Countries around the world — and some Canadian provinces — are beginning to lift coronavirus restrictions, the first step in a long, slow road back to some semblance of normalcy in the wake of the peak of a global pandemic.

But the fight against COVID-19 will continue as the world attempts to rebound. Managing the peak of the outbreak is just one — albeit significant — hurdle to contend with.

Here’s a look at four aspects of the coronavirus outbreak that could complicate our return to normal life.

There are silent spreaders

Experts were initially skeptical that people with mild or no symptoms of COVID-19 played a significant role in spreading the disease.

But four months on, top scientists now speculate that people who are asymptomatic could comprise between 25 and 50 per cent of cases and could be a “major driver” of the pandemic.

While it is not clear how effectively asymptomatic people are transmitting the virus — another question that needs answering — the possibility that silent spreaders are one of the embers keeping this pandemic aflame makes ongoing restrictions in Canada all the more important, especially to vulnerable people.

Immunity is complicated

Immunity passports — cards that let people who have recovered from COVID-19 return to work or travel — have been touted as a possible avenue for some people to resume their normal lives.

Experts and officials in countries like Chile, France, the United Kingdom and the United States have floated the idea, based on the theory that individuals could only contract coronavirus once before developing the antibodies they need to fight it off. Another strategy to get people back to their normal lives centres around “herd immunity,” the belief that exposing a large number of people to the virus in a measured, gradual way will help them develop a natural immunity.

While most experts believe it’s very likely that people will develop some form of immune protection to the virus if exposed, the unanswered questions are how much protection and for how long.

The World Health Organization has pushed back on the idea of passports, based on the scientific evidence at this stage. A brief from the organization issued last week stated there is no evidence that people who have become sick develop antibodies effective in providing “immunity to subsequent infection.”

“Laboratory tests that detect antibodies to SARS-CoV-2 in people, including rapid immunodiagnostic tests, need further validation to determine their accuracy and reliability,” the briefing said.

On the same day, Canada’s chief public health officer Dr. Theresa Tam warned against putting too much weight on herd immunity, saying the federal government has put in place an immunity task force that will investigate how people’s immune systems respond to COVID-19.

Preparing for multiple waves

After weeks and months of lockdown in Asian and European countries, governments began slowly lifting restrictions in April.

The process came with many unknowns, but one thing seemed certain: global health officials are expecting multiple waves of the virus until a suitable vaccine is on the market. What the waves are going to look like remains to be seen.

WHO director-general Tedros Adhanom Ghebreyesus summed it up like this last week: “this worst is yet ahead of us.”

This has caused concerns that a return to normal activity could worsen the impact of a second wave and increase the burden in terms of testing swabs, protective equipment for health-care workers and hospital capacity.

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There’s no quick fix

Dr. Tam has been very clear from the early days of the virus being detected in Canada: It will take at least year for a vaccine to be developed.

Meanwhile, she said back in January, it’s up to government and public health authorities to manage the outbreak.

Fast forward a few months and the commonly accepted time required to create such a vaccine remains 12 to 18 months. That would be the fastest vaccine development in human history; the mumps vaccine, which took four years to develop, currently holds the record.

As of mid-April, five vaccines were in clinical trials around the world according to the WHO, with 71 candidates at the preclinical stage. There are a variety of factors that could complicate things, including whether people do in fact develop immunity after catching the virus, as well as the required number of doses.

Those two things will determine how much of the vaccine is needed and how quickly it can be rolled out.

With files from Star Staff and Star wire services