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What happens if a coronavirus vaccine is never developed? It has happened before.

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By Rob Picheta, CNN
Updated 3:33 AM EDT, Mon May 04, 2020

While countries around the world navigate this new social distancing/ shelter in place reality, we optimistically await a vaccine that could bring daily life back to normal.  Perhaps as soon as 12-18 months according to Dr. Fauci.  But other epidemiologists and virologists caution it could be the latter, and even then, it is the best case scenario.  But  what if one never comes?  It has happened before (HIV, malaria, dengue fever, common cold adenoviruses and rhinoviruses).  And although we have several vaccine candidates, some of which have begun human trials, it is the testing phase which is the limiting step, holding up or completely scrapping vaccine candidates when lack of efficacy or safety data knocks out an entire team’s Herculean efforts.  The human body is just not as predictable as we might wish it to be, and vaccine development can often seem hit or miss.

So for the next two years or, in the worst case, decades until a vaccine is found, what will life look like?  

Everyone agrees, it will be very different.  Lockdowns are not economically (or probably politically) sustainable.  As countries try to creep out of their paralyses, experts would push governments to adopt an awkward new way of living and interacting, fundamentally requiring a social contract among citizens to stay home if they feel sick, and for employers and coworkers to treat them as heroes rather than pariahs.  In the short term, a vast program of testing and contact tracing would need to be implemented to allow societies to function alongside Covid-19.  One that dwarfs any such prior program and one which remains some time away for major countries like the US and UK.  We will need a robust public health system, contact tracing, testing in the workplace, symptom surveillance, and early communication of the need to re-implement social distancing.  With these systems in place, and during periods of minimal transmission, it may be possible to open things up for sporting events and large gatherings, perhaps with fans separated in the stands, and other precautions.  But it would not be permanent, and would require continual monitoring by governments and public health bodies.  NFL and MLB games might resume for weeks at a time — before quickly shutting down stadiums when the threat rises.  And from time to time, there will be outbreaks, movement will be restricted, within counties, states or regional state coalitions.

While many debate the timing, the outlook is optimistic that an effective vaccine will come.  But if previous outbreaks have proven anything, it’s that hunts for vaccines are unpredictable.