Is COVID-19 Likely To Be At Pandemic Proportions For Two Years?

This question was originally posted on Quora.com and was answered by Scott Hsieh, works at David Geffen School of Medicine at UCLA



Here’s the problem with Covid-19:

If we do nothing, it goes out of control. There is nearly universal agreement on this point. Every week the number of infected people doubles or triples, according to the best estimates of R0 today. Within about two months, hospitals start to collapse under the pressure (Italy) and can survive only by building emergency new facilities using help from the rest of the country (Wuhan). However, if you really are doing nothing, then two months later the rest of the country falls down and no one can help you. At this point, there are no more ICU beds left and the mortality rate goes from 2% to 5-10% because we run out of respirators.

On the other hand, if we declare a state of emergency … schools shut down, airports virtually close, and the country goes on lockdown. All for what, like 3,000 cases?? Then if the disease is successfully suppressed a few months later, everything opens back up and we look around and say, gee, why did we even do that?! Why did the country shut down when the ordinary flu killed 100x more people this year? Didn’t we way overreact?

But the difference between 5,000 cases and 5 million cases is 10 weeks of inaction. That is why governments around the world are taking severe and enormous action now, because we are at the edge of the precipice.

To answer the original question — will Covid-19 be considered a pandemic in two years? That depends on us. Please, if you have a cough and/or a fever, stay at home and stay away from others. You probably have a cold, but if you’re a minimally symptomatic carrier, you can do your part by making sure your particular Covid-19 ends at you and doesn’t get passed on to another person.

And was also answered by Richard Muller, Prof Physics, UC Berkeley, author "Now, The Physics of Time"


Originally Answered: Is Covid-19 likely to be at pandemic proportions for 2 years?
There is a possible cure for Covid-19 that is getting only limited attention, possibly because the government does not want to raise false hopes. I attached a chart that was published 4 days ago by a prestigious set of medical scientists in the prestigious International journal of Antimicrobial Agents.


This chart shows the results of a controlled test of medications hydroxychloroquine and azithromycin. The bottom curve (green) is the most exciting one. When these medicines were used together, 8 seriously infected patients showed no presence of the coronavirus after 5 days. The upper curve is the controlled group.

The entire paper can be found at this link: cover19 treatment paper

Even better, these medicines have been in common and extensive use for other illnesses, particularly malaria, and thus have only known and well-established side effects.

Anthony Fauci is currently trying to determine whether to approve use of these medications for coronavirus. Trump seems to be pushing him to do that. It requires FDA approval. Right now, if you have covid-19, your local physician can prescribe these drugs, but doing so is “off label”, that is, they are FDA approved drugs but not for this purpose. I think (I’m not sure) that this leaves the medical doctor open to being sued.

Fauci expressed in his morning briefing that more tests are necessary. From a statistics point of view, that is not true. Eight people were cured in 5 days, while only one person in the control group spontaneously cured. The likelihood of that happening by chance are less than 1%. Larger groups are not needed to demonstrate this efficacy. “Small numbers” can be a valid criticism for marginal results, but these results are not marginal. The positron was discovered with 1 event; only 1 positron was seen, but it was enough. Anderson got the Nobel Prize for his one event. If you have one positron, that is good enough to show it exists. Small numbers do not necessarily imply weak statistics. I hope that Dr. Fauci understand that.

Part of the holdback, I suspect, is the terrible experience of the early release of a medicine called thalidomide in the 1950s that caused horrible congenital malformations in babies. Ever since this happened, the medical community has exercised enormous caution before approving a new drug. But the disruption to the world livelihood is so severe, that I believe the thalidomide cautions are not called for. Extreme caution may be inappropriate when the alternative consequences are extreme disruption.

Anthony Fauci certainly knows an enormous amount about biomedicine that I don’t know. But I worry that he doesn’t understand statistics as well as I do. The published paper shows extremely significant statistics, despite the small numbers tested.

I concur with the conclusions published in the cover19 treatment paper, in which the authors state:

“We therefore recommend that COVID-19 patients be treated with hydroxychloroquine and azithromycin to cure their infection and to limit the transmission of the virus to other people in order to curb the spread of COVID-19 in the world.”

I am optimistic by nature, perhaps by choice, so take what I say with some degree of caution. I see a path in which we can be largely rid of the coronavirus scourge in weeks rather than in months or years.


Timothy Sly, Epidemiologist, professor, Ryerson University, Toronto, also answered this question


All indications, from this pandemic, and by comparison with the dynamics of previous pandemics of acute viral respiratory diseases (1918, 1957, 1968, 2009), suggest that we could easily still be in some form of pandemic response for many months, possibly to the end of the year.

Where strict confinement and quarantine are used, the rate of infection (Ro) can be reduced close to, and even less that 1.0, (as is currently the case in China, where only 7 new cases were confirmed March 6). But it is important to realize that as soon as those restrictions are relaxed, the virus can spread again. The 81,000 cases recorded in China sounds a lot, but it is only 7 per 100,000 population. We can expect 20–60 percent of the population of any country affected by COVID19 to become infected unless severe restrictions on person-to-person contact are imposed.

Putting the brakes on transmission - even in the short term - (1) reduces the chance of complete collapse of the hospital/testing/monitoring systems (“flattening the curve”), (2) it may also reduce the number of secondary cases from each primary case, and (3), gives us time, perhaps bringing the availability of an antiviral closer. However, it also lengthens the pandemic and extends the catastrophic social and economic impacts.

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