John Locher / AP
Two years ago, the science writer Ed Yong wrote an article for Atlantic in which he warned that a new global pandemic was inevitable – and that the world would not be prepared for it when it arrived. Now, with the COVID-19 outbreak, much of what Yong warned about in his reports has come true.
Yong says scientists are still working on understanding how the new coronavirus travels through the air. His last article for Atlantic wonders if people other than health care workers and other front line workers should wear some kind of mask to help prevent the spread of coronavirus.
Yong notes that there are two ways in which respiratory viruses generally travel through the air: as droplets of fluid and as spots of evaporated fluid called “aerosols”.
Yong describes aerosols as “distant” and “durable” viral spots. “There is growing evidence that aerosol transmission – what people have traditionally described as” airborne “- applies, to some extent, to the new coronavirus,” he said.
He adds that it is not yet clear whether living infectious viral particles remain in the air where the infected were: “This is the crucial thing to know,” he said. “And then, really, and most importantly, are there enough of these viral particles to actually trigger an infection?” We don’t know the answer yet. “
Yong said that the experts he consulted did not reach a consensus on whether the general population should wear some sort of mask, when in public places. “There is a lot of movement towards recommending widespread use of masks in different countries,” he said. “The CDC seems to be thinking about it. Health experts to whom I have in the past been contemptuous about the use of masks are about to recommend it. “
But Yong adds that the shortage of N-95 respiratory masks and even professionally made surgical masks makes matters more difficult.
“We are currently in a situation where the masks are already exhausted in hospitals and for health workers, who are the people who need them most. And only then should we think about whether the general public should consider wearing masks. ”
Looking to the future, Yong says that while masks, frequent hand washing and social isolation strategies are effective in slowing the spread of the virus, the end of the pandemic is still a long way off: “We are in this long game prolonged hitting a mole with the virus where different places will kill it at different times. He will reappear. It will have to be checked again. ”
What we know about how the virus spreads through the air and how we are likely to inhale it
A study has just projected fluids loaded with viruses into a rotating cylinder to create a cloud of aerosols. And they discovered that inside this cloud, the virus remained stable for several hours, which suggests that it can at least survive in the air around us. Now, this is a pretty artificial configuration. It’s probably closer to a medically invasive procedure like intubation, rather than a person who just breaths while walking on the street or sitting in a room. It is therefore difficult to know what to think of this outside of the healthcare environment.
But other studies suggest that coronavirus can be released into the air in less dramatic ways. For example, a new [study] published by the University of Nebraska Medical Center searched for traces of virus genetic material in the rooms of several patients who had COVID-19 – many of whom had only mild symptoms. So they found traces of this genetic material on many different surfaces, including hard-to-reach places like ventilation grilles and the floors under the beds. This corresponds to the idea that the virus travels through the air for longer distances than a droplet could land.
What we don’t know is if there are any real infectious viral particles in the air. The presence of genetic material does not indicate this. It’s like finding a fingerprint at a crime scene. This means that the culprit was once there, but they may have been gone a long time ago. So this is the crucial thing to know. … And, [in each case], are there enough of these viral particles to actually trigger an infection? We do not yet know the answer to this. And this is a really crucial piece of the puzzle.
On how thinking about masks for the general population might change
The confusion is understandable, because even among the experts I have spoken to – including those who have studied airborne transmission and its possibilities – opinions are divided on the role of masks and the protection they can provide. to offer. There is just a mess of data on whether the masks worn by the general population will provide protection against respiratory diseases in general; if the masks prevent you, if you are infected, from infecting other people. I think it is a little clearer, both from the evidence and only by common sense. And that could be very important for a disease like COVID-19.
We know that the virus that causes it can spread from person to person before they show symptoms, and this is perhaps the strongest argument in favor of widespread use of masks. Even if you don’t cough, sneeze, or have a fever, you may not know you have a virus, and wearing a mask can prevent you from spreading the virus to someone else.
Why touching your mask denies its protection
One of the reasons why some people are still on the fence recommending the widespread use of masks is this idea that people who wear masks and who are not used to these kinds of futz with them. They wave with the masks, they touch their faces. There’s not a lot of data on this … but almost everyone I spoke to who actually used the masks correctly, whenever they saw people using them more casually, people almost always deceive. They pull the mask over their chin, wipe their faces. They constantly touch the masks. They always adjust it. And that carries a risk, and the risk may be that you lure yourself into a false sense of security, thinking that you are safe, but in a situation where you actually increase the likelihood of infection.
How American pride and exceptionalism contributed to the slow response
[A virus] has no interest in people’s terror, only in their cells. He just wants the hosts to infect and doesn’t care if you feel brave or not. And I think that certain aspects of the American national character seem to have made it more difficult for people to take the necessary measures to slow the spread of the pandemic. And not only this feeling of resilience, of being brave in the face of frightening threats, but also a sense of individualism and exceptionalism. This idea that “I have the freedom to do what I want to do,” which prevents people from staying inside and listening to advice to isolate themselves when necessary. And I think the famous exceptionalism of the country – the idea that it is the largest country in the world – which, I think, helped to delay the reaction of the nation.
COVID-19 took off in China for at least a month before reaching the American coast for the first time. And during this month, not much happened [in the U.S.]. Many preparatory measures could have been launched. The country could have taken action, ready for it, so that the virus would eventually reach it. But if anything, America had more or less remained inactive. It was slow. And I wonder if this propensity to consider oneself truly exceptional, this slight pride, left her more ill-prepared than she should be. And I think even if many people had warned him for a long time, the disappointing nature of the American response to this threat really surprised even the people who had warned, who had raised alarms.
There is an item called the Global Health Security Index, which ranks different countries based on their level of pandemic preparedness, based on 140 different criteria, based on regulations from the World Health Organization. And among all the countries that have been evaluated, the United States has the highest score – 83.5, a solid B. But if you look at how the country has actually responded to the pandemic, I think we are probably getting some thing like an F. The nation that was supposed to be the most prepared of all really undermined its response, and I think, to some extent, it shocked even the most alarmed or pessimistic people I had talked about before, in my previous report.
On what happened to the medical supply chain of masks and pads
The medical system operates on a just-in-time economy, much like the rest of the world, and products are made to order and depend on these very long international supply chains, many of which have fractured during this pandemic. For example, Hubei Province, where the pandemic started in China, is also one of the world’s major centers for manufacturing medical masks. So the fact that the pandemic hit this region first and hardest has really exacerbated the shortage of medical supplies. There is also now a shortage of swabs that people used to take viral samples as the first step in the test. And one of the companies that runs the manufacturing of these swabs is based in northern Italy, which is one of the hotbeds of the pandemic in Europe. …
It’s really unlucky that these two regions were particularly affected, but you could consider the same problems for all kinds of other regions. I think that’s what happens when you rely on a medical system that depends on these big international chains and that really doesn’t have much capacity to flex and increase in a crisis. And this is particularly serious now, because the pandemic has spread so quickly that the whole world faces the same problem at the same time and finds itself at the same time with the same supplies – which has really spread most of these supply chains at a breaking point. Everyone is looking for the same supplies and there is not enough to go around. Everyone is competing instead of cooperating because the crisis has spread so quickly.
On the deployment of a COVID-19 vaccine
So far, the first steps have been encouraging. A vaccine candidate has already started early safety trials after a record time to identify and sequence the genome of this new virus. But the journey between those first attempts and having a product you can hold in people’s arms is very long and difficult to shorten. You need to know if the vaccine is safe, if it triggers an immune response. Then you need to know if it is actually effective in preventing infections. You need to know what dose to use, how many doses to use, if it also works in older adults who are at higher risk. All of these steps take time, and if you don’t follow them, you risk creating a product that has really serious side effects or that is widely deployed but just doesn’t work.
So the experts I spoke to estimate that it will probably take between 12 and 18 months to even develop an effective vaccine, let alone build the manufacturing capacity to create enough doses, and then distribute and distribute these doses. inject into people. It will not be a quick process. And until this process is completed, COVID-19 will be part of our lives.
On the different methods used to develop a vaccine for COVID-19
Most existing vaccines [against other viruses] use a dead or weakened virus or a fragment of this virus. So the idea is that you show that to the immune system, [and] the immune system can prepare the defenses in advance. [One new vaccine candidate in development against the coronavirus] works in a slightly different way. It uses a piece of the genetic material of the virus, its RNA. You inject this into a person in the hope that that person can then build their own fragments of the virus using the instructions in that genetic material and that these kinds of local fragments can then train the immune system. These RNA vaccines are a new technology. They have the potential to be really important and to be much faster. But the caveat is that none of these vaccines have ever been on the market before. We are therefore innovating and there are not already facilities available to manufacture such vaccines in the necessary quantities.
In contrast, other teams are using more traditional approaches. For example, there is a group in France that is trying to reuse the existing measles vaccine to target the new coronavirus instead. It might take longer at the front. But on the positive side, if it works, the world knows how to make large quantities of measles vaccines. So we don’t know which of … these solutions will end up being the quickest. But it is certainly reassuring that many different options are being tried – not just these two, but many others. And we’ll just have to wait and see what happens at the finish line sooner.
On the idea that the spread of the coronavirus could slow down in summer
So, traditionally, coronaviruses and many other respiratory viruses, like the flu, disappear in the summer, and there are several reasons for this. Moisture and heat certainly make it easier for cells to get rid of viruses from our airways, and part of the immune response to these respiratory viruses seems to be stronger under these climatic conditions.
Now, will this new coronavirus behave the same way? Perhaps. Will it make a difference with the pandemic? I am not sure. And the reason is that the virus circulates through a world population which is completely immunologically naive to it. Our immune systems are not ready to deal with something like this. And so the virus has a large proportion of hosts among which it can easily spread. Hoping that summer will minimize these dynamics enough to contain the pandemic is, I think, wishful thinking. … We are witnessing a transmission in places like Australia, which has just finished its summer, or Singapore, which is hot and humid in the tropics. And what that tells us is that it’s probably wishful thinking that heat and humidity are the things that contain this virus. They can help, but only if we can slow its spread by other means, such as through social distancing.
In preparation for the return of COVID-19
I think it’s very likely. I think most experts would expect some sort of resurgence once the current social distancing measures are released. It’s sort of in the nature of these viruses. It’s certainly likely because the pandemic is now so widespread that unless the entire world tests the virus simultaneously, there will always be pockets where epidemics are still going on, and which can sow [and] can rekindle sparks of infection in places where outbreaks have already been extinguished. …
And so we are probably considering several cycles of social distancing, multiple social upheavals. Now, it is possible that if we act together and if we succeed well in this first wave, these subsequent fights will be less dramatic and less uprooting than this current period, and it could well be just because of this spread inequality. So, currently, the virus is everywhere. It strikes everywhere … about the same time. If different places can control it, there could be less potential for this type of explosion in the world. And then, over time, we hope that the surveillance measures will be better. We are becoming better at testing the virus and determining who is immune to it, to make the supplies necessary to protect health care workers. All of these measures could mean that we can be a little more sophisticated where social distancing is deployed, in the nature of these measures. But I think it’s very clear that it’s going to be a long game.
On how the pandemic has hit the most vulnerable in society
Clearly, the economic implications of this will be far-reaching. I think that, as with many disasters, it will hit people in different ways which are amplified by existing inequalities; people in low-income groups, people in marginalized groups will feel the effects much more.
Pandemics often reveal the fault lines that exist in societies and reveal to whom a society cares and which it often ignores. The people who still have to serve on the front lines of society while everyone takes refuge inside, people like grocers, janitors, they are currently risking their lives because many of them don’t have the choice. The elderly who have often been marginalized on the margins of society are now [being asked to] isolate themselves further, deepening the loneliness that many of them have already felt. People with mental health issues, people with anxiety and obsessive-compulsive disorder who have long been struggling with infection and cleanliness, are now seeing some of their worst nightmares unfold around them and struggle in a context where they do not have access to their usual support networks or therapists.
Thus, many societal dynamics which were already ignored and which were crumbling will further crumble. I think it’s important to be wary [that unraveling] and find the people who need help the most. A pandemic causes a wave of physical suffering, but then there is also economic suffering, mental suffering, emotional suffering. We will have to be wary of all these things when society rebuilds itself following this crisis.
On the potential of the pandemic to inspire positive change
I think this is the time to imagine what a better world could look like and start working actively on it. These periods of great social upheaval involve great risk and tragedy, but also great potential. So, at a very simple level, after the spread of HIV worldwide and in the 1980s, this led to a better awareness of sexual health which led to the integration of condom use, screening [for sexually transmitted infections]. And maybe the COVID-19 pandemic will lead to a normalization of health behaviors that have been difficult enough to induce people to adopt, such as regular hand washing for 20 seconds – sometimes a rarity even in hospitals, and still less at home. And now all of us – well, many of us, hopefully – [are] wash your hands regularly every day. I hope this will become a normal part of our culture in the future.
I also really hope that much of the ethic of cooperation that we are starting to see, people in communities who are looking for each other, meeting at a time of crisis, will continue for the rest of this long-term pandemic and beyond. I think we will need it if we are to be better prepared for what will happen. We need this feeling of cooperation between neighbors in a community, between states, in a country and between countries – an international community.
Amy Salit and Seth Kelley produced and edited the audio for this interview. Bridget Bentz, Molly Seavy-Nesper and Deborah Franklin have adapted it for the web.