Quarantine is not a sustainable solution for the next pandemic

As governments around the world begin to execute plans for reopening, billions of people now gratefully envision a post-coronavirus future on the horizon.

While there have been numerous influenza pandemics, the global response to COVID-19 has been unprecedented. According to PEW Research, nine out of 10 people worldwide live in countries with COVID-19 travel restrictions. At least nine-tenths (91 per cent) of the world’s population, or 7.1 billion people, lives in countries with restrictions.

The extent of global economic devastation has yet to be calculated.

Containment strategies have largely focused upon travel restrictions and social-distancing, however some countries have taken different approaches. According to U.S. think-tank McKinsey & Company, “Although a consensus has emerged around the use of physical distancing to slow transmission in many high-prevalence settings, a few countries, such as Sweden, are pursuing an alternative ‘herd immunity’ strategy focused on protecting the most vulnerable populations while using only limited distancing measures to flatten the curve for others. The goals are to maintain many aspects of economic and social life today and, over time, to develop a large enough pool of exposed people (about 70 to 80 per cent) to ‘protect the herd.’ ”

As with previous strains of coronavirus, recovery from an infectious disease typically creates immunity to further infection. WHO studies show that people who have recovered from infection have antibodies to the virus. However, as of 24 April, “… no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans.”

A Time article April 13 addressed reports of cases of reinfection in some countries: “There remains a lot of uncertainty, but experts Time spoke with say that it’s likely the reports of patients who seemed to have recovered but then tested positive again were not examples of reinfection, but were cases where lingering infection was not detected by tests for a period of time.”

But what about the majority of countries pursuing containment strategies, once the dust settles on COVID-19? Without the “herd immunity” being developed immediately in countries like Sweden, most countries will be vulnerable to new cases once current restrictions are lifted.

A 1995 Harvard Health article published by CDC explains the role of travel in the spread of infectious disease: “Travel is a potent force in the emergence of disease. Migration of humans has been the pathway for disseminating infectious diseases throughout recorded history and will continue to shape the emergence, frequency, and spread of infections in geographic areas and populations. The current volume, speed and reach of travel are unprecedented. The consequences of travel extend beyond the traveller to the population visited and the ecosystem. When they travel, humans carry their genetic makeup, immunologic sequelae of past infections, cultural preferences, customs and behavioural patterns. Microbes, animals and other biologic life also accompany them.”

With governments currently focused upon reopening the world, it would seem prudent to also look beyond. Whether a resurgence of COVID-19, or the next new virus, will it be feasible to shut down again? Is quarantine a rational response?

The negative health, social and economic impacts of COVID-19 demonstrate that quarantine is not a sustainable strategy for future pandemics. Time to map out a better future.