The Likely Real Disease Curve

We have all now seen a million curves of the supposed trajectory of coronavirus disease, showing infections or deaths.  These curves almost always peter out after some enormous peak.  But that is very unlikely to be what happens with coronavirus.  The virus is clearly present in the US.  It exists in humans, but also apparently can exist in other animals and for some period of time, potentially extended, in certain environmental niches.  It is very unlikely that that current extreme suppression of spread measures are actually going to eradicate the virus.  And even if somehow we accomplished that in the US, it would still be present elsewhere.  We are going to have to adapt to that presence, just as we do with many other infectious agents.  We can adapt by development of immunity in enough of the population to limit infection and transmission.  We can facilitate that development of immunity with vaccines.  Vaccines are at least a year off, realistically.  Every effort we make to suppress spread now only limits development of natural immunity.  No one can possible be thinking that it is possible to keep the economy locked down for any extended period.

As I have said before, a more realistic expectation for the course of the epidemic is a series of roller coaster bumps, going up as there is more spread, going down when more intensive suppression efforts are made.  The higher the first bump up, the smaller the remaining ones and the quicker we get to some more stable level of infection and disease, as now occurs with flu.  A website called ZeroHedge published a post with a chart that illustrates this very nicely.  (zerohedge post)  I have tried to replicate the chart here.  There are aspects of the labeling, that I think should be expanded.  You can reach a steady state by natural immunity levels as well as a vaccine.  There may be some aspect to infection rates that is seasonal, so that could be incorporated.  But overall, it gives a more realistic picture of what we might expect if and when the extreme suppression measures are lifted.