Can we please stop talking about a second wave of COVID-19
The blockage subsides. People return to work and the shops raise their shutters. But we have no vaccine and are far from achieving herd immunity. So this newly discovered freedom is full of fear: fear of a second wave of infections.
In fact, people are already talking about a "second wave" that is hitting China and Iran. However, the concept of a second wave is flawed and leads to dangerous misunderstandings about the pandemic.
The idea of a second wave results from the incorrect comparison with the seasonality of the flu virus.
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At the beginning of the pandemic, many experts discussed the similarities between SARS-CoV-2 and the influenza virus. They are both viruses that cause respiratory infections - mostly mild. Influenza is also the cause of the recent pandemics. Because of these similarities, it was tempting to assume that COVID-19 would behave like a flu pandemic. However, these are very different viruses with very different behavior.
COVID-19 has a much higher death rate compared to the flu, along with a much higher rate of hospitalization and serious infections. Influenza is also a seasonal virus. Every year, the cases of flu start in early autumn, increase in winter, and then decrease as we approach summer. This repeats itself annually, and if a new strain of flu occurs, we would probably have a first wave of infections in winter-spring, then the virus would return in a second wave in autumn-winter the following year.
The worst pandemic ever registered was the so-called Spanish flu pandemic. During this pandemic, the virus infected the northern hemisphere in spring 1918, partially died in summer 1918, and came back into force in autumn 1918. It is tempting to speculate that COVID-19 will decrease or disappear in the summer, only to reappear when the weather gets colder. However, we do not know if COVID-19 is a seasonal virus.
Emergency hospital during the 1918 flu epidemic, Camp Funston, Kansas. Otis Historical Archives / Wikimedia Commons
The flu is less permeable in summer because the combination of higher humidity, increased UV light and people who spend less time inside are close together. Some of these factors can also affect COVID-19, but we really don't know to what extent.
Even if seasonal factors affect COVID-19 transmission, the spread of a new virus through a population without immunity will overwhelm the influence of seasonal factors. The 2009 swine flu pandemic virus and the 1918 pandemic virus were new viruses against which humans had no immunity. As a result, the virus did not go away in summer, although the transmission was somewhat reduced. We therefore cannot expect COVID-19 to behave as a seasonal virus and decrease in summer to return with a second wave in autumn.
The first wave is not over yet
Apart from the seasonality, there is another reason why the idea of a second wave is flawed. The concept of a second wave implies that it is something inevitable, something peculiar to the behavior of the virus. It goes away a bit and then comes back with all my might. However, this idea does not take into account the importance of ongoing preventive measures and shows us as helpless and at the whim of this pathogen.
We are not between waves. We have new cases in the UK every day. We are in an up and down of the COVID-19 transmission that is constantly affected by our precautions.
Precautions will lead to an increase in cases. This is the new normal and what is to be expected until we have an effective vaccine with a significant population uptake. Until then, we have to rely on our actions to keep the cases low - both now and in the fall.
The concept of a second wave shows the pandemic as a force of nature that is beyond our control. However, we have evidence from many countries that a strong public health system (consisting of widespread testing, contact tracking, isolation, and health support) combined with public participation in safe behavior (wearing face covers, keeping a distance, washing hands) is very effective the COVID-19 transmission.
We are not at the mercy of the virus now or in the future. This is hopeful news, but it is responsible for all of us. We have to keep fighting, but we shouldn't fear an inevitable second wave.
This article is republished by The Conversation under a Creative Commons license. Read the original article.
Jeremy Rossman was funded by the Medical Research Council and the European Commission. He is president of the non-profit organization Research-Aid Networks.
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