What is a second wave and what will it mean for the United States?

In the past few weeks as phased reopening has begun gradually in states around the U.S., there’s been talk of an upswing in cases, and increase in outbreaks, and a potential rise in deaths and hospitalizations -- all part of what some sources are calling a second wave of coronavirus. Many are criticising states for reopening too quickly after the initial outbreak, blaming widespread demonstrations against racial violence for the spike in infections, and demanding answers about the dreaded second wind of COVID-19.

 

What many don’t realize, though, is that the second wave may be a longer way off than many are predicting or forewarning. In fact, many say that the United States isn’t even through the worst of the first wave quite yet, albeit one in which infection rates are dipping significantly in some parts of the country and again rising in others. While talk of coronavirus’s second coming matriculates, it’s helpful to keep in mind that another wave of the virus may yet be a long way off

 

  • China and South Korea are just now reporting the beginnings of a second wave, while Italy is just gearing up preventative measures in fear of one. Iran comes closest for meeting the true criterion for being in the midst of a second wave: a sustained rise in infections after an initial diminishing (hence the wave metaphor). Hit hardest and earliest on, it follows that these countries would be at risk of a second wave far earlier than the U.S., especially with the slow responses to COVID-19 at its onset in the States.

 

So why is it so far off here? The answer has to do with a plateau effect. You may have heard the mantra “flatten the curve” abundantly a few months ago, about at the same time that people were rushing to buy up personal protective equipment, or PPE. PPE includes items such as nitrile gloves, KN95 masks, N95 respirators, disposable, surgical, and cloth masks, nitrile gloves, hand sanitizer, infrared thermometers, and antibacterial wipes -- all of which, along with grocery items like toilet paper, rice, and canned goods, sold out quickly across the United States. The point of flattening the curve wasn’t necessarily to stop the virus, but rather to slow its spread so as to avoid an overwhelming the healthcare system and flooding hospitals, who were at a shortage of doctors, respirators, and surgical masks (hence the CDC’s recommendation to use cloth masks to preserve respirators and surgical masks for medical personnel). At the peak of the virus’ severity and death toll in April, its reproduction number (commonly abbreviated as “R”), indicating the average number of people an infected person would infect after contracting the disease, was above two. This means that one infected person went on to infect 2 people, those 2 to infect 4, those 4 to infect 8, and so on. Being above two meant that this rate was quickened exponentially -- but this was all before social distancing guidelines and other measures were implemented to keep the coronavirus in check. Since protective measures such as stay-at-home orders and other guidelines were put in place this spring, the United States’ R has hovered around .91. Once the R is 1 or below, exponential increase in cases is plateaued, thus accomplishing the goal of flattening the curve.

 

However, with the gradual reopening of states, the R is rising again, creeping above 1, causing an uptick in the number of new cases in the U.S. Things will only get worse as weather gets


colder, sources report, as flu season will compound the effects of coronavirus and make it spread more quickly, especially as people confuse the overlapping symptoms and don’t get tested. If reopening goes too quickly, especially when compounded with the effects of flu season, it’s not hard to see how a second wave could be imminent, and that’s exactly what health and government officials are gearing up for.

 

What would a second wave look like? Well, as we approach cooler weather in the impending winter and fall and continue phased reopening, it looks nearly inevitable. A second wave may look much like the first, some say, with a renewed emphasis on controlling the rate of spread of the virus to keep the healthcare system afloat. It also depends on the development of a vaccine or the mutations of the virus, which so far show no evidence of becoming tamer, less infectious, or less deadly, as some virologists assert that it is not unusual for viruses to become less of a threat as they mature. However, this is something that takes place over an incredibly long period of time -- not the six short months during which COVID-19 has been at large.

 

Rather than a second wave, though, researchers are using a forest fire analogy, saying that this new rise will be steady as reopening continues and we feel the seasonal effects of the virus. If there’s wood, it’s going to burn, some say, explaining that cases will continue to rise rather than fall and suddenly create an onslaught, as the second wave model suggests. It will be gradual rather than sudden, and our best strategy will be to continue trying to control the rate of spread and continuing to protect ourselves using social distancing and PPE until we are collectively out of the woods.

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