How the COVID-19 pandemic could end, based on past pandemics.

The COVID-19 pandemic has been ongoing for months now.

In Australia, we’re looking to the future. We’re easing restrictions that have flattened the curve and we’re being cautious of a second wave, but we are ahead of the global fight.

In other countries – the United States, for example, which has 1.37 million cases and 80,000 deaths, and Russia, one the world’s new coronavirus hotspots – community transmission is still rampant and case numbers are rising rapidly.

Australian PM Scott Morrison outlines step one in our three-step plan out of COVID-19 restrictions. Post continues below video.

What we all have in common is that no matter where we are, the coronavirus is going to be a defining part of our lives for months, if not years, to come.

But how does it end? When will we have a day when we don’t think about the pandemic/social distancing/the economic fall out? What will life even look like on the other side?

Drawing information from past pandemics like the 1918 Spanish Flu and the many iterations of the plague, we can consider how the COVID-19 pandemic may end.

There are two possible different ‘endings’. The medical ending, and the social ending.

Mamamia’s daily podcast The Quicky on how past outbreaks came to an end. Post continues below audio.

The medical end.

COVID-19 is an entirely new virus, meaning there is no existing immunity in our communities, and knowledge about how it behaves is limited.

No medication or vaccine is approved to treat the virus, and international researchers are working with accelerated research processes to meet global demand and to try to find a vaccine and medications.

On March 16, the first clinical trial of a vaccine started with four volunteers in Seattle, United States. The vaccine contains a harmless genetic code copied from the virus that causes the disease, and it is practically unheard of for a vaccine to be trialled on humans so quickly.

It is currently unknown if past infection provides effective and long-term immunity in people who have recovered from the virus. In other words, it is currently unclear how likely it is that a person could contract the virus twice. Or more.

There is also debate over whether COVID-19 will be a recurring, seasonal virus that will mutate, like influenza.

We have eradicated illness in the past: Smallpox, a virus which on average killed three out of every 10 people who got it, was completely eradicated in 1980 after multiple epidemics swept the globe over thousands of years.

Prevention was primarily by the smallpox vaccine.

The medieval plague, known as the Black Death, killed up to 75-200 million people in Eurasia and North Africa from 1347 to 1351. It was largely carried by fleas living on black rats, but can also be passed from human-to-human.

It is not entirely clear what slowed the spread of the plague. Some scholars argue cold weather helped to kill the disease-carrying fleas, but that would not have slowed the community transmission. There is also a suggestion a change in the rat carriers - from small black rats to stronger brown rats - made an impact, or that the bacteria that caused the disease evolved to become less deadly.

The plague still exists, mostly across the African continent but also in the United States, but medical treatment is now fairly simple thanks to the development of antibiotics.

The Spanish Flu outbreak of 1918 infected 500 million people - about a third of the world's population at the time - and killed between 50 and 100 million.

Speaking to Mamamia's daily news podcast, The Quicky, in February, Dr Sanjaya Senanayake, an infectious disease specialist and Associate Professor at ANU Medical School, explained the outbreak's downfall was likely due to its infectiousness.

"It infected so many people, that those who weren't dead had immunity to it.

"On top of that of course, people did recognise that infected people could infect others so there was a lot of quarantining and that definitely would've had an impact. Those are probably the two biggest factors [in ending the pandemic]."

The social end.

Rigorous social distancing and lockdown measures are working.

Countries like Australia, Taiwan and New Zealand have been successful in slowing the spread of the virus.

Taiwan has had three days in a row of no new infections, for a total of 440 cases.

In the case of New Zealand, the virus has already been deemed 'eliminated' by the government, which in epidemiological terms means cases within the community are zero, with new infections only linked to known cases or in New Zealanders returning from overseas.

The successes of Australia and New Zealand means the countries are beginning to ease strict restrictions, and while a return to 'normal' is not on the cards yet, our current scenario is enviable to so many other countries around the world.

So much so, the prospect of travelling between each country - likely the only international travel on the cards in the foreseeable future - is being explored by our governments.

Then there is the other form of 'social end'. The New York Times presented research from historians that the pandemic could end while the virus is still circulating within the community, but when the fear about it subsides.

"When people ask, 'When will this end?,' they are asking about the social ending," Dr Jeremy Greene, a historian of medicine at Johns Hopkins, told the publication.

In other words: The 'end' could occur not because the virus has been eliminated, but because people grow tired of the panic and fear surrounding it and learn to live with it in their community.

This is heightened in the United States, where perceived 'freedom' and the distrust of authority and government is stronger than here. In certain US states, protests against lockdown measures began weeks ago (there have also been protests in major Australian cities like Sydney and Melbourne, though on a smaller scale).

In some states, governors have lifted restrictions despite warnings from scientists and public health officials that the virus is not under control in America.

A medical end could be in sight - albeit far, far off in the distance - but members of the public may force a social end earlier.

The challenge, Harvard historian Dr Allen Brandt told the New York Times, is that either way there will be no sudden victory.

The end of the pandemic will be slow, and difficult. It will look very different depending on where you are in the world, and will depend on a mixture of medical breakthroughs and societal values.

In the meantime, all we can do as individuals is control what we can - self-distance, maintain hand hygiene and work as a team to ensure our great strides continue (plus, we can be grateful for our home near the bottom of the world).

Read more:

• What you need to know about COVID-19 today, Monday May 11.
• Australia is entering stage one of easing restrictions. Here's what that means for you.
• COVID-19 has highlighted a fundamental difference between Australia and the US.
• The two permanent lifestyle changes that could stick around long after COVID-19 is gone.
• A 3-step plan: What we just learnt from Scott Morrison's 'road out' press conference.
• 100-person gatherings and bars open: New Zealand's plan to ease COVID-19 restrictions.
• A 'travel bubble' between Australia and New Zealand is on the cards. Here's what that means.
• Three ways people are reacting to coronavirus: 'accepting', 'suffering' and 'resisting'.

Feature image: Getty.