The coronavirus has changed how we socialize and where, as well as wondering how activities like travel and basic interactions (are handshakes gone forever?) will change.
To help us understand what it could take to get back to interacting with people other than family and pets with relatively more freedom, Sharmin Mossavar-Rahmani, Goldman Sachs’ Chief Investment Officer, hosted a Talks at GS to discuss what’s needed for a phased reopening of the economy with a group of leading medical experts. Those experts included Drs. Luciana Borio, Vice President, In-Q-Tel, Florian Krammer, Professor of Vaccinology, Icahn School of Medicine at Mount Sinai and Mark McClellan, Director, Duke-Margolis Center for Health Policy.
The R-factor (officially the R0 Factor). A virus’ reproductive number, or the number of people an infectious patient could infect. Borio says social distancing measures have helped reduce the reproductive rate from the 2-to-4 range, and we need to get this number below one. She notes that seven states have a rate of 1.1.
Testing prevalence. Borio, Krammer and McClellan identified different pieces of the testing puzzle. One includes how widespread testing is. This is important for a number of reasons including getting a better understanding of Covid-19’s fatality rate. Right now, Borio says testing is limited, so it’s unclear how many people have Covid-19 and the people being tested generally have severe cases, which drives up the mortality rate. McClellan says we’re nowhere close to the ability to test the number of people required and that we need tests and contact tracing to keep an eye on how the virus is spreading.
Testing accuracy and sensitivity. Krammer says we need reliable tests that are 100% accurate, and we’re not there yet. He also said that tests need to be able to reveal information such as the amount of antibodies someone has, as opposed to a simple yes or no as to whether a person has been infected. This more detailed information could be important in determining if someone is immune.
Immunity. There has been a lot of discussion about herd immunity, but it’s not clear that if you’ve had Covid-19 that you won’t get it again. Krammer says current research shows that although patients do produce antibodies that neutralize Covid-19 (which is good), more information is needed to understand if patients could be immune or for how long. As for herd immunity, if patients do gain some sort of protection, Krammer says that group effect would only happen when 60 percent to 75 percent of a population was immune and “we’re far from that even in places like New York where the prevalence is relatively high, we’re not even close to that number.” He says a reliable vaccine, if it becomes available, would help get us to that level of immunity.
Social distancing and vigilance to continue. In short: we need a vaccine and will have to maintain social distancing measures and adopt contract tracing to help contain the virus. McClellan says that more restrictive measures for vulnerable groups (like the elderly) will probably need to stay in place even if other measures loosen up.
Outbreaks. “Cases will continue to go up when restrictions are lifted,” says Borio, who also noted that “we’ll likely see a lot of peaks and troughs . . . until there is herd immunity through a vaccine.” These are points Krammer and McClellan echoed. As for the fall season, McClellan says “A fall wave might be bigger . . . it’s definitely a real concern and one we should prepare for.” McClellan.
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