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What a second wave of coronavirus could look like

What a second wave of coronavirus could look like

With so many unknowns swirling around a probable resurgence, one thing is certain: We need to be as prepared as possible

What’s next?

As the weather warms up and some parts of the country have reopened for business, it may be tempting to get sloppy when it comes to public health measures like social distancing and wearing masks. But that’s the last thing we should be doing right now. A new report from the University of Minnesota found that a COVID-19 vaccine probably won’t be available until 2021, and with up to a quarter of those infected having no symptoms and others spreading the disease for days before feeling ill, the spread is likely to continue and even worsen. In fact, researchers say that we may see a major resurgence before the end of 2020, followed by smaller waves in 2021, or we may be faced with another scenario not seen in previous pandemics that would feature a “slow burn” of viral transmission with no clear pattern. Here are 13 ways coronavirus is already different from all epidemics throughout history.

“We are in this for the long haul. We’ve been saying for some time, ‘This is not just get over this hump right now and then we’re back,'” Michael Osterholm, MD, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told CBS News. At this point, we’re not exactly sure what a second wave of the outbreak would look like, but here are some potential scenarios from experts, along with some ideas on what we can do to help minimize its damage.

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Reopening should happen only under certain conditions

Many people, understandably, are strongly in favour of reopening society as soon as possible. But if we’re not prepared, there will be a second wave that may be even deadlier than the first, according to California State Senator Richard Pan, MD, a national vaccine advocate and one of two physicians in the state legislature. “We can reopen much of our community safely as soon as we put essential public health measures in place to control this contagion,” he tells Reader’s Digest. “These measures include sufficient testing, so we know who has the infection; contact tracing of the infected, so we know how far it is spreading; and isolation of the contagious to stop new infections. A large majority of Americans do not feel safe to go out right now because we are not ready.” 

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The pandemic will continue to have a major impact on our mental health

The COVID-19 pandemic has been wreaking havoc on our mental health, and a second wave could do even more damage, according to Jasleen Chhatwal, MD, chief medical officer for Sierra Tucson, an Arizona-based mental health treatment facility. “This pandemic is challenging us in ways we could not have imagined a year ago,” she tells Reader’s Digest. “It is bringing our human vulnerabilities to the surface, showing how our life is fragile, our freedom is threatened, and our way of life is put to test. This is bringing us face-to-face with immeasurable stress, worry, grief, and loss. A second wave is likely after the reopening of our states, given models available from other countries and communities.”

The prolongation of stress, worry, grief, and loss is typically seen to have a tremendous impact on mental health conditions including depression, anxiety, and trauma-related conditions, as well as substance-use disorders. “A second wave of COVID-19 could mean an even larger tsunami of mental distress,” Dr. Chhatwal explains. “It will definitely test our resilience as a community and a species.”


The second wave could coincide with cold and flu season

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A second wave—and potentially recurrent waves—of COVID-19 is likely this fall, if not sooner. “As we reopen, we increase the risk of rapid viral spread, which could be exacerbated by summer travel, lax social distancing, and the start of school,” says Lisa Doggett, MD, a family physician and the senior medical director for HGS-AxisPoint Health. “While much is unknown, a resurgence of COVID-19 in the fall or winter could coincide with cold and flu season. Flu activity often begins to increase in October, peaking between December and February, and results in 140,000 to 960,000 hospitalizations each year.”

While we should be better prepared for future coronavirus outbreaks after our experience this spring, the combination of COVID-19 and influenza would strain our health care infrastructure, Dr. Doggett says. That could lead to more shortages of personal protective equipment (PPE), ventilators, and ICU beds for sick patients.


Regulatory processes for a vaccine will likely be loosened and streamlined

The lack of a preventive vaccine or even a consistently effective treatment has been a big issue, but every day that passes between now and the time when a second wave rears its head puts us closer to those medical breakthroughs, notes attorney Richard P. Console Jr., founder of Console & Associates. Already, the Food and Drug Administration (FDA) has loosened some of the regulatory processes by which treatments and vaccines get approved.

“The looming shadow of a second wave of infection will serve as an increased impetus for the discovery of a usable vaccine,” Console tells Reader’s Digest. “There’s certainly both good and bad in this. On one hand, rushing the development of a vaccine or a treatment could be dangerous if it means cutting corners on making sure the drug is safe. I believe that’s a big concern of the individuals out there who are already expressing hesitation to get a vaccine. On the other hand, the stakes are so high that a delay could be catastrophic, and if you’ve ever spoken to a medical researcher, then you know how arduous a process it can be to get a drug or medical device on the market, even when it has every appearance of being safe.”


We should be better prepared for a second wave

Because we expect a second wave of COVID-19, we should be better prepared when it hits. “Predictive models, as well as our understanding of the disease and ability to treat it, will be better,” Dr. Doggett explains. “We will be able to use our experience to recognize and respond to outbreaks and to mitigate the impact on our hospitals and communities.”

In addition, flu shots, hand washing, and social distancing will continue to be important, especially for those at the highest risk for both influenza and COVID-19 complications—older adults and those with chronic diseases. Plus, Dr. Doggett adds, “a rapid community response, which may include new shelter-in-place orders and other restrictions, will be needed in areas where COVID-19 outbreaks occur, especially when influenza is circulating, to save lives and prevent overwhelming our hospitals.”


Our behaviour this summer will partially determine the severity of the second wave

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As much as we may want to go on our planned vacations this summer, how we act over the next few months will determine what we’re going to have to deal with in terms of a second wave of the pandemic. “Fundamentally, the virus has put life, liberty, and the pursuit of happiness into conflict—we no longer get all three,” says Alan Pitt, MD, professor of neuroradiology at the Barrow Neurological Institute and chief medical officer of CloudMedx. “With regard to the next wave, with summer coming and the hardships of the past few months, I believe that people are going to take risks. New hot spots are going to happen, but it’s not likely people will be willing to shut down the economy or give up other social freedoms again.”


The economy will continue to take a beating

And this won’t be great for the economy, either. “A second wave of the disease will further damage our economy and lead to even more deaths that will destroy confidence in our country,” Dr. Pan says. The downturn in the economy is going to impact more than our bank accounts, according to Tashfeen Suleman, the CEO of CloudMedx. “As far as human behavior is concerned, people are genuinely concerned about joblessness, the financial pressures, and the uncertainty in the economy,” he explains. “We have a high population that is stuck indoors and trying to figure out what the near future and a long-term future looks like.”


More people will create wills, advance directives, and other legal plans

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One thing the COVID-19 pandemic has taught us all is the uncertainty of life—the reality that no one really knows what will happen in the future. “Seeing even young, healthy people become severely ill, or even lose their lives, due to the coronavirus will prompt more people of varying age groups to give more thought to their final wishes,” Console explains. “People sometimes think that only the very wealthy need to have a will, but that’s not true at all. If you’re a parent, you should have it documented who you would want to care for your children in the event that you’re unable to do so. If all of the adults in the household were to end up hospitalized, you wouldn’t want your kids to then have to go through the ordeal of the government trying to figure out where they should go or a custody battle between different relatives.”

Console says that you might also want to think about having an advance directive, or a living will, written to address your wishes pertaining to medical care. “No one wants to think about these things happening, but COVID-19 has forced us to confront them,” he adds.


There may be more than two waves

Nate Favini, MD, medical lead of Forward, a preventive primary care practice, anticipates seeing rolling waves of the pandemic through different geographies, based on how vigilant people are with social distancing and the timing around lifting restrictions. “With many medium-sized cities opening up before they’re ready, we’ll likely see a surge in cases happen in those geographies over the next few months,” Dr. Favini tells Reader’s Digest. “For states that are making decisions based on metrics like testing capacity, the number of beds in the hospital, and ICU capacity, we’ll see that the spike in cases will be smaller when they reopen. It’s unfortunate that it takes losing lives to change attitudes. Hopefully, the cities and states that open too quickly will take this virus seriously when they see the devastating impact of their actions. The reality is that while we’ve seen over 80,000 deaths in the United States, we’re not even halfway to the total number of deaths as a result of this pandemic.”

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In theory, the numbers for the second wave shouldn’t be as high

Because we’ve already experienced what it’s like to live through a COVID-19 outbreak, theoretically the nationwide numbers should not be as high moving forward, according to Anthony Barile, MD, an infectious disease specialist at Health First. “Being proactive is crucial to protecting our community. We are testing. We are aware. And we are looking for answers,” he notes. “A lot of this is up to your community members as well. If we all continue to practice social distancing, frequent handwashing, and wearing a mask in public, those efforts will continue to slow the spread of COVID-19. The best way we can prevent a second wave is to avoid exposure. So, we must all be vigilant in protecting ourselves and our loved ones through these precautionary measures.”

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