When Can We Expect COVID-19 To End?

This is an excellent summary of how South Korea has managed to contain COVID-19 more effectively than many other countries thus far. What follows are Dr. Woo Joo Kim's key points on COVID-19 and what we can expect in the months ahead.

The Chinese government notified the World Health Organization of COVID-19 on December 31, 2019.

The virus is thought to have originated from bats, but may have spread to humans through pangolins or snakes.

The death rate varies widely from country to country because of varying demographics, quality of health care, and quarantine protocols.

In South Korea, they were well prepared to mass produce test kits because of their previous experience with MERS in 2015, and their preparedness is what allowed them to test hundreds of thousands of people early in this pandemic.

In South Korea, the death rate for different age categories is as follows:

80s: 11.6%
70s:   6.3%
60s:   1.5%
50s:   0.4%
40s:   0.1%
30s:   0.1%
20s:   0.0%
10s:   0.0%

Summary - 90% of those who have died from COVID-19 in Korea have been over 60 years of age - this is largely because general immune function tends to drop once people hit their 60s.  Out of 9000-plus cases thus far, 20 percent have been asymptomatic.

Those who have cardiovascular disease, lung disease, a history of smoking, or a compromised immune system are more vulnerable to COVID-19.

Even after recovering from COVID-19, it's possible to experience a repeat infection.

The virus can enter the body via mucous membranes that line the eyes, nose, and mouth through the following modes of transmission:

1.  Aerosol or Airborne: via droplets greater than 5 microns in size that come from coughing or sneezing - these droplets can travel up to 6 feet from the point of emission before falling to a surface, thus the 6-feet guideline for social distancing.

2.  Direct:  via contact with the virus on an infected person.

3.  Indirect:  via contact with surfaces that the virus lives on (fomites).

In Korea, if a physician doesn't deem it necessary to test you for COVID-19, you can pay $140 USD to have the test done.  If you test positive, the government reimburses you in full.  

Data from multiple countries clearly indicates that wearing face masks and washing hands frequently significantly reduces the risk of being infected.

Previous announcements from the U.S. Surgeon General and WHO indicating that masks are not effective were likely meant to ensure that there would be enough masks for health care workers.

A critical component of containment efforts is stringent screening of people arriving from overseas at international airports.  This includes reliable tracking measures to ensure that quarantine measures are followed and enforceable.

Going forward, the best case scenario is for COVID-19 to be eradicated by July or August of 2020 - Dr. Woo Joo Kim estimates that the possibility of this scenario playing out is 10% - the sheer amount of international travel that takes place is what makes this scenario unlikely.  

A more likely scenario is COVID-19 numbers falling in northern hemisphere countries in the coming warmer months while numbers increase in southern hemisphere countries like Australia, South Africa, and much of South America as those areas go through their winter months, and then to have numbers rise again in the northern hemisphere when winter returns.

Another scenario would see development of an effective vaccine that could be used globally.  If all goes as well as possible, the timeframe to develop such a vaccine is approximately 18 months, but even if a country like the United States or China were to succeed with this, there is no guarantee that they will freely share it with the rest of the world.  Dr. Kim feels that such a vaccine would be in short supply, and most people in their teens and 20s wouldn't have a chance to receive it.  

Drug repurposing is the current best approach to treating people with COVID-19.  Kaletra (developed for AIDS), hydroxychloroquine (malaria), and remdesivir (Ebola) are examples of drugs that have been repurposed to treat COVID-19.  Using convalescent plasma - blood from people who have recovered from COVID-19 - is also a viable treatment option.  

Dr. Woo Joo Kim reiterates the importance of social distancing and each individual doing all they can to protect their own health and that of their families to help end COVID-19.  Above all else, he reminds us of the value of staying humble and not becoming complacent in our efforts.