A 2nd wave of coronavirus may already be underway, experts say

As states begin the process of reopening, there are concerns about areas experiencing a second wave, or even a second peak, of COVID-19 cases. (Photo by Olivier DOULIERY / AFP) (Photo by OLIVIER DOULIERY/AFP via Getty Images)
As states begin the reopening process, there are concerns about areas experiencing a second wave, or even a second peak, of COVID-19 cases. (Photo: Olivier Douliery/AFP via Getty Images)

Most states across the country have eased lockdown restrictions, and some have had restrictions lifted for weeks. And now, a dramatic rise in COVID-19 cases has followed.

Nearly half of states have seen an increase in cases, according to an analysis by the Associated Press of data from the COVID Tracking Project, a volunteer organization that collects data on COVID-19 cases across the U.S. The increases are largely being seen across the South and Western parts of the U.S., the analysis found.

COVID Exit Strategy, a data-tracking website that similarly breaks down COVID-19 cases by state, clearly shows via data and a poignant graphic on its website that many states across the country are currently experiencing a surge in cases. Cases in Arizona and Arkansas, for example, have increased about 198 percent in the past two weeks. During that same time frame, cases in North Carolina have jumped up 54 percent.

While there’s no clear link to what has sparked the rise in these cases, experts say a lack of restrictions may be fueling it. Arizona, for example, started to see an increase in cases about 10 days after stay-at-home restrictions were lifted, and there were no requirements to wear face masks, the AP points out. But this is expected, Dr. Amesh A. Adalja, senior scholar at the Johns Hopkins Center for Health Security, tells Yahoo Life. “As people interact, you’re going to see upticks in cases in certain parts of the country,” he says.

This could, in fact, be the second wave that public health experts have warned about, Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Yahoo Life. “I think this is it,” he says.

However, there is some debate. This isn’t necessarily a second wave everywhere, points out Ryan Panchadsaram, former U.S. deputy chief technology officer at the White House during the Obama administration and co-founder of COVID Exit Strategy. “Each state has its own unique story. For many states, this is not a second wave. It's an amplification of the first one,” he tells Yahoo Life.

“Most states have not fully cleared their ‘first wave’ and the new cases we are observing may still be part of that wave,” Jason Yang, a research faculty member with Rutgers New Jersey Medical School and a member of the Rutgers Center for COVID-19 Response and Pandemic Preparedness, tells Yahoo Life. “There is a possibility that some regions may be encountering a second wave, but this is not yet true for the country as a whole.”

For weeks, public health officials have warned that a second wave of COVID-19 cases is possible. Recently, Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases, doubled down on his comments that a second wave of the virus could happen. However, he told CNN that it’s not “inevitable.”

“We often talk about the possibility of a second wave, or of an outbreak, when you’re reopening. We don’t have to accept that as an inevitability,” he said. “It could happen, but it is not inevitable. If we do the kinds of things that we’re putting in place now, to have the workforce, the system and the will to do the kinds of things that ought to be clear and effective — identification, isolation and contact tracing — we can prevent this second wave that we’re talking about, if we do it correctly.”

But now there’s another term floating out there with regard to the spread of the coronavirus: second peak. Dr. Mike Ryan, executive director of the World Health Organization’s Health Emergencies Programme, recently used it during a media briefing.

“We need to be also cognizant of the fact that the disease can jump up at any time,” he said, according to CNN. “We cannot make assumptions that just because the disease is on the way down now that it’s going to keep going down.” Ryan added that some areas may “get a number of months to get ready for a second wave — we may get a second peak in this way.”

Ryan also said a second peak or wave could come at the same time as flu season.

This raises a lot of questions — particularly, is a second wave the same as a second peak? Here’s what you need to know.

What is a second wave?

Both of these terms are slightly open to interpretation. “There’s a bit of confusion about whether ‘second peak’ and ‘second wave’ are the same thing. They’ve been used interchangeably, and it’s a little confusing,” Schaffner says. But in general, a second wave of COVID-19 refers to “concerns about an increase in cases as states open up again,” he says.

A second wave can also be used to refer to illnesses like multisystem inflammatory syndrome in children, which can happen weeks after an initial COVID-19 infection, Dr. Lawrence Kleinman, survey/data core director at the Institute for Health, Health Care Policy and Aging Research at Rutgers Robert Wood Johnson Medical School, tells Yahoo Life. “Even though it’s from the initial infection, it’s been referred to as a second wave of illness,” he says. However, he adds, when Fauci and Ryan use the term, they’re likely referring to a large swell in cases.

What is a second peak?

The term “second peak” is a little clearer. It refers to a rapid increase in cases followed by a drop-off, Adalja says. “The second peak doesn’t necessarily have to be as high as the first peak, but you can clearly see it on a graph,” he says.

“We have to expect that cases may rise again because the virus is still out there,” Adalja says. As people become relaxed about practicing social distancing, “the virus is going to take advantage of that.”

As for what a second peak will look like, experts say it’s hard to tell at the moment. “I think we are better prepared now than we were,” Schaffner says. “Certainly, we have testing much more widely available.” Many health departments also now have a higher capacity for contact tracing, and hospitals have more room, procedures and equipment to deal with infected people, he says.

Can there be a second wave and second peak at the same time?

The answer is yes. A huge concern for the medical community is that a second wave and second peak of cases could coincide with flu season. “We’re concerned there might be an even larger increase this winter along with the flu — that could strain the health care system again,” Schaffner says.

“In the late fall and winter, people anticipate that COVID-19 and flu would be playing tag team, sometimes peaking together, sometimes happening separately in different parts of the country. That could be a much more serious circumstance,” Schaffner explains.

While many areas are expecting a second wave and second peak this winter, Adalja points out that some places — like Montgomery, Ala.; Arkansas; and Minnesota’s Twin Cities region — are already experiencing a second wave of cases.

Is this new increase in cases the second wave, or will that only happen in the fall?

It’s hard to say for sure. “The terms ‘second wave’ and ‘second peak’ don’t have exact definitions,” Adalja says. “We’re still having 20,000 new cases per day. It’s not that we’ve had some kind of trough in new case counts.” Certain states have seen dips in their numbers—largely in the Northeast—but it’s not uniform across the country, Adalja points out. “In about half of states it’s going up, in half it’s going down,” he says. “That’s what we’re going to see—local waves that occur.”

Public health officials expect that there will be a major wave of cases in the fall but, whether that’s a second or third peak is unclear at this point. Either way, it’s expected to happen. “No one is going around numbering waves but, as we get to the fall, we worry about many places having increased transmission,” Adalja says. “We’re prepared for intense spread in the fall because of seasonality.”

“It does now appear that this is the second wave, and a third wave will be in the fall,” Schaffner says.

Until there is a vaccine, waves and peaks can keep happening. “There is no finite number of peaks and valleys that we might see,” Kleinman says. “States will continue to experience spikes as long as they are not strongly reinforcing re-opening practices, from mandating masks to restricting large gatherings to requiring proper protocols for offices [and] businesses,” Panchadsaram says. “As a datapoint, only 38 states have a mask policy. Twenty six of them recommend it, 12 mandate it. Masks are the simplest, cheapest solution we have to stopping the spread of COVID-19.”

Overall, Kleinman stresses that the best way to lower the risk of another wave of cases — and another peak — is to keep practicing the guidelines of COVID-19 prevention and acknowledge that things aren’t the way they used to be. “It’s an illusion to think the things we used to do are safe,” he says.

This story was originally published on May 28, 2020 at 4:06 p.m. ET and has been updated to include new information on coronavirus cases in the U.S.

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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