COVID-19: How do we live with coronavirus in the absence of a vaccine?

The answer is disappointing: Nobody knows.

Professor David Tscharke, the head of the ANU's Department of Immunology and Infectious Disease, warns against "punditry" and "speculation".

"We need to accommodate ourselves to uncertainty," he said.

Rely on the science.

The general view among scientists is that a vaccine to prevent infection is a year to 18 months away - though so much money and effort is being thrown at the problem that a more optimistic view is emerging that one may be available by the end of the year.

The Oslo-based but international Coalition for Epidemic Preparedness Innovations is funding nine different coronavirus research projects.

Its head, Richard Hatchett, said several vaccines could become available in 2020 but probably not in any great quantities, so they would be confined to the vulnerable and to essential workers - if the vaccine emerges at all.

About 100 potential vaccines are being researched around the world.

This decentralised approach is ideal. "Vaccine development has a large experimental component; we just have to make educated guesses and try different things and see what works," professor Marilyn Roossinck of Pennsylvania State University said.

A few are already being tested on people, initially just to make certain that they are safe.

The next step would be to establish whether the compound will actually drive out the virus.

The ANU's professor Tscharke said one factor in any potential vaccine's favour was the virus wasn't like those which cause AIDS, malaria, tuberculosis or hepatitis C for which there are either no vaccines at all or not ones with any great effectiveness.

In the absence of a means of preventing people from catching the virus, a lot of effort is going into finding ways of treating people already infected by it.

The World Health Organisation says there is no effective treatment for COVID-19 at the moment. "WHO does not recommend self-medication with any medicines, including antibiotics, as a prevention or cure for COVID-19," the organisation said.

But there are trials taking place, both in Australia and abroad, often with collaboration between scientists in different countries like in the "Solidarity" project which is comparing four different treatments.

The WHO says: "By enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence."

Finding 'antiviral' treatments is usually a lot faster than developing preventative vaccines. Professor Tscharke said a drug trial in the United States seemed hopeful - it "suggested some good effects".

But it was too soon to be sure.

No.

We are searching for what Tom Snow of the Snow Medical Research Foundation calls a Plan B.

If we can't prevent it and we can't treat it, we need to know how to avoid it and control it when we catch it, minimising the damage.

This demands knowledge, and demands widespread testing and tracing so when and if outbreaks occur in future, they can be closed down quickly without a wide spread of disease.

Professor Tania Sorrell, the director of the Marie Bashir Institute for Infectious Diseases and Biosecurity at Sydney University, likened the tactic to fighting fire.

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The aim was "to stop a small bushfire growing into a a big bushfire".

She and her researchers want to know how much coronavirus is out there where carriers don't show symptoms.

They are working to find out the effects on different groups of people - the young, the old, the obese, healthcare workers, in particular. Why do some people catch it and transmit it while others don't?

If you can identify who is vulnerable and who is not, different groups could be freed up.

Australia is ramping up its testing but it is still way behind South Korea and Iceland, for example, which have tested swathes of the population and kept the rate of infection very low.

More than 630,000 people in Australia have been tested, with tests ramped up to about 23,000 a day.

But testing everyone is a huge and expensive operation. There is no guarantee all tests are accurate or that tested people don't contract the virus later.

Iceland is a tiny and affluent country.

And South Korea experienced an outbreak of MERS in 2015 and started stockpiling chemicals.

Australia is widening testing beyond those with symptoms. It's called "sentinel testing", whereby people are tested at random to give a picture of where the virus might be in the community.

Not soon. We probably have to learn to live with it.

That means a gradual easing on rules about meetings, for example, but keeping others - like social distancing - tight, and always with the proviso the clamps go back on if there is a serious spike.

There will be more testing so we can be sure people back at work, for example, or travelling, are clear of the disease.

Knowledge will increase so outbreaks can be caught early and infected people and their contacts can be isolated and treated.

Until - and if - a vaccine comes along, it's Plan B.

Get used to it.

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