July 29, 2020

expert comments on fears of a second wave of COVID-19

There has been reporting int he media and discussion about whether the UK and Europe are entering a second wave of COVID-19. 

Prof Jose Vazquez-Boland is the Chair of Infectious Diseases at the University of Edinburgh, said:

“What we are facing is a comeback of community transmission after removing the lockdown measures. 

“We have to be clear that the efficacy of lockdowns is only temporary. There will be a resurgence of new cases every time social restriction measures are lifted as long as the virus remains in circulation.

“The perception of a second wave is to some extent the consequence of the synchronous imposition and lifting of lockdown measures across Europe and internationally after the first peak, potentially leading also to a synchronous new increase in the incidence. 

“So in this sense the WHO is right in considering a “one big pandemic wave”, although this is mainly a semantic question.

“What is important to consider is that we will most likely have to deal with new peaks of incidence unless SARS-CoV-2 is eradicated.  These peaks may become shallower if previously exposed people become immune, but whether this happens is unclear at this point.

“Until a sufficiently efficacious vaccine becomes available, the only way we have to achieve covid-19 eradication is through the mass, systematic, regular screening of the population for subclinical transmitters that maintain the virus in circulation.”

Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:

“It is a little early to say definitively whether some European countries, such as Spain or Germany, are experiencing the start of a second wave, or simply seeing spikes in their caseloads. The long-term decline to zero cases of COVID-19 will always see bumps in their graphs within the downward trend. It is up to all of these countries to ensure that these are only ‘spikes’ and not a ‘second wave’.

“Therefore, we simply have to implement a proactive approach that will rapidly squash any emerging outbreaks. This includes the need for rapid case detection, effective contact tracing, immediate sharing of data across public health authorities, and will sometimes require local lockdowns or quarantine measures.”

Prof James Naismith FRS FMedSci, Director, Rosalind Franklin Institute, said:

“We all need to be clear what we mean when we discuss “second wave”. The UK has never been free from infection, we have had 100’s of cases per day every day since March. However, the number of cases measured today are not comparable to those in detected March. In March, we had far too little testing, as a result the numbers in March massively underestimated the number of infections. Although the current testing regime does not catch every positive case, we do have much better sight of the virus. We and other countries are detecting young people with covid19, in February we never noticed them. It seems likely that the virus spreads in this group first but with few symptoms and little illness. We know the virus will spread in time from young to old / more vulnerable where we will see hospitalisation, severe illness and death. This will happen in a few weeks if we don’t keep the virus suppressed. Neither human biology nor virus have changed. Scientific breakthroughs have reduced the proportion of infections that lead to death but COVID-19 is a very serious illness.

“The increase in cases was to be expected, as the lockdown eases, the opportunity for the virus to spread will increase. The government intervention that will make the most difference in keeping the lid on this flare up, is the isolation of positive cases. I remain concerned that not enough effort has been put into isolation measures (for example financial support, free hotel stays). Its self-defeating to vilify young people who are infectious but otherwise well for not wanting to keep making disproportionately heavy financial and life sacrifices. The testing and tracking (which still need improvement) will all be for nothing if infectious people do not isolate. Without effective isolation, all we will have a more detailed view of an unfolding tragedy. A lockdown is just a blunt method of isolation. We all still have a role to play, isolate if we are sick or test positive, wash our hands regularly, socially distance and wear a mask indoors.

“What I fear is that if we fail to check this flare up, we will head into the winter months with a high level of circulating virus. With the normal winter illnesses (coughs, colds, flu) and greater indoor living, we could then see a return to exponential growth in covid19 cases that overwhelms the NHS and requires complete lockdown. This is what I term a second wave. Many scientists have consistently emphasised that we have only short time to get our systems ready to prevent this.”

Dr Gail Carson, Head of the ISARIC Coordinating Centre and Consultant in Infectious Diseases, University of Oxford, said:

“I do not think we should focus on phrases but messages, messages that clearly communicate risk to the public, the health service and business.

“We knew that SARS-CoV2 had not been eliminated and that we were to learn to live with it using a package of measures including social distancing, contact tracing, hand hygiene and cloth mask wearing, possibly even localised versions of lockdown.  The mention of ‘waves’ usually refers to influenza epidemics and a seasonality when it peaks in the cooler, winter months. This is not flu, it is SARSCoV2 and we are still learning about how best to manage it. However, we are seeing that some measures work but the situation appears fragile and therefore, we must maintain vigilance. A few months ago I mentioned, as did others, the need to scale up our preparedness for a resurgence, further peaks, upticks or, wave. This is a unique situation as we find ourselves recovering, responding and preparing all at the same time. The preparedness, recovery and response will continue to require a multi-disciplinary approach to ensure a timely, comprehensive, and effective one. Countries must learn from each other and this is where the ‘eagle eye’ view of the WHO can come in. Governments need to communicate regularly across the world to learn real time what measures/steps work in helping ease out of lockdown, the processes involved to support that and to recognise the warning signs of an increase in virus spread. Do not let the virus activity drive us apart as countries but bring us together to protect our health, economy, political relations and society.”

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