In Depth

Is Britain prepared for a second wave of coronavirus?

Scientists say the government has made serious progress - but more action is needed

Packed parks and beaches and the prospect of an alcohol-fuelled “super Saturday” when pubs reopen next week have sparked predictions of an impending surge in coronavirus infections.

Although reports of new Covid-19 cases currently remain in decline, “health leaders are calling for an urgent review to ensure Britain is properly prepared for the ‘real risk’ of a second wave”, The Telegraph reports.

Second wave - or more of the first?

While the term is widely used, “the concept of a second wave is flawed”, says Jeremy Rossman, a senior lecturer in virology at Kent University.

“We are not between waves,” he explains in an article first published on The Conversation. “We have new cases in the UK every day. We are in an ebb and flow of Covid-19 transmission that is continually affected by our precautionary actions.”

A true second wave is more likely to come in the winter, says England’s Chief Medical Officer Chris Whitty. That’s when respiratory infections spread more easily - and also, unfortunately, when the NHS is under most strain.

“It is entirely plausible for a second wave to actually be more severe than the first if it is not mitigated,” Whitty said last month. “Every country has got an extremely difficult balancing act, and we all need to be honest about the fact there are no easy solutions here.”

However, says Rossman, “we should not fear an inevitable second wave”, but instead act now to prevent or contain it.

Test and trace

In an open letter to ministers published in the British Medical Journal this week, health leaders including the presidents of the royal colleges of surgeons and nursing called for an acceleration of planning to deal with a flare-up of Covid-19 cases.

“Many elements of the infrastructure needed to contain the virus are beginning to be put in place,” the letter said, “but substantial challenges remain.”

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One such challenge is the contact-tracing app, which last week was shelved until autumn at the earliest. 

The UK has implemented other systems for tracking new outbreaks, however.

A manual contact-tracing programme launched on 28 May has succeeded in contacting 113,925 people to warn them that they have come into contact with someone infected with the new coronavirus, according to the Department of Health. This figure represents 89% of a total 128,566 identified as recent close contacts of the 21,105 people who tested positive for Covid-19.

But worryingly, more than one in four people with the virus have not been reached to provide details of their contacts.

Latest figures show that of 6,923 people who tested positive for coronavirus in England last week, the system failed to reach almost 30%. To put that another way, “2,054 people with the virus – and potentially thousands of their close contacts – could not be traced”, says The Independent

Scientists have described the statistics as “worrying” and said the problem “could only be solved with better cooperation from the public - not by the government”, reports the Daily Mail.

Nevertheless, even an imperfect system will disrupt chains of infection and limit the spread of Covid-19. “Government experts believe with the testing-and-tracing system in place, the virus can continue to be suppressed,” says BBC health correspondent Nick Triggle.

Handwashing and masks

By the time the UK government launched public health campaigns to encourage frequent hand-washing and avoid shaking hands, in late February, the virus was already in widespread circulation. If we now see another rise in infections, better standards of basic hygiene this time around may slow the spread of the virus.

“By keeping the importance of handwashing and cleaning surfaces in mind, we can help prevent the spread of infection as the country opens back up, and hopefully prevent a second wave of infections,” says Dr Rodney Rohde, a virologist and clinical laboratory expert, in an article for Forbes.

Although the scientific debate about masks has yet to reach any definitive conclusions, a growing number of researchers are also advocating their use.

“Wearing masks is a good idea and I don't know why we’re not pushing it more,” Professor Sian Griffiths of Staffordshire University told The Sun. “We need leaders out there wearing masks to encourage the public to do so.” 

Face coverings are now mandatory on public transport in England, but Griffiths said people should be wearing them more widely “as part of basic measures to get the virus down”.

Vaccines and treatments

The most effective way to prevent a second wave of coronavirus infections would be to create, distribute and administer a vaccine that works.

A potential vaccine developed by researchers at Oxford University is “considered one of the world’s best hopes for a lasting solution to the Covid-19 pandemic”, says CBS News - but even if trials are successful, the drug is unlikely to go into widespread use before the end of the year.

Until then, doctors will focus on better treatments for Covid-19. Drugs such as remdesivir and dexamethasone will not prevent a second wave of cases, but are expected to reduce the death toll and speed the recovery of people infected with the virus.

Hospital capacity

One of the big fears at the start of the pandemic was that the NHS would be overwhelmed by coronavirus patients, but the Nightingale hospitals - combined with lower-than-expected demand for intensive care beds - kept the health service well within capacity.

The seven emergency facilities, which between them provide more than 10,000 beds, have now been mothballed, but they could be reactivated at short notice. 

“Ministers have already said that the temporary Nightingale Hospitals set up in case the NHS was overwhelmed by Covid-19 cases will remain on standby over the coming months,” The Telegraph reports.

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