If only the US had taken this virus as seriously as the major European countries, we would not be seeing increasing cases now.
All of the countries shown on the chart below (except for one) had national mask mandates (apparently national mandates are not as magical as some believe) and restrictions on businesses much more severe than the US. They all had leaders who wore masks in public and took this virus seriously. Apparently, viruses do not care about mask mandates, even if they are national. Apparently, viruses do not care about business restrictions, even if they are severe. Apparently, viruses do not care if the leaders of the country take it seriously.
Viruses react to their environment and behaviors in the environment. Based on what I have learned over the past several months of this pandemic, I offer the following:
1. Why do infections from the flu increase in the Fall and Winter? People get cold and they go inside. Viruses spread much more easily inside, where ventilation is poor. Viruses do not spread well when people are outside. We should not be surprised that infections are on the rise, since it is starting to get cold. We also know through contact tracing that much of the current spread is occurring within families and in small family gatherings. When it gets cold, many of these gatherings move indoors.
2. Why do some areas of the world get infected with viruses at different rates? Viruses mutate and sometimes these mutations are more contagious. There is some good evidence (I have provided this detail previously) that he strain of the Coronavirus that has impacted the Asia Pacific region is less contagious and virulent than the strain that has infected Europe, Latin America, and the US.
3. Why do the populations of some nations not get infected to the level as other nations? They have built-up T-Cell immunity/resistance due to past infections by closely related viruses. There are many scientists that believe T-Cell immunity offers as good as, if not better immunity to viruses. It is one of the theories currently being studied with respect to younger adults in the US who have recently been infected with coronavirus versions of the common cold and with people who lived in Asia Pacific countries at the time of the SARS outbreak. The theory is these people are protected from Covid-19, due to T-Cell resistance from the previous infections.
4. Is the virus gone in those countries with no reported infections? No. Many of these countries are either islands or they are countries with zero travel across their one boarder (S. Korea). These countries have cut off travel completely and since they are islands (or effectively an island), the ability for people to travel there and bring the virus is effectively zero. Once travel restrictions are lifted, they will see the infections from the virus again.
5. Will the virus come back in those countries with no reported infections? Yes. See the above.
6. Will the virus be present, even when we have a vaccine? Yes. We know the vaccine is likely only to be 50-70% effective, since many people will not get vaccinated (either by choice or due to limited supply initially). Additionally, we know viruses mutate and it is possible the mutations will become resistant to the vaccines currently available. This is why we have to get a flu vaccine every year.
7. Will the virus and outbreaks from the virus be happening 5-10 years from now? Yes. As mentioned above, viruses mutate. This is what they do. Sometimes the mutation can cause them to become less virulent and they go away, but in cases of other viruses (normal flu and common cold), the mutations help them evade the antibodies created by a vaccine.
8. Do national lockdowns on their populations stop a virus from spreading, long-term? There is no evidence in history of this being the case and it has not been demonstrated with Covid-19 restrictions worldwide. While spread has been slowed or stopped temporarily (see above), there is no evidence lockdowns can end a pandemic.
9. Do lockdowns have unintended consequences? Yes. Lockdowns do have very definite consequences. They cause increases in suicide and drug use, due to social isolation and the inability of people to work effectively with their peer support groups. They cause increased violence in the home to spouses and children, due to the stresses of the lockdown. Shutting down of schools severely impacts the critical early development of young children at a time when the ability to learn and grow socially is the most prevalent. Businesses that are locked down can not get the revenue they need to pay employees, leading to layoffs and massive unemployment. Even the best of economies can not go through lengthy lockdown periods. It is the responsibility of national leaders and elected officials to balance the costs of lockdowns against the loss of life due to the virus and make reasoned and sometimes tough decisions.
10. Will Americans agree to wear a mask and social distance for another year? I am highly doubtful this will be the case, particularly if we do get a vaccine and effective therapeutics. I believe Americans will begin to more broadly resist government mandates on mask wearing and businesses, once a vaccine becomes widely available (likely early in 2021). As I mentioned in point 9, lockdowns and failure to open schools is having severe consequences on the population. People recognize this and at some point, policies will have to be modified to allow for less restrictions. Today, science tells us that schools should be open to in-person instruction and at some point, science will win out over opinion and fear.