Mayo Clinic: Second COVID-19 wave during fall, winter ‘an inevitability’

Coronavirus

In this screen grab from video issued by Britain’s Oxford University, a volunteer is injected with either an experimental COVID-19 vaccine or a comparison shot as part of the first human trials in the U.K. to test a potential vaccine, led by Oxford University in England on April 25, 2020. About 100 research groups around the world are pursuing vaccines against the coronavirus, with nearly a dozen in early stages of human trials or poised to start. (University of Oxford via AP)

DAYTON, Ohio (WDTN) – While Ohio is taking steps to begin re-opening its population during the COVID-19 outbreak, infectious disease experts are expecting a second wave of the deadly virus to occur during the fall and winter months.

Dr. Gregory Poland, a Professor of Medicine and Infectious Diseases with the Mayo Clinic told WDTN.com on Tuesday that a second wave would likely occur alongside the normal seasonal influenza outbreak, which could post major challenges to health care systems and the general population.

“I think among those of us who study (infectious diseases), we believe a second wave will be an inevitability,” Poland told WDTN.com.

The major concern Poland has is the first wave of COVID-19 didn’t strike the United States until March. He said by the time the virus began hitting the US the influenza season was 90-95 percent complete. The next wave of the virus would most likely occur during the fall and winter months during the winter influenza season.

“The increased danger is influenza and COVID-19 would this time overlap in timing and their symptoms overlap exactly,” Poland said. “You have a double whammy because many won’t know what’s going on. Is it the flu? Is it COVID-19? Is it both?”

Poland said the second wave of COVID-19 would occur as the virus circulates the globe. As the southern hemisphere enters its fall and winter months, the virus is now hitting below the equator with countries experiencing their first wave of the virus.

“The overall reason is so many people remain susceptible,” Poland said. “It’s already starting now as they move into fall and winter in the Southern Hemisphere. As we come into our winter, it will just recirculate. This is the normal way viruses travel.”

Whether COVID-19 becomes seasonal is a question Poland said medical experts don’t have an answer for. He said the flu mutates rapidly from season to season. Poland said influenza viruses tend to mutate more than coronaviruses, but it would take at least two seasons to determine if COVID-19 would become a regular seasonal virus.

How the U.S. needs to prepare for second wave of COVID-19

“The concerns are, 1. do we have surge medical capacity? 2. can we replenish our Personal Protective Equipment (PPE), 3. Can we get people to take the influenza vaccine because there will be panic and concerns over what these symptoms mean if you or loved ones start having them,” Poland said.

There are also questions as to how bad a second COVID-19 wave would affect the population. Because coronaviruses mutate slower than influenza viruses, no one has the answer: Poland said there’s a chance the second wave could be worse, it could be the same as the first or it could be less severe.

Preparing for the second wave would mean the U.S. along with other countries would have to learn from failures and successes from the first wave.

“What we have to do is strip away denial and the second is to institute the lessons we just learned the last three months,” Poland said. “We’re going to have to have a plan to phase back in during the summer months and a plan to phase back out during the fall and wintertime. Hospitals will have to be prepared. People will also be prepared – it’s been recommended since 9/11 that people should have sufficient supplies in their home for 30 to 60 days.”

Poland said another major issue is a simple one – handwashing.

“The problem is I have never – and I mean ever – seen a layperson wash their hands properly,” Poland said. “The problem is psychological or behavioral, people just believe they know how to do it right.”

Mayo Clinic’s Dr. Gregory Ramey shows Jimmy Kimmel how to wash his hands

Poland said the U.S, would have to become more of a mask-wearing society as Asia has become in recent decades. The country would also have to learn to use telecommunications regularly, especially for people who can work from home and for those who will need to continue schooling at home.

He said the biggest concern for himself and other infectious disease experts are vaccines. Poland said 70-80 percent of younger adults in their 20s and 30s don’t get their flu vaccine every year, even though the recommendation from every major healthcare entity since 2010 has been for people six months and older to get a flu vaccination every year. For the population most at risk of catching the flu, their vaccination rate is 50 percent.

“They could move that whole epidemic off the table by getting the flu vaccine,” Poland said. “That could be a major impact, just if older people and people susceptible to get vaccines against the flu and pneumonia, but it’s a very difficult thing to imagine, because even where we have good science people don’t act on it. Maybe they will out of fear due to COVID-19, but we don’t know.”

Countries find mistakes comes at tremendous cost

Sweden’s attempt at herd immunity has set it apart from its European neighbors. The country didn’t have a mandatory lockdown and relied on the population to administer best practices. The result has been over 2,800 deaths in a country of 10 million people. Neighbor Finland, with 5 million people, has 240 deaths, thanks to a steady stock of PPE, medical equipment and an aggressive lockdown policy.

With unemployment mounting in the United States at record levels, frustration has boiled over for many in the country. There have been protests at state capitals, including in Ohio. Some pointed to Sweden’s policy as an alternative to the current shelter-in-place order in Ohio, but the Swedish model has come with a cost.

“I would tell people to look at the letter by a number of Swedish physicians in Stockholm, where the hospitals are about ready to break,” Poland said. “They are at close to 3,000 deaths, Finland next door is at 280. You can do it their way but you pay a terrible human cost.

We’re going to have to have a plan to phase back in during the summer months and a plan to phase back out during the fall and wintertime

Dr. Gregory poland, mayo clinic

Poland said England tried the herd immunity approach but recognized early it wasn’t working and instituted lockdown measures. He said Japan successfully started to ease down from its surge, but opened schools too early and saw a resulting spike.

He said people, some governments and different officials have made decisions about planning when they don’t have the necessary information.

“We live in a funny culture where people think they know (how it will work out),” Poland said. “The only way we know anything about this epidemic is in the percent that end up going to get medical care. We know next to nothing about community transmission. The numbers you see today aren’t a reflection of what’s happening today, ut a reflection of what happened 14 to 28 days ago. You have a lag period and you have to wait until you supress these cases and wait another 14-28 days to sound the all-clear.”

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