{"id":21176,"date":"2020-06-30T23:20:08","date_gmt":"2020-06-30T23:20:08","guid":{"rendered":"https:\/\/www.lifeandnews.com\/articles\/?p=21176"},"modified":"2020-07-02T15:38:07","modified_gmt":"2020-07-02T15:38:07","slug":"the-us-isnt-in-a-second-wave-of-coronavirus-the-first-wave-never-ended","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/the-us-isnt-in-a-second-wave-of-coronavirus-the-first-wave-never-ended\/","title":{"rendered":"The US isn&#8217;t in a second wave of coronavirus \u2013 the first wave never ended"},"content":{"rendered":"<p><a href=\"https:\/\/theconversation.com\/profiles\/melissa-hawkins-1116324\">Melissa Hawkins<\/a>, <em><a href=\"https:\/\/theconversation.com\/institutions\/american-university-1187\">American University<\/a><\/em><\/p>\n<p>After sustained declines in the number of COVID-19 cases over recent months, restrictions are starting to <a href=\"https:\/\/nymag.com\/intelligencer\/2020\/06\/failed-us-reopening-serves-up-a-feast-for-the-coronavirus.html\">ease across the United States<\/a>. Numbers of new cases are falling or stable at low numbers in some states, but they <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/coronavirus-us-cases.html\">are surging in many others<\/a>. Overall, the U.S. is experiencing a sharp increase in the number of new cases a day, and by late June, had surpassed the peak rate of spread in early April.<\/p>\n<p>When seeing these increasing case numbers, it is reasonable to wonder if this is the <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(20)30845-X\/fulltext\">dreaded second wave of the coronavirus<\/a> \u2013 a resurgence of rising infections after a reduction in cases.<\/p>\n<p>The U.S. as a whole is not in a second wave because the first wave never really stopped. The virus is simply spreading into new populations or resurging in places that let down their guard too soon.<\/p>\n<p><iframe loading=\"lazy\" id=\"D0knc\" class=\"tc-infographic-datawrapper\" style=\"border: none;\" src=\"https:\/\/datawrapper.dwcdn.net\/D0knc\/1\/\" width=\"100%\" height=\"400px\" frameborder=\"0\"><\/iframe><\/p>\n<h2>To have a second wave, the first wave needs to end<\/h2>\n<p>A wave of an infection describes a large rise and fall in the number of cases. There isn\u2019t a precise epidemiological definition of when a wave begins or ends.<\/p>\n<p>But with talk of a <a href=\"https:\/\/www.theguardian.com\/world\/2020\/jun\/27\/new-covid-19-clusters-across-world-spark-fear-of-second-wave\">second wave in the news<\/a>, as an <a href=\"https:\/\/www.american.edu\/cas\/faculty\/mhawkins.cfm\">epidemiologist and public health researcher<\/a>, I think there are two necessary factors that must be met before we can colloquially declare a second wave.<\/p>\n<p>First, the virus would have to be controlled and transmission brought down to a very low level. That would be the end of the first wave. Then, the virus would need to reappear and result in a large increase in cases and hospitalizations.<\/p>\n<p>Many countries in <a href=\"https:\/\/doi.org\/10.1038\/s41562-020-0908-8\">Europe and Asia have successfully ended the first wave<\/a>. <a href=\"https:\/\/www.theguardian.com\/world\/2020\/jun\/08\/new-zealand-abandons-covid-19-restrictions-after-nation-declared-no-cases\">New Zealand<\/a> and <a href=\"https:\/\/www.newyorker.com\/magazine\/2020\/06\/08\/how-iceland-beat-the-coronavirus\">Iceland<\/a> have also made it through their first waves and are now essentially coronavirus-free, with very low levels of community transmission and only a handful of active cases currently.<\/p>\n<p>[<em>Get our best science, health and technology stories.<\/em> <a href=\"https:\/\/theconversation.com\/us\/newsletters\/science-editors-picks-71\/?utm_source=TCUS&amp;utm_medium=inline-link&amp;utm_campaign=newsletter-text&amp;utm_content=science-best\">Sign up for The Conversation\u2019s science newsletter<\/a>.]<\/p>\n<p>In the U.S., cases spiked in March and April and then trended downward due to social distancing guidance and implementation. However, the U.S. never reduced spread to low numbers that were sustained over time. Through May and early June, numbers plateaued at <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/coronavirus-us-cases.html\">approximately 25,000 new cases daily<\/a>.<\/p>\n<p>We have left that plateau. Since mid-June, cases have been surging upwards. Additionally, the percentage of COVID-19 tests that are returning positive <a href=\"https:\/\/coronavirus.jhu.edu\/testing\/individual-states\/arizona\">is climbing steeply<\/a>, indicating that the increase in new cases is not simply a result of more testing, but the result of an increase in spread.<\/p>\n<p>As of writing this, new deaths per day <a href=\"https:\/\/www.nbcnews.com\/health\/health-news\/coronavirus-deaths-united-states-each-day-2020-n1177936\">have not begun to climb<\/a>, but some hospitals\u2019 intensive care units have <a href=\"https:\/\/www.newsweek.com\/texass-largest-hospital-reaches-100-percent-icu-capacity-1513481\">recently reached full capacity<\/a>. In the beginning of the outbreak, deaths often lagged behind confirmed infections. It is likely, as Anthony Fauci, the nation\u2019s top infectious-disease specialist said on June 22, that <a href=\"https:\/\/www.washingtonpost.com\/health\/coronavirus-deaths-lag-behind-surging-infections-but-may-catch-up-soon\/2020\/06\/24\/22263b50-b620-11ea-a510-55bf26485c93_story.html\">deaths will soon follow the surge in new cases<\/a>.<\/p>\n<figure class=\"align-center zoomable\"><a href=\"https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\"><img src=\"https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" sizes=\"(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\" srcset=\"https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/344632\/original\/file-20200629-155303-f53zoh.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w\" alt=\"\" \/><\/a><figcaption><span class=\"caption\">After months of strict social distancing rules, New York has reduced its new cases to a fraction of what they were in April and is still being cautious.<\/span><br \/>\n<span class=\"attribution\"><a class=\"source\" href=\"http:\/\/www.apimages.com\/metadata\/Index\/NYC-enters-Phase-2-Reopening-6-26-20\/0d49884b9787416b92c0e5607d154fa4\/128\/0\">John Nacion\/STAR MAX\/IPx 2020\/AP Images<\/a><\/span><\/figcaption><\/figure>\n<h2>Different states, different trends<\/h2>\n<p>Looking at U.S. numbers as a whole hides what is really going on. Different states are in <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/coronavirus-us-cases.html\">vastly different situations right now<\/a> and when you look at states individually, four major categories emerge.<\/p>\n<ol>\n<li>Places where the first wave is ending: States in the Northeast and a few scattered elsewhere experienced large initial spikes but were able to mostly contain the virus and substantially brought down new infections. <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/new-york-coronavirus-cases.html\">New York<\/a> is a good example of this.<\/li>\n<li>Places still in the first wave: Several states in the South and West \u2013 see <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/texas-coronavirus-cases.html\">Texas<\/a> and <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/california-coronavirus-cases.html\">California<\/a> \u2013 had some cases early on, but are now seeing massive surges with no sign of slowing down.<\/li>\n<li>Places in between: Many states were hit early in the first wave, managed to slow it down, but are either at a plateau \u2013 like <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/north-dakota-coronavirus-cases.html\">North Dakota<\/a> \u2013 or are now seeing steep increases \u2013 like <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/oklahoma-coronavirus-cases.html\">Oklahoma<\/a>.<\/li>\n<li>Places experiencing local second waves: Looking only at a state level, <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/hawaii-coronavirus-cases.html\">Hawaii<\/a>, <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/montana-coronavirus-cases.html\">Montana<\/a> and <a href=\"https:\/\/www.nytimes.com\/interactive\/2020\/us\/alaska-coronavirus-cases.html\">Alaska<\/a> could be said to be experiencing second waves. Each state experienced relatively small initial outbreaks and was able to reduce spread to single digits of daily new confirmed cases, but are now all seeing spikes again.<\/li>\n<\/ol>\n<p>The trends aren\u2019t surprising based on how states have been dealing with reopening. The virus will go wherever there are susceptible people and until the U.S. stops community spread across the entire country, the first wave isn\u2019t over.<\/p>\n<figure class=\"align-center zoomable\"><a href=\"https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\"><img src=\"https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" sizes=\"(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\" srcset=\"https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=337&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=337&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=337&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=423&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=423&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/344634\/original\/file-20200629-155330-davgh7.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=423&amp;fit=crop&amp;dpr=3 2262w\" alt=\"\" \/><\/a><figcaption><span class=\"caption\">The 1918 flu came back with a vengeance after a mutation and lack of preparedness set the stage for tens of millions of deaths during the second wave.<\/span><br \/>\n<span class=\"attribution\"><a class=\"source\" href=\"https:\/\/www.gettyimages.com\/detail\/news-photo\/image-shows-warehouses-that-were-converted-to-keep-the-news-photo\/520830329?adppopup=true\">Universal History Archive\/Universal Images Group via Getty Images<\/a><\/span><\/figcaption><\/figure>\n<h2>What could a second wave look like?<\/h2>\n<p>It is possible \u2013 though at this point it seems unlikely \u2013 that the U.S. could control the virus before a vaccine is developed. If that happens, it would be time to start thinking about a second wave. The question of what it might look like depends in large part on everyone\u2019s actions.<\/p>\n<p>The <a href=\"https:\/\/dx.doi.org\/10.1086%2F592454\">1918 flu pandemic<\/a> was characterized by a mild first wave in the winter of 1917-1918 that went away in summer. After restrictions were lifted, people very quickly went back to pre-pandemic life. But a second, deadlier strain came back in fall of 1918 and third in spring of 1919. In total, <a href=\"https:\/\/www.cdc.gov\/flu\/pandemic-resources\/1918-commemoration\/1918-pandemic-history.htm\">more than 500 million people were infected<\/a> worldwide and upwards of <a href=\"https:\/\/theconversation.com\/compare-the-flu-pandemic-of-1918-and-covid-19-with-caution-the-past-is-not-a-prediction-138895\">50 million died<\/a> over the course of three waves.<\/p>\n<p>It was the combination of a quick return to normal life and a mutation in the flu\u2019s genome that made it more deadly that led to the horrific second and third waves.<\/p>\n<p>Thankfully, the coronavirus appears to be much more <a href=\"https:\/\/doi.org\/10.1016\/j.meegid.2020.104351\">genetically stable<\/a> than the influenza virus, and thus less likely to mutate into a more deadly variant. That leaves human behavior as the main risk factor.<\/p>\n<p>Until a <a href=\"https:\/\/theconversation.com\/what-needs-to-go-right-to-get-a-coronavirus-vaccine-in-12-18-months-136816\">vaccine or effective treatment is developed<\/a>, the tried-and-true public health measures of the last months \u2013 <a href=\"https:\/\/theconversation.com\/this-simple-model-shows-the-importance-of-wearing-masks-and-social-distancing-140423\">social distancing,<\/a> <a href=\"https:\/\/theconversation.com\/masks-help-stop-the-spread-of-coronavirus-the-science-is-simple-and-im-one-of-100-experts-urging-governors-to-require-public-mask-wearing-138507\">universal mask wearing<\/a>, frequent hand-washing and avoiding crowded indoor spaces \u2013 are the ways to stop the first wave and thwart a second one. And when there are surges like what is happening now in the U.S., further reopening plans need to be put on hold.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img loading=\"lazy\" style=\"border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;\" src=\"https:\/\/counter.theconversation.com\/content\/141032\/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\" width=\"1\" height=\"1\" \/><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https:\/\/theconversation.com\/republishing-guidelines --><\/p>\n<p><a href=\"https:\/\/theconversation.com\/profiles\/melissa-hawkins-1116324\">Melissa Hawkins<\/a>, Professor of Public Health, Director of Public Health Scholars Program, <em><a href=\"https:\/\/theconversation.com\/institutions\/american-university-1187\">American University<\/a><\/em><\/p>\n<p>This article is republished from <a href=\"https:\/\/theconversation.com\">The Conversation<\/a> under a Creative Commons license. Read the <a href=\"https:\/\/theconversation.com\/the-us-isnt-in-a-second-wave-of-coronavirus-the-first-wave-never-ended-141032\">original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Melissa Hawkins, American University After sustained declines in the number of COVID-19 cases over recent months, restrictions are starting to ease across the United States. Numbers of new cases are falling or stable at low numbers in some states, but they are surging in many others. Overall, the U.S. is experiencing a sharp increase in [&hellip;]<\/p>\n","protected":false},"author":44,"featured_media":21177,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[42],"tags":[4159,7559,7689,8274,3181,451,4151,7790,8276,2327,8275],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/21176"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/44"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=21176"}],"version-history":[{"count":2,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/21176\/revisions"}],"predecessor-version":[{"id":21191,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/21176\/revisions\/21191"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/21177"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=21176"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=21176"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=21176"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}