Prep for second coronavirus wave begins in earnest

Prep for second coronavirus wave begins in earnest
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Fears about a second coronavirus wave have continued to mount since the initial wave in China. The U.S. is now preparing for a second wave of the coronavirus, although experts disagree on when it will hit. Some projections put it within the next few months, while others don’t expect the next wave of COVID-19 to hit until next year. Regardless of when it arrives, the consensus is that preparations must be made.

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Warning about reopening too early

One of the biggest concerns about a second wave of the coronavirus is easing stay-at-home orders too early. An epidemiologist from the University of Hong Kong told CNBC that lifting those restrictions too early could trigger a second wave of COVID-19.

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Professor Ben Cowling told the news outlet that figuring out a timeline to ease restrictions will be difficult. He added that no country will want to reopen too early and be the first to have a sizable second wave. He explained that even countries that beat their first wave will face challenges from other countries that are still dealing with their first wave or starting to experience their second wave. He believes China could be starting to see its second wave of the coronavirus.

He said testing is key to controlling the second wave, but social distancing will still be needed. He believes countries may not even fully reopen by June or July.

Timing of the second coronavirus wave

Pinning down the timing for the second wave of infections will be a critical part of keeping it under control. However, experts disagree on when that second wave will hit. Some say it could hit over the summer, while others put that timeline later.

Dr. Robert Redfield, head of the U.S. Centers for Disease Control and Prevention, told Good Morning America that the next wave of COVID-19 could hit next year or possibly as early as next fall. He believes they should assume the virus will be like other respiratory infections and that there will be a seasonal component to it.

He added that the U.S. should boost its testing capacity before that second wave hits and implement contact tracing and other control measures.

Lessons from second coronavirus waves in other countries

Cowling noted that Singapore received praise for its handling of the first wave of COVID-19. However, the country is having difficulty with its second coronavirus wave due to imported cases. He added that the lesson to be learned from Singapore is that while testing and contact tracing are still important, social distancing must still be part of any exit strategy.

One other part of the world that handled the first wave of COVID-19 very well was Hokkaido prefecture in Japan. The region was the first part of the country to declare a state of emergency from the coronavirus in late February. In mid-March, the prefecture had declined to only one or two new cases per day, and then officials lifted the state of emergency and reopened everything on March 19.

Now the second wave of the coronavirus has hit Hokkaido prefecture, and officials declared another state of emergency 26 days after the previous one was lifted. According to the BBC, the second wave appears to have reemerged from within the prefecture rather than via imported cases like the first wave.

There are some lessons to be learned from what Hokkaido has experienced. The first is that it is possible to get the outbreak under control early. Japan used contract tracing and isolation to control it by focusing on clusters of infections. However, the second lesson is that continued testing is needed to track those who are infected. The BBC reports that Japan is still only testing a "tiny percentage" of its population.

Japanese officials say they will increase testing, but they're dealing with some barriers to that plan. The health ministry is concerned that hospitals will be inundated with people who do test positive for COVID-19 but have just minor symptoms. Further, local health centers are tasked with managing the testing, but many of them don't have enough staff or equipment to deal with such a massive undertaking.

Another lesson that can be learned from Hokkaido is that even if the virus is gotten under control quickly, as long as infected people are in the country and moving around, it will continue to be a problem.

Antibody tests needed for second wave of coronavirus

As the U.S. prepares for the second wave of the coronavirus, Redfield said antibody testing will be an important part of the response. NBC News reports that officials want to know who is immune to COVID-19, and the only way to do that is to test for antibodies.

Antibody tests should reveal patients who had the virus but showed no symptoms. They should also reveal when those who have recovered from it can safely return to work. Redfield told NBC in an interview that antibody testing will help them understand the ratio of symptomatic to asymptomatic patients. He also said it should help them identify "high-risk populations that are conceptually immune."

He emphasized that no one has proven that it is possible to become immune to the coronavirus. Having antibodies could in theory mean that someone is immune, but that's still only a hypothesis. He said this won't be proven until the second wave of the coronavirus hits, possibly in the fall or winter. At that time, many people in high-risk professions like healthcare will have tested positive for the antibodies.

Development on serology tests for COVID-19 continues, although the FDA has approved the first tests. The next step will be determining a strategic method for testing. Redfield expects serology tests to become widely available.

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