By Don Aguiar
Mumbai, May 8, 2020: The first thing that disappeared was the annoying sound of a power drill up the street, from a house under construction. Then the newspapers. Then the fruit sellers, the taxis, the rickshaws, and chicken.
Day by day, life under coronavirus lockdown took away something else, usually something good. And nearly six weeks into it, much of this country is still frozen.
In many cities such as Mumbai, practically nothing moves on the roads. People stay indoors, as instructed, emerging only to collect the basic necessities. They have not left their house for a month.
All the airlines are grounded. Schools and offices are closed. The only businesses operating are food shops, pharmacies and banks. The banks have lines running out the door and down the sidewalk where white circles have been spray-painted for people to stand in, six feet apart, like little islands.
The other day, we drove to Mumbai’s outskirts. No teeming crowds and riotous traffic. There seems to be a national aversion to sticking to your lane, so I felt almost guilty blazing down an empty highway, past miles of shuttered shops, with no one to cut me off.
Whenever we turned off the highway, every village, no matter how small, was barricaded — some with oil drums, others with rope. Behind the barricades, stood villagers with their faces covered. The new virus vigilantes carried sticks to keep strangers away.
Even the sky above us is different these days, with so few cars and factories running.
I asked my driver if he had managed to get outside. “No.” Did his neighbors? Again, “no.” His answer came quickly: “Everyone’s scared. People are saying if they get sick, where will they go?”
That explained a lot. It explained why I wasn’t seeing anyone in my neighborhood venturing into the parks or strolling under the banyan trees. It explained why few people were testing the lockdown limits. It’s not that they are automatically more willing to follow the rules than say, they are more scared.
They’re scared of catching a highly contagious disease, and they don’t trust that a beleaguered healthcare system will save them. Or they’re scared about how they’ll pay for it, even if they get the care they need.
India has a lot of great doctors, but the ratio of doctors or hospital beds per person is much lower than in the West. And many people survive on a few rupees a day.
The government is trying to loosen the national tourniquet and reopen some industries, such as agriculture and select manufacturing. But many Indians don’t want to take the tourniquet off, even if it is stanching the economy’s flow.
A good chunk of the population has decided that the best way to protect them is not only to stick to the lockdown rules, but to go above and beyond them, like the volunteer virus squads who sealed off entire villages.
There is so much suffering around me. Just a few days ago I met a mother and her 9-year-old daughter moving from spray painted circle to spray-painted circle down a sidewalk in a food line. The mother was a maid who had lost her job because of the lockdown. They had zero money, and I could tell from how listlessly they accepted their two chapattis and two lumps of potato curry that they hated taking hand outs.
Behind them, in the bright sun, were hundreds of people just like them, marching slowly forward.
As countries lie frozen in lockdown and billions of people lose their livelihoods, public figures are teasing a breakthrough that would mark the end of the crippling coronavirus pandemic: a vaccine.
But there is another, worst-case possibility: that no vaccine is ever developed. In this outcome, the public’s hopes are repeatedly raised and then dashed, as various proposed solutions fall before the final hurdle.
Instead of wiping out Covid-19, societies may instead learn to live with it. Cities would slowly open and some freedoms will be returned, but on a short leash, if experts’ recommendations are followed.Testing and physical tracing will become part of our lives in the short term, but in many countries, an abrupt instruction to self-isolate could come at any time. Treatments may be developed — but outbreaks of the disease could still occur each year, and the global death toll would continue to tick upwards.
It’s a path rarely publicly countenanced by politicians, who are speaking optimistically about human trials already underway to find a vaccine. But the possibility is taken very seriously by many experts — because it’s happened before. Several times.
There are some viruses that we still do not have vaccines against, we can’t make an absolute assumption that a vaccine will appear at all, or if it does appear, whether it will pass all the tests of efficacy and safety.
It’s absolutely essential that all societies everywhere get themselves into a position where they are able to defend against the coronavirus as a constant threat, and to be able to go about social life and economic activity with the virus in our midst.
Most experts remain confident that a Covid-19 vaccine will eventually be developed; in part because, unlike previous diseases like HIV and malaria, the coronavirus does not mutate rapidly.
Many, including National Institute of Allergy and Infectious Diseases director Anthony Fauci, suggest it could happen in a year to 18 months. Other figures, like England’s Chief Medical Officer Chris Whitty, have veered towards the more distant end of the spectrum, suggesting that a year may be too soon.
But even if a vaccine is developed, bringing it to fruition in any of those timeframes would be a feat never achieved before.
We’ve never accelerated a vaccine in a year to 18 months, it doesn’t mean it’s impossible, but it will be quite a heroic achievement.
It’s been very difficult to develop vaccines for the common rhinoviruses and adenoviruses — which, like coronaviruses, can cause cold symptoms. There’s just one vaccine to prevent two strains of adenovirus, and it’s not commercially available.
We have high hopes, and then our hopes are dashed. We’re dealing with biological systems, not mechanical. It really depends so much on how the body reacts.
If the same fate befalls a Covid-19 vaccine, the virus could remain with us for many years. But the medical response to HIV/AIDS still provides a framework for living with a disease we can’t stamp out.
If a vaccine can’t be produced, life will not remain as it is now. It just might not go back to normal quickly.
The lockdown is not sustainable economically, and possibly not politically, so we need other things to control it.
That means that, as countries start to creep out of their paralyses, experts would push governments to implement an awkward new way of living and interacting to buy the world time in the months, years or decades until Covid-19 can be eliminated by a vaccine.
It is absolutely essential to work on being Covid-ready, a new “social contract” in which citizens in every country, while starting to go about their normal lives, take personal responsibility to self-isolate if they show symptoms or come into contact with a potential Covid-19 case.
But if previous outbreaks have proven anything, it’s that hunts for vaccines are unpredictable, no vaccine has been developed quickly, till date and it would be really amazing if we had something in 18 months.