Many readers have said consistently throughout the pandemic that they will not travel until there is a vaccine. CNN recently interviewed several people taking this position. I think it’s the wrong paradigm for thinking about future travel both because a vaccine won’t be the cure all many people expect and because travel itself seems pretty safe, the issue is what you find at your destination.
We know a lot more about Covid-19 than we did three and four months ago. Much of what we think we know is still speculative. There’s learning which suggests real optimism, even as the virus spreads rapidly through much of the country (especially the southern portion). But the idea that we’re just hanging in for a vaccine, and once we have one everything goes back to normal, no longer holds up as we learn more about what vaccines against the novel coronavirus can do. At the same time it’s one part of a tool kit that will bring life and travel back to what it once was – and taken together likely even get us most of the way there in the first half of 2021.
Travel Is Safe Now, But You Can’t Do As Much As Before
Business travel isn’t returning this year because it isn’t just flying that needs to be safe (and large companies tend to take a very cautious view putting travelers on the road) but the destination needs to be also, and business travel involves a whole lot of coordination around the idea that travel is safe.
Offices need to be open, or else remote workers won’t be traveling to headquarters, and you can’t go visit a client that isn’t at their office or where their office isn’t accepting visitors. That’s even aside from large gatherings being inadvisable, so conventions and meetings aren’t coming back for awhile. Those get planned pretty far in advance, too.
Planes with HEPA air filtration seem pretty safe, there really haven’t been demonstrated cases of virus spread inflight. If airlines were really a spread vector we’d see a lot of spread that we simply don’t find. IATA acknowledges that a Vietnam Airlines London Heathrow – Hanoi flight probably spread the virus on March 1, but even there it could have happened in the gate area or on the jetway. Millions of people have flown since the start of the pandemic and we just haven’t found evidence of significant spread on airlines.
That doesn’t mean travel makes sense. You may fly somewhere the virus is spreading at a high rate, exposing yourself at the destination. Flying does involve being around more people, in the airport and to and from. And once you get there… will you be let in? It’s not just foreign countries that are limiting entry, several U.S. states are imposing quarantines on arriving travelers from several other states.
If you’re allowed to travel freely to your destination you may find the bars closed (if that’s your thing), restaurant dining options limited, service at your hotel limited, and sporting events and other activities closed too.
And what if you’re exposed to someone who catches the virus while you’re traveling, and you have to quarantine while you’re gone? Then you’re facing additional time away from home, inconvenience (even if you don’t get sick) and additional travel expenses.
Some people are driving long distances to avoid flying, I think that’s a mistake – that air travel is probably safer than driving still. We shouldn’t focus only on one type of risk to the exclusion of others.
Vaccines Aren’t A Silver Bullet
There’s no question we’ll have vaccines, because we already have vaccines. The question is how effective they’ll be and how safe?
That is why clinical trials are proceeding in the U.S. The mRNA approach is new, seems to generate antibodies to the virus, and hasn’t been causing unacceptable levels of side effects, but what happens at scale when used across a huge variety of races, ages, and people with background conditions? We have to find out before making these vaccines widely available.
The Chinese have a vaccination they’re giving to their military and now some state-owned companies too, though it’s probably the least effective among current world candidates. It’s an attenuated virus, and it may help a little and probably won’t have major side effects.
There’s an idea of ‘a vaccine’ as though it’s a binary event, we either have one or we don’t, and that’s the wrong mental model. We’ll likely have several iterations of vaccines, a first generation and then subsequent generations that are more effective.
An initial vaccine might be, say, 40% effective which would mirror last year’s performance of the flu vaccine (the FDA has said their target is 50% effective for approval, though they would consider an emergency use authorization below this threshold). And not everyone will take the vaccine, let’s say we have 50% adoption, just look at the number of people who won’t wear masks and ‘anti-vaxxers’ have been on the rise in recent years.
Vaccines are one tool in a rapidly expanding toolbox that will help fight the virus and bring us back to normalcy, but the introduction of a vaccine – call it winter 2021 – won’t bring everyone back out of the shadows. (This is a prediction, feel free to disagree, though my predictions from early in the pandemic have a pretty good track record so far.)
Even if we have a vaccine candidate determined before end of year, and beginning to be distributed early in 2021, it will take time for production and distribution to fully scale up, even though that’s starting now to some extent. It’ll initially be available to health care workers and politicians and the wealthy and well-connected. It’ll take time for the rest of us to get it. And once it does it’ll reduce spread but not eliminate it. Some vaccinated people will likely still get the virus.
20% Protection From A Vaccine May Be Enough, As Part Of A Portfolio Approach
If 50% of people take a 40% effective vaccine, call it 20% protection. That layers onto the percentage of the population that’s gotten Covid-19 and retains immunity, and the percentage of the population with pre-existing immunity.
This should be enough to keep the virus under control, and though there’s been a lot of media coverage about antibodies wearing off quickly after someone recovers from Covid-19 that doesn’t mean they lose immunity quickly as new research on t-cell mediated immunity suggests: it appears that some number of people already have t-cell mediated cross-immunity from other common cold coronaviruses, and t-cell memory of this virus should reactivate an immune response even after antibodies wane.
How robust these effects are remains speculative, of course – and how immunity will be impacted by future mutations of the virus, though this one seems to be mutating less than many expected – but this research is the best news we’ve had in awhile. Still, as immunity does wane, more people may become vulnerable to infection again in a cycle of maintaining herd immunity.
Fortunately there’s a lot of thinking that herd immunity, which isn’t really just an either-or proposition but about a slowing down of spread as there are fewer people vulnerable to infection, may be achieved or approximated at lower levels of infection than some early estimates had claimed, “20% – 60%” is a wide range but helps explain low infection in New York City even as re-opening continues there. (See this too.)
We’re also seeing new therapeutics – not just the ones that have been broadly covered, but others where trials are underway – and even without those in use yet we’re seeing improved patient outcomes (for instance prognosis for someone on a ventilator is much better than in March). As infections have spread and especially in nursing homes (as we’ve seen this week in Texas) that will mean more absolute numbers of case fatalities, but I’m optimistic that improvements in how patients are treated will mean shorter hospital stays (helping to reduce the strain on health care systems) and that the virus won’t be as deadly when people get it. There’s some evidence suggesting this now, but we’ll have to see whether it continues to hold (and the point is, it should get better in any case better drugs).
The upside here to a gradual return to normalcy as we layer on protections and improvements that allow us to live with the virus effectively is that it means improvements like aircraft and hotel cleaning regimens – which would have been desirable even before the pandemic – probably stick around awhile.
Things Will Get Better Here, But That Doesn’t Mean They’ll Be Better Everywhere
As poor a response, and as widespread as the virus is here in the U.S., it’s hard to imagine that things could become better and safer for travel in the United States before doing so in (some) other countries. But the one area that the U.S. seems to be doing well, along with the U.K. and Germany, is in its biomedical response.
Some combination of pre-existing protection, recent infection, therapeutics and vaccine may suppress the virus to where it’s manageable here in the U.S. and life goes back to something like normal by spring 2021. That doesn’t mean everything is up and running – many events will require long lead times to switch back on, the most vulnerable may still rationally shelter, and habits take time to break too.
If the vaccine comes here and to Europe and North Asia first, what does that mean about travel to parts of South and Central Asia, Latin America and Africa? Availability of the vaccine seems likely to be an issue at least initially.
If you’re considering trips to South America and to Africa, they may not have access yet or for awhile. And that means some activities on the ground may not be fully open, and that since a vaccine won’t be 100% prophylactic you may still become infected during travel. The advisability of medical evacuation insurance coverage may be greater and certainly more top of mind though do due diligence on the terms.
If you disagree with any of this – and there’s plenty here that remains speculative, and as Yogi Berra is said to have said “It’s tough to make predictions, especially about the future” – please say what precisely you think is wrong and offer your reason why so we can have a constructive dialogue about what the markers of going back to normal travel will look like.
[…] already written about a vaccine not being a silver bullet, that it’s likely not to be 100% effective and not everyone will take it. That means the […]