Second wave of COVID-19: What we can learn from 1918 Spanish flu and why caution fatigue is biggest challenge

Many in India are starting to join millions worldwide in wondering about a potential second wave of COVID-19. The thought usually goes: Isn’t the first wave of COVID-19 enough, and do we really need to worry about a second wave? The answer is yes because it’s not just within the realm of possibility but something that’s highly probable given the deciding factors. In fact, second waves of the pandemic have already reportedly shown up in China and Japan. The SARS-CoV-2 virus first affected China in December 2019, and the nation’s government introduced severe restrictions in the Hubei region (which was the epicentre of the disease) which helped control the disease by March 2020. However, a new wave of infections started in March, which led to newer restrictions being imposed. [caption id=“attachment_8472701” align=“alignnone” width=“640”]  Representational image. Image by fernando zhiminaicela from Pixabay.[/caption] Japan, similarly, witnessed a new wave of infections in April. A study conducted by Japan’s National Institute of Infectious Diseases said at the time that this was due to reinfections from people coming back from Europe and the US. The study also suggested that Japan is likely to witness even a third or fourth wave of the infection if epidemic control measures are relaxed. What is a second wave? So, a second wave is not a theory, but a reality that many nations, which have already crossed the peak of COVID-19 pandemic, might have to grapple with in the coming years (if not months). And this is not the first disease that can have follow-up waves. The 1918-1919 Spanish influenza pandemic had a similar trajectory. The first outbreak occurred in March 1918, which subsided in the summer months. A far deadlier second wave started in the fall months in 1918, followed by a third wave in winter-spring 1919. Fifty million died during the Spanish flu pandemic, and though that flu is not the same as COVID-19, that pandemic does indicate how another one caused by a different virus can pan out. The first wave of COVID-19 has already claimed over 400,000 lives, and most parts of the world haven’t even crossed the first wave’s peak. This is the reason why epidemiologists and researchers are claiming that a second wave of the COVID-19 pandemic can have even more devastating effects. A study published in Disaster Medicine and Public Health Preparedness in May 2020 even insists that governments thinking about easing lockdowns and restrictions right now should also prepare their healthcare systems for the second wave simultaneously. What factors can spur a second wave? There are a number of factors that can lead to the start of a second wave. Weather change, like in the case of the Spanish flu, was considered to be a major factor with the running assumption (even myth) that the coming of summer and humidity would reduce the number of cases. That has clearly not happened. Premature and untimely relaxation in precautionary measures — whether by governments, communities or individuals — is a sure-shot way of paving the way for the second wave, as most studies have indicated. A recent podcast discussion between epidemiologist Marc Lipsitch and JAMA editor-in-chief Howard Bauchner threw light on the fact that though a lot of governments are easing restrictions due to the increasing economic burden, they should also work on imposing non-pharmaceutical interventions and a contingency reclosing plan in case of a second wave. What can you do about it? For individuals and communities, caution fatigue is the biggest challenge. Tiring of restrictions and taking precautions such as hand-washing, wearing masks and staying home, people are relaxing the severe rules they placed on themselves just a few months ago. This recklessness is another way of ensuring that the transmission of COVID-19 continues after the first wave is done. A recent study published in the Proceedings of the Royal Society A indicates that widespread mask use, proper social distancing, compliance with the lockdown and other restrictive measures can help mitigate the risk and intensity of any resurgence of SARS-CoV-2 in the coming months. So, even though your mind might feel like giving up on all safe hygiene practices after months of lockdown, don’t. For more information, read our article on COVID-19 prevention tips for young and healthy people. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.