Study warns of delayed flu outbreaks after pandemic ends
The positive steps we are taking to prevent disease might have a negative side effect.
13 November, 2020
Credit: Christopher Furlong/Getty Images
- A new study out of Princeton suggests that measures to prevent COVID-19 are also preventing certain other diseases.
- The nature of seasonal diseases means that people who avoid them this year may just be putting it off, leading to a large wave later.
- These estimates don't mean we should be less preventive now, only that we must be sure to take care in the future.
<p> As the United States continues to struggle with the pandemic, the proven effectiveness of face masks to reduce the rate and risk of infection continues to be underutilized. Places that have implemented mask and distancing mandates are seeing generally lower rates of transmission and infection than those without these mandates, as more fully explained <a href="https://www.pnas.org/content/117/26/14857" rel="noopener noreferrer" target="_blank">here</a>, <a href="https://www.eurekalert.org/pub_releases/2020-06/tl-pss060120.php" rel="noopener noreferrer" target="_blank">here</a>, and <a href="https://www.vox.com/science-and-health/21546014/mask-mandates-coronavirus-covid-19" rel="noopener noreferrer" target="_blank">here</a>. <br> <br> However, one of the three iron laws of the cosmos is the law of unintended consequences; no matter what you do, there will be at least one.</p><p> As a study out of Princeton has just shown, this also applies to live-saving mask mandates. Given that many other diseases follow predictable cycles, a team of researchers has shown that the steps we're taking to prevent the spread of COVID-19 now may lead to larger outbreaks of seasonal diseases later. <br> <br> Before we go any further, we want to make it clear that we are not telling you stop wearing a mask, social distancing, or taking all the precautions against catching and spreading COVID. The point of this study and this article is to make people aware of a side effect of these measures so that we can better deal with them later, not to suggest that these measures not be taken. </p>
<iframe width="730" height="430" src="https://www.youtube.com/embed/UFX9oS2kpUA" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe><p> A team of researchers based out of Princeton published a <a href="https://www.pnas.org/content/early/2020/11/06/2013182117" target="_blank" rel="noopener noreferrer">study</a> in the Proceedings of the National Academy of Sciences showing the predictions of a model that estimates the after effects of our current efforts to avoid COVID-19.</p><p>As it turns out, Non-pharmaceutical interventions (NPIs) such as social distancing and wearing masks help prevent more than just COVID-19. Instances of other diseases, such as respiratory syncytial virus (RSV) and the flu, are also lower than they would otherwise be due to people taking these precautions. Cases of RSV may have declined by as much as a 20 percent already. </p><p> This makes a lot of intuitive sense. Your mask doesn't care what kind of virus it keeps you from exhaling towards other people; it stops all of them. If you stay inside to avoid catching a particular disease, you still avoid all of them. This kind of thing has happened before. The precautions taken during the 1918 flu pandemic probably reduced measles cases by a third. <br> <br> However, these diseases come back seasonally and will be there waiting for us when the current pandemic ends. This might be a bit of a problem, as lead author Rachel Baker <a href="https://www.princeton.edu/news/2020/11/09/large-delayed-outbreaks-endemic-diseases-possible-following-covid-19-controls" target="_blank" rel="noopener noreferrer">explained</a>:<br> <br> "While this reduction in cases could be interpreted as a positive side effect of COVID-19 prevention, the reality is much more complex. Our results suggest that susceptibility to these other diseases, such as RSV and flu, could increase while NPIs are in place, resulting in large outbreaks when they begin circulating again."<br> <br> Think of it like this: As fewer and fewer people get these diseases due to our current mask and social distancing tendencies, fewer and fewer people have immunity to them. Immunity to RSV lasts only a few <a href="https://en.wikipedia.org/wiki/Respiratory_syncytial_virus" target="_blank" rel="noopener noreferrer">years</a>. If people who would have gotten it this year don't, they may contract and spread it next year when they aren't working so hard to avoid respiratory infections, along with all the other people who were likely to get it next year anyway for typical reasons. <br> <br> The model is less exact for the flu, given the number of variables affecting how contagious the flu is from year to year, but a similar principle applies. </p><p><br> There is a fair amount of uncertainty to these findings, as the authors admit. Outbreaks in some areas have been better studied than others. The behavior of these seasonal outbreaks is more thoroughly understood in Florida than in Minnesota, for example, and these predictions may not be as applicable there. The models are also highly dependent on what measures we take and when to fight COVID-19, and the worst-case ones rely on a lot of things happening in tandem. </p> So while we can't know exactly what that next flu season will look like, the essential finding of this study is that it is likely to be worse than it otherwise would be, everything else being equal. Various measures, such as getting more people vaccinated against the flu and keeping people home when they are sick with seemingly banal colds, will be necessary in the years to come. Hospitals should also brace for higher than average numbers of people coming in as a result of this.
Why you should still wear a mask
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc3NDYzNS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMzc1ODM1Nn0.UNIHh2X2AtR6fq_fhAwejphFKIOY9J3lGFWgDf-R6oE/img.jpg?width=980" id="d681e" class="rm-shortcode" data-rm-shortcode-id="1dc1e7ee8c2f01ac128b4b48c1675510" data-rm-shortcode-name="rebelmouse-image" />A chart from another study on the effectiveness of masks and lockdowns. The grey line in the bottom two marks when mask mandates were imposed.
Credit: Zhang, Li, Zhang, and Molina
<p><br>Again, before you decide that this means mask mandates are just delaying some kind of reckoning, we can look at the numbers. Several <a href="https://www.nationalgeographic.com/science/2020/07/coronavirus-deadlier-than-many-believed-infection-fatality-rate-cvd/" target="_blank" rel="noopener noreferrer">sources</a> agree <a href="https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm" target="_blank" rel="noopener noreferrer">that</a> the <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu" target="_blank" rel="noopener noreferrer">coronavirus</a> is <a href="https://www.livescience.com/covid-19-vs-flu-deaths-hospitalized-patients.html" target="_blank" rel="noopener noreferrer">deadlier</a> than <a href="https://www.snopes.com/fact-check/flu-kills-more-people-covid-19/" target="_blank" rel="noopener noreferrer">the </a><a href="https://www.snopes.com/fact-check/flu-kills-more-people-covid-19/" target="_blank" rel="noopener noreferrer">flu</a><a href="https://www.snopes.com/fact-check/flu-kills-more-people-covid-19/" target="_blank" rel="noopener noreferrer">.</a> We also don't have a vaccine for it yet, unlike for the flu, and keeping yourself and others from getting sick now remains extremely important for keeping people alive. </p><p> A friend of mine remarked at the beginning of the pandemic that certain events in society leave marks on the people in it, much like growth rings on a tree showing years of drought decades after it occurred. If the findings of this study are accurate, then COVID-19 will leave rings visible in seasonal outbreaks over the next few years alongside the slew of others it will create. <br></p><p>Given what this study shows us and the hard-learned lessons we have about what happens when you don't listen to scientists, maybe we'll do a better job at controlling those potential epidemics.</p>
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England rolls out 'Test and Trace' program to combat COVID-19
The program aims to notify people after they've come in close contact with someone who tested positive.
29 May, 2020
Sean Gallup / Getty
- The program currently involves 25,000 contract tracers who are capable of tracing 10,000 contacts per day.
- Participation in the program is voluntary, though officials said it may become mandatory if necessary.
- The program will eventually include a smartphone app that records who you've come in close proximity to.
<p>England started a test-and-trace program on Thursday that aims to contain the spread of COVID-19 as the nation eases its lockdown.<br></p><p>Under the new program, anyone who tests positive for COVID-19 will be contacted by staff with the National Health Services (NHS), and they'll be asked to share the contact information of people with whom they've recently come in contact. People who've crossed paths with someone who tested positive for COVID-19 will be asked to self-isolate for 14 days. </p><p style="margin-left: 20px;">"As we move to the next stage of our fight against coronavirus, we will be able to replace national lockdowns with individual isolation and, if necessary, local action where there are outbreaks," U.K. Health Secretary Matt Hancock <a href="https://www.telegraph.co.uk/news/2020/05/29/test-trace-track-uk-coronavirus/" target="_blank">said</a> in a statement. "This new system will help us keep this virus under control while carefully and safely lifting the lockdown nationally."</p>
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzM1OTkwNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNDEzNTAzMX0.JPLPypAt3aRDktg-3St5khJvT5QAR0DrJPPNg62XQ2U/img.jpg?width=980" id="9da0d" class="rm-shortcode" data-rm-shortcode-id="b07c6e672c06c55f220389eeb657e632" data-rm-shortcode-name="rebelmouse-image" />
TIMOTHY A. CLARY / Getty
<p>Hancock said the program will be voluntary at first, but that the government will make it mandatory if "that's what it takes."</p><p style="margin-left: 20px;">"If we don't collectively make this work, the only way forward is to keep the lockdown," he said. "The more people who follow the instructions, the safer we can be and the faster we can lift the lockdown."</p><p>The NHS wants people who are experiencing symptoms to visit <a href="https://www.nhs.uk/conditions/coronavirus-covid-19/" target="_blank">nhs.uk/conditions/coronavirus-covid-19</a>. The agency also wants to automate its Test and Trace program through the <a href="https://www.telegraph.co.uk/technology/2020/05/27/nhs-app-covid-19-uk-coronavirus-track-trace/" target="_blank">NHS COVID-19 app</a>, which is currently being tested by more than 52,000 people on the Isle of Wight. If the test on the Isle of Wight is successful, the app is expected to be available for the rest of England in June.</p>How the contact-tracing app works
<p>The app doesn't ask for names or personal information, except for a partial postal code. Rather, each user's phone is assigned a randomized identifier number that's transmitted to a centralized database. The app doesn't do much else, besides ask users how they're feeling each day.</p><p>Other governments have already been using digital contact tracing apps to limit the spread of COVID-19. South Korea, for example, made a tracing app mandatory for new arrivals to the country, and people who violate quarantine are required to wear location-tracking bracelets. As of May 29, South Korea has reported less than 300 deaths. The U.K. has suffered <a href="https://www.reuters.com/article/us-health-coronavirus-britain-casualties/uks-covid-19-death-toll-tops-40000-worst-in-europe-idUSKBN22O16T" target="_blank">more than 40,000</a>.</p>Privacy concerns
<p>Manual contact tracing has been used for decades to help contain viruses — the NHS describes it as a "tried and tested method used to slow down the spread of infectious diseases." But the prospect of digital contact tracing has <a href="https://www.washingtonpost.com/politics/2020/04/28/contact-tracing-apps-can-help-stop-coronavirus-they-can-hurt-privacy/" target="_blank">raised concerns for privacy advocates</a> who question how governments and private companies might use the technology. </p><p>Speaking about the new NHS app, Ian Levy, the technical director of the National Cyber Security Centre (NCSC), told <a href="https://www.wired.co.uk/article/nhs-covid-19-tracking-app-contact-tracing" target="_blank">Wired U.K.</a>:</p><p style="margin-left: 20px;">"In theory, that's a privacy risk, but it's only stored on the NHS app system and there's no way to link device 123456 to 'Ian Levy' or a particular place," Levy said. "If you discover that my app ID is 123456, there are some theoretical things you can do to try to understand my contacts if you've followed me round. But if you've followed me round, you've probably seen my contacts anyway."</p><p>In the U.S., federal officials haven't indicated that they're developing a national contact-tracing app. But several states — <a href="https://www.forbes.com/sites/rachelsandler/2020/05/20/alabama-north-dakota-and-south-carolina-to-debut-apple-and-googles-covid-19-contact-tracing/#4147ac591732" target="_blank">Alabama, North Dakota, and South Carolina</a> — are working individually with Apple and Google to implement their own contact-tracing apps. </p><p>Similar to the NHS app, Apple and Google's system uses Bluetooth signals to record when users come in close proximity with each other. The companies said their system won't collect users' personal information. </p><p><span></span>Apple and Google develop the contact-tracing apps themselves. Rather, they've made the technology available so that individual health agencies to do so. In addition to the three U.S. states, <a href="https://www.forbes.com/sites/rachelsandler/2020/05/20/alabama-north-dakota-and-south-carolina-to-debut-apple-and-googles-covid-19-contact-tracing/#49f900e1732e" target="_blank">22 countries have also signed on to use Apple and Google's system.</a></p>
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Where citizen science meets the coronavirus—and how you can help
Creators of the popular protein-folding game, Foldit, are seeking help to design a treatment for COVID-19.
01 April, 2020
Photo: Getty Images
- Since being founded in 2008, the crowdsourced protein-folding game, Foldit, has helped solve many novel problems.
- In recent months, the Foldit team has presented its community with problems relating to COVID-19.
- Foldit founder, David Baker, says over 20,000 different designs for potential COVID-19 antiviral proteins have been submitted.
<p><span style="background-color: initial;">In 2008, </span><span style="background-color: initial;">University of Washington professor <a href="https://www.hhmi.org/scientists/david-baker" target="_blank">David Baker</a> created the <a href="https://fold.it/" target="_blank">Foldit</a> research project. As a protein research scientist he had spent a good portion of his career designing methods to predict three-dimensional structures associated with proteins. His group initially developed an algorithm for protein structure prediction called Rosetta, which they then turned into a distributed computing project.</span></p><p>The initial incarnation, Rosetta@home, allowed citizen scientists to help out, much as astronomy enthusiasts have crowdsourced research and <a href="https://www.space.com/31626-crowdsourced-astronomy-finding-faint-galaxies-in-deep-space.html" target="_blank">discovered new planets</a>. Foldit is the evolution of Rosetta@home. Upon the project's launch it boasted 240,000 registered users. By gamifying protein folding, Baker's team helped the field of citizen science blossom. </p><p>There have been many rewards. Since its launch, Baker's team has posed over 2,000 design puzzles to their community. Foldit players <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705907/" target="_blank">helped to solve</a> a 15-year problem relating to a monkey virus in 2011. The following year, gamers <a href="https://www.scientificamerican.com/article/victory-for-crowdsourced-biomolecule2/" target="_blank">successfully redesigned a protein</a> initially created by Baker's team. Now this community is being asked to help out with another daunting task: solving the coronavirus problem. </p>
Foldit Lab Report 7: Quarantine Edition
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="7d7e9081ebec48e1d95fd8ac4b7a53a1"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/fbvvunp_wPY?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>While most Americans are self-isolating, which certainly helps stop the spread of COVID-19, Baker is asking Foldit gamers to help hunt for proteins that could stop the virus in its tracks. They're specifically seeking proteins that block the viruses's entry into new cells upon entering the human body. If successful, new antiviral drugs could be developed that would reduce the symptoms once you're infected. </p><p>Brian Koepnick, who works in Baker's lab and helps run Foldit, <a href="https://www.hhmi.org/news/citizen-scientists-are-helping-researchers-design-new-drugs-to-combat-covid-19" target="_blank">says</a> the diversity of responses they receive to problems posed is a necessary step in discovering new solutions. </p><p style="margin-left: 20px;">"We find that the creativity of crowdsourcing is really, really useful—if you ask 100 people to do something, they'll do it in 100 different ways. That's really valuable for us in protein design problems."</p><p>As COVID-19 plagues the entire planet, driving fear and uncertainty in citizens, at least there is precedent for this disease. We know that this type of virus infects cells through its spike protein, which latches onto certain cells and proliferate. Baker says that a protein that "grabs the coronavirus's spike protein might be able to run interference," preventing it from attaching to other cells and spreading. </p><p>Every puzzle Baker's lab publishes is online for roughly a week. They work with up-to-the-minute information about COVID-19; thus, the team is constantly updating its puzzles. According to Baker, a few entries seem promising—there have been 20,000 different designs submitted already—though as with any treatment, each design will require real-world testing. </p><p><span style="background-color: initial;">Baker notes that they've successfully crowdsourced strategies for dealing with flu, which brings hope that a treatment could be found in this situation. </span><span style="background-color: initial;">"In general, the coronaviruses appear to mutate less than influenza viruses. So that makes them a little bit easier of a target."</span></p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjkwOTA3NS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYwOTc1NDAyM30.AfqTNKtwYk-orkXDsYubyIQnHB2wtJR2MXYudnU4nz4/img.png?width=980" id="08235" class="rm-shortcode" data-rm-shortcode-id="99df70f387ececc6dace7c67aa0ab14f" data-rm-shortcode-name="rebelmouse-image" />
Foldit players have come up with more than 20,000 different designs for potential COVID-19 antiviral proteins. Scientists plan to test 99 of the most promising designs (shown here) in the lab.
Photo: Foldit
<p>This is truly an unprecedented moment in history. While researchers have worked on pandemics across the planet before, there has never been such a sense of urgency. Our global response to this coronavirus is likely to set the stage for how we treat diseases of this magnitude in the future. And as science writer Ed Yong <a href="https://www.npr.org/sections/health-shots/2020/04/01/825179922/fighting-covid-19-is-like-whack-a-mole-says-writer-who-warned-of-pandemic" target="_blank">says</a>, there is reason for hope. </p><p style="margin-left: 20px;">"The first steps so far have actually been encouragingly quick. A vaccine candidate has already entered early safety trials after a record breakingly short time from actually identifying and sequencing the genome of this new virus."</p><p>There is a long road from trials to implementation, Yong says. We're 12 to 18 months away from a vaccine. Still, the rapidity of this process has been aided by the sheer number of researchers simultaneously working on the problem. </p><p>Give the number of players on Foldit's platform, it's not about expertise as much as, in Baker's words, persistence and ingenuity. Citizen science is one of the greatest benefits of the digital age. In many ways, platforms like Foldit are leading the way to a new form of education. If you're interested in contributing, <a href="https://fold.it/" target="_blank">download the software and start playing</a>.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a>. His next book is</em> "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</p>
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What Are the Biggest Global Threats to Public Health?
Dr. Larry Brilliant played a key role in eradicating smallpox from the world – so what are the biggest dangers humanity faces now? Brilliant rates politics as on-par with infectious disease.
02 February, 2017
The greatest global threats to health can be divided into two categories, explains epidemiologist and former head of philanthropy at Google, Dr. Larry Brilliant: there is the biological, and the socio-political. In the last 30 years, there have been at least 30 heretofore unknown viruses that have jumped from animals to humans, for worrying reasons Brilliant attributes to modernity and our increase in animal protein consumption. Still, the socio-political threats are the more immediately dangerous. There are centrifugal forces at play that are pushing society to two extreme camps. The domestic and global division caused President Trump’s ‘America First’ mentality and disregard for public health leaves us vulnerable to new viruses that, if they aren’t detected early enough, could be the next pandemic. "Right now because of the re-organization and nationalism… and dislike for the United Nations and its agencies, I think we're in a period of grave vulnerability," says Brilliant. Larry Brilliant is the author of Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History.
<p>Larry Brilliant is the author of <a href="http://www.indiebound.org/book/9780062049230"><i>Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History</i></a>.</p><p><a href="http://www.indiebound.org/book/9780062049230"><img height="150" src="%5Cr%5Cnhttps://s3.amazonaws.com/edge-misc-assets/Book+Covers/Larry+Brilliant.jpg" width="225"></a></p>
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