Coronavirus: Hunker down, but for how long?

Josh Greenman, Tribune News Service

Social distancing makes all the sense in the world in the pivotal early stage of a fast-moving outbreak like this coronavirus. We must prevent our hospitals and ICUs from being overwhelmed as Italy’s currently are, not only for those struggling with this particular bug, but for all others who depend upon them.

We need to flatten the curve. We don’t want infections growing exponentially so that large numbers of vulnerable people get infected and some fraction of those people die.

What I do not understand, and I’m worried nobody has thoroughly thought through, is how long we’re supposed to cancel mass gatherings, keep museums closed and the like, and what any of this has to do with the progress of the pandemic.

Yes, there’s a possibility that we get rescued by the weather. Warmer weather makes it harder for some viruses to thrive. There’s a possibility a vaccine comes online sooner than any medical professionals anticipate, which is a year or 18 months at the soonest.

But setting those possibilities aside for a moment, consider a few scenarios.

• Confirmed cases and deaths spike. The big fear is that we’ve already passed some tipping point, and that the trend line of cases and fatalities now keeps going sharply up. (This is likely to happen in the near term in the US if only because testing, which has been outrageously rare, will ramp up, revealing previously unknown cases and driving numbers higher.) Suppose in a week a so, there are verified infections in the tens of thousands and many hundreds of deaths in the US. Suppose in a month there are hundreds of thousands of infections and many thousand deaths.

If the current rush to substantially slow the pace of the outbreak patently fails, in other words, will that mean continued social distancing or even more drastic measures are imperative, or will it mean that the virus will at some point be widespread enough that there’s no point in trying to hold back the floodgates any longer? My guess is the former, meaning if it doesn’t work, we must hunker down and do more of it.

• Confirmed cases and deaths plateau. The hope is that cancellations and self-quarantining have a real impact. Within a matter of weeks, the number of new cases starts to taper off, and so do the number of fatalities.

Will a highly successful containment campaign mean that we are out of the woods and can relent in our vigilance, or will it mean that we must keep everything closed and cancelled lest we snatch defeat from the jaws of victory? My guess is the latter, meaning if it works, we will have a strong reason to keep doing it.

• Confirmed cases and deaths go up, but not as fast as expected. A third scenario would be a muddle, where we can’t confirm whether social distancing and cancellation of mass gatherings are having the desired effect. They’re doing some good but not enough.

Will that argue for keeping it going for additional weeks and months, or reverting back to something closer to the old normal? My guess is a mixed record will argue for an escalated effort to isolate those with the virus.

In other words, we may be entering a stage in which, given our expectations and goals, no matter what the results of our prophylactic measures are, we have to dig in our heels for fear of unleashing the worst. And ironically, the strongest ultimate case for relaxing the restrictions may be the scenario in which cases have spiked sharply, making extraordinary measures to hold back its spread futile.

Or am I wrong? I hope I’m wrong.