Originally posted on jessy.io.

March 1st.

Besides wearing masks, social distancing, contact tracing and isolating people, and developing herd immunity...

1. Proactive: special medicine and vaccines

   1. The most promising medicine currently is Remdisivir, developed by Gilead originally to treat Ebola. However, more clinical trial cases are needed to determine the effectiveness based on a large enough sample size. We might hear results sometime in early April.
   2. Vaccines are still months, if not 1-2 years away. Vaccines need to go through processes like phase 1-3 of the clinical trials, FDA/EMA licensing, large scale production and distribution, administration and then finally immunity.

2. Proactive: can't really prevent, but can slow down the spread

   1. Since COVID-19 has become a pandemic (roughly defined as community-sustained spread of the virus and unknown traces of origin in more than one continent), versus an epidemic (spread in only one continent/place, such as Ebola), it is most likely not able to be contained, at least not from travel restrictions.
   2. Now, the priority becomes whether we can prevent a sudden spike of cases of people crowding and exhausting the hospitals all at once. Where then, the fatality rate of COVID-19 will jump to at least 5% (e.g., Wuhan, Italy). Needless to say, the shortage of medical supplies and the societal panic and unrest that might follow it afterward. Therefore, easing hospitals into the process of treatment will become critical.
      1. Halt inbound infections: more people wear masks the better, if medical staff are taken cared of)
      2. Aggressively test people: make it easy, fast and free, like what South Korea did with drive-through testing to incentivize citizen collaboration
      3. Rigorous contact tracing: testing, treatment, and quarantine are paid for, for those who've been in close contact with the confirmed patient (extreme social distancing is needed)
      4. Treat patients (& extensively disinfect their living areas), collect data, share data and collaborate with other hospitals for tips and insights
      5. FYI, the best way to gauge the real time severity of infections in your area, therefore, is not through official reporting of the CDC (only use for reference, as many countries are lagging behind with testing), but how crowded your local hospitals are. In which you should try staying away.

3. Reactive: hope the virus will mutate in the positive direction & until herd immunity is achieved

   1. Virus is made of RNA strands, which is more easy to mutate than DNA strands
   • It can mutate in 4 ways (remember, the purpose of the virus isn't to kill us, but to coexist with the host so can survive and pass on their genes too)
     1. Less contagious, more fatal: this is the worst combination for the virus, as survival of the fittest would mean the virus cannot spread and live as long in this form
     2. Less contagious, less fatal: possible, but not ideal
     3. More contagious, more fatal: possible, but not ideal
     4. More contagious, less fatal: the most likely option, as this is the best option for the virus to survive and reproduce
     5. The virus has already evolved into L (mutated) and S (original) strands
   • It seems like those who are the most likely to develop critical and fatal cases are Asians (with more binding ACE2 receptors to the lungs), male, elderly, smokers, with previous chronic illnesses such as diabetes
   • If about 60-80% (~66.7%) of the population in one are gets infected and recover, then we can effectively stop the epidemic in that area; but actively getting your community infected for the public to gain herd immunity instead of holding on to wait for vaccines will cause lots of unnecessary deaths.

4. Reactive: betting for the summer to hit and temperature rise to make the virus go away

   1. SARS quietly went away when summer came, since SARS-Cov-2 (the virus) is a cousin of SARS, people suspect COVID-19 (the disease) can end in a similar way. Which is what countries like Japan and the USA are betting on (2020 Summer Olympics and 2020 Election, respectively).

   2. However, we are seeing countries in hotter climates like SE Asian countries and Australia to have infected cases. Though, they don't have nearly explosive growing cases like China, Korea, Iran, and Italy, yet. Therefore, I think the weather change is still promising.

      

      As of Mar 10th, we have seen COVID-19 establishing significant community spread in regions roughly along the 30-50 N” corridor at consistently similar weather patterns (5-11 degrees C and 47-79% humidity).

   3. Although, experts predict that the most likely result is for COVID-19 to become a part of the normal flu - which means it will live among us and come back every flu season (not too bad if fatality rate goes down).

   4. We might see a trend of the virus getting spread to the southern hemisphere during the summer (their winter) and then spreading back to the northern hemisphere. So possibly, it won't go away unless 70%-80% of the population develops herd immunity. Which means this will be a long marathon.

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   No virus will probably spread like fear, panic, and false information. What are the actions that the public will take under this sentiment? The government must ensure the fuel of supplies coming in to prevent civil unrest.