A second wave of COVID-19 cases is coming. In some corners of the world, it's already upon us. This is not a vague projection by fevered anti-Trumpers. It's a reality proven by past pandemics.
Across Europe and Asia and especially in the United States, the world has begun to emerge from deep isolation and social distancing designed to help flatten the infection curve. But without a viable vaccine, there is little real chance that this virus can be prevented from re-emerging suddenly and dramatically in the not-so-distant future.
Add to this mix several sustained days of demonstrations across America, and pandemics experts are bracing for an earlier, rather than later, arrival of a second wave.
A week ago, the World Health Organization said even countries with declining coronavirus rates could still see an "immediate second peak" if they're not careful. Meanwhile, in the U.S., where we recently passed the 100,000 dead mark, videos surfaced over Memorial Day weekend of parties crammed into pools and bars across the country.
Add to this mix several sustained days of demonstrations across America, and pandemics experts are bracing for an earlier, rather than later, arrival of a second wave. As former FDA Commissioner Dr. Scott Gottlieb said on Sunday, “There's going to be a lot of issues coming out of what's happened in the last week, but one of them is going to be that chains of transmission will have become lit from these gatherings.” Tom Frieden, who headed the Centers for Disease Control under President Barack Obama, predicted a new wave of 20,000 additional cases within a month from these events alone.
In May, responding to questions about too-rapid openings in areas like Texas, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, warned Congress that such states could find "little spikes that might turn into outbreaks" if they reopen too soon. Since May 3, the caseload in Crawford County, Iowa, has risen by 750 percent, while Colfax County, Nebraska, has seen a huge surge in cases, along with increases in Dallas and Houston, along the southeast Gold Coast of Florida and in Alabama. According to a model developed by PolicyLab at Children's Hospital of Philadelphia, this suggests that a second U.S. wave is on the horizon.
And history suggests that this second wave could actually be deadlier than the first. The first wave of the 1918 flu pandemic, which appeared in early March, initially seemed little different from the seasonal flu, with a drop-off in the warm summer months. But the virus returned with a vengeance in September, with 195,000 Americans dying in October alone, most from what would later become known as a cytokine storm of mega-immune reactions.
The next year, there was a third deadly wave, with a mortality rate approaching that of the second, in the millions worldwide.
Back then, there was no magical vaccine. Today, there is a possibility of a vaccine. But there isn't yet a sense of how long the immunity might last. On the aircraft carrier USS Theodore Roosevelt, at least 13 sailors tested positive for a second time this month after having recovered from COVID-19.
"We have the potential here to go through days we have not seen since World War II," Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told USA Today. "As a nation, we will not be ready."
But America may not be alone.
On May 11, France, Germany and several other European countries hit hard by COVID-19 began lifting the tight restrictions that have been in effect for nearly two months in most locations. Even in Italy, a center for the European outbreak, life was beginning again, with shops and restaurants opening May 18.
In Paris, by the weekend of May 16, most stores had reopened and the streets were packed. Though shops would allow only a handful of people in at a time, lines snaked outside along the sidewalks. The radius of travel was expanded from less than a mile to around 60 miles, though the city itself remained in the red zone. My son, who'd been snagged by police and turned around two weeks ago when he tried to walk from his apartment just north of the Tuileries to the River Seine, was able to pile his family into their car and drive out to a friend's country place. Their 7-year-old son went back to school in Paris, though with barely 10 children out of a class of 30, the others not having returned from self-quarantine.
But even as cities start to loosen restrictions, fear remains. In Germany, a parcel distribution center in North Rhine-Westphalia that processes millions of packages daily was closed after 42 people tested positive. Hundreds of workers were immediately quarantined.
One of the greatest concerns is simply that in many places, too small a percentage of the population has been affected to develop any sort of herd immunity. In Germany, the coronavirus reproduction rate remained above 1 for several days in mid-May, meaning every patient was infecting more than one other person. This is a key indicator, because it can help tell us whether infections are continuing apace or slowing. Even still, the government has continued to reopen.
A comparison of exit strategies and reopening timelines across Europe, compiled by Politico, shows a crazy quilt of measures or non-measures that will likely only accelerate the return of the pandemic. While Spain's prime minister, Pedro Sánchez, extended the country's state of emergency for another month, ending May 24, the Czech Republic had already opened its first wave of small shops on April 9; cinemas, shopping centers and restaurants on May 11; and gatherings of up to 500 people, along with sports, cultural events and church services, on May 25. Residents are no longer required to wear masks. Yet on May 18, the World Health Organization was still reporting full "community transmission" of the virus in Czechia.
Even in some regions that were the earliest affected and the first to see dramatic flattening of the curve of infection — regions of Asia, particularly China, Hong Kong and South Korea — there has been new evidence of a second wave despite the favorable impact of the often draconian measures of containment. More than 100 million residents across northeastern China were being locked down again after a succession of clusters raised fears around Shulan, a town in the Jilin region. The government announced that it conducted an astounding 856,128 tests on May 20, more than twice the daily figure in the entire United States.
At a briefing at WHO headquarters in Geneva on May 20, Tedros Adhanom Ghebreyesus, the agency's director general, told reporters: "In the last 24 hours, there have been 106,000 cases reported to WHO — the most in a single day since the outbreak began."
On May 15, President Donald Trump suggested that "at some point, it'll go away. It may flare up, and it may not flare up. We'll have to see what happens. But if it does flare up, we're going to put out the fire, and we'll put it out quickly and efficiently."
But the coronavirus isn't a normal fire — and these flare-ups could start a whole new blaze.