Explainer: COVID-19 is still here – 5 crucial points

As lockdown eases, it is important to appreciate the pandemic is not yet over. Professor Martin Michaelis and Dr Mark Wass of the University of Kent’s School of Biosciences explain how we may be living with the virus for a long time, and that our responses will decide how the virus proceeds. They said:

‘With the ease of the lockdown, there is a strong tendency to think that the COVID-19 pandemic is over, at least in the UK, and that everything will now normalise. This is not the case. Here are the critical points that explain how the pandemic may further develop and why, and what we can do about it.

1) The virus has not gone away.
‘Although Europe and the UK are over the first peak, SARS-CoV-2, the virus that causes COVID-19, still remains and has increased worldwide. Globally, the spread of SARS-CoV-2 is currently accelerating with about 200,000 confirmed new infections every day. Notably, most of these cases occur in countries that do not have as developed health systems as Europe. Hence, the number of undetected cases and, therefore, the total number is likely to be much higher. Consequently, it is likely that we will see future flare-ups and peaks. The recent outbreaks, for example in a meat factory in Germany or in Leicester, are a timely warning how quickly things can get out of control when we lower our guard.

2) Scientifically, two metres’ distance is better than one.
‘The decision to reduce the minimum physical distance to one metre is political, not scientific. We must appreciate that the determination of safety distances is not an exact science and depends on the individual situation. There will always be rare cases in which individuals become infected in unlikely circumstances. Essentially, we are less likely to become infected the further we stay apart. An increase of the distance from one metre to two metres reduces the risk of infection, but not from 100% to 0%. Importantly, we must avoid touching contaminated surfaces, too.

3) The worst-case scenario.
‘When it comes to vaccines and SARS-CoV-2 in general, we must remember all the things that we do not know. One of these is whether SARS-CoV-2 infection results in immunity to future infections. If it does, it is not clear how long this immunity will last. For other coronaviruses that cause common colds, it has been shown that individuals can be infected twice within one year. In agreement with this, most recent data from King’s College London suggest that immunity may be short-lived.
‘Recent data suggests that severe disease may be associated with a stronger immune response, which may result in more sustainable immunity; though this is uncertain. For some viruses, such as the Dengue virus, later infections are more severe than the first. Some results from animal experiments suggest that similar phenomena are possible for coronaviruses. Thus, we still do not know whether the natural infection provides sustainable immunity. If it does not, it will be much more difficult to develop a vaccine that does. Therefore, it may be impossible to develop a vaccine that provides long-term protection in the foreseeable future and we may have to find other ways to live with SARS-CoV-2.
‘Even if there are vaccines, it is possible that they provide some but not complete protection or that they protect the individual but do not stop the spread.
‘Also, we do not know how the virus might change and adapt to an immune response. Even if survivors develop long-term immunity and we have a highly effective vaccine, we will have to examine whether SARS-CoV-2 will be able to find a way around this immune response. If it can, we may need yearly vaccinations similarly to the flu jab that needs to be adapted every influenza season.

4) What we can do.
‘Viruses are not living organisms. They are a piece of genetic information surrounded by a “coat” (the capsid). To reproduce, they must infect a cell and re-programme it to produce new viruses. Therefore, viruses always need a host.
‘If we break the transmission chain, viruses cannot replicate and will disappear. We need to adopt a lifestyle that avoids virus transmission or minimises it. Independently of lockdown rules, every individual can think of how they can change their lifestyle to reduce the likelihood of infection. Washing your hands regularly, not touching your face, avoiding crowds, and avoiding items touched by others can make a big difference. Therefore, each individual’s behaviour has a strong impact on whether we will see more regular flare ups or substantial disease waves.

5) 2020 is a snapshot – the future remains unpredictable.
‘Nobody can predict how the pandemic is going to develop as there are too many things unknown. For this reason, it is also too early to draw conclusions. At the moment, we only see a snapshot. Countries that have been largely spared may be hit hard in the future and the impact on different regions may look significantly differently in a year or two.
‘Finally, though lockdown eases; the pandemic is not over. The virus remains. There will be future flare-ups and peaks. Our individual and collective behaviour, regionally, nationally, and globally, will determine the future of the pandemic. Now is not a time for complacency.’

Professor Martin Michaelis and Dr Mark Wass, School of Biosciences, University of Kent
Professor Michaelis and Dr Wass run a joint computational/ wet laboratory. Dr Wass is a computational biologist with expertise in structural biology and big data analysis. Prof Michaelis’ research is focused on the identification and investigation of drugs and their mechanisms of action, with a focus on cancer and viruses. With regard to viruses, Prof Michaelis and Dr Wass work on virus-host cell interactions and antiviral drug targets. In the cancer field, they investigate drug resistance in cancer. In collaboration with Professor Jindrich Cinatl (Goethe-University, Frankfurt am Main), they manage and develop the Resistant Cancer Cell Line (RCCL) Collection, a unique collection of 2,000 cancer cell lines with acquired resistance to anti-cancer drugs. They are also interested in meta-research that investigates research practices in the life sciences.