of the disease.

When I talk to Toner at the end of June, our mood has changed. This is no longer an emerging threat. And unlike our previous discussions, I don’t expect him to tell me about the quick fix that will end this crisis.

It is clear that we are no longer in the sprint. We are facing a marathon.

“There will be no break”

Many countries have had success in fighting coronavirus by closing early, quickly taking advice from the World Health Organization, and stepping up diagnostic tests to identify and isolate localized outbreaks as they appear.

But when the northern hemisphere entered summer, hopes of a flattening of the curve in the United States soon met with reports from Cases continue to increase reopened as states. However, toner quickly speaks of any mention of a “second wave”.

“When you’re under water, it’s really hard to tell how many waves are going over you,” Toner says. “I don’t know if it’s a first or a second wave. I don’t think it makes a difference. There is a resurgence of cases that in some states look like a continuation of their outbreaks. In others. ” It will look more like a second wave.

“I think what’s important is that there won’t be a summer break with a big wave in the fall. It’s clear that in the summer we see a significant revival of the cases and they get bigger. And it will continue until we do things lock again. “

In contrast to the influenza virus that was behind the 1918 pandemic, which killed 50 to 100 million people worldwide, according to Toner, there is no good evidence of seasonality with COVID-19. Until we have a vaccine, any increase or decrease in cases will depend on social factors: blocking communities and protecting families. And as in 1918, people wearing masks.

There is some good news from the first six months of the pandemic. Hospitals can better treat and intervene in symptoms before the cases reach a point of no return, which helps to lower the mortality rate. He refers to therapies such as remdesivir, which has shown positive effects in studies and has been approved for COVID patients in hospital, and to convalescence plasma therapy, which can be used to transfer a certain degree of immunity to sick patients.

But there is no silver ball. Experts agree that it will be at least a year before we have a vaccine that is accessible to most people. Mass immunization is unlikely to occur until 2022, and even then, Toner said, a double dose may be required to be effective.

And until then?

“I think we will live with masks and a certain degree of social distance for a few years – hopefully live happily,” he says.

For many of us, this long period of time can lead to a feeling of hopelessness. But Toner says there’s a way to control our future, and it’s not all that different from the advice he gave in simulations, advice that goes back over a century.

“It’s actually pretty easy. Covering our faces and wearing a mask on both you and everyone you’re interacting with reduces the risk of transmission. If you’re outside and you are at a distance, that reduces Risk of transmission dramatically.

“There are a lot of things you can do and keep these conditions going. If you spread out, if you keep your distance, if you avoid crowded places, you can go to a beach, you can go to the mountains, you can go to a lake you can go to work outside without any problems. “

As for those who refuse to wear a mask, toner doesn’t shred his words.

“You’ll get over it,” he says. “It’s just a question of how many people get sick and die before they get over it.”