Bracing for aftershocks: When will the second coronavirus wave hit?

Even the UK, which has seen some of the highest numbers of infections and deaths from COVID-19 in Europe, is thinking about “reopening the economy,” as several top officials have urged in recent days. Earlier this month, India extended its lockdown for another two weeks amid concerns that if nations ease restrictions too soon, the world may well see a second wave of infections.

A second wave is more or less inevitable. “This virus may just become another endemic virus in our communities,” said Dr Mike Ryan of the World Health Organization at a press conference streamed live on May 13. “This virus may never go away.” Ryan, the executive director of the WHO’s Health Emergencies Program, pointed out that other viruses like HIV haven’t gone away either. Instead, we’ve developed drugs to mitigate its affects and we’ve learned to live with it. Only the fewest of deadly viruses, such as smallpox, have ever been eradicated.

The rest live on in the community. Some, like tuberculosis, make a comeback, and history shows that a second wave of a pandemic can be worse than the first. This was the case with the Spanish flu pandemic of 1918, which continued in waves until letting up in 1920. So, should we be a little more patient? Should we stay in lockdown?

When the coronavirus reproduction rate R fell from a threshold of 1 down to 0.76 at the end of April, the German government and health authorities agreed to partially reopen schools for those sitting major exams or moving from primary to secondary schools in the autumn.

The schools set about redesigning classrooms and segmenting concrete playgrounds into safe zones, to ensure they met physical distancing and hygiene guidelines. But before schools and their pupils had a chance to return to class and test those ad hoc safety designs, the government decided to lift restrictions further. Now, even younger children were to return to school, for a day at a time.

Zoos and museums are reopening with new physical distancing rules, ensuring that people remain apart from each other. But there’s no sign of any such rules at playgrounds, which reopened on May 7, and where a physical distancing rule of 1.5 meters (about 5 feet) between kids has quickly dwindled to 1.5 cm. Was this a controlled experiment for good behaviour? Germany is, after all, a democracy “built on trust,” said Chancellor Angela Merkel last week as she announced the relaxed regulations.

The WHO, however, would prefer that the transition from lockdown be “evidence based and data driven,” one that is “implemented incrementally” to “reduce the risk of new outbreaks.” “Ideally there would be a minimum of 2 weeks (corresponding to the incubation period of COVID-19) between each phase of the transition, to allow sufficient time to understand the risk of new outbreaks and to respond appropriately,” the WHO said in its COVID-19 strategy update from April 19.

But it would appear that there is no agreed standard for what constitutes a second wave of an epidemic or pandemic — either at a global or national, regional level. So, the 50 cases per 100,000 people may be nothing more than a nice round figure. WHO spokesperson Christian Lindmeier said the “second wave” is not a fixed technical term. “The term only refers to renewed outbreaks after an initial reduction in cases. Hence, the same applies for a ‘third’ wave.”