Eric Toner, a senior fellow at the Johns Hopkins Center for Health Security and a global leader in pandemic preparedness , has briefed world leaders on pandemic outbreaks in an effort to prepare nations for mass casualties. He has simulated epidemics in real time and studied the world’s response to global emergencies, such as the 1918 flu pandemic and SARS. When it comes to the COVID-19 pandemic, it’s nothing new to Toner. Among the key points Toner makes about COVID-19 is that we’ll be wearing masks for years. But let’s take a closer look at Toner and his work in the pandemic space.
In October 2019, Toner and his team at Johns Hopkins ran a coronavirus pandemic simulation in New York City, months before COVID-19 began spreading around the world. Toner met with other health professionals to consider the possibility of a hypothetical coronavirus outbreak, as well as how governments and private businesses to such a situation.
Johns Hopkins has been running such simulations for years, with codenames like “Dark Winter” (smallpox) and “Clade X” (“a biologically engineered, intentionally released airborne pathogen” that caused hundreds of millions of hypothetical deaths). The goal of the simulations is to help public health experts and policymakers better prepare for a real pandemic. And now one has become a reality. But simulating a pandemic is a far cry from watching the world handle a real pandemic. Toner argues that some countries are failing to respond to the pandemic, citing the United States. In particular, he calls the U.S. response to the COVID-19 pandemic “extremely disappointing and flawed,” stressing that the U.S. needs to recognize that it “claims” the number one or two spot as the country hardest hit by the virus.
Toner notes that we must remain ignorant so that we are not scared now with the COVID-19 pandemic, as it is worse than other pandemics and will remain a “truly bad event” in history. He adds, however, that while the world enters the second semester of the pandemic, the situation remains equally serious.
According to a Johns Hopkins update released on July 1 (which tracks pandemic statistics and provides regular status reports), the pandemic has affected nearly every country, with more than 10 million reported cases and more than half a million deaths. Of the more than 200 countries and territories reporting cases, 86 are reporting community transmission.
Many countries have been successful in the fight against the Coronavirus, imposing lockdowns, adopting the advice of the World Health Organization (masks, antiseptics, etc.) and accelerating diagnostic tests to identify and isolate identified outbreaks of infection. However, now that countries are returning to “normality” and slowly “opening up” again, adopting masks and other measures that may remain in the spotlight for years, cases continue to increase.
The Toner reports that he cannot know if it is a first or second wave, but that does not matter since there is no difference. He adds that cases are making their reappearance in certain states, a fact that appears as a simple continuation of the first wave. In other states, something like this may seem like a second wave of COVID-19. Toner notes that it is clear that there is a significant resurgence of cases in the summer, which is expected to become even larger. And this will continue to happen until the countries “close” again.
Unlike the influenza virus, which was behind the 1918 pandemic that is estimated to have killed over 50 million people worldwide, Toner claims there is “no good evidence of seasonality” with COVID-19. Until a vaccine, any increase or decrease in cases will be based on social factors, such as lockdowns. He also noted that people wore masks in 1918.
Nevertheless, Toner reports some positive findings that emerged from the first half of the pandemic. Specifically, hospitals are improving symptom management and intervening before cases reach a point of no return, significantly contributing to reducing the death rate. He also highlights therapies such as remdesivir, which has shown positive results in trials and has been approved for hospitalized patients with COVID-19, and plasma therapy, which could be used as a means of transferring a level of immunity to patients.
Experts point out that it will take at least one year to develop a vaccine that will be affordable to most people. At the same time, mass immunization is unlikely to arrive until 2022, and even then, Toner argues, vaccination may require a double dose to be effective.
Until then, Toner believes we will be living (at best) for several years with masks and some degree of social distancing. For many, this long timeline can lead to a sense of hopelessness. But Toner says there is a way to control our future, and it is not much different from the advice he has given in simulations, advice that dates back more than a century. If we all cover our faces with masks, the risk of transmitting the virus is reduced, while being outside, keeping our distance from each other, reduces the risk of transmitting the virus to a significant extent.
According to Toner, there are many things we can do, while still adhering to the recommended protective. We can keep our distance, avoid crowded places, go to a quiet beach, to the mountains, to lakes – we can do many things without a problem. As for those who refuse to wear masks, Toner does not “chew his words” and says that at some point they will “get over it” and wear masks, but it will take many people to get sick and die before they are convinced to do so. Finally, Toner warns that this is an ordeal that could last years.
