'The discussion that follows is not intended to be alarming, but I do want it to wake you up, because it’s a real risk. The only thing that prevents the worst outcomes below is that humans are capable of changing their behavior, and I would expect that we would do so in response to an emerging second wave. Given the needless politicization of even basic containment measures like masks, I’m not certain of that. So my hope is to provide not only an illustration but also a warning.
If you examine the 1918-1920 influenza pandemic, you’ll see that it occurred in multiple “waves,” where the second episode was markedly worse than the first. Though some historians have proposed that maybe the virus mutated between those two episodes, there’s actually no scientific evidence to support that. Indeed, the scientist who reconstructed the 1918 virus from RNA extracted from century-old lung tissue (talk about Jurassic Park) notes that the period between waves was almost undetectable in some areas, and the virus would have had to mutate simultaneously around the world.
While influenza viruses do have some amount of seasonality to them, an important driver of the second wave was most likely an increased level of interaction in the fall of 1918, not only as kids returned to school (children do tend to be significant vectors when it comes to influenza), but also as summer ended and adults increased their own interactions, particularly indoors – all of this in an environment where there was a larger pool of active cases to “feed” that second wave.
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The problem is that the pool of infected cases has expanded again, and it remains large enough to keep us teetering right at the edge of a second exponential outbreak.
It’s important to understand how bad this could get, and how quickly the situation could deteriorate in response to even a slight easing of containment – unless we shrink the infective pool first.
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..The main prerequisite for opening up on a large scale is to first shrink the infective pool. The other prerequisite is to improve the speed and effectiveness of testing, isolation and contact tracing when new cases emerge. Again, the people who are most adamant about “opening up” and sending kids back to school are also the people that should be most adamant about measures that would first shrink the pool enough to get going.
Containment measures essentially provide a combination of actions that “substitute” for immunity. Provided that strong testing, isolation, and contact tracing measures are in place, other containment measures can be gradually relaxed as case numbers diminish. At present, essential ones include social distancing, use of outdoor settings where possible, ventilation, encouraging face masks – particularly in shared public indoor airspace (including transportation) and also outside if distancing isn’t possible, avoiding the creation of “network hubs” where previously separated groups are mixed without other containment measures in place, limiting superspreader events that involve large numbers of person-to-person interactions, reducing the length of meetings, using stable student groupings, and ensuring that local “reopening” decisions are supported by local containment practices and a sustained reduction in infection rates.
Look. This thing has not suddenly gone to sleep. We’ve had 7000 U.S. fatalities from COVID-19 in just the past week. That’s more than twice the number of Americans lost on 9/11. We’ve already lost more Americans than the number of U.S. soldiers lost in World War I; more than in every war since World War II. For those who reveal their baseness of character by arguing that “it’s mostly old people,” I somehow can’t imagine they would have the same dismissive response if terrorists were lining up the same Americans and shooting them in the head. Must we really insist on protecting others only when the response involves hatred and bloodshed, but rail against every measure that involves reason and common humanity?'
- John P. Hussman, Ph.D.,
Avoiding a Second Wave, July 30, 2020
Context Dr. Fauci: "You Don't Make The Timeline, The Virus Makes The Timeline"Cellular and Molecular Mechanisms of COVID-19, and Potential Points of Therapeutic Intervention, July 29, 2020
(Bloomberg)(SARS-CoV-2 (COVID-19)) - ‘False Dawn’ Recovery Haunts Virus Survivors Who Fall Sick Again(BBC) - '..a possible link between high levels of air pollution and Covid-19 deaths in northern Italy.'(SARS-CoV-2 (COVID-19))(Second wave: in the fall of 2020?)(Will the virus have mutated?) - 'Be prepared for another cycle' - Dr Fauci - Why the Second Wave of the 1918 Spanish Flu Was So Deadly(BBC) Coronavirus confirmed as pandemic by World Health Organization - 'He said he was "deeply concerned" by "alarming levels of inaction" over the virus.' - 'The case of the Netherlands..'