Since the start of the COVID-19 pandemic, experts have been warning about the horrors of the 1918 flu. After the first dangerous wave of infections that spring, cities and people have slowed down their efforts to contain the virus that has returned. to roar in the fall and winter, killing far more people.
So far, COVID-19 hasn’t behaved the same way. There were no summer lulls and we are not seeing the ebb and flow that characterized the 1918 outbreak. It was more like a bushfire that occurred in one area while it went out in another.
But for months, public health officials predicted that a comparison would be valid: we would have a terrible winter.
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The fear is that cases increase as more people spend more time indoors, grow weary of public health measures, travel for vacations, and struggle with mixed messages from national and local leaders.
Nobody really knows what the next few months will bring. But as COVID-19 cases increase in 39 of the 50 states, there are some clues as to what is likely to happen, both for good and for bad.
An upcoming approach to testing, with lots of cheap, readily available, and fast testing could transform everyday life, allowing people to do the kinds of things they could only dream of in the past eight months.
Some colleges are already proving they can keep students safe by adding regular tests on mask wearing and social distancing. Airlines are starting to test all passengers on some flights, because who would no longer feel safe and would be more likely to travel if they knew the person next to them is not infected?
Many other activities, such as meetings, dentist appointments, gym visits, and weddings, would all start to seem reasonable again if everyone could be tested on the journey.
Of course, testing alone is not enough, as President Donald Trump’s recent infection shows. A “super-loud” event apparently occurred in the White House after politicians relied solely on testing to protect themselves from infection.
The tests need to be combined with other public health measures, including wearing masks and tracking the interactions of anyone who tested positive to make sure anyone exposed doesn’t transmit the virus, said Pınar Keskinocak, professor at the Georgia Institute of Technology and president. of the Institute for Operations Research and the Management Sciences, an international association of operations research and analytics professionals.
“If you can use triple action together, testing tracking and isolation, this will help a lot” to contain infections, Keskinocak said.
While quick, inexpensive, easy-to-administer tests are not yet widely available, they are expected to be available in the coming months, with the first of 150 million government-funded tests shipping this month and more rapid tests likely to be available later of the year.
At least one vaccine is likely to gain preliminary approval by the end of the year, with sufficient doses first to protect health workers and then the most vulnerable elderly. It will likely be next year, officials said, before enough people can be vaccinated to provide widespread protection.
The bad news: we can’t give up yet.
Gallery: Fauci: We could avoid flu season in the US (ETNT Health)
“Things are likely to go wrong in the winter if what we continue to do is loosen measures in places where COVID-19 cases are high or on the rise,” said Samuel Scarpino, assistant professor at Northeastern University in Boston. , where he directs the Laboratory school on emerging epidemics.
Scarpino is worried, for example, about Massachusetts Governor Charlie Baker allowing large groups to eat in restaurants again, which research suggests it will allow for “super-spreading” events, spreading the virus to many others. Massachusetts, like many states, has seen a recent surge in cases, so now is not the time to ease restrictions, Scarpino said.
Shruti Mehta, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said she was more concerned about the public becoming less alert. He conducts regular polls on public attitudes towards COVID-19, and each shows people a little more complacent than the last, he said.
She is also looking forward to gatherings during the holidays. Cases have surged after every long weekend this year, he said, and “Thanksgiving is the mother of all holidays” in terms of travel. People will flock to airplanes and dining rooms, he said, potentially transmitting the virus.
Dr. Michael Mina, an epidemiologist at Harvard T.H. Chan School of Public Health, said people tend to forget a crucial fact about coronaviruses such as the one that causes COVID-19: they are seasonal.
The drop in COVID-19 cases in August and most of September may have been a seasonal advantage, Mina said.
He is furious that more has not been done to avoid what he sees as a terrible future.
“We have basically done nothing since April to put in place an active system as a country to prevent it from spreading this winter,” he said.
Mina said she is unsure when the virus causing COVID-19 will peak – other coronaviruses rise at different times. But in both late October and late December, he said: “I expect we will see a strong escalation very soon and that will force us to shut things down once again.”
“If we think we can get through this winter without a seasonal recovery, probably a massive recovery in cases, we are wrong,” he added.
How will we know when it’s getting worse?
Barry Bloom, a Harvard immunologist, said with COVID it can be difficult to know exactly what’s going on as it unfolds.
“What you see now is not what is really there. You have to be able to anticipate what is coming,” he said. It takes at least two to three weeks for someone who gets COVID-19 to request hospitalization, so measures such as the number of people needing treatment describe who was infected a few weeks ago, not today.
Bloom said he would like to see the existing national influenza surveillance network expanded to examine all respiratory viruses. Hopefully, he said, this could offer an early warning sign of where infections are starting to rise.
Another leading indicator – wastewater. The University of Arizona, for example, tracks campus output to look for the virus that causes COVID-19.
In New Haven, Connecticut, the virus’s genetic material began to increase up to two days before positive COVID-19 tests revealed a rising infection rate, according to a study this month in Nature Biotechnology. Data on sludge was 1-4 days before hospital admissions and – due to delays in obtaining test results – 6-8 days before people realized they were infected.
This kind of early information can help public officials make decisions about whether to loosen or tighten public health restrictions, Bloom said.
So how do you do it?
Forecasts are bleak, public health officials admit. But it’s possible to stay safe during COVID-19 outbreaks through measures such as masks, social distancing, and frequent hand washing. Goggles can also provide some protection to prevent viral particles from entering the body.
So, put on that mask and get ready for a long winter without hugs.
“What we will see in the coming months,” Keskinocak said, “will really depend on what people do individually, as a family, as a community.”
Contact Karen Weintraub at firstname.lastname@example.org and Elizabeth Weise at email@example.com
USA TODAY patient health and safety coverage is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not make editorial contributions.
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This article originally appeared on USA TODAY: What Can We Expect From a Second Winter Wave of COVID-19? Nobody knows for sure, but there is reason for hope and concern