Second Wave - Yes or No?

[MysticMeghan]

So the papers are now full of warnings about a "deadly second wave" but if you ditch the articles and look at the comments 99% of people don't agree. People want lockdown over, they want to get out, they want things back how they were. Look at the beaches today.

Most people I know think it's going to peter out in the next few weeks. The tabloids seem to be going with this, but then they print whatever sensationalist crap sells newspapers, it's not necessarily true. Even my own friends think that in a worst case scenario few people might have mild flu like symptoms, it's not worth going crazy over, we're all over reacting and we've stuffed the economy and everyone's businesses and jobs for nothing. Just so the government can flex its muscles and control us. Many even think it's a conspiracy.

Justification for the "overreaction" theory seems to be that the Nordic countries haven't really locked down and only a few have died. Many European countries now opening up again with few ill effects and many tourist destinations in Spain etc.now looking to have a late tourist season.

In the UK we are constantly being reminded that deaths are going DOWN. Therefore it's ok.. "It's over" seems to be the prevailing theme. McDonalds and Burger King open again, people in England allowed to travel and taking full advantage, going to the beach, the park, hanging out with their mates. Prevailing theory seems to be that the experts over reacted and got it wrong, we all self isolated for nothing and the same experts warning of a second wave just want their 5 minutes of fame. Ignore them and lock them up. Most people don't know anyone who has had it or died of it and therefore the risk is small, it's just a bit of flu and people die of flu all the time.

Or....there might be a very deadly second wave after all, this is being glimpsed in China but is being covered up. Governments and companies are desperate to re-start economies so are taking the view that if a few more die who cares, they were probably old people who would have died anyway. And young people aren't affected so just put things back the way they were and if a few oldies die then just collateral damage.Oldies can stay at home if they're worried.

Which is it? I think the truth is somewhere in the middle. It IS a deadly disease, it's being desperately underplayed now in the interests of preventing economic ruin. I certainly think the British Media is being manipulated and that's why we have one story one day and a completely different one the next.

Am I the only person in the world who thinks that pubs and restaurants re-opening and global travel re-starting for the sake of keeping a tourist industry alive is a really bad idea?

From the BBC:

We have been here before. The threats of a second wave were borne out in the 1918 influenza pandemic, in which a third of the world’s population were infected with the virus.

The spread was successfully curtailed in San Francisco thanks to the prompt implementation of mitigation measures including a city-wide shutdown and requirement to wear masks in public.

As the infection rate dwindled, city leaders relaxed the lockdown measures in November 1918; bars, restaurants and sports arenas reopened, and people poured out onto the streets in celebration, tossing their masks in the process. A month later, the second wave hit San Francisco, but this time much of the public – including the Anti-Mask League – resisted public health mandates. The city ended up with nearly 45,000 cases and over 3,200 reported deaths. San Francisco ended up being one of the country’s worst-hit major cities.

But who is advocating opening up bars, restaurants and sports arenas right now? Or celebrating in streets?
Slow, gradual lifting of restrictions, while monitoring numbers and tracking and tracing.

Its been here since Nov/|Dec, we have just had the second wave.

Its been here since Nov/|Dec, we have just had the second wave

That simply doesn't bear any scrutiny, are you saying that the first wave didn't involve any noticeable increase in deaths, no health professionals noticed any strange new virus, no hospitals were overwhelmed, no increased need for ventilators, no effects on care home residents?

Was it in fact an invisible non-existent wave? If we going to have a third wave let's hope it like the first one then and we can all get back to normal.

I do get why people compare it with the Spanish flu pandemic but I really wish they wouldn't. It scares the pants off people with no real reason. The effects of that pandemic were very specific to that time in History and lacked the technology and medicine that we have now. There may well be a second wave but it won't perform like the second wave of the Spanish flu because we're in a completely different age.

The Spanish flu killed 50 million people worldwide. I don't think even the most pessimistic of forecasters have predicted it'd be anything like that I agree it's an unhelpful comparison. None of us know how deadlly Covid will be in the longterm, but there's no way of knowing that a second wave (even if it occurs) would even remotely resemble the second wave of the SF.

when in fact commuting to work on a regular basis has a higher chance of killing them and nobody is advocating destroying all cars.

Why do idiots keep using this analogy? It’s so uneducated and stupid I can’t even comprehend why anyone would say it? 🤦‍♀️

Its been here since Nov/|Dec, we have just had the second wave

Then why would excess deaths only have started happening in March?

@palacegirl77

If it was widespread here in November/December (as opposed to the odd isolated case) then how do you explain the excess death stats? And if no containment was in place at all, how did it fade out only to return in March? It makes no sense.

Given it appears that different infected people will a very different number of other people depending on their infectivity (children are very low it seems) and levels social interaction (some people have infected dozens at social events), it’s plausible that it could have been around since the end of last year in very low numbers without much initial spread. For instance. if 10% of those infected are responsible for 90% of transmission, the median R could be zero, allowing it to bubble along for quite a while until some super-spreading events occur, and, after numbers get high enough, the trajectory becomes exponential as super-spreading events become ever more frequent.

I don't think it's a second wave either. There are always winter flu/pneumonia cases. Friends and family who work in hospital (including ICU) said that this winter was normal, and if anything flu was lower in their Trust than previous years.

Combined with lower immune systems due to winter, the usual other illnesses around, our hospitals would have been overwhelmed late Winter/early Spring.
I do agree that it was probably in the country earlier the first recorded case.

Also, many people tested in hospital in March were tested because they had Covid like symptoms - two thirds of these (on average) tested negative, yet they presented with all the signs. This reinforces that there are always severe illnesses that share the same characteristics as Covid 19. So, if posters who are saying that the first wave was early in the year, why were so many people admitted to hospital not testing positive after becoming ill from that wave? I think it's because they had the usual severe chest infections/pneumonia that is typical of the season.
And, the curve went up at a steady pace - it didn't suddenly rocket up - and surely it would have done if loads of people had it in December/January, because there was obviously no social distancing, no PPE used in hospitals, so the first wave, without measures in place would have definitely been more apparent.

Also, many people tested in hospital in March were tested because they had Covid like symptoms - two thirds of these (on average) tested negative, yet they presented with all the signs.

And yet people persist in thinking that because their uncle had a nasty persistent cough in November it “MUST have been Coronavirus!” It’s a weird form of attention seeking.

All we can do is sit back and keep our fingers crossed.

If there is a second peak we are more prepared, Nightingale hospitals are on standby, track & trace should be being widely used, Covid tests should be easily accessible and results should be coming back quicker.

Isn’t that all we can hope for. No one can say for definite whether a second peak will arrive, how many people it will affect, it’s all second guessing at the moment isn’t it.

Another reason why I think we've only had one peak: Care Homes.
If this was around late last year/early winter, deaths in Care Homes and the elderly not in care homes would have been huge. No PPE, lots of visitors...and deaths were, according to Chris Whitty, average for Dec - February, and not very different from previous years. There was just the usual seasonal rise.

Hanamuslim congratulations on the pregnancy!!! Sounds like we're in the same boat, the kids are starting to grow out of everything and we've now holes and rips in so many clothes do I'd love to go out clothes shopping for them! We were talking about soft play and wondering how they'll open in the future, the thought of the spread from kids grabbing everything etc. Such a pity, and playgrounds too

And yet people persist in thinking that because their uncle had a nasty persistent cough in November it “MUST have been Coronavirus!” It’s a weird form of attention seeking.

Almost every winter there are a few threads about a weird cough that doesn't go away.
I know because I've had one of those almost every winter from 4 or 5 years ago. One that was pretty bad.
It could have been "a" coronavirus, that cause more than 10% of colds. Or a respiratory syncytial virus. (www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098 - see sever forms)

Or one of a number of viruses that circulate in the population.

This is different. One of many coronaviruses, but different and, ahem, new.

Nightingale hospitals are on standby
But we don't have enough trained staff to fully utilise them .....do we🤔

Yes to a second peak. But not now. The other endemic corona viruses are powerfully seasonal; they basically only cause problems from Dec-March/April. So I would imagine the second peak will happen in the late autumn.

Will we lockdown again? I doubt it. A relatively wealthy country might be able to afford to sacrifice 10-15% of GDP and induce a depression to save about 1% of its population (mostly elderly and economically unproductive). It can't sacrifice much more than this without ruining the lives and futures of almost everyone in the country, and (for the approx 99% of people who aren't going to die of coronavirus anyway, even if infected) worsening their health outcomes. I think we will look back on these months in the spring as a noble, altruistic, probably futile effort in the winter.

Of course, therapies might have improved a lot by then. Let's hope so. The safest thing, in the absence a vaccine, would still be to allow low-risk people to get infected. All recent studies show short term immunity for survivors. And what explains the fact that London's R rate is 0.4 (under social distancing) compared to 0.7-1 in the rest of the country other than a wider spread (17% with antibodies as opposed to 5%). A lot of people don't seem to realise that even a small % of people with antibodies reduces the R once it's at 1 or below. (So if the R is got down to 0.9 by social distancing alone, 17% with antibodies reduces it by a further 17%, leading to much more rapid decay.)

Sorry if its been mentioned earlier, I've not read the full thread, but second wave or a second peak?

Does a second wave mean a peak though or does it just mean that cases/deaths will go up a bit, but not as high as before?

I really can't see why there wont be a second wave and I expect as we open more then there may be a second wave. However a second peak I'm not so sure. Possibly, but it does really depend what we have learned from the first peak. By we I mean all of us including the government.

I think a second wave would have a peak? But I get what you mean, the peak won't necessarily be as high as the first. If I had to guess I'd say there'll be several more waves with a lower peak and lower death rate each time (as ways of treating it, testing and immunity increase) until eventually it becomes just another part in of our medical landscape.

@hopsalong

Yes, the immunity point is interesting. Lots of people seem to think that because we are “nowhere near herd immunity” the number of people with antibodies is sort of irrelevant.

However, if 10 people are passing the virus on to say 8 people (due to social distancing so an R of 0.8) but 17% of those 8 people are immune that will reduce the transmission rate to less than 0.8). Not enough to stop it, but it will slow it down.

That is presumably why we don’t have epidemics of all the other illnesses that exist that do not have vaccines. A low level of naturally occurring immunity in the population keeps the prevalence of those illnesses at a lower level.

Some epidemiologists have suggested that 10% with immunity would be enough.
I suspect that's optimistic, but with an already low transmission rate, it might indeed help.

It will also be interesting to see how significant the role of T cells is in fighting the disease (or not) and how that translates to immunity.

If those who fight the disease off using only T cells (as I believe it’s been hypothesised some younger people do) do those people produce antibodies? Or are they immune via another mechanism? If so, does that different type of immunity show up in the antibody testing?

Check out spanish flu, first wave, infected many but mild symptoms. Second wave was the killer, before dying out (as is the case now)

I think a second wave in winter, possibly but not now. I hope we are more prepared for the next one (be it second wave or new virus). I hope the handwashing and infection control individuals seem to do more now of stick though as that will help in winter to keep other sickness down.