There Will Not Be a Coronavirus Vaccine Before Society Largely Reopens

Over the past few weeks, an interesting, and rather dramatic, development has occurred: A good minority of the population, often those in possession of what they deem to be stable incomes and sufficient savings, or who are otherwise cradled by some sort of safety net so they need not worry about homelessness and destitution, have moved the goalposts of the lockdowns from “flatten the curve to buy time for the hospital system to deal with a dramatic rise in patient loads” to “shelter-in-place until a vaccine is developed so this thing doesn’t spread.”

The latter is predicated upon a fundamental misunderstanding that ignores the scientific reality of what we are facing.  Looking at subsequent developments in the pandemic, it’s time to face facts based upon all available presently-known factors.

Fact #1: There may never be a vaccine developed for the virus that causes COVID-19.  Am I optimistic?  Yes, reasonably.  But you have to assign various probability factors to things and the odds of a vaccine never materializing despite all human efforts and billions in research are much higher than the press is indicating to the general public.  As such, behaving as if a vaccine is inevitable, or even relatively close in the near future, will cause enormous destruction and death because it will cause trade-off decisions that are entirely irrational and not supported by fact.

Fact #2: Even if a vaccine is developed, it will likely not be available to the public in a meaningful way during the next 18 months as there is simply no precedence for a safe, reliable vaccine being developed and brought to market that quickly.  Vaccines usually take decades to develop.  The only real shot we seem to have at trying to reach a 12 to 18 month development table will require a so-called “human challenge trial” in which people are purposely infected with the virus.

Fact #3: Even if a vaccine were available during that time frame through the miracle of modern science, it still wouldn’t matter because there is a nearly insurmountable supply chain problem.  Namely, there are quite literally not enough syringes in existence to inject everyone with the vaccine – especially when you consider a large part of the existing syringe supply is necessary for the health of existing patients, including diabetics who need to inject insulin to stay alive – and we are not using war powers to mass produce them in anticipation of such a vaccine so by the time we needed to reach for them, they wouldn’t be there.

Fact #4: In recent weeks, mounting evidence indicates that the true R0 value of the virus is much, much higher than previously believed as tests across multiple states, countries, and continents indicates a far higher proportion of society is testing positive and/or have antibodies than would have otherwise been expected and despite lock-downs.  For example, as reported in The New England Journal of Medicine somewhere north of 1 out of every 6 pregnant women admitted for delivery tested positive for SARS-CoV-2, a vast majority of whom either had no symptoms or who had still not developed symptoms during the measurement period.  Note that this only tested those who were currently positive for the virus.  It’s entirely possible some of the women had the virus in the past and would have had antibodies despite testing negative.  Paradoxically, this is fantastic news because it means the true mortality rate of COVID-19 for the general population is likely to be dramatically lower than previously estimated and used in all trade-off decisions to date.

Conclusion: While the data is always becoming clearer so it is impossible to say with certainty, barring any subsequent horrific mutations that cause the virus to become more deadly, my guess is that the actual real-world mortality rate probably ends up somewhere equal to or below 1.00% after all is said and done.  Combined with a higher R0 value, this means nearly everyone will be infected with the virus in the next 18 months, if they haven’t been infected, already, and:

• A vast majority of those people should escape all but unscathed. Many, if not most, won’t even realize they had the virus.
• A small number will have horrific medical complications that may last a lifetime including permanent damage to organs.
• An even smaller number will die an excruciating, truly horrific death.  (To put it in clearer terms, if my earlier assumption of ≤1.00% turns out to be the case, this would be 10 out of every 1,000 people under a worst-case scenario; possibly far fewer.)

That is where we are.  Those are the facts.  Political, economic, and cultural forces have now aligned in a way that all but assure society will open far earlier than epidemiologists, focusing solely on their discipline, would advise or deem prudent.  This means that unless you are financially independent, the odds are you cannot and will not be able to shelter-in-place much longer even if you thought you were safe (e.g., the wave of unemployment and/or salary reductions that is cascading through the system is now hitting higher paying white collar workers, including physicians, attorneys, accountants, and engineers).  Further, still, if you are the exception, your ability to remain so relies upon other people not sheltering-in-place much longer as you are benefiting from the dividends, interest, royalties, and rents produced by their productive behavior so bemoaning the situation would be hypocritical.  Thus, the only intelligent way to behave is to begin making personal and professional decisions accordingly, taking into account your own unique risk factors and trade-off decisions.

That is, the name of the game is going to be risk reduction / mitigation, not risk elimination as the latter is simply not in the cards for most folks.  For example, if you are older, have underlying health conditions, and are fortunate enough to enjoy significant income from your investment portfolio, wisdom may dictate you should remain in isolation for the next few years whereas, all things considered after weighing potential outcomes, it is likely folly for most 25-year olds who were otherwise healthy to do the same.  For the time being, this particular coronavirus is simply a fact of life that must be accepted the same way individuals must contend with everything from the risk of contracting HIV to the risk of driving a car.