Six months after China first reported a cluster of mysterious pneumonia cases in the city of Wuhan, the World Health Organization had a stark warning for the world: ‘the worst is yet to come’. Despite clear progress in containing the virus in some regions, especially those that saw early outbreaks, globally the number of new virus cases have soared recently as the world passed the grim milestone of 500,000, and 10 million infections. Although scientists and health officials have had months to learn about the virus, it’s immense scale and pace has proved too big for any one person to fully comprehend, leaving many unanswered questions about the future of the virus.
AN INEVITABLE SECOND WAVE?
Governments, as well as the public, are now keen to start removing the stringent restrictions and return to normal life, yet alarming headlines about a second wave have continued to dominate the news. While the term “second wave” has no agreed-upon scientific definition, it generally refers to a sustained rise in cases after a virus has brought under control and cases fallen substantially. These warnings often refer to the 1918 flu pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, most of whom died when the outbreak returned the following winter in a deadlier form after the first outbreak had been controlled. While it too soon to say for sure what will happen in the coming months, some experts predict that the coronavirus could be seasonal and may spread more easily in winter. They also fear that more time indoors during the colder months may also exacerbate viral transmission. A COVID-19 resurgence coinciding with flu season may wreak havoc and overwhelm the health care system.
Fear of a second wave or second peak of infections now hangs over countries that have managed to stamp out the disease, mostly through economically and socially painful lockdowns. South Korea, which has been widely praised for its handling of the coronavirus, grabbed international attention last month when its disease control authorities were the first in the world to announce that the country had entered a second wave, focused around the capital and apparently triggered by gatherings over a May holiday. Signs of a second peak or wave are also appearing in Germany, where hundreds of people have tested positive for the virus after an outbreak at an abattoir, and in China where a strict lockdown was reinstated near Beijing, affecting around 400,000 people, after a small surge in cases.
As COVID-19 is unprecedented and complex, it may not necessarily show historically expected patterns of spread or resolution. Accordingly, there’s a lack of consensus from scientists about whether we’ll see a second wave of coronavirus cases and what the extent of the resurgence will be.
Chief medical officer for England, Chris Witty, has said that a second wave of coronavirus could be “more severe” than the first wave, and it could spread more rapidly than before if it arrives in winter. In an online lecture for Gresham College, Prof Witty said that countries looking to ease their lockdown measures must negotiate an “extremely difficult balancing act” in order to keep the pandemic under control. He said: “Covid-19 is a very long way from being finished and eradication is technically impossible for this disease.”
Others are more optimistic. In a statement to CNN last month, Dr. Anthony Fauci, who is director of the National Institute of Allergy and Infectious Diseases, commented to CNN last month, “It is not inevitable that you will have a so-called 'second wave' in the fall or even a massive increase if you approach it in the proper way.”
One argument against a deadly second wave is that viruses has become less dangerous as they evolve, to better infect people. In Italy, there's an ongoing public debate about a possible encouraging shift toward a weaker version of Covid-19. A leading virologist and doctor have endorsed this idea as the number of deaths, cases, severely ill patients and viral load they’ve seen on swabs are declining or holding steady even as the country reopens. The virologist, Arnaldo Caruso, suggested that the virus could vanish even without a vaccine and that distancing and masks may no longer be needed soon. But coronaviruses have proven a remarkably stable type of virus and there is no evidence to support this kind of mutation occurring in a matter of years, let alone weeks.
Researchers that have been analysing and tracking the novel coronavirus since it first appeared in China in January have, however, found that the strains spreading so quickly in Europe and the U.S. have a mutated S “spike” protein that makes it about 10 times more infectious than the strain that originally was identified in Asia. The mutation does not appear to make the virus any more deadly than it already is.
Visitors wearing protective facemasks admire the view from the Eiffel Tower during its partial reopening on June 25, 2020, in Paris, as France eases lockdown measures taken to curb the spread of the COVID-19 caused by the novel coronavirus. (Getty)
A LIGHT AT THE END OF THE PANDEMIC TUNNEL?
While much about the COVID-19 pandemic remains uncertain, we know how it will likely end: when the spread of the virus starts to slow because enough people have developed immunity to it. At that point, whether it’s brought on by a vaccine or by letting the virus run its course and spread through the population until “herd immunity” is reached. But without a vaccine, we should not think of herd immunity as a light at the end of the tunnel as getting there would without a vaccine is extremely costly as it would result in millions of deaths.
A new study published last month showed that Sweden's soft approach to the coronavirus resulted in only 6.1% of the population developing coronavirus antibodies by late May, a lower measure than some of its health agency's earlier models had predicted. Sweden's also has a mortality rate per capita is very significantly higher than its neighbouring Scandinavian countries as well as one of the highest in the world. This means that countries appear highly unlikely to tackle the virus by achieving herd immunity.
Moreover, there is still no confirmation on how long immunity would even last, and therefore there is no certainty about whether people could become re-infected after a couple of months or years. The answer to this question has broad implications for reopening the economy and for the effectiveness of the vaccine in the long term.
The virus sparked an unprecedented global effort to find vaccines and treatment. There are 17 vaccines that are currently in clinical trials, according to the WHO. Researchers at Oxford University in the United Kingdom are testing a vaccine made from a weakened cold virus combined with genes from the coronavirus and hope to have the first doses ready by the autumn. There is no evidence yet to prove that the vaccine being developed by AstraZeneca works — even though the pharmaceutical giant has already began mass-manufacturing it – but so far experts say it offers the best chance of having something protective against the virus before the end of year.
Battered by grim headlines, horrifying statistics and dire reports in a pandemic characterized by extreme uncertainty, these pronouncements have brought hope to many pandemic-weary people across the world. While it’s natural to want some good news in troubling times to counterbalance negativity, some experts are concerned the recent predictions of a COVID-19 vaccine by next year are raising false hopes. They say it will be difficult for research to be completed that assures the safety and efficacy of such a new vaccine.
Gaining public trust is an additional obstacle. A Reuters/Ipsos poll released in late May found that 1 in 4 Americans says they won’t trust a vaccine for COVID-19. Some of those surveyed specifically cite the speed of the development as a reason to fear. And with at least 70 percent of the public needing vaccination to achieve “herd immunity,” experts say trust is going to be a vital active ingredient here.