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How Long?

Have you enjoyed the last month? Because we’re looking at 18-24 more just like it.

A new study from the laboriously named Center for Infectious Disease Research and Policy (CIDRAP) projects a long, painful ordeal.

The new coronavirus is likely to keep spreading for at least another 18 months to two years—until 60% to 70% of the population has been infected, a team of longstanding pandemic experts predicted in a report released Thursday.

They recommended that the US prepare for a worst-case scenario that includes a second big wave of coronavirus infections in the fall and winter. Even in a best-case scenario, people will continue to die from the virus, they predicted.

“This thing’s not going to stop until it infects 60 to 70 percent of people,” Mike Osterholm, who directs the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, told CNN.

“The idea that this is going to be done soon defies microbiology.”

There isn’t a huge amount of detail here that hasn’t already been discussed in the national conversation, but it synthesizes the lessons from previous influenza pandemics to make useful projections. The paper outlines three different scenarios that the pandemic may follow, but they all result in a similar time scale. From CIDRAP’s report:

Whichever scenario the pandemic follows (assuming at least some level of ongoing mitigation measures, we must be prepared for at least another 18 to 24 months of significant COVID-19 activity, with hot spots popping up periodically in diverse geographic areas.

This will be a long game, not a short one. Herd immunity appears to be the only end point to the pandemic, which means 200+ million people will either be infected or inoculated before this is over. A vaccine is months away under even the most optimistic projections. Optimistic efforts to “crush the curve” are likely only to delay the inevitable. Barring a miracle, this is going to be a serious issue for a long time.

This would mean that the true impact of the pandemic can only be evaluated over a longer time frame. Leaders currently judged on how fast COVID-19 has spread in their communities may be judged differently if all communities end up suffering roughly the same impact. New York City may not be the “worst,” but merely the “first.” Imagine Bill de Blasio bragging in a year that under his leadership New York City achieved herd immunity sooner than anywhere else in the country.

It also means that policy cannot be focused merely on how soon states re-open, but on how sustainable those openings are. Governors must be prepared to fine-tune their orders as the situation on the ground changes and infection rates rise. A governor that says this month that “the worst is behind us” is a governor that is likely to hear those words again in an opponent’s campaign commercial. On the other hand, A governor that attempts to keep their state closed indefinitely to wait the virus out may find that they have no economy and no voters left. The proper goal, perhaps, is not how to defeat the novel coronavirus, but merely how to live with it.

Our national political situation must also be considered. Imagine, if you will, and if you have the stomach for it, a presidential election in which countering the pandemic and its fallout is the central issue of the campaign. One candidate favors a renewed, vigorous lockdown to wait until a vaccine is produced and proposes an unprecedented package of European-style income support. The other candidate advocates to continue the controlled move toward herd immunity with a partially-open economy, at an expected cost to hundreds of thousands of lives. The American people, anxious to have their voice heard, look forward to November 3…

And it is the middle of an infection spike. States wrestle with keeping polls open. Some states move to mail ballots only, triggering fears of fraud and disenfranchisement. Key states, too close to call, take days or even weeks to count all of their mail-in votes, leaving a nation in crisis stuck in a cruel limbo. It would be the equivalent of holding the 2000 election the day after 9/11. Congress and the state governments need to start planning for this, and they need to start planning for it now.

The American people need to start thinking about it, too.

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