Experts expected a second wave of Covid-19 to arrive by the fall, and those expectations were met – at least at first glance. After a relative lull in most countries in July-August due to the implementation of unprecedented restrictive measures, statistics for new cases of coronavirus infection began to rise dangerously in mid-to-late September, soon surpassing the spring peak several times over. As the first wave of the pandemic became a tsunami, claiming at least half a million lives in three months (from April to June) and nearly destroying the health systems of even the wealthiest countries, authorities around the world have begun to reintroduce the strictest restrictions that had been lifted just a few months ago. If the main burden of the pandemic initially fell on the metropolises, the infection has now reached the provinces. For cities and other settlements further away from major transportation centers, the “second wave” of the epidemic has actually become the first.
“If in the spring people in many regions of Russia read about the pandemic mostly on the Internet and saw it on television, then in the fall the virus arrived there (photo – Barnaul)”. Many countries have given local and regional authorities the right to decide for themselves what quarantine measures are necessary to prevent overcrowding in hospitals and to minimize the inevitable economic damage. In the United Kingdom, for example, the “traffic light” system includes three levels of restrictions: the severity of the measures taken depends on the authorities’ assessment of the coronavirus threat. The highest, third tier of restrictions was only introduced in Liverpool and Lancashire. This means that bars and entertainment venues were closed, casinos, gaming clubs and bookmakers were shut down. Schools and public transportation will continue to operate, but the public is urged to walk or ride bicycles and not to cross the borders of “high risk zones” unless absolutely necessary. Indoors, residents are prohibited from meeting with anyone other than those who live under the same roof. And even outdoors, more than six people can gather in one place only if social distancing measures are observed. Since last Friday, nearly three million more people have been subject to similar restrictions, despite the active opposition of Greater Manchester Mayor Andy Burnham. With the support of local councils, the mayor openly confronted the country’s government and Prime Minister Boris Johnson personally – and as a result, Westminster was effectively forced to impose an unpopular decision against the will of local residents.
Manchester Mayor Andy Burnham has been dubbed the “King in the North” by local residents, drawing an analogy to the character Robb Stark from the Game of Thrones series who refused to submit to the new monarch of Westeros. Whether London’s plan to tame rebellious Manchester will work (in other words, whether the conflict will end amicably) is still not very clear. After all, if the authorities’ prescriptions depend primarily on their assessment of the risk to the health system, then compliance with the quarantine measures is more likely to depend on how high the threat of the epidemic is perceived by the city’s residents themselves. And these assessments can vary widely. One of the main reasons for the reintroduction of restrictions – not only in Liverpool, but worldwide – is statistics showing a sharp increase in Covid-19 infections over the past month. In the same United Kingdom, for example, in the first half of October, more than 15 thousand new cases of coronavirus infection were diagnosed every day (by the end of the third week, this figure even exceeded 25 thousand) – the spring-summer peak barely exceeded 6 thousand new diagnoses per day. However, despite this sharp increase, the number of COVID patients in hospitals-severe cases of infection in which a patient requires professional medical care-is currently much lower in the country than at the peak of the first wave.
We explain quickly, simply, and clearly what happened, why it matters, and what will happen next. The number of offers should remain: Episodes The End of History Podcast Advertisement If in spring almost 20 thousand beds in the UK were occupied by patients with a confirmed diagnosis of Covid-19, by mid-October this indicator was three and a half times lower. A similar situation is observed in France: the number of confirmed Covid-19 infections is several times higher than in the first wave, while the number of patients in hospitals is much lower. Even more telling is the gap between the surge in new infections and the number of deaths from the virus – although this statistic lags about two weeks behind the diagnosis, and only three weeks have passed since the beginning of the “second wave,” so any conclusions here are premature. However, since the beginning of October, the total number of coronavirus victims in the UK has increased by approximately 2,000. At the time of writing, the “peak” of the second wave of the epidemic was on the 21st, when a total of 188 Covid-19 patients died across the country. For comparison, there were eight days in April when a thousand or more people died (see graph below). And in the first three weeks of this spring month, the virus claimed at least 17,000 lives across the country.
The current numbers of virus victims in both the UK and France seem relatively modest by comparison. The situation in Moscow is quite different from that in Western Europe. For example, the number of hospitalized COVID patients has never exceeded the daily statistics of new infections since the beginning of the epidemic. At the end of April, when the number of new diagnoses jumped by almost 3.5 times, the hospital statistics began to fall – and the curves have not yet crossed. Although there are also obvious similarities. The graph also clearly shows the first wave of diagnoses that hit the Russian capital in early May, then a gradual decline, relative calm in the summer, and since the beginning of October – again a sharp and confident growth: the so-called “second wave”.
However, it should be noted that the number of hospitalized patients with Covid-19 – i.e., severely ill patients requiring professional medical care – in September-October was almost half the number in the first wave. From September 14 to October 14, the daily number of newly registered cases of infection in Moscow increased more than sixfold, while the number of hospitalizations increased by only 50%. The statistics of coronavirus deaths in Moscow resemble European graphs, but are much smaller. By this indicator, the second wave hardly differs from the first: the mortality rate has already reached almost 80% of the spring peak and continues to rise.
However, when this graph is superimposed on the image above (with all three curves – diagnoses, hospitalizations, and deaths – on the same scale), the contrast is even more striking. Against the backdrop of several thousand daily registered cases of Covid-19 and hundreds of hospitalized coronavirus patients, which give reason to speak of the first and second waves of the epidemic, the humpbacked curve of daily casualties looks almost like a straight line. You can see both waves on it, but you have to increase the scale considerably – anyone reading this text on a phone or tablet screen can quickly verify this.
It appears that the second wave of coronaviruses is very different from the spring tsunami – and it is most like its “older sister” in that scientists are still struggling to explain many things about it. There are many possible explanations for such an apparent statistical discrepancy – but at least part of the solution may lie in the fundamental change in approach to testing that has been implemented over the past six months. First, the number of tests performed has increased significantly in all countries. In the UK, approximately five to six times more people are being tested each day than in early May. It is not surprising that more people are being detected. In relative terms, however, the number of positive results is much lower than in the spring. If in April there were 200 or even 400 infected people per thousand tests processed, now – during the second wave – there are just over 50. The situation is similar in France.
In Russia, there was also a slowdown in testing in the spring. According to official data, from the beginning of May to mid-October, the number of daily tests performed in the country increased fourfold (up to 400,000). At the same time, the proportion of positive results is currently significantly lower than during the first wave.
Second, during the first wave of the epidemic, tests and reagents themselves were in short supply, so people tried to conserve them. In the UK, for example, only those who went to the doctor with suspicious symptoms were tested. Although scientists had warned as early as March, an infected person is a danger to others even before symptoms appear. And in some cases, the infection may not show up at all. In the spring, it was believed that asymptomatic patients could account for up to a quarter of all infected individuals. By July, this estimate had risen to 40-45%, and according to the latest data, Covid-19 only manifests itself externally in one in four infected individuals. Moreover, even among these (already relatively small) infected individuals, almost a third will present with a common respiratory infection, such as cough and low-grade fever for a few days, without any specific coronavirus symptoms such as loss of smell. At the same time, asymptomatic patients can spread the infection just as successfully: their viral load is no lower than that of other coronavirus patients, and they get sick for about the same length of time – at least according to recent studies.
The third possible explanation sounds rather optimistic to city dwellers. Researchers have a version that residents of large cities with high population density (the epidemic hit them hardest) are better protected against the virus, because a significant part of the local population has already encountered the virus and recovered from it (for example, in London – about 45%). And for the inhabitants of the regions – be it Kurgan or Manchester – the “second wave” may prove to be even more painful, since in these places it has essentially become the first.
In the spring, Moscow entrusted the authorities of Russia’s regions to decide for themselves what restrictive measures they needed – but the pandemic did not reach many federal subjects until the fall. And fourth, experts say the accuracy of the diagnosis leaves a lot to be desired. Several scientific studies have already pointed to the possibility of so-called cross-reactivity. Cross-reactivity occurs when a standard PCR test (which is the primary test used to diagnose Covid-19 worldwide) identifies something as the causative agent of Covid-19 that is not. For example, it could identify another coronavirus that causes the common cold, or even viral fragments that are not capable of infecting the carrier or those around them. In this case, any patient with a common cold risks testing positive for coronavirus – and receiving a diagnosis of Covid-19, with all the resulting consequences for the infected person: quarantine, mandatory self-isolation, etc. According to experts, there are a number of questions regarding the PCR tests used to diagnose Covid-19. After all, the presence or absence of the virus in a particular person is not important: what interests doctors and government officials are the answers to two completely different questions.
Doctors still know very little about both the virus itself and the disease it causes. First – can the virus lead to the development of a serious illness in this particular patient (i.e., does he need medical attention)? Second – is he capable of infecting others. Unfortunately, the PCR test does not provide an accurate answer to any of these questions. Watching government officials around the world try to avoid repeating their own mistakes of the spring, it is hard not to be reminded of Churchill’s attributed aphorism that generals are always ready to win the last war. Or, in this case, the previous wave of Covid-19.
In several cities in Italy, protests against the second lockdown turned into mass riots.
On the one hand, the statistics of two waves of infections in the last six months are so different that it is not really clear how to draw any parallels between them.
On the other hand, over the past six months, the world has managed to adapt to living with the new coronavirus, enduring daily news updates and reports about it. The epidemic began to be taken into account by default. Regardless of future plans, the virus is built into the coordinate system from the outset as an inevitable element of chaos.
Of course, few people think about the fact that only a year ago, the pathogen of the new infection not only had no name, it was not even known to exist. Not surprisingly, in response to the overwhelming majority of questions about the virus, scientists are still shrugging their shoulders and asking to wait another year or two. Carl Heneghan and Tom Jefferson of the Center for Evidence-Based Medicine at the University of Oxford emphasize that “no one knows what the right strategy to combat the new coronavirus infection should be. And, by definition, it cannot be known. In the absence of information, they say, any action to contain the epidemic is like groping in the dark, trying to find a way out of a vast labyrinth.
But each scientific study only adds another example to the great system of equations. With an infinite number of terms and one big unknown. An additional 17,347 cases of COVID-19 infection were identified in Russia. This is the highest daily increase since the beginning of the pandemic. Authorities explain why there is a lack of space to store the bodies of COVID-19 victims. This and other news – in the BBC overview.