When is a pandemic over?

4,922,854 views ・ 2020-06-01

TED-Ed


Please double-click on the English subtitles below to play the video.

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Consider this unfortunately familiar scenario.
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Several months ago a highly infectious, sometimes deadly respiratory virus
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infected humans for the first time.
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It then proliferated faster than public health measures
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could contain it.
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Now the World Health Organization (WHO) has declared a pandemic,
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meaning that it’s spreading worldwide.
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The death toll is starting to rise and everyone is asking the same question:
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when will the pandemic end?
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The WHO will likely declare the pandemic over
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once the infection is mostly contained
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and rates of transmission drop significantly throughout the world.
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But exactly when that happens depends on what global governments choose to do next.
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They have three main options:
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Race through it, Delay and Vaccinate, or Coordinate and Crush.
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One is widely considered best, and it may not be the one you think.
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In the first, governments and communities do nothing to halt the spread
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and instead allow people to be exposed as quickly as possible.
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Without time to study the virus,
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doctors know little about how to save their patients,
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and hospitals reach peak capacity almost immediately.
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Somewhere in the range of millions to hundreds of millions of people die,
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either from the virus or the collapse of health care systems.
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Soon the majority of people have been infected
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and either perished or survived by building up their immune responses.
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Around this point herd immunity kicks in,
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where the virus can no longer find new hosts.
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So the pandemic fizzles out a short time after it began.
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But there’s another way to create herd immunity
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without such a high cost of life.
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Let’s reset the clock to the moment the WHO declared the pandemic.
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This time, governments and communities around the world
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slow the spread of the virus to give research facilities time
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to produce a vaccine.
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They buy this crucial time through tactics that may include widespread testing
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to identify carriers,
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quarantining the infected and people they’ve interacted with,
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and physical distancing.
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Even with these measures in place, the virus slowly spreads,
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causing up to hundreds of thousands of deaths.
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Some cities get the outbreak under control and go back to business as usual,
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only to have a resurgence
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and return to physical distancing when a new case passes through.
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Within the next several years,
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one or possibly several vaccines become widely, and hopefully freely, available
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thanks to a worldwide effort.
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Once 40-90% of the population has received it—
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the precise amount varying based on the virus—
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herd immunity kicks in, and the pandemic fizzles out.
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Let’s rewind the clock one more time, to consider the final strategy:
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Coordinate and Crush.
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The idea here is to simultaneously starve the virus, everywhere,
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through a combination of quarantine, social distancing, and restricting travel.
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The critical factor is to synchronize responses.
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In a typical pandemic, when one country is peaking,
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another may be getting its first cases.
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Instead of every leader responding to what’s happening in their jurisdiction,
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here everyone must treat the world as the giant interconnected system it is.
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If coordinated properly, this could end a pandemic in just a few months,
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with low loss of life.
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But unless the virus is completely eradicated— which is highly unlikely—
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there will be risks of it escalating to pandemic levels once again.
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And factors like animals carrying and transmitting the virus
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might undermine our best efforts altogether.
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So which strategy is best for this deadly, infectious respiratory virus?
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Racing through it is a quick fix, but would be a global catastrophe,
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and may not work at all if people can be reinfected.
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Crushing the virus through Coordination alone is also enticing for its speed,
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but only reliable with true and nearly impossible global cooperation.
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That’s why vaccination, assisted by as much global coordination as possible,
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is generally considered to be the winner;
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it’s the slow, steady, and proven option in the race.
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Even if the pandemic officially ends before a vaccine is ready,
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the virus may reappear seasonally, so vaccines will continue to protect people.
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And although it may take years to create,
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disruptions to most people’s lives won’t necessarily last the full duration.
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Breakthroughs in treatment and prevention of symptoms
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can make viruses much less dangerous,
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and therefore require less extreme containment measures.
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Take heart: the pandemic will end.
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Its legacy will be long-lasting, but not all bad;
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the breakthroughs, social services, and systems we develop
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can be used to the betterment of everyone.
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And if we take inspiration from the successes
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and lessons from the failures,
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we can keep the next potential pandemic so contained
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that our children’s children won’t even know its name.
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