Learn to live with the coronavirus

Apprendre à vivre avec le coronavirus

Photo: Paul Chiasson, The canadian Press
If you want to avoid a second wave, it is not necessary to release the measures of distance too quickly, ” insists Dr. Raynault.

Nobody really knows when and how to end this pandemic, which undermines not only Quebec, but the whole world. Will there be to eliminate the virus or shall we learn to live with it for a long time ? Everything seems to indicate that the SARS-CoV-2, which has managed to conquer the planet will survive beyond the present epidemic and that there will be a lot of time before getting back to our former life.

In 2003, the SARS epidemic was eventually shut down and the coronavirus that was responsible, by would disappear from the surface of the Earth. But the infectiologist Raymond Tellier, of the McGill university health Centre, reminds us that, unlike the viruses of the COVID-19, that the SARS did not transmit by asymptomatic individuals, and it was not as contagious. And it is largely for these reasons that it has not led to a pandemic.

Since the virus of the COVID-19 has spread across the planet, it would be illusory to believe that we will be able to eradicate it, say the experts. Even if we manage to stop the current epidemic, the SARS-CoV-2 will re-appear likely to be seasonal, like various respiratory viruses, including influenza, which appear each winter.

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But how does the epidemic that is currently raging in Quebec will end up-does it dissipate ? The epidemic can end only in two ways, either ” by interrupting all chains of transmission, which means that before letting everyone out, you should expect that there are more viruses that may be transmitted. However, this will probably not be feasible because there will always be a region of the planet where the virus will continue to circulate and it may réenflammer the chains of transmission. In addition, we will not be able to maintain containment as severe indefinitely, ” says Dr. Bowen.

Ce text is part of our “Outlook” section.

A pandemic may also end when the immunity of the population crosses a certain threshold beyond which it can no longer be epidemic in large scale. However, this immunity can be acquired two ways : by surviving to the infection and by vaccination.

To determine what proportion of the population must be immunized in order that one can hope that the epidemic stops, we use the parameter basic reproductive number of virus (Ro) which corresponds to the average number of people that a sick person can infect. Thus, assuming that the Ro of the COVID-19 is three, which means that a person with the COVID-19 is likely to contaminate other three, it was determined that it should be 66 to 70 % of the population is immune to the epidemic ran out and did réenflamme not. Gold “we are still very far from that !” said Dr. Bowen.

“The strategy that seems to want to apply at this time is to slow down the spread to ensure that the hospital system is not overwhelmed and that we can thus maintain the rate of mortality as low as possible pending the development of a vaccine and antiviral drugs. And up to now, Quebec has arrived, ” says Dr. Bowen.

However, even before getting a vaccine, when the number of cases has greatly decreased to the point where ” our health system will again be able to care for all patients other than those with the COVID-19 — because it must be remembered that the hospitals have reached a lot of place for patients with the COVID-19, because we didn’t want that happening here’s a scenario to the Italian, will start the déconfinement “, says Dr. Marie-France Raynault, of the School of public health of the University of Montreal.

The dashboard on the evolution of the coronavirus in Quebec and in Canada

How will the déconfinement, and will we be able to avoid a second wave ? Dr. Raynault believes that it will take “déconfiner by small steps and proceed with monitoring” at each of these stages. “We’re going to re-open a few more shops, such as garden centers and mining, in particular, and we will monitor to see if our health system is able to absorb it. There will probably be a small increase in the number of cases, but this is not bad, as long as it continues to protect the people who are most at risk, because this allows the population to immunize quietly. The dose of re-opening will be determined by the ability of our health system to fulfill its overall mission, and we will have to readjust depending on what happens. If all continues to go well, we will continue to reopen gradually, day care services, in particular, and possibly schools. Plans to reopen that are being considered in Europe are progressive and combined with a close monitoring of the situation. If after three days it was in full swing, we will have to tighten the screws a little more, ” she explains.

“When déconfinement, it will be necessary to follow carefully the circumstances in which the case will reappear, and it is from the investigations that will be carried out that we will be able to know what have been the door of entry of the virus. We will then be able to determine what are the situations most at risk and decide what measures are most effective to keep it in place or add “, adds Dr Marc Dionne, Institut national de santé publique du Québec (INSPQ).

“When will déconfinement, it will be necessary to maintain several measures of social distancing to reduce the second wave. We will not be able to return to the status quo of a sudden. Otherwise, we will have to return to confinement very severe if one realizes that there are channels of transmission that are recovering, ” says Dr. Bowen.


Follow the spread of the COVID-19 around the world

If you want to avoid a second wave, it is not necessary to release the measures of distance too quickly, says Dr. Raynault. “As long as there will not be a sufficient proportion of the population who had the disease and has antibodies, there is a risk of having another outbreak. It only takes a few cases to ensure that the transmission is resumed “, she said.

“The danger of removing too many actions at the same time. The epidemic may leave and there would in this case be obliged to put in place harsh measures that would be highly frowned upon. So it is better to go slowly rather than risk crippling the economy for a long time “, she says, while acknowledging ” all the work that is being done now to develop public health recommendations that companies will be able to apply when they will re-open so that their employees can protect themselves “. Because ” if we change our ways of working, this will protect us from the second wave. Work as before would be too dangerous.”

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