Kristof: Remember the coronavirus is still a mystery
The odd thing about reporting on the coronavirus is that the nonexperts are supremely confident in their predictions, while epidemiologists keep telling me that they don’t really know much at all.
“This is a novel virus, new to humanity, and nobody knows what will happen,” said Anne Rimoin, a professor of epidemiology at UCLA.
Some of that epidemiological humility should seep into public discourse.
Some conservatives scoffed that the coronavirus was like the flu, which was utterly wrong. Some liberals foresaw a disastrous outbreak when Jerry Falwell Jr. kept Liberty University open this spring, and that never happened. Viruses are complicated.
It has now been more than three weeks since Georgia started reopening, and there hasn’t been the abrupt statewide surge of infections that many had feared. That’s a good sign for reopening. But it’s early, and it’s in part because people in Georgia are still distancing to some degree on their own.
Texas opened up and lately has reported a spike of new infections, which is bad news. But that’s in part because Texas increased testing, and if you do more testing you find more infections.
We know that social distancing works, for China, Italy, Spain, Iran and New York all were hard-hit and eventually squelched horrifying outbreaks by imposing tough restrictions. Governors of Washington and California acted early and avoided such catastrophic outbreaks. One study reported in Health Affairs found that government restrictions collectively averted some 35 million infections in the United States by the end of April; if that’s true, those restrictions also saved an enormous number of lives.
Yet the same study found that school closures didn’t much help, and we still haven’t figured out the optimal level of restrictions to smother the virus’s spread without stifling citizens’ daily routines.
That’s not surprising, notes Michael Osterholm, an epidemiologist at the University of Minnesota, because we still haven’t figured out the 1918 pandemic. “In 1918, why did the spring wave go away, and then why did it come back in the fall?” Osterholm asked. “We don’t know.”
Epidemiology is full of puzzles. In 2003, the World Health Organization feared that SARS would return in a devastating wave that fall, but instead it was extinguished. In 2009, experts worried that the H1N1 flu would be a lion, but it turned out to be a kitten. Random luck shapes outcomes along with biology; some officials took reckless risks this year and got away with them, but that doesn’t make the actions prudent
“You’ve got to have a lot of humility with these viruses,” Osterholm said. “I know less about viruses than I did 10 years ago.”
In the spirit of that humility, let me relay some advice from public health experts.
First, don’t swoon at every vaccine announcement. Remember that even when we get a vaccine that is proven both safe and effective, we will have to manufacture it on a huge scale — especially if each person requires more than one dose — and that will be a monumental task. Even if we make enough vaccine, we may be held back by shortages of syringes, needles and glass vials.
“It could take up to two years to produce enough vials for U.S. vaccine needs,” Rick Bright wrote in his whistleblower complaint concerning his removal as a senior official for pandemic response.