Since the novel coronavirus first emerged in late December 2019, our world and day-to-day reality has drastically changed. Now, as elected officials move to either reopen their states or further extend stay-at-home or shelter-in-place orders, it’s understandable if you’re feeling worried or confused about what comes next. Unfortunately, public-health and infectious disease experts warn that we could be in for an even more devastating “second wave” of COVID-19 cases and deaths.
“There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,” Robert Redfield, M.D., director of the Centers for Disease Control and Prevention (CDC) told The Washington Post.
Anthony Fauci, M.D., presidential advisor and director of the National Institute of Allergy and Infectious Diseases director, reiterated this concern. “In my mind, it’s inevitable that we’ll have a return of the virus … when it does, how we handle it will determine our fate,” he recently stated.
Naturally, this leads to a bunch of questions: Why might the virus come back even stronger, and when could it hit? In the meantime, what can you do to prepare for a potential second wave of COVID-19? Read on for the answers, with insight from infectious disease experts.
First: What does a “second wave” mean, exactly?
“A second wave refers to the resurgence of COVID-19 cases in our population,” says Robert Amler, M.D., dean of the School of Health Sciences and Practice at New York Medical College and former chief medical officer for the CDC.
Currently, the first wave of novel coronavirus cases in the United States seems to be “breaking” after its “peak” around late March when upwards of 20,000 new cases of COVID-19 and approximately 2,000 deaths from the virus were announced every day, says Jay Varkey, M.D., an infectious disease specialist and director of the Antimicrobial Management Program at Emory University Hospital. While these numbers are staggering, they have begun to stabilize or go down in some states. However, a second wave—and perhaps multiple waves—may strike for many months to come, he says.
Why? While social distancing measures have helped slow the spread of the virus, to stop additional waves, we still need to develop a broad immunity to the novel coronavirus or produce an effective vaccine, which might not be available for another year or so, says Dr. Varkey. Since both are a long way off, that leaves many of us at risk of catching the virus, especially since you can spread it without any symptoms.
An uptick in novel coronavirus cases could come about if we relax social distancing measures too quickly and too much (allowing the virus to spread more rapidly again) or if the virus ends up following a seasonal up-and-down pattern like other types of coronaviruses and the influenza virus, which tend to arrive in fall and peak in winter months, says Nasia Safdar, M.D., Ph.D., an infectious disease specialist and medical director of infection control at UW Hospital and Clinics.
“That’s been the predictable behavior for so many of these viruses over the years, so we think this virus will behave similarly,” Dr. Safdar says. Past pandemics can give us an idea of what we might expect from COVID-19, too: The H1N1 influenza pandemic, for example, hit the U.S. in the spring of 2009 and returned for a second wave in the fall and winter.
So, when is a second wave of COVID-19 expected to hit?
“It’s highly likely we will experience a second wave and possibly more waves starting this fall and winter, with a potential peak around October or November,” says Dr. Varkey. But remember: We’re dealing with an entirely new (and therefore unpredictable) virus, so it’s probably too early to say whether the novel coronavirus will follow a seasonal pattern for sure, he says. Again, if we relax social distancing measures prematurely, a second wave could possibly come even sooner—like sometime this summer, adds Dr. Safdar.
You’ll likely experience waves of the novel coronavirus at different times depending on how the virus responds to seasonal changes in your state and how your local government deals with it. Waves are expected to strike at different times around the world, too. For example, models of the novel coronavirus pandemic predict that the southern hemisphere will be disproportionately affected by COVID-19 in the upcoming months as the first wave recedes in the northern hemisphere.
Will a second wave be just as bad as the initial coronavirus outbreak?
How bad the second wave could be remains unknown. “We couldn’t really predict the current behavior of the pandemic until it was actually among us, so it’s hard to make sweeping statements about what a second wave might look like,” says Dr. Safdar.
A few possibilities: We might experience a series of waves similar in intensity to the first, a second wave that’s far more severe than the first (which is what happened during the 1918 influenza pandemic), or a “slow burn” of ups and downs in various “hot spots” depending on differing responses to the virus around the world, per a report released by the Center for Infectious Disease Research and Policy (CIDRAP) in late April 2020.
If the virus does strike again in the fall, one complicating factor is our already taxing flu season, says Dr. Safdar. “Our health systems already deal with thousands of people coming in with flu-related illness, and when you have COVID-19 on top of that, it can get overwhelming quite quickly,” she says. To put this into perspective, during the 2019-2020 flu season, there were at least 39 million cases of the flu and upwards of 24,000 deaths, according to estimates by the CDC. As of May 3, 2020, COVID-19 has already infected over 1.1 million Americans and taken the lives of 65,735 people in the United States.
Whether we face a tsunami, ripple, or something in between depends on how we respond worldwide, as a nation, and as individuals, says Dr. Varkey. If we’re well-prepared, the wave could be smaller, he says.
How are experts preparing for a second wave?
For starters, public-health officials and infectious disease experts are working hard to communicate that social distancing practices must continue, even as many states reopen, says Dr. Varkey. Doctors and healthcare workers are also coming together to demand action from elected officials. Organizations like the American Hospital Association and National Nurses United are sounding the alarm on severe and widespread shortages of personal protective equipment (PPE), ventilators, medication, medical supplies, testing kits, and hospital staff desperately needed to continue fighting COVID-19.
Many infectious disease experts are working hard to try to better determine who has been infected with the virus by expanding testing of people with symptoms of COVID-19 as well as testing for antibodies, or proteins your body makes in response to the virus. Although having antibodies for COVID-19 doesn’t necessarily mean that someone is immune to becoming reinfected with the virus, it can give us an idea of who was infected in the first wave in order to figure out just how big or small the second wave will be, says Dr. Varkey.
Contact tracing (or identifying who has been infected with COVID-19, tracking who they’ve been in contact with, and enforcing quarantine to stop the spread of the virus) will also be important as we prepare for a second wave, says Dr. Varkey. The U.S. will need some 300,000 specially-trained contact tracers to do the job, according to an estimation by Tom Frieden, M.D., a former head of the CDC, and there are an estimated 7,000 contact tracers at work so far. The most recent coronavirus aid bill dedicated $11 billion to states’ testing and tracing efforts.
How to prepare for a second wave of coronavirus
Thinking about a second wave of COVID-19 can be really stressful, but you can empower yourself by focusing on what’s within your control right now, says Dr. Safdar. Thankfully, there are many things you can do to prepare yourself and your loved ones for a potential second wave. Here, your quick guide:
✔️Shift your perspective.
COVID-19 is exhausting, but it isn’t over, says Dr. Varkey. Rather than looking forward to “getting back to normal” as your area reopens, understand that this is our “new normal” for the foreseeable future—and that could mean periods of social distancing as needed, per the World Health Organization. Restaurants won’t be able to serve at full capacity, parks will still enforce six-foot distancing, and working from home could extend longer than you’d prefer.
✔️Get your flu shot.
Since the second wave might hit this fall or winter, getting your yearly flu vaccine is a must (yet only about 45% of American adults do it!), says Dr. Varkey. While a flu shot won’t protect you from catching the novel coronavirus, it can reduce your risk of being hospitalized for a gnarly case of the flu—which could leave an ICU bed open for someone who needs it in order to recover from COVID-19, he says.
✔️Find a new way to say “hello.”
It might sound silly, but we need to figure out a new way to greet other people without touching, says Varkey. No judgment if you’re having a hard time not automatically shaking hands or hugging someone when you see them (after all, you’ve been doing this your whole life!). But now’s the time to pick a new go-to greeting, whether that’s a friendly wave, an air high-five, or “namaste,” he says.
✔️Keep doing what you’re probably already doing.
Chances are, you’ve mastered washing your hands properly, not touching your face, putting on a face mask before you go out, following social distancing guidelines, and self-isolating if you have symptoms of COVID-19. As we brace for the second wave, keep it up and make sure to stay informed and follow recommended precautions, says Dr. Amler.
Bottom line: We’re all in this crisis together.
The steps you take to protect yourself aren’t just for you—ultimately, you’re doing your part to keep your family, friends, and neighbors safe. Getting through a pandemic is like running a marathon, so check in with yourself and the people you care about and reach out for help when you need it, says Dr. Varkey.
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