When Will the Pandemic End? And How?

When Will the Pandemic End? And How?


When will the Covid-19 pandemic end? And how?

According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes.

Among the diseases to have achieved a medical end is smallpox, which has an effective vaccine that gives lifelong protection. Bubonic plague struck several times in the past 2,000 years, killing millions of people and altering the course of history, but cases are now rare.

An end can also occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease.

“When people ask, ‘When will this end?’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins.

The 1918 flu killed 50 million to 100 million people worldwide, preying on young to middle-aged adults — orphaning children, depriving families of breadwinners, killing troops in the midst of World War I.

After sweeping through the world, it evolved into a variant of the more benign seasonal flu. It ended socially, too. People were ready for a fresh start, a new era, and eager to put the nightmare of disease and war behind them.

That virus still circulates as a seasonal flu, but its initial path of destruction is rarely recalled. Until recently, even the 1918 flu was largely forgotten.

One possibility with the Covid-19 pandemic, historians say, is that it could end socially before it ends medically. People may grow so tired of the restrictions that they declare the pandemic over, even as the virus continues to smolder in the population and before a vaccine or effective treatment is found.

“Looking back, we have a weak narrative,” said Dora Vargha, a historian at the University of Exeter. “For whom does the epidemic end, and who gets to say?”

Delta Air Lines started 2020 celebrating what it said was the most successful year in company history. Not long after, it shared a record $1.6 billion in profits with its 90,000 employees. But with air travel nearly shut down by the coronavirus, the airline is now bleeding money and will drop 10 more airports from its already skeletal network on Wednesday.

Even as Delta and the other major airlines in the United States drastically slash schedules, they are averaging an anemic 23 passengers on each domestic flight and losing $350 million to $400 million a day as expenses like payroll, rent and aircraft maintenance far exceed the money they are bringing in. Passenger traffic is down about 94 percent and half of the industry’s 6,215 planes are parked at major airports and desert airstrips, according to Airlines for America, a trade group.

Yet, devastating as the downturn has been, the future is even more bleak. With much of the world closed for business, and no widely available vaccine in sight, it may be months, if not years, before airlines operate as many flights as they did before the crisis. Even when people start flying again, the industry could be transformed, much as it was after the Sept. 11 terrorist attacks. And airline executives need only look in the not-distant past to see how lesser crises sank carriers that were household names like Pan Am and Trans World Airlines.

The current crisis could push some airlines, especially smaller ones, into bankruptcy or make them takeover targets. Consumer fears about catching the virus on crowded planes could lead to reconfigured seating. Carriers may initially entice wary travelers with discounts, but if they cannot fill up flights, they may resort to raising ticket prices.

Henry Harteveldt, president of Atmosphere Research Group, a travel analysis firm in San Francisco, said that carriers might continue to leave middle seats empty in coach “until they see demand exceed two-thirds of where it was before the pandemic.” Now, he said, “You can be benevolent. It’s easy to give away a product that you don’t have any demand for.”

To get through the next few months, airlines successfully lobbied for a huge federal rescue. But half of that money was intended to cover payroll and that will run out by the end of September. Few in the industry expect Congress or the public to tolerate another bailout. So, for now, airlines are preparing for a long, lonely fight for survival.

The Trump administration is racing to contain an outbreak of the coronavirus inside the White House, as some senior officials believe that the disease is already spreading rapidly through the warren of cramped offices that make up the three floors of the West Wing.

Three top officials leading the government’s coronavirus response have begun two weeks of self-quarantine after two members of the White House staff — one of President Trump’s personal valets and Katie Miller, the spokeswoman for Vice President Mike Pence — tested positive. But others who came into contact with Ms. Miller and the valet are continuing to report to work at the White House.

“It is scary to go to work,” Kevin Hassett, a top economic adviser to the president, said on CBS’s “Face the Nation” program on Sunday. Mr. Hassett said he wore a mask at times at the White House, but conceded that “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”

He added: “It’s a small, crowded place. It’s, you know, it’s a little bit risky. But you have to do it because you have to serve your country.”

The discovery of the two infected employees has prompted the White House to ramp up its procedures to combat the virus, asking more staff members to work from home, increasing usage of masks and more rigorously screening people who enter the complex.

It is not clear how many other White House officials Ms. Miller or the valet might have come into contact with in recent days, but many members of the West Wing staff who were most likely in meetings with Ms. Miller before she tested positive are still coming to work, according to senior administration officials.

Late Sunday, the White House put out a statement saying that Mr. Pence would not alter his routine or self-quarantine. The vice president “has tested negative every single day and plans to be at the White House tomorrow,” said Devin O’Malley, a spokesman for Mr. Pence.

At the White House, all employees are being tested at least weekly, officials said, and a handful of top aides who regularly interact with the president are being tested daily.

“To get in with the president, you have to test negative,” Mr. Hassett said on CNN’s “State of the Union” program.

Mr. Trump continues to reject guidance from the Centers for Disease Control and Prevention to wear a mask when meeting with groups of people. But a senior administration official said the president was spooked that his valet, who is among those who serve him food, had not been wearing a mask. And he was annoyed to learn that Ms. Miller tested positive and has been growing irritated with people who get too close to him, the official said.

Concern about the spread of the virus in the White House has temporarily sidelined three of the most high-profile members of the coronavirus task force — Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention; Dr. Stephen Hahn, the commissioner of the Food and Drug Administration; and Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases.

Dr. Redfield and Dr. Hahn announced over the weekend that they would self-quarantine for two weeks after coming in contact with an infected member of the president’s staff. Both attended a meeting in the Situation Room last week where Ms. Miller was present, and they said they would continue to participate in the response effort from home. Dr. Fauci said he, too, had begun a “modified quarantine” after what he called a “low risk” contact with an infected staff member.

The Navy’s top admiral, Michael M. Gilday, will self-quarantine for one week after coming into contact with a family member who has tested positive for the coronavirus, the Pentagon said in a statement on Sunday night. And Senator Lamar Alexander, Republican of Tennessee, said Sunday that he, too, would self-quarantine after a member of his staff tested positive.

Before coronavirus cases hit hard a few weeks ago, paramedics would respond to calls for patients whose hearts had stopped by beginning chest compressions, administering epinephrine or using the defibrillator to try to shock the heart back to life.



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