Some health experts first postulated that a second wave of coronavirus cases would rock the United States when winter arrived later this year, alongside the seasonal flu — but many are now wondering if a second outbreak is already here. After spending the better half of two months sheltering in place, Americans are eager to get back to work and into their normal routines, with governors in virtually every state rolling back stay-at-home orders while following new Centers for Disease Control guidelines on reopening non-essential businesses (some as early as the end of April). With social distancing efforts still in place at the local level, some states are showing a downward trend in new cases (including New York), while others are reporting steady cases (from Maine to Mississippi), according to CNN. But in the wake of reopenings taking place across the country, 30 states are reporting steady increases in new COVID-19 cases, according to data collected by Johns Hopkins University.
According to ABC News, 12 of these states — Florida, California, Texas, Utah, South Carolina, Nevada, Georgia, Missouri, Montana, Tennessee, and Oklahoma — saw record numbers of new COVID-19 cases over Father's Day weekend, more so than any weeks prior. Florida's upward trend in cases is particularly worrisome as it's posed to become the next epicenter of the outbreak; the state reported over 4,000 new cases on June 20, a huge impact for its elderly residents. Internationally, some areas are also reporting new mini-outbreaks. Beijing reported 120 plus COVID-19 cases in the second week of June, almost two months after its last reported case, per Al Jazeera — and in Brazil, 35,000 new cases were discovered on June 17 alone, NPR reports.
Does all of this mean that a second wave has already arrived in the United States? "I don't think that it would be appropriate to use the term 'second wave' for the uptick in COVID-19 cases at this time," says Bojana Berić-Stojšić, MD, PhD, CHES, an ambassador for the United Nations' Society for Public Health Education and director of the master of public health program at Fairleigh Dickinson University. "It is still the first wave of the pandemic, and this uptick could be directly attributed to the Phase II of the states' 'reopening' plan."
The upward trend in new cases could get a lot worse for states across regions during the summer, as more people are likely to leave their homes (trending upward, per this CDC-sponsored mobility tracker) to head back to work, go shopping, eat in restaurants, or even head out on vacation. "Coupled with people not complying with CDC guidelines for preventing community spread of SARS-CoV-2, this is most likely the cause of the uptick," Dr. Berić-Stojšić explains.
What is a wave? Will we see another one during the summer?
Jonathan Fielding, MD, MPH, a professor of health policy and management at UCLA and the former public health director of Los Angeles County, tells Good Housekeeping that certain cities, states, and regions show variability in new cases that makes it hard to understand what a "wave" is. The idea of a wave comes from the curve on a graph that illustrates how many cases there are during an outbreak; the curve looks like a wave if more and more people become sick (this all relates back to "flattening the curve").
A second wave would indicate that there was a lull in activity for all 50 states, but states that are experiencing an upward swing in new cases may be just "lagging behind" the states that are now reporting downtrends, Dr. Berić-Stojšić says. There hasn't been enough of a drop off in new cases (despite social distancing efforts in April) to allow for a second wave to start; it seems that states are going through a delayed chain of spikes in new cases. These new cases could be these states' first wave compared to places like New York and California. "You should expect continued increase in some, but not all, states," Dr. Fielding adds. "There are some disturbing examples of increases associated with loosening requirements for protective behavior, but the public desire for the 'old normal' is swamping common sense in some individuals."
— Steve Lookner (@lookner) June 16, 2020
As states continue to move into Phase II of their reopening plans, it's important for them to continue to follow current CDC guidelines to reduce the spread of SARS-CoV-2, the virus that causes a COVID-19 diagnosis. It'll be a while before all states can maintain or lessen the number of new COVID-19 cases they're reporting, which will be the threshold for a second wave of coronavirus.
When will there be a second wave of COVID-19?
While it's likely that we'll continue to see spikes in new cases over the summer, understanding when the next outbreak across all states will occur is a bit more complicated. Top experts at the World Health Organization have previously shared that a proper second wave could impact European nations as early as September or October, and Dr. Hans Kluge doubled down on his warnings in a recent WHO briefing held by Russian officials in mid-June, per the Daily Mail.
In the United States, Dr. Berić-Stojšić believes that the first wave won't be over in June or July: "It's not over yet, although the incidence of new confirmed positive cases, number of hospitalizations, and the death rates due to COVID-19 are tapering off." Depending on the region, some states will continue to spike as they experience their first wave of cases, until they peak, and eventually show a downward trend. "The second wave should be expected only later, after the number of new cases is stabilized at lower levels and before the safe and effective vaccine becomes available."
Will states close again?
Another unclear question that will largely depend on the actions of leadership, Dr. Fielding says. "For me, the distinction between waves isn't really helpful — the tough question is when, if ever, those in authority should reinstate some behavioral constraints?" he asks. "It may make sense, but it's hard for political leaders to backtrack."
Florida's Governor Ron DeSantis told the public on Tuesday that the state isn't considering reinstating stay-at-home orders, despite record new case counts. "No, we’re not shutting down, you know, we’re going to go forward,” he said, per an NBC report. “You have to have society function.” Similarly, Governor Greg Abbott of Texas also has publicly stated that the state is "better prepared to deal with COVID-19" now than in March.
State health departments are continuing to pass recommendations onto businesses that are reopening, but experts say it's crucial for people to exercise best practices while out in public. If you do choose to visit non-essential businesses, Dr. Fielding and Dr. Berić-Stojšić stress the following:
Physical distancing: Maintain a 6-foot distance between yourself and all those who do not live with you currently.
Face masks: You should be wearing them when you are outside the home in public spaces, per current CDC guidelines.
"The most important is the risk reduction. Reducing the number and length of exposure to people in closed spaces and keeping safe distance is very important," Dr. Berić-Stojšić explains. "In addition, knowing the data... and deaths from COVID-19 in where one lives is very important, and helps guide our decisions and behavior."
Which states are experiencing new cases?
Remember, you can always learn more about new cases in your own vicinity by visiting the COVID-19 resources provided by your state health department. Here's how states are currently trending in new case counts, according to trend reports from Johns Hopkins University:
Upward trends: Alabama, Alaska, Arizona, Arkansas, California, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Ohio, Oregon, Oklahoma, Louisiana, Montana, Michigan, Missouri, Minnesota, Nevada, New Mexico, North Carolina, South Carolina, Tennessee, Texas, Washington, West Virginia, Utah and Wyoming.
No growth in average new cases: Maine, Mississippi, Indiana, Nebraska, and South Dakota.
Downward trends: Colorado, Connecticut, Illinois, Kentucky, Maryland, Massachusetts, New Hampshire, New Jersey, New York, North Dakota, Pennsylvania, Rhode Island, Virginia, Vermont and Wisconsin.
There are more than 2 million cases of COVID-19 in the United States; 117,000 and counting have died from the virus. Internationally, there are more than 8 million cases, with 450,000 plus deaths recorded thus far.
As more information about the coronavirus pandemic develops, some of the information in this story may have changed since it was last updated. For the most up-to-date information on COVID-19, please visit the online resources provided by the CDC, WHO, and your local public health department. You can work to better protect yourself from COVID-19 by washing your hands, avoiding contact with sick individuals, and sanitizing your home, among other actions.
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