Amid the Coronavirus Pandemic, Looking to the Future

https://www.nytimes.com/2020/04/23/opinion/letters/coronavirus-future.html

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To the Editor:

Re “What the Next Year (or Two) May Look Like” (front page, April 19):

I appreciated the spectrum of opinions offered by nearly two dozen experts, predicting the future of the Covid-19 pandemic. With all due respect, at some point we may need to consult an epidemiologist just to model the models. As more data accrue, models will become more predictive and reliable.

In the meantime, we must remember that the virus is “novel.” This explains the broad range of estimates of expected cases, proportion of cases that are asymptomatic versus fatal, duration of the pandemic, and likelihood and magnitude of subsequent surges.

Increased testing for clinically evident and silent infections will eventually inform the true mortality rate, currently estimated to be anywhere between about 0.1 percent and 5 percent, a 50-fold spread. Based upon preliminary serologic data from investigators at my university, I suspect that the lower estimate will be closer to reality.

Respiratory viruses are typically seasonal pathogens, and this virus may have a similar pattern. It is possible that, like SARS, it will burn out or at least become less severe. I acknowledge that I am more optimistic than many of my colleagues. Optimism is an occupational hazard of pediatricians!

Charles G. ProberStanford, Calif.The writer is a professor of pediatrics, microbiology and immunology and senior associate vice provost for health education at Stanford University.

To the Editor:

Re “What the Next Year (or Two) May Look Like” and “Germany Tries Antibody Tests as a Way Back”:

I was stunned after I read these two separate articles on the front page of Sunday’s Times. If I were still in college, the exam might be “Compare and Contrast the U.S. and German Handling of the Coronavirus Pandemic.”

It’s no contest. The United States loses by a landslide due to lack of leadership.

Michael S. OlinMiami

To the Editor:

My immediate reaction to the headline “What the Next Year (or Two) May Look Like” was: “This is precisely what we do not need.” In-depth reporting on the pandemic is the obligation of any responsible news outlet. However, particularly given the precarious mental health of so many, featuring a story rooted in speculation (and the bleakest of speculations at that) can be harmful to those feeling fragile.

I, like countless others, have struggled with periods of debilitating depression that have driven me to retreat entirely from life. Yet in recent months, I had finally turned a corner and was beginning to re-engage with the world. Thus, to be compelled by external circumstances back into isolation is devastating.

Your article notes that “isolation and poverty caused by a long shutdown may drive up rates of domestic abuse, depression and suicide.” Well, stories like this are sufficient to tilt the psychologically fragile into a potentially fatal state of despair. What we need now is cleareyed reporting on current circumstances and known facts, not dire projections that may or may not prove accurate.

Emily MacauxEast Greenwich, R.I.

To the Editor:

Neither I nor my daughter would ever suggest planning Covid-19 parties for herd immunity to restart the economy, as implied by how I am quoted in this article. This activity would be dangerous and could have serious public health consequences, by spreading disease through asymptomatic younger people.

The point to be made is that there could be a temptation to go to such gatherings if the social and economic value of being antibody positive became too great. But this would be an activity associated with poor public health behavior. And it is unclear as of yet whether antibody positivity is even associated with real immunity.

Michele BarryStanford, Calif.The writer is a professor of medicine and director for the Center for Innovation in Global Health at Stanford University.