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As various nations begin to relax their blocks after an initial spike in COVID-19 cases, the focus is on how they can avoid a “second wave” of infections as social distancing is reduced.
Italy and Spain, two of the hardest hit countries, have already begun allowing outsiders to exercise for the first time in nearly two months, and several states in the United States (USA) are allowing companies to return to open.
In France, where confinement measures will be lifted on May 11, Prime Minister Edouard Philippe said there is a “fine line” between lifting movement restrictions and preventing a further increase in infections from a disease that has killed nearly a quarter of a million people worldwide.
“The risk of a second wave, which would hit our already fragile hospitals, which would require us to reimpose the confinement and waste the efforts and sacrifices that we have already made, is serious,” he said last week.
Social distancing has been shown to be effective in flattening the curve of new cases of COVID-19, buying health systems a crucial moment to recover and regroup. But it has also meant that a very small percentage of populations have probably become infected and thus developed immunity.
The Pasteur Institute in France estimates that only about six percent of the country’s population will have been infected before May 11.
Even at virus hotspots in France, no more than 25 percent of people are believed to have caught COVID-19 during the first wave of the pandemic.
This means that without a viable vaccine, experts say it is impossible to imagine life going back to normal anytime soon.
Waiting game
“It will take several weeks or even several months to see the virus circulating again” at a high level, virologist Anne Goffard told France Inter radio.
There is likely to be a second wave of infections, he said, “at the earliest in late August.”
But while experts are more or less united on the probability of a new spike in cases where blockages are alleviated, there is debate over how the second wave will compare to the first.
Some senior health officials, especially in Germany and the USA. The US has warned that it could bring even more infections than the March / April peak. Others are more optimistic that changes in personal behavior could delay new cases.
Pierachille Santus, a Milan-based lung expert, said the second wave “will likely be smaller than the first” thanks to control measures.
It is not yet known how or if the new coronavirus will respond to warmer weather. Other viruses tend to remain dormant during the summer months.
“There is probably a link (between the virus) and heat and humidity,” Jean-Francois Delfraissy, president of France’s scientific council, said Monday.
“We are looking forward to a fairly peaceful summer,” he said, cautioning, however, that the virus could return in force by the end of the year.
Even if businesses can reopen and people return to the streets, there are several ways to slow the spread of the virus.
This includes staying away from others, avoiding touching your face, washing your hands, wearing a mask while in public – all the habits that people have acquired, to some degree, during the first wave.
A model led by the Public Health Experts research group showed that such measures could reduce the total deaths from COVID-19 to 85,000 in France, compared to the 200,000 anticipated without social distance or wearing masks.
However, even in the best case of new infections, hospitals are likely to be flooded with new patients.
‘Mini-waves’
Other vital measures after the blockages end are testing and contact tracing – looking for those new infections and isolating people they’ve been in close contact with.
According to Didier Pitter, head of infection control and prevention at the Hospitals of the University of Geneva, countries were able to increase their testing and tracking capacity, “we could have a series of mini-waves.”
Governments will seek to limit the transmission rate of COVID-19 (R0) to less than one: that is, each infected person infects less than another on average.
A study published last month in The Lancet showed that testing, contact tracing and isolation of confirmed infections reduced R0 in the southern Chinese city of Shenzhen to 0.4.
This helped the city avoid an outbreak like the one that hit Wuhan, where the virus first emerged in December. – AFP
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