This phrase has a long history dating back to biblical times in one form or the other. Though the origin of this saying cannot be pinned down, it seems particularly pertinent to what we are experiencing as a nation today. It is a reminder that regardless of our troubles today with coronavirus and the overwhelming impact it often has on our daily lives, it will indeed ultimately pass. We have been damaged physically, emotionally, socially and economically. Thousands of lives have been lost, but we and the rest of the world will get over this sooner or later. Hopefully, we will all be smarter and stronger having gone through this so that we are better prepared for the next pandemic which is sure to come at some point.
So now one wonders what is next with outbreaks of the virus occurring in different parts of the country when it just began to look like we might have had things under control. Keep in mind that this should not have been unexpected. The virus is here to stay until one of two things happens. First, the virus may mutate itself out of existence meaning that it changes in such a way that it becomes less capable of attaching to and invading human cells. However, there is a caveat to this first scenario since the virus could also mutate in such a fashion as to make itself more likely to attach to a human cell and replicate. The second thing that could happens, which we should hope for, is that so-called “herd immunity” develops. This occurs when a large portion of the population either asquires the illness, survives and produces antibodies to the virus; or, a vaccine is given which also creates immunity. When immunity develops in either fashion, the virus is less likely to enter a host to replicate, cause illness and spread to other susceptible people. Those who were either sick and have recovered and those who have had the vaccine can no longer harbor the virus and thereby prevent it from replicating and invading the remaining susceptible individuals. In those who have been vaccinated and developed antibodies, the virus is not longer able to attach to the host cell and enter it to cause damage to the cell and replicate itself. In those who have acquired the immunity by having had the illness, antibodies likewise develop which prevent attachment of the virus to the susceptible cell so the virus once again cannot replicate and spread. Either way, the chain of transmission is thereby blocked and the incidence of viral infection decreases in a population. However, there is a caveat here also in terms of those who have naturally acquired immunity through infection; namely, that some individuals who have had the illness and recovered may theoretically become carriers of the virus. Not enough is yet known about this virus to make any comments about a carrier state. Remember that our objective here is “flatten the curve.” That does not mean that we have eliminated the virus. What is means is that we have reached a point where the rate of new cases occurring has slowed and reached a plateau making it much easier to control the pandemic. Hopefully at some point the virus will have disappeared, but that may never completely occur. Instead, what we may see is a situation similar to the influenza virus where we have to deal with a new strain or strains every year. In the meantime while we await the development of vaccines and antiviral medications, we try to identify and isolate infected people as quickly as we can, maintain social distancing in a reasonable way in order to minimize exposure, and we try to resume our lives as close to normal as possible.
How And When Will The Pandemic End?
We do not know yet how and when the pandemic will end, but it will will end. This does not mean that the virus itself will completely disappear though it may. Instead, we may see this coronavirus or other similar coronaviruses popping up periodically in different places for years to come.
Lessons To Be Learned
This Sars CoV -2 coronavirus is “novel.” Its combination of easy transmissibility and its wide range of symptoms makes it somewhat unique, but there are lessons that can be learned from previous pandemics like the Spanish Flu of 1918. This pandemic lasted over two years and came in three waves that killed 50 million and 100 million people. Exactly why the virus became extinguished remains unclear. There were no vaccines for it and no effective treatments. It has been estimated that over a period of two years 500 million people worldwide were infected and somewhere between 50 and 100 million people may have died. Several theories for its disappearance have been postulated, but it seems likely that this was due to a combination of factors. One of these might have been that the virus mutated to a less pathogenic form which often happens with viruses. Social distancing once it was used more aggressively likely decreased the rate of transmission. Also, as time went on more and more people got exposed to the virus and became immune leading to so called “herd immunity.” When enough people in a population are immune either through naturally occurring infection or immunization, the likelihood of transmitting the virus to the remaining others in the population who are not immune decreases dramatically. This is where we are hopefully heading now.
What happens next and how soon this pandemic ends depends on a combination of factors in addition to the development of herd immunity. This includes the natural history of the virus itself, in other words, will the virus mutate to a less aggressive form; how effective the vaccines are; how good we get at discovering new antiviral medications; and how good we get at treating the inflammatory effects of the viral infection such as the so called “cytokine storm.”
Through all of this turmoil just remember that “this too shall pass.”