What is the Covid-19 endgame? How long are we going to have to live like this?
Right now, it looks like we are going to have to wait at least 12-18 months until we get a vaccine. (1/n)
Right now, it looks like we are going to have to wait at least 12-18 months until we get a vaccine. (1/n)
The devastation to the economy of social distancing practiced at the current level would be mind-boggling, dwarfing pretty much anything we've ever seen. Someone described it as an undergrad dorm discussion for econ majors (2/n)
Maybe some damage could mitigated if we followed the Korean example of aggressive case tracking. Fast and free testing would make that easier. But I think it's still an open question whether this approach will remain effective in Korea...will it come roaring back ? (3/n)
But some clinical reports over last few days suggest a different route. Hydroxychloroquine (cheap malaria drug) is apparently useful in the treatment of CV19, and might be work prophylactically. In one study it shortened the duration of a hospitalization from 20 to 6 days (4/n)
Several other drugs, including remdesivir and favipiravir, also show promise. (5/n)
If these (or other drugs) work well enough, it's possible that we won't need to use social isolation to flatten the curve. Instead, we could remove area from under the curve, by reducing the total number of people who ever get seriously ill (6/n)
Under these assumptions, if these treatments are effective enough, soon we could start letting young and healthy people back into the population, while keeping the most vulnerable as isolated as possible. With time, immunity would build up, reducing reproduction number R (7/n)
Rapid and cheap testing to see who has protective antibodies may also be coming online soon. This will help us know who can safely be back in general circulation, and especially who can interact with vulnerable people (8/n)
This is admittedly a rosy best-case scenario, and assumes many things (especially that chloroquine or something else will be effective in limiting the severity of the disease). It certainly doesnt mean we have any choice about what to do now, ie social distancing (9/n)
But it's just too hard to imagine going on this way for months or years, until we get an effective vaccine (10/n)
