In Depth

Coronavirus: what we know about second waves

Boris Johnson is keen to keep lockdown in place to avoid a secondary outbreak

Boris Johnson has signalled that he favours a continuation of coronavirus lockdown measures over alternative plans to ease restrictions, according to reports.

During a two-hour video call on Friday, the prime minister is understood to have told Foreign Secretary Dominic Raab and advisers including Dominic Cummings that his “overriding concern” is avoiding a fresh outbreak of the new coronavirus in the UK.

Lifting restrictions too soon could result in a “second peak” of infections and cause a repeat of stricter lockdown measures, Johnson reportedly warned.

How likely is a second wave?

Cabinet Office Minister Michael Gove and Chancellor Rishi Sunak last week suggested that lockdown measures could be eased once the transmission rate had lowered to below one (meaning each infected person infects fewer than one person, on average).

Raab, who is deputising for Johnson in his absence, is likely to be among those lobbying for restrictions to begin being lifted once the PM returns to Downing Street after recovering from the virus, which put him in hospital for a week.

“He has kept his cards very close to his chest but that will change once the prime minister is back,” an unnamed minister told The Times.

But insiders say Johnson is wary of any action that could prompt a second wave, and is prepared to keep the lockdown in place for much longer.

“It’s a question of how comfortable you are with the virus circulating in the community,” a source told the newspaper. “Everyone wants the rate of transmission to be below 1. But the question is how much lower it should be.”

Professor Carl Heneghan, director of the Centre for Evidence-Based Medicine at Oxford University, said that the effects of lockdown could be more severe than the consequences of allowing the virus to spread.

Speaking to the BBC Radio 4’s Today programme, he said models had often been proved to be “some way out” and that the government had not tested nearly enough people.

“The key is no one has really understood how many people actually have the infection,” he said. “You could do that really quickly with random sampling of a thousand people in London who thought they had the symptoms. You could do that in the next couple of days and get a really key handle on that problem and we’d be able to then understand coming out of lockdown much quicker.

“In fact, the damaging effect now of lockdown is going to outweigh the damaging effect of coronavirus.”

Even when the current lockdown measures end – which won’t be anytime soon – there is a chance they will be reintroduced.

“The idea that we will be rushing to lift measures is a non-starter,” a government source said. “If the transmission rate rises significantly we will have to do a harder lockdown again.”

Viral pandemics often hit in waves. “While second waves and secondary peaks within the period of a pandemic are technically different, the concern is essentially the same: the disease coming back in force,” says The Guardian.

“Other flu pandemics – including in 1957 and 1968 – all had multiple waves. The 2009 H1N1 influenza A pandemic started in April and was followed, in the US and temperate northern hemisphere, by a second wave in the autumn,” adds the paper.

Have other countries prepared for a second wave?

Some European countries have already started lifting some lockdown restrictions, allowing people more freedoms but risking a greater spread of infections.

But even those considering easing measures are trying to avoid a second wave by keeping most lockdown measures in place.

In Germany, where some federal states are relaxing curbs on public life, Chancellor Angela Merkel has warned she is “greatly concerned” the public might let its guard down and there could be a second wave of the virus in the country.

In Norway, pre-schools have opened; primary schools have opened in Denmark; parks and forests are set to open in Poland; and open air markets have reopened in the Czech Republic.

France has indicated that nurseries, primary and secondary schools would reopen on 11 May, while Merkel has said that Germany would consider reopening schools next month.

But French Prime Minister Edouard Philippe said the return would be gradual, The Guardian reports.

“I don’t have answers today … given the barrier rules, it doesn’t seem reasonable that a marriage of say 200 people gathered in a confined place is to be envisaged. For how long I don’t know,” Philippe admitted.

Countries like Singapore, which eased restrictions on the basis it would protect its population with a strong contact tracing system, has seen a sudden resurgence in infections.

“With 1,426 new cases reported on Monday and nine dormitories – the biggest of which holds 24,000 men – declared isolation units, Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly”, says the Guardian.

Justin Lessler, an associate professor of epidemiology at Johns Hopkins University, wrote in The Washington Post in March: “Epidemics are like fires. When fuel is plentiful, they rage uncontrollably, and when it is scarce, they smoulder slowly.

“Epidemiologists call this intensity the ‘force of infection’, and the fuel that drives it is the population’s susceptibility to the pathogen. As repeated waves of the epidemic reduce susceptibility (whether through complete or partial immunity), they also reduce the force of infection, lowering the risk of illness even among those with no immunity.”

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