Pandemic Predictions (Part 1)

April 27, 2020

Like everyone else, I've had a number of conversation in the last few weeks around the question of "when will we go back to normal?". So here's how I think we need to approach the answer, based on my readings so far. The TL;DR is "not soon".

It's important to understand why this virus is problematic. It's not just that the disease is so bad. Even though it is bad, we can treat most people who get it. The main issue is that it's spreading so fast, and that means overwhelming the healthcare system. Medicine may "know" how to help someone, but if there are no doctors or hospital beds or other equipment to deliver the treatment, the knowledge does us no good.

So the main risk is overloading the health care system. Therefore, "when will we go back to normal" is really asking "when can we do everything we used to do, without running the risk of overloading the health care system?". That question in turn is really asking "when will we be confident there won't be a surge of infections from our day-to-day activities?"

In order to be confident of that there won't be a surge, one of the following must be true:

  • We have a vaccine. This is, in the best case, 1.5-2 years out. Additionally, once a vaccine exists, it must be manufactured in sufficiently large quantities. Likely, it'll have gradual rollout, and that will take time.
  • We have herd immunity. This is also either very slow (order of years) or very catastrophic.
  • We have a treatment. A vaccine is not strictly neccessary, if we can find treatments that won't require prolonged, intense hospitalizations for the most-affected patients. I haven't read anything about this, and I'm not sure how likely it is.
  • We have pervasive and fast testing. Having this requires competent planning and execution. We seem to be in a pretty good place on that front in Canada and specially in BC. However, this path also requires access to equipment/manufacturing capacity, and I'm not sure if we can get that in Canada.

From what I can tell, barring some miraculous breakthrough, achieving any of these solutions at a sufficiently large scale is an effort in the order of years.

Assuming we have one of these options available, we must subtract from this asset any liability that will put its gains at risk. For example

  • Will individuals who have had the virus be able to get sick from it again? (The fact that we don't know this six months later should give a sense of the timeline before we can get a handle on it.)
  • Will the Canadian government buckle under some political pressure & open the border with the USA? If that happens, we can have American pee in our pool.
  • Will we allow foreign travel/tourism? Again, if we're doing well locally, but we don't have closed borders, we can be inviting the virus from abroad.
  • Will the "solution" we come up with be optional or mandatory? If we find a vaccine tomorrow, how many hicks will refuse to vaccinate to avoid autism, for example? If we do pervasive testing, can some people opt-out and yet go about their day?

All of this is to say, I doubt we're going back to normal any time soon, not for years - until we have a vaccine and/or herd immunity. But that doesn't mean we'll be in lockdown or staying home the whole time. I think the most likely scenario – the option that seems most immediately available – is that we will cycle through periods of lockdown and relaxing restrictions. We won't really flatten the curve, we'll break it down into several smaller curves over a longer time.

Some things, like international travel or large-crowd events (concerts, sports), will be the last to make a come back. Other activities can come back more quickly. We may be able to hang out in small groups. Some public spaces may be able to open with some restrictions (like mandatory masks). Some workplaces may be able to operate in-person again (should they still want to). And I sure hope BC will open its provincial parks again. But we should not hope to go back to living the way we used to any time soon. In fact, we probably never will.

A long period of living under restrictions will re-shape society. We will find new ways of doing the things we did before, and we may find that the new ways are, in some cases, not so bad. For example, more people will work from home permanently. This will have widespread ramifications for the economy. I hope to follow up with additional posts on how I think this situation will affect different industries. Stay tuned.