People sometimes joke (well, maybe theyâ€™re not joking) that this is â€œthe darkest timelineâ€, between COVID-19, the idiots in the White House, the idiots in 10 Downing Street, etc. But itâ€™s easy to imagine the development of COVID-19 taking even darker turns. I think about this sometimes, and wanted to write down some of my thoughts.
This is going to be a pretty dark post, so if this isnâ€™t your thing, then you should skip it.
I have two what-ifs for you, one building on the other, and some thoughts on how they might go:
1) What if we never develop a vaccine?
This is possible. Weâ€™ve never developed a vaccine for the common cold, which can be caused by coronaviruses. We donâ€™t yet know whether COVID-19 can be vaccinated against, and we probably wonâ€™t know for a year, if not several years.
What does it mean if we canâ€™t develop a vaccine? Well, it means that almost everyone in the world will eventually contract the virus, which at a 1% fatality rate means that about 70 million people will die worldwide, 3.5 million in the United States, and many more will have serious health problems, probably for the rest of their lives. (I donâ€™t know what percentage of infected survive but develop such problems.) I donâ€™t think humans have the will to be able to go into the long-term total lockdown that would be necessary to prevent this.
It also seems likely that immunity to the virus provided by recovering from it won’t last forever – maybe it would last for 2-5 years. So if there’s no vaccine, then everyone who contracts it and recovers would contract it again a few years later. People who got seriously ill the first time around might not survive the second time, raising the fatality rate. And maybe people who came through fairly easily the first time would have a harder time the next time. Or the next. We might each of us end up living in fear of the day that the virus eventually hits us hard.
Moreover, we know that older people are more susceptible to the virus than younger ones, so as we age we may be aware that the next time we catch it could be the last time. People who before were expecting to live to age 70 or 80 might start thinking theyâ€™ll live 10 or 15 fewer years – and most of them might be right.
What might such a world look like? Well, we might just decide that since thereâ€™s nothing we can do, weâ€™ll just go back to living the way we did before. Maybe weâ€™d ramp up medical services to ameliorate the impact on individuals, but maybe not. (Many nations probably wouldnâ€™t be able to. Some nations might not have the political will to do so.)
Alternately we might continue the lockdown for years, or forever, altering the way the economy works to accommodate. Office buildings would largely be a thing of the past, as would restaurants as we know them and many other social gatherings. Lots of things would move online further. Weâ€™d probably see a gradual reshaping of our cities and suburbs along lines itâ€™s difficult to predict – more single-family homes? Fewer? No mass transit? As some have already predicted, people who work in jobs where they can telecommute would no longer be motivated to live near work, and housing prices in places like the Bay Area might plummet as people leave. On the other hand, jobs where people need to interact with other people might become less desirable – but no less critical. Maybe theyâ€™d start to pay better as a result.
Some people have already clamored for Internet to be classified as an essential service, regulated or free. That might be a necessity in such a world, but of course the need for medical care hasn’t prevented the U.S. from developing a for-profit health care system where people get raked over the financial coals for essential care. So Internet service might be no different. And even if it is, providing quality Internet service across as large a nation as the U.S. would take time, as many rural areas still have poor service.
If this were to continue into the future, one can imagine significant investments in robotic technology and other automation to serve people who are mostly living in their homes. Automated production, packaging, and delivery, overseen by a bare minimum of people. Restructuring of infrastructure around this sort of life, where cities have automated distribution centers and roads get narrower and mainly used by robots. At an extreme there’s the cheesy science-fictional idea where humanity becomes slaves to our machines, letting our physical bodies atrophy as we’re all living alone in our own homes without the interest in going anywhere. (Much like the “Seerons” in this comic book.)
But I digress. Maybe.
2) What if the virus mutates?
From what I’ve read, COVID-19 is not mutating very quickly. The reason we need to get a flu shot every year is because influenza mutates rapidly, so there are new strained every year. Fortunately we do a pretty good job creating influenza vaccines, though it’s not perfect. COVID-19 doesn’t seem to have this characteristic, and the strains we’re aware of seem to be closely related.
However, we could be wrong about how fast it’s mutating. Alternately, it might start to mutate faster. Either way, it might become more virulent, or more fatal, and mutations might also mean the temporary immunity gained from contracting one strain wouldn’t provide any immunity from another strain.
This isn’t necessarily game over for the human race. If the virus doesn’t become more fatal then it would just be a rougher form of the scenario above. If it does become more fatal, though, well… it probably means mass deaths, close to an extinction-level event. Our only hope as a species then is that it kills so many people that it kills off its ability to spread, and a few pockets of uninfected humans manage to survive long enough to restart the species, without being infected by the remnants of the virus left elsewhere. This is sort of how Europe survived the Black Death – exactly how things play out depends on how fatal the virus becomes.
A cheery picture, yes?
How likely is all this? Heck if I know. Probably not very likely. I choose to be optimistic that we will develop a vaccine, and that at worst we’ll all be getting an extra shot every year or two to stave off the virus. While it could take longer than the 18 month minimum, supposedly we were close to developing a vaccine for the 2012-13 MERS outbreak before it was determined to be much less virulent than feared and research funding petered out. If so, then hopefully we’ll be able to develop one for COVID-19.
Everyone keep your fingers crossed.