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he world is battling Covid-19 and trying to assess how much this pandemic will affect the global outlook. Nobody has a ready answer. However, one thing everybody agrees on is that the world after Covid-19 will not be what it used to be before the outbreak. Events of such magnitude have always altered the course of history. It is unlikely to be otherwise this time.

The United States has become the epicentre of Covid-19 with around 1.7 million positive cases. With the number of deaths in the country crossing six figures and an economic impact already worth trillions of dollars, political administration and public health officials are trying to come up with strategies to deal with the new normal. Experts believe that there is no ready answer, but they do assert that the world will have to remain extremely vigilant in the foreseeable future to fight the deadly virus.

Dr Umair A Shah is the executive director of Harris County Department of Public Health in Texas. Harris County is the third most populous county in the United States and has the highest number of Covid-19 cases in Texas. He says that public health experts have been learning new lessons every day since the start of Covid-19 in December 2019, and are applying the lessons learnt on the go. “You have plans, but you are also building the plane while you are flying it,” he says.

Dr Rashid Chotani is an epidemiologist and public health physician in Maryland, United States. He is actively involved in Covid-19 research as well. He says that scientists are still trying to understand the virus and there is a likelihood that it has already mutated. The new Kawasaki disease symptoms found in children were the latest discovery. However, the mortality rate in children due to these new symptoms was much lower compared to Covid-19. The precautions (hand washing, social distancing etc) were pretty similar to what scientists had been urging all along.

The uncertain and indefinite nature of the current situation caused by Covid-19 has also sharply divided opinion regarding lockdown and reopening. President Donald Trump has been urging a reopening while health experts have been very circumspect about a premature reopening. In several US states, an uptick in Covid-19 positive cases was witnessed after those states eased restrictions and allowed partial reopening subject to certain standard operating procedures (SOPs). However, not many followed these SOPs in letter and spirit.

In several US states, an uptick in Covid-19 positive cases was witnessed after those states eased restrictions and allowed partial reopening subject to certain SOPs.

Dr Shah says that this could be due to the element of fatigue in the public that had remained confined to their homes and wanted to get back to normal life sooner rather than later. “It has become a challenge. It is almost a binary argument that you can either reopen or you can take care of health and safety. What we have been trying to say is that it is not an either/or, it’s an “and” as you can do both. You can reopen and you can do it safely”, he says.

Dr Chotani agrees with the idea of reopening the economy to allow the businesses and workforce to breathe. He, however, cautions against doing it prematurely and without implementing proper protocols. “The way people in Pakistan have acted during Ramazan and in the markets for Eid shopping is very irresponsible and unsafe.” He says that reopening without the public adhering to safety guidelines runs the risk of jeopardising public health gains.

But the reopening of educational institutions after summer vacations is a subject both experts are cautious about. “Education, as we know it, will be very different. It’s about how to reduce the density. Does that mean that one set of students are on a Monday-Wednesday-Friday schedule, and the other set of students are told you don’t come in except on Tuesday, Thursday and Saturday so that you have half the students there at a time to allow you to socially distance kids?” Dr Shah suggests. Dr Chotani also favours the idea of using more technology and distance learning in the immediate term to reduce the risk at educational institutions. “It is also a question of parents having the confidence to send their children back to school and whether they think they will be safe there,” he says.

So how long will the public have to live with the new normal? Both experts say that it will take at least eighteen months until a vaccine becomes publicly available. “We (in America) have already started and if you look at 18 months starting from January of this year, you are looking at the summer of next year. That’s about the timeline for a vaccine,” says Dr Shah adding that a vaccine could hopefully create immunity for the population. He, however, hastens to add that there shouldn’t be too high hopes at this point since health experts have concerns that even vaccine immunity could be short lived. “We just don’t know if this is the new normal. And that, I think, is our biggest concern right now as we move forward.”

Dr Chotani explains the Catch-22 situation scientists developing vaccines find themselves in: “They are hoping that it will be available by the time experimentation and clinical trial phase is over. However, we don’t know yet how efficacious this vaccine will be at the time,” he says while adding that the chances of success and failure are just about 50-50 at this stage. Regarding the production of a drug in Pakistan under a joint arrangement with an American pharmaceutical company, he says that this is a life-saving drug that will only be available to acute care patients in hospital emergencies and is not meant for mass availability or consumption.

Scientists are also warning about a second wave of coronavirus outbreak in fall since the initial assumption that summer heat could kill the virus hasn’t really materialised. “The most worrying factor is that if you do get a transmission decrease in summer, but it comes back with a vengeance, may be the population does not create the immunity that you were hoping for – it’s not long lasting – and it’s coupled with flu season, influenza in the fall, and then you have a second wave which unfortunately could mean that you have more transmission and more overrun on the healthcare system, and certainly complications leading to death”, says Dr Shah. This, he warns, is an even bigger challenge for countries in South Asia and Africa where health facilities are already inadequate.

Dr Chotani says that low numbers of documented Covid-19 patients and deaths related to the virus in countries with inefficient health systems are misleading. There is insufficient testing and no system in place for contact tracing infected patients as well as deaths caused by this virus, he says. This pandemic, he says, is also an opportunity to change this situation for the better in the future. Going forward, the governments need to prioritize education and health care because only a healthy population could be more productive.