When it comes to COVID-19, no one has a crystal ball.
State leaders expressed some cautious optimism this week as data show the number of new COVID-19 cases leveling off in Illinois as the state continues to flatten the curve.
But despite extensive modeling, it’s been difficult to pinpoint whether the worst of the pandemic is over in Chicago, when that might be or what lies ahead.
While models can guide leaders and doctors, they aren’t perfect. For one, they’re only as good as the data fed to researchers, and local researchers say it’s been difficult to get that data quickly.
“This lack of structured surveillance and sluggish data flow from [the Illinois Department of Public Health] to researchers constrain our ability to understand the current situation and evaluate the effects of potential interventions,” said Sarah Cobey in an email. She is principal investigator at the Cobey Lab at the University of Chicago where she and her team study the ecology and evolution of pathogens.
Here are a few other reasons experts say it’s so difficult to know when the worst of this pandemic is behind us.
1. Lack of testing leaves a lot of unknowns
Testing for coronavirus hasn’t been available enough across the United States to truly understand the extent that the virus has spread in our local communities.
“Until we really know those metrics it’s hard to get a handle on planning on how this may evolve over time,” said Dr. Ronald Hershow, director of the division of epidemiology and biostatistics at the University of Illinois at Chicago.
As testing expands, those models change, which experts say is positive.
“That's why the numbers have all changed in the last 36 hours,” said Dr. Robert Murphy, executive director of the Institute of Global Health at Northwestern University, on Monday. “There’s not going to be 100,000 deaths based on the model now. So, they've adjusted that model.”
Scientists are also excited for a new antibody test that could determine how many people may have had the virus and recovered, and provide additional information about how much the virus has spread. That kind of information could be another piece of data to help improve the predictive models.
2. Human behavior is unpredictable — especially as the pandemic continues
Experts said no matter how much data we have, models can't predict one vital factor: human behavior. As weeks of social distancing turn into months, will people continue to follow those directives as stringently?
“You can fatigue on prevention strategies, you can burn out in them,” said Hershow. “To what extent will that happen and how will that influence future events regarding this part virus? There's no way of predicting that exactly.”
It’s unclear how the coronavirus will continue to spread during the summer months and how warmer temperatures might affect the virus. Some experts have expressed concern of a fall resurgence. A spike in cases could also happen if governments reopen society too quickly, which doctors cautioned could have swift consequences.
“You may have some states that have a double hump where they go down, they lift restrictions too soon and then they go up,” said Murphy.
Doctor Bala Hota at Rush University likened that possibility to dealing with a mountain range rather than a single peak.
As some states or regions bend the curve before others, it’s also unclear how the United States would prevent infected people from states with weaker restrictions from traveling to areas where the virus’ presence is reduced or eradicated.
“Shelter in place and social distance are working,” Murphy said. “But what about these states that came on late and have more holes than rules?”
He said that’s where strong leadership is required.
3. Adjusting to a new normal
There’s one thing all these scientists agree on: the easiest way to avoid a mountain range of surges in the coming months is to accept that things will not go back to “normal” quickly.
As Illinois sees cases level right now, doctors and scientists said people should not take that to mean they can ease up on social distancing.
“It makes me uncomfortable even saying, ‘Oh things are looking up a little bit,’ because it depends on all of us doing the right thing,” Hota said.
He and others said social distancing should continue, even as governments ease up restrictions.
“I would envision let’s say when people go to restaurants in the fall they'll still be wearing masks and tables will be further apart and those kind of adjustments,” said Hershow. “Then there’s doctors waiting rooms and all kinds of settings to think about.”
It’s likely we’ll continue to see increased hospitalizations and even deaths over the next few weeks as the virus continues to run its course. But bending the curve and keeping it down means stopping the virus from spreading in the first place. For now, experts say that means staying at home
“It’s not time to relax,” said Hershow. “It’s not Miller time as far as this virus is concerned.”