June 29, 2020
In brief:
- A second wave is characterized by a sustained rise in infections following the virus being brought under control and cases haven fallen substantially.
- Many health officials within Canada and in other countries believe the second wave to be probable if not inevitable.
- With respect to timing, health officials warn that if measures are relaxed too significantly or too quickly a second wave could occur in late August or early September.
- This upcoming winter is seen as a crucial time. A rise in coronavirus cases would coincide with the start of influenza season, thus, putting greater strain on healthcare systems.
- However, a positive is that health professionals have learned about the virus through the first wave, and will be better equipped to respond to subsequent waves.
After months of strict lockdown measures imposed to contain the spread of COVID-19, many jurisdictions are now beginning to ease certain restrictions as they move into phase 2 or beyond of their restart plans. However, with public health officials warning that lifting restrictions too quickly can lead to a spike in new cases, many are wondering whether a second wave of the pandemic is inevitable. If a second wave were to occur, when should it be expected, what will it look like, and most importantly how can we prepare? Though there remain many unknowns, there are suggested practices to help mitigate the acuteness of the second wave, including the following:
- Easing lockdown measures in stages that can be reversed if there is a spike in cases
- Importance of putting oneself in an anticipatory dynamic rather than a reactive one (this is hindered by ongoing multiple micro-outbreaks including in cities like Montreal).
- Implementing high levels of testing and contact tracing.
- Understanding demographics and health infrastructure in the context of COVID-19 to better respond to surges in cases. This requires quality data collection and clarity on the types of data needed.
- A former president of Doctors Without Borders International would like to see the government set up a civilian reservist workforce that would have the training necessary to move in when the next wave hits.
Canada’s public health officials have concerns about the onset of the second wave. One of the key challenges we face is our ability to trace contacts. Based on anecdotal evidence, the consensus is that contract tracing is not being done in a rapid fashion. In hardest hit cities, such as Montreal, emergency departments remain near or even over maximal capacity which is worrisome given that mitigation measures are being relaxed.
Learning from our first wave, an area of grave concern is long-term care environments. Health officials are warning that we must address the deficiencies within long-term care facilities before a second wave arrives, including lack of training and access to proper PPE.