Upcoming Coronavirus Third Wave
The Issue
This Blog addresses three questions:
- When do infectious disease specialists expect the coronavirus third wave to occur, here in Canada and elsewhere?
- Will it be as punishing as the infection rate waves that have preceded it?
- Finally, why won’t putting the vaccine in citizens’ arms affect its duration and impact?
An Imminent Wave Three
What is the third wave? A common benchmark used since the COVID-19 pandemic appeared last January is the flu pandemic of 1918-1919 that swept the world in three waves — killing an estimated 50 million people (COVID-19 has killed 2.5 million people so far). Dubbed the Spanish Flu (because Spanish media were free to report on the sickness as they were not under First World War press censorship,) the first wave began in spring 1918 — as the German Army began its last offensive on the Western Front — and peaked in June. The first wave stabilized over the summer, then the virus surged again in the fall. This was the second and deadliest wave of sickness — unlike COVID-19, it was generally worse for young people. A third wave came in the winter of 1918/1919 and by summer the disease had mostly died out.
Why is it more dangerous? Colin Furness, an infection-control expert working at the University of Toronto, is quoted as saying that data showing cases of COVID-19 dropping across the world is hiding something worrisome. He said that while cases of regular COVID-19 were dropping very fast, the proportion of more dangerous variant COVID-19 cases are on the rise. “While that rise has not been noticed yet, it will be soon, given the variants are of concern because they are more contagious,” he said. It’s vital to also keep in mind that a coronavirus infection doesn’t have a binary outcome—that is, people don’t either fully recover or die. Many of those who survive their initial bout with the disease go on to experience mysterious and sometimes disabling symptoms for months.
When will it hit and how long will it last? “Sometime in the next few weeks we are going to see the numbers come up. April is going to be an unpleasant month for us.” On the brighter side, Furness said the wave would be steep and short-lived as the weather gets warmer and vaccinations pick up in speed across Canada. “I expect summer solstice and Canada Day to be a time where we can celebrate a lot. Not life back to normal, but definitely moving in that direction.” He thinks that by the summer solstice (June 21) things should be returning to normal.
Can vaccines beat it? Wave three presents the distinct risk of an explosive new rise in the number of cases, testing positivity rates, and hospitalizations. Israel has been not only a learning ground for the successful deployment of mass vaccination but also the cautionary tale that vaccines are not a silver bullet. With more than 50 per cent of the population inoculated, that country is still in lockdown. Its hospitals and ICUs are still at capacity. A leading Israeli health officer has noted that the introduction of the British strain has been a negative game-changer for Israel. The vaccines have been a big success, but they are not enough to curb the rise in contagion brought by the mutation. “The danger confronts any country that chooses a primarily vaccine‐reliant policy before COVID‐19 is finally vanquished.” This is a crucial lesson for Ontario as the B117 variant, first identified in the United Kingdom and the one creating havoc in Israel, will likely become the dominant strain in Ontario.
Conditions Accompanying and Promoting Wave Three
Certain news reports speak of America and Europe as already entering into their third nationwide surge in COVID-19 cases — what some are calling a “third wave” — with reported cases hitting a record high of more than 100,000 new confirmed cases in the US in one day.
Paradoxically, a slow vaccination roll-out and the risk of major outbreaks of fast-spreading variants already identified here and elsewhere could (and should) make any easing of restrictions more difficult, precisely when some governments are poised to do just that. Infectious disease specialists point to a number of factors that will drive the timing, duration and effect of a third wave of COVID-19. These include:
- the emergence of more contagious variants of the disease that pose a distinct risk of an explosive rise in the number of cases, positive testing rates, and hospitalizations
- continuing failure of public-health officials to implement targeted and comprehensive testing and tracking linked to quarantining like that found in other countries like South Korea, Thailand and Japan
- Hospital beds left free by an inoculated over‐70 years of age population such as in Israel are being filled by the under‐50 population
- failure to selectively restrict travel from and between high infection rate regions
- workplaces (food processing, warehouses, post offices, abattoirs) where strong, recommended health measures are still not being implemented
- lack of provincial support for sick pay for self- isolating workers (despite funds from Ottawa under the Safe Restart Agreement sitting unused in provincial treasuries)
- stronger emergence of more complacency among us as “pandemic fatigue” sets in
- Europe and North America have failed to learn from Asia about targeted adaptation strategies.
As argued in EthicScan Blog A No-End to COVID Scenario (February 8) we may not achieve herd immunity in this country or the vanishing of the virus globally for months or years. In a globally interconnected world, several experts believe that the coronavirus is better understood as a chronic condition, not a conquerable illness. In all of known, recorded human history, we have treated infection, plague or leprosy by isolating only the sick. With coronavirus, however, we’ve implemented comprehensive, reactive workplace and school lockdowns that have indiscriminately punished and isolated the well and the sick together.
Global Variations and Timing
As the map shows, many parts of North America (the United States), South America (Brazil), Europe (Great Britain, Spain, France, Germany, Greece, and Italy) and Asia (Iran, Russia, and India) are seeing worrying rises in confirmed COVID-19 infections as authorities grapple with (a) outbreaks, (b) too short a time for lockdowns to reduce inter-personal contact cases, and (c) the spread of more virulent, infectious variants of the virus. This is occurring despite the number of new, contagious infections falling dramatically in some parts of several regions.
Human Agency
What’s happening now with this third wave, say epidemiologists, is not a result of how the virus treats humans, but rather how humans are treating the virus—that is, how we test for it, how we avoid it and how we combat it.
Our provincial and territorial governments have administered less than 3 per cent of the 14.5 million rapid virus tests purchased and supplied. The federal government has purchased enough vaccines for five times our population only to realize that depending on foreign vaccine manufacturers has made us vulnerable to vaccine supply constraints of our own making.
Experts caution that we should not allow vaccines to distract us from this potentially devastating third wave. The prospective impacts of that third wave likely will include:
- potential to set provinces’ and territories’ COVID-19 fight back weeks or months due to the slow rollout of vaccines (caused by federal government supply problems)
- the worrisome characteristics of some of these new COVID variants, which appear to challenge our assumptions about transmissibility (such as two‐metre distancing, 15 minutes of exposure, and use of regular cloth masks)
- further stress on burnout of front line workers.
Conclusion
The COVID-19 crisis is far from over, and its imminent third wave is expected to be more dangerous than what we’ve experienced thusfar.
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Further Readings
Doris’ Covid-19 Blog – RNAO’s letter to the premier on the vaccine rollout and the current context:
https://doris-blog.rnao.ca/post/rnaos-letter-premier-vaccine-rollout-and-current-context
Vancouver Sun – Will a third wave of COVID-19 hit B.C.? Five things you need to know:
https://www.msn.com/en-ca/news/canada/will-a-third-wave-of-covid-19-hit-bc-five-things-you-need-to-know/ar-BB1e6jS3
The Star – Experts raise alarm over a possible third Covid-19 wave:
https://www.the-star.co.ke/news/2021-02-28-experts-raise-alarm-over-a-possible-third-covid-19-wave/
EthicScan Blog – A No-End to COVID Scenario:
http://ethicscan.ca/blog/2021/02/08/a-no-end-to-covid-scenario/
Money Control – COVID-19 crisis far from over, third wave to be more dangerous: CSIR official:
https://www.moneycontrol.com/news/coronavirus/covid-19-crisis-far-from-over-3rd-wave-to-be-more-dangerous-csir-official-6585751.html
Time – U.S. COVID-19 Cases Are Skyrocketing, But Deaths Are Flat—So Far. These 5 Charts Explain Why:
ttps://time.com/5903590/coronavirus-covid-19-third-wave/
Vox – America’s third Covid-19 surge, explained:
https://www.vox.com/21523039/covid-coronavirus-third-wave-fall-winter-surge
DW – Coronavirus: WHO warns of COVID-19 third wave, says Europe failed to learn from Asia:
https://www.dw.com/en/coronavirus-who-warns-of-covid-19-third-wave-says-europe-failed-to-learn-from-asia/a-55690325
The Daily Mail – Merkel admits -‘We are in coronavirus third wave’: Germany is in the grip of pandemic as it defends closing its borders and pleads with population to take AstraZeneca jab:
https://www.dailymail.co.uk/news/article-9291471/Merkel-admits-coronavirus-wave-Germany-urges-population-AstraZeneca-jab.html
CNBC – A tale of two Europes? Covid infections fall for some but others fear a ‘third wave’:
https://www.cnbc.com/2021/02/25/a-tale-of-two-europes-covid-infections-fall-for-some-but-others-fear-a-third-wave.html
IOL – How dangerous will the COVID -19 third wave be?:
https://www.iol.co.za/news/south-africa/how-dangerous-will-the-covid-19-third-wave-be-10f3a3c3-710a-4399-a94e-3efcb731df9e
USA Today -‘It’s like we’re trying our best to help the virus’: A fourth wave is looming if US fails to contain COVID-19 variants, experts say:
https://www.usatoday.com/story/news/health/2021/02/16/covid-19-us-fourth-wave-variants-coronavirus/4460958001/
David has provided ethics training, advice and research for over 200 clients both internationally and in Canada who collectively employ over 750,000 employees. He consults and trains widely with a variety of clients, including corporations, industry associations, public service sector organizations (integrity commissions, human rights commissions, and anti-corruption tribunals social agencies, professional ethics certification organizations, not-for-profits; and civil society organizations.
- Upcoming Coronavirus Third Wave - March 3, 2021
- An Immoral Side Of COVID - February 24, 2021
- International Tourism, Sustainable Travel and the Pandemic - February 15, 2021