It is almost exactly one year since the coronavirus Sars-CoV-2 was identified by Chinese scientists as the source of a new, lethal respiratory illness.
Since, more than 1.5 million people have died globally, economies worldwide have shut down multiple times and societies have isolated in their homes and watched holidays pass without the closeness of family and friends. Ahead of us is a year undertaking the most logistically challenging public health campaign ever.
But, in this, Yale professor and social epidemiologist Dr Nicholas Christakis brings cold comfort, as laid in his new book Apollo’s Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live. And that is because he sees a pattern. “One of the arguments in the book is that what’s happening to us may seem to so many people to be alien and unnatural, but plagues are not new to our species – they’re just new to us,” said Christakis, whose expertise is in how our behaviors influence contagion in society.
Here is the comfort that might be taken in Christakis’s observations of disease over millennia: plagues and pandemics end. They always end. They ended even before we had vaccines to respond to them. And how we react to these germs – through social distancing for example – determines the force with which they hit our society.
Further, while distributing vaccines from Pfizer and Moderna will be one of the greatest public health challenges of our time, they also represent one of humankind’s great achievements.
If we can vaccinate a sufficient portion of the population (roughly 75% according to some estimates), we will bring the pandemic to heel much earlier and with less death than it might have ended on its own.
“We’re the first generation of humans alive who has ever faced this threat that allows them to respond in real-time with efficacious medicines,” said Christakis. “It’s miraculous.”
Then, once pandemics end, often there is a period in which people seek out extensive social interaction, and which Christakis predicts will be a second “roaring 20s” just as after the 1918 flu pandemic.
“During epidemics you get increases in religiosity, people become more abstentious, they save money, they get risk averse and we’re seeing all of that now just as we have for hundreds of years during epidemics,” said Christakis.
As well, economies of ancient civilizations collapsed in times of disease.
“Many people seem to think it’s the actions of our government that are causing the economy to slow – that’s false,” he said. “It’s the virus that’s causing the economy to slow, because economies collapsed even in ancient times when plagues happened, even when there was no government saying close the schools and close the restaurants.”
This future, Christakis predicts, will not come until society has had time to distribute the vaccine, probably through 2021, and had time to recover from the socioeconomic devastation it has wrought, probably through 2023. But the vision he lays out for 2024 and beyond is one filled with experiences pined for in isolation: packed stadiums, crowded nightclubs and flourishing arts.
“In 2024, all of those [pandemic trends] will be reversed,” he said. “People will relentlessly seek out social interactions.” That could include “sexual licentiousness”, liberal spending, and a “reverse of religiosity”.
In the coming year, these predictions ride on people’s continued adherence to social distancing measures. That is because even with two vaccines authorized for distribution in the US, there are only currently enough doses to reach 150 million Americans.
Scientists will need to continue to develop other vaccine candidates, the government will need to assess and approve them if they are safe and effective, and people will need to take them to reach the broad enough swath of the population necessary to extinguish the pandemic. There will also be continued learning about the vaccines, including how long the immunity they confer lasts and whether they are safe for children.
The coming year will test the world’s endurance in continuing to social distance, hand-wash, wear masks and avoid crowds, the 14th century’s answer to plagues, and strategies which work like breakwaters to curb the tidal wave of force now being experienced across the US.
Christakis warns we have already proved to be vulnerable to the poor leadership, lack of coordination and misinformation widespread during a pandemic. “As a society we have been very immature,” said Christakis. “Immature, and typical as well, we could have done better.”
Succumbing to misinformation, divisiveness and denial are also features so typical of a pandemic, they might be “required”, said Christakis. But, reservoirs of expertise continue to exist, he says, and it is possible we may come together to meet a challenging year ahead.
“Our world has changed, there’s a new deadly pathogen that is circulating, we’re not the first people that have had to face this threat, and a lot will be asked of us,” said Christakis. “And we’re just going to have to be grown up about it.”