Hasan Gokal MD
August 26, 2021
Through all the restrictions, uncertainty, politics and loneliness that COVID-19 has brought for so many, the eventual goal of herd immunity within our communities is not going to be enough to stop this virus. The real challenge is getting adequate control of the spread of COVID-19 throughout the world through global herd immunity, and quickly. Without fast global control, future waves of the COVID-19 infection will continue to surface and spread in repeated cycles.
The major problem with the virus that causes COVID-19 is that it is an incredibly well suited virus to overcome our current state of science and mindset.
Look at it this way:
1. It is a great imitator. COVID-19 is mostly invisible in the population. If someone gets infected, they do not look much different. Perhaps it may cause a runny nose, cough, or some other minor symptoms, which could easily be explained by so many more benign conditions. It can mimic the common cold, the flu, gastroenteritis, sinusitis, pharyngitis, bronchitis, and walking pneumonia, among many other common and mild illnesses that we routinely encounter. Nothing about the COVID-19 patient screams of terror or worry. There’s no distinctive rash or disfigurement that would alert others to stay away. For this reason, this virus can infect many others before it is discovered, and by then it’s too late to control in the population.
2. It plays dead to deceive. When a person is exposed to the virus which causes COVID-19, it does not cause illness immediately. 
By the time the symptoms begin (if they begin), it is impossible to tell where the original infection came from. This quiet “incubation” period serves to mislead us into thinking that we did not get infected. Even if you get tested during the first few days, the test will be negative, providing a false sense of security and allowing you to put your guard down.
3. It is mostly invisible. Many other illnesses in the past have left their survivors with horrifying and easily recognizable side effects. Polio left its victims with severe physical deformities. Smallpox left its victims with a disfiguring rash that scarred the victim for the rest of their lives. Rubella, or “German Measles” leads to a high rate of severe and recognizable birth defects. Each of these illnesses has a vaccine that is widely accepted and used extensively throughout the world. In the case of COVID-19, it mostly exists behind the closed doors of the hospital, where the victim either dies or recovers. There is very little visible disability that would alarm others of the dangers of this illness. It is one of the reasons why there are so many people who doubt its existence. It is only when you speak to someone who works behind the frosted doors of the hospital do you realize the horrors that it actually brings. The experience in India may help demonstrate this. Before the major Delta surge, there was very little effort in controlling the virus. Festivals and travel went on without much concerns. However, once the hospitals were full and people started dying in the street in masses, the public finally started adopting public health measures.
4. It picks and chooses its victims. Other illnesses uniformly infect and cause similar outcomes in their victims. COVID-19, however, stays completely silent and without symptoms in large percentage of people, and in others, it goes on to kill them. From the virus’s perspective, this is a fortunate occurrence. If an illness kills 100% of its victims, then it is treated as a much bigger threat and gets eliminated. But if it only kills a few of its victims, it is never taken seriously enough to be treated as a major threat. Additionally, because it mostly spares the young and healthy from its most serious effects, it feeds on our worst impulses and encourages the less impacted to ignore vaccines and prevention measures.
5. It mutates and thrives when people get lazy. If there are enough people without immunity, infectious diseases that primarily infect humans will continue to mutate and thrive. Mutations are a normal part of viruses and bacteria. It is this reason why antibiotics stop working after being overused. It is also why doctors often recommend that if you start a course of antibiotics, finish it. This is because if you only kill off some of the bacteria, the stronger ones are likely to survive and reproduce. Much the same way: if vaccination efforts are ineffective due to hesitation or supply issues, the virus will evolve and eventually evade the immunity for everyone. It will take the vast majority of the world population to join forces and collectively deprive this virus of the reservoirs it needs to keep mutating. In an age of frequent worldwide travel, any community in the world which is under-immunized becomes an incubator for mutations. Every community has the potential for becoming a Wuhan, the epicenter for the next mutation which could render all our previous efforts useless.
6. It finds ways to get around our immune system. The good news is that our bodies do respond to the vaccines and the illness to protect us. Unfortunately, the immunity appears to be short lived. As time goes on, we get to see what the long-term pattern of immunity is turning out to be. Unlike other vaccine-controlled illnesses, immunity against the virus which causes COVID-19, seems to diminish in a matter of months. This seems to be the case for immunity from vaccines, as well as natural immunity from the illness itself. At this point, it appears that multiple doses of the vaccine will be needed for full control, even before considering the need for additional vaccines against new variants. Since vaccines often cause flu-like symptoms, it further discourages its use. This is especially true for our age of instant cures and aversion of treatment discomfort of any kind.
7. It uses our social nature against us. In a strange way, this virus takes away the very things which gives richness to our lives. Forcing us to live a life away from others: without handshakes, hugs, kisses, cuddles, and always hidden beneath masks. Viruses have many different modes of spread, including through touch, water borne, blood borne, etc. However, respiratory transmission is the hardest for people to manage. How long can one go without the touch of a loved one? Keeping kids away from critical education? Unable to put food on your family’s table? Without a vaccine, these would be the only means to control the illness, and will likely take years to develop natural immunity against the various strains.
In many ways, we were all blindsided by this very deceptive and formidable opponent. It knocked us down- but not out. This virus is going to to work hard to prevent us from returning to our way of life if we do not recognize how it works and work together to beat it. In many ways, it tests our ability to unite and work with others from around the world to beat this. Otherwise, we run the risk of playing whack-a-mole with this virus for a long time to come.