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A Second Wave of Coronavirus Could Mean a Devastating Fall

As the summer approaches and the rate of transmission of the coronavirus begins to move in undulations instead of huge spikes, complacency could trigger a bigger wave as schools open and people move inside.

In the fight against the coronavirus, assuming the best-case scenario — the population continuing to maintain social distancing and hand hygiene; keeping the elderly protected by sheltering in place; wearing masks; robust testing; and “really good contact tracing” — we’ll see the virus smolder. Absent that good behavior, we may see a potentially devastating second wave in the fall.

“Some places will have a problem and then go back into shelter and place but we’ll never have anything as horrific as what happened in New York City. We’ll see undulations until it’s over. That’s the best scenario,” said Dr. John Swartzberg, clinical professor emeritus at UC Berkeley-UCSF Joint Medical Program, Infectious Diseases and Vaccinology Division. 

On the other hand, of all of those protections and mitigation tactics fade into complacency, we could see the darkest period yet, beginning around October.

The summer may not be catastrophic as people move outside and are not confined indoors and practice reasonable social distancing and so forth. But things could begin to change drastically as schools open and people move indoors.

“Over the summer, people are going to get complacent, and we may see a gradual increase in cases but nothing dramatic,” Swartzberg said. “When schools and universities open up, people will be moving around the country a lot more and this may represent a major transmission.”

In October, after two incubation periods, the cases could start to dramatically increase. That would also coincide with flu season and, in California, fire season, where the smoke could exacerbate the seriousness of the virus in some people.

“It’s completely dependent on how human beings behave,” Swartzberg said. “If we behave badly like in the Ozarks [where a number of people gathered to party without social distancing and at least one person later tested positive for the coronavirus] we’re going to see a lot of pain and a lot of deaths and a lot of awfully sick people.”

Dr. Julie Swann is a professor for the Edward P. Fitts Department of Industrial and Systems Engineering at North Carolina State and was a science advisor for the H1N1 pandemic response at the Centers for Disease Control and Prevention in 2009. Swann says there will be a second wave, and that given the nature of the virus and the inability to shelter in place for a more extended period of time, is inevitable.

She said that in looking at the places where the virus hit, had those places waited for a vaccine or herd immunity before opening up, it would take years or decades for that to happen.

“When people talk about second waves, sometimes there are different kinds they have in mind,” Swann said. “Someone says are we going to have a second wave of cases now that we’ve lifted shelter-in-place policies and, yes, I do think that we are seeing and will continue to see a second wave of cases after distancing policies are released.”

Swann said the second wave may look different from what was experienced in hard-hit areas, such as New York City, New Jersey, Connecticut, and other areas, but that everyone will get hit. “We do know that the virus will eventually get everywhere,” she said.

“Often the first locations hit by viruses are those that are dense and enable transmissions quickly and those that are very connected, either through airplanes or workplace commuting.” She said. “So of course that explains the reason the New York region was hit sooner than some areas of the country.”