NRPLUS MEMBER ARTICLE R ight now there are plenty of reasons to worry deeply about the toll COVID-19 will take on America. Cases and deaths are spiraling upward. Our main tools for addressing the crisis involve simply locking society down, leading to shocking economic harms. And even if these tools prove effective, the virus may simply begin to spread again when they are lifted, or perhaps rebound in the fall and winter when the weather cools down again. Perhaps most troublingly, there are some reports of people being “reinfected,” raising the possibility that even those who survive COVID-19 are not always immune to it going forward. A worst-case scenario would force us to decide between a year or two of repeated lockdowns while we wait for a vaccine on the one hand, and millions of deaths on the other.
I am not going to tell you this is all a hoax. I am not going to tell you to ignore the restrictions lawmakers have placed on your movements or the advice of public-health authorities. But I am a big believer in capitalism and human ingenuity, so I’d like to provide a quick overview of some routes out of this mess people are working on. I have immense hope that at least a couple of them will pan out, and in that event I also hope the folks behind them become unbelievably rich.
1) Find a drug that fights the virus or treats the symptoms. Vaccines take a long time to develop and test, because each must be tailored to a specific virus, but there are already lots of drugs around that might work to treat or prevent COVID-19. We need to figure out which ones immediately. The World Health Organization has launched a “global megatrial” of four possibilities: remdesivir, a drug developed to treat Ebola that, alas, did not work for that purpose; chloroquine and hydroxychloroquine, which are used to treat maladies including lupus and malaria; ritonavir/lopinavir, an HIV drug; and ritonavir/lopinavir combined with interferon-beta, which shows some signs of fighting MERS. If they work against COVID-19, these drugs could reduce the disease’s death toll, lessen pressure on intensive-care units, and change the tradeoffs inherent in reopening the economy. Thank God for Big Pharma!
2) Give people antibodies. Antibodies fight infections — and stick around afterward as a way of, basically, remembering how to do it in case the disease returns. They’re the reason you generally don’t get the same viral infection more than once (and a reason that some viruses, such as influenza, mutate to avoid detection in people who’ve been infected with earlier versions). As it happens, antibodies can also be given to people who haven’t been infected yet, or whose bodies are failing to control a disease on their own. “Convalescent plasma therapy” is when you simply take this magical stuff from one person and give it to another, and it’s showing some promise against COVID; you can also make antibodies synthetically.
3) Make lots more ventilators. The key concern with this outbreak is that the worst cases need ventilators, and if it spreads far enough we won’t have enough. If patients need ventilators but can’t get them, many will die who otherwise could have survived the disease; on the flipside, if we have plenty of ventilators, we have more room for error when we loosen lockdowns. So make more. This effort is underway, including through President Trump’s invocation of his defense powers to twist GM’s arm into making some without further bickering over terms.
4) Test, trace, masks. One way to control the virus while loosening the lockdowns might be to aggressively test people to see who has it, quarantine cases, and figure out whom these folks have been in contact with so they can be tested ASAP too. Mask-wearing, meanwhile, can dramatically reduce the rate at which the virus spreads among people who come into contact with each other in public places. This approach has worked well in other countries, but right now the problem is that we have too few masks, too little testing capacity, and too many cases for it to be possible to track down all their contacts. (Not to mention that the epicenter of the U.S. outbreak is hyper-dense New York City.) Some experts are dubious we can solve all these problems, but we have to try. On the good-news front, a fast new test just came out and its maker is pumping out machines as fast as it can, and there’s evidence that simple homemade masks are surprisingly effective.
5) Luck out with herd immunity. One of the big unknowns right now — though we’ll have better data soon — is what percentage of the people infected with the virus don’t show any symptoms. The higher this percentage is, the more people are already potentially immune to it, and the lower the per-infection death rate. I’m dubious of the most extreme suggestions (one paper posited that half the U.K. could already be immune), but the more asymptomatic infections there are, the faster immunity will build up, and the less bad the worst-case scenarios become.
Stay safe till we figure this out, everyone. And don’t lose hope that we will.