As countries begin to ease lockdown restrictions, new outbreaks of COVID-19 have raised concerns that we might be in for a ‘second wave’ of infections. What does that mean, and is it inevitable?

Expectations partly depend on what the wave ‘pattern’ means. There is no scientific definition of this wave of infection. It essentially implies that the first outbreak of infection was brought under control, but the infection rate has started to rise again and is continuing to rise. Patterns vary and in some countries such as Brazil, rates of coronavirus infection in the first wave are still increasing. In others such as South Korea, who were free of the virus, local infections have started to increase again after a period where COVID-19 was well-controlled. These patterns are better described as outbreaks.

Following recent localised outbreaks in UK cities and other countries, some believe that a second full wave of infection is inevitable as lockdown restrictions lift further. But it is possible to identify and suppress local outbreaks with local measures. Much will depend on continued public vigilance, an understanding of where outbreaks are occurring and what seeds them. Appropriate restrictions can be reinstated to bring the virus brought under control. By expecting and responding quickly to outbreaks there is hope that a wave can be avoided.

Where did the story come from?

BBC News is one of many media outlets who have reported on the possibility of a second wave. They reference a letter published in the British Medical Journal which calls for a review of the UK’s preparedness and warns politicians to prepare for a second wave.

The NewScientist is among sources to have reported on the COVID-19 ‘hotspots’ in the UK. They raise concerns from local public health officials that accurate information from the government is lacking because testing predominantly takes place in the hospital and doesn’t account for community rates.

What is the basis for the claim?

The BMJ letter states: “Several countries are now experiencing COVID-19 flare-ups. While the future shape of the pandemic in the UK is hard to predict, the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk.” Among UK policy areas that the authors consider need urgent review is coordination of public health and infectious disease control infrastructures, international collaboration, and addressing the disproportionate burden on ethnic communities.

A Situation Report from the World Health Organization showed that as of 29th June, a total of 10 million cases and 500,000 deaths from COVID-19 had been reported globally. There was a “recent record numbers of new cases, with several countries reporting their highest number of new cases in a 24-hour period.” The US, Brazil and India had all reported over 100,000 new cases in the 7 days preceding 29th June.

Local restrictions have been reintroduced in countries where rising infections have been detected, including the province around Beijing in China, Melbourne in Australia and Leicester in the UK. Meanwhile, the US has the world’s highest number of confirmed cases, a total of 2.5 million as of end June. Two months ago nearly all states had an R-rate below 1, but this is now above 1 for 33 states.

As lockdown restrictions are eased, these findings highlight the need to remain vigilant, follow hand washing and infection control measures, and maintain social distancing in line with government recommendations. Testing and tracing is an important part of this public health response.

What do trusted sources say?

The June Situation Report from WHO stated: “As some countries start to reopen their societies and economies, WHO strongly encourages individuals, communities, and nations to take measures to reduce transmission, extend testing and contact tracing, and provide optimal care for every case.”

Analysis by EIU Healthcare, supported by Reckitt Benckiser

 

Citation

  1. Adebowale V et al. Covid-19: Call for a rapid forward looking review of the UK’s preparedness for a second wave—an open letter to the leaders of all UK political parties BMJ 2020; 369 :m2514 https://www.bmj.com/content/369/bmj.m2514

Reading list

  1. James Gallagher, BBC News. Coronavirus: What is a second wave and is one coming? https://www.bbc.co.uk/news/health-53113785 (Accessed 1 July 2020).
  2. World Health Organization. Covid-19 Situation Report 161, 29 June 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200629-covid-19-sitrep-161.pdf?sfvrsn=74fde64e_2 (Accessed 1 July 2020).