COVID-19 Is a Second Wave inevitable?

[Pete W.]

Apr 13, 2020

Dr. Mobeen discusses immunity and when lockdowns are lifted, different approaches to the management of the pandemic after an introduction describing how herd immunity works. Notably the locked down flattened curve approach is also a progression toward her immunity as well as future vaccines. He also discusses the use of prophylaxis to slow the the progression of the disease itself once contracted by an individual and if effective could enable the body to better develop stable immune response.

Mobeen Syed M.D, MS graduated from King Edward Medical University (Pakistan) in 1994. After practicing clinical medicine for a few years, he continued his studies in Computer Science with the goal of merging innovative technologies and healthcare. Dr. Mobeen's dedication for teaching began at Horizon Medical Institute, where he and his world-renowned brother Dr. Najeeb, focused on teaching basic sciences to medical students.

[toomuchbaloney]

I think that we need to get our testing up to speed. We can encourage people to resume public interactions, employing social distancing, and good hand and public space hygiene...when the community spread is on a clear trajectory downward. We must continue to explore early dx treatment plans. We need to better understand what type of immunity is achieved after infection in order to seriously contemplate herd immunity without vaccine.

I sure hope the vaccine is more effective than the seasonal influenza vaccine. More like measles would be great.

[turtlesRcool]

I think a second wave is inevitable as long as there are people out there who are actively working against reasonable efforts to contain the viral spread.

People who refuse to wear masks, social distance, etc., and harass others who do practice precautions - those are the people I fear.

If we all do our honest best to limit spread, we can likely keep the transmission down to rates our medical system can absorb. We can't stop the spread, but we can keep the curve flattened.

So, no I don't think it's technically inevitable that we will have a second wave, but I do think it's realistically inevitable that we will have a second wave because people just don't want to limit their "freedoms."

[A Hit With The Ladies, BSN, RN]

Even if it were inevitable, there's no point in fussing about it. What would you do if there were a second wave? Close down for yet another month or two? Then you'd have a third wave after that ended. Et cetera et cetera et cetera.

[toomuchbaloney]

3 hours ago, A Hit With The Ladies said:

Even if it were inevitable, there's no point in fussing about it. What would you do if there were a second wave? Close down for yet another month or two? Then you'd have a third wave after that ended. Et cetera et cetera et cetera.

Are you trying to comprehend or explain the human experience with a novel contagion for which there is no vaccine or natural immunity? Approximately 1.6 million Americans have been proved to have this infection and that had resulted in almost 100,000 deaths in but a couple months. How many deaths will accompany 5 million infections or 15 million or 50 million.

It sounds like you are advocating ignoring the benefit and efficacy of slowing spread with common sense measures like social distance, facial coverings and improved hygiene. Are you recommending that millions of Americans should ignore the dangers of this virus...yep, it seems you are. Was public health studies a portion of your nursing degree?

[turtlesRcool]

4 hours ago, A Hit With The Ladies said:

Even if it were inevitable, there's no point in fussing about it. What would you do if there were a second wave? Close down for yet another month or two? Then you'd have a third wave after that ended. Et cetera et cetera et cetera.

There's absolutely a point in "fussing about it." We're in health care because we want to save lives and preserve quality of life. When there's a threat to public health, looking for ways to mitigate the impact is exactly what we do.

For the first wave, we were caught way unprepared - not nearly enough PPE, testing, etc. Some of the assumptions we made about comorbidities and treatments turned out to be wrong, so we're adapting to the ways we treat patients, too.

When the second wave comes, I think we will shut down again, though not to the extent we shut down this time. Shut downs will probably be more localized, and we'll be able to use testing and contact tracing to better focus our efforts. The total shut down was a very blunt tool, akin to taking a sledge hammer to the problem; it was generally effective at its purpose, but it did a lot of damage, too. The longer this goes on, and the more we learn, the better we'll be able to react with more precise tools.

Our focus needs to be on creating a "new normal" that focuses on sustainable risk reduction measures. It would be a disaster to just go back to the old normal. Part of that preparedness is being able to respond quickly to a second wave and nip it in the bud so we don't see another outbreak like the one in the NY metro area. The faster we act at each local flare up, the shorter and less disruptive the shutdowns.

[Guest219794]

22 hours ago, A Hit With The Ladies said:

Even if it were inevitable, there's no point in fussing about it. What would you do if there were a second wave? Close down for yet another month or two? Then you'd have a third wave after that ended. Et cetera et cetera et cetera.

100%

This is why fussing is not part of a well coordinated pandemic response plan.

But- you know that.

Using the word "fussing" is a great way to manipulate the conversation, much like claiming that people who take precautions to protect others are cowards.

To those responding- look at the post history before you spend much time trying to have an actual conversation.

OP- I don't know about "inevitable", but it is certainly highly likely. And a good topic for discussion among nurses.

[toomuchbaloney]

4 hours ago, hherrn said:

100%

This is why fussing is not part of a well coordinated pandemic response plan.

But- you know that.

Using the word "fussing" is a great way to manipulate the conversation, much like claiming that people who take precautions to protect others are cowards.

To those responding- look at the post history before you spend much time trying to have an actual conversation.

OP- I don't know about "inevitable", but it is certainly highly likely. And a good topic for discussion among nurses.

I suspect that many, like myself, aren't expecting engagement or discussion from our responses. It's simply necessary to correct the flawed and irresponsible opinions as a matter of routine.

Yes, we do need to discuss what this is going to look like in the autumn.

[A Hit With The Ladies, BSN, RN]

23 hours ago, turtlesRcool said:

There's absolutely a point in "fussing about it." We're in health care because we want to save lives and preserve quality of life. When there's a threat to public health, looking for ways to mitigate the impact is exactly what we do.

For the first wave, we were caught way unprepared - not nearly enough PPE, testing, etc. Some of the assumptions we made about comorbidities and treatments turned out to be wrong, so we're adapting to the ways we treat patients, too.

When the second wave comes, I think we will shut down again, though not to the extent we shut down this time. Shut downs will probably be more localized, and we'll be able to use testing and contact tracing to better focus our efforts. The total shut down was a very blunt tool, akin to taking a sledge hammer to the problem; it was generally effective at its purpose, but it did a lot of damage, too. The longer this goes on, and the more we learn, the better we'll be able to react with more precise tools.

Our focus needs to be on creating a "new normal" that focuses on sustainable risk reduction measures. It would be a disaster to just go back to the old normal. Part of that preparedness is being able to respond quickly to a second wave and nip it in the bud so we don't see another outbreak like the one in the NY metro area. The faster we act at each local flare up, the shorter and less disruptive the shutdowns.

All of that sounds sensible on paper, but is politically not feasible. The economy cannot run on shutdown after shutdown, and people quite frankly are over it. Burnt out. People aren't going to put up being treated like lab rats in a science experiment, and will ignore any new quarantines, whether hell or high water.

[toomuchbaloney]

3 hours ago, A Hit With The Ladies said:

All of that sounds sensible on paper, but is politically not feasible. The economy cannot run on shutdown after shutdown, and people quite frankly are over it. Burnt out. People aren't going to put up being treated like lab rats in a science experiment, and will ignore any new quarantines, whether hell or high water.

That sounds like panic. What is the source of the fear and anxiety? There is a good bit that is not feasible in Trump's irresponsible focus upon congregating people in the middle of a pandemic...politically or otherwise.

How are people being treated like lab rats in a science experiment? Are you referencing things like meat packing plants and crowded community pools...are those the science experiments?

Yes, the "hell or high water" folks are the reason that we have continued preventable spread of this virus. They are a selfish but sizeable minority. It's like they won't be convinced that this pandemic is worth some personal sacrifice until a million Americans die.

[herring_RN, ASN, BSN]

19 hours ago, A Hit With The Ladies said:

All of that sounds sensible on paper, but is politically not feasible. The economy cannot run on shutdown after shutdown, and people quite frankly are over it. Burnt out. People aren't going to put up being treated like lab rats in a science experiment, and will ignore any new quarantines, whether hell or high water.

Can you give us examples of where you want to go and what you want to be able to do that would make you feel better?

[Nurse SMS, MSN, RN]

On 5/24/2020 at 8:07 PM, toomuchbaloney said:

That sounds like panic. What is the source of the fear and anxiety? There is a good bit that is not feasible in Trump's irresponsible focus upon congregating people in the middle of a pandemic...politically or otherwise.

How are people being treated like lab rats in a science experiment? Are you referencing things like meat packing plants and crowded community pools...are those the science experiments?

Yes, the "hell or high water" folks are the reason that we have continued preventable spread of this virus. They are a selfish but sizeable minority. It's like they won't be convinced that this pandemic is worth some personal sacrifice until a million Americans die.

I think it is a panic, primarily because in general Americans lack resilience, lack adequate savings, don't tend to live within their means, are massive consumers and carry debt as a matter of normalcy. This makes them an easy audience to convince that this is "no big deal", as they are facing a level of financial readjustment that is beyond anything they have ever known. To these individuals, the economic downturn isn't something they can survive. They are vulnerable to convincing because the struggle is real. So the vocal minority casts out their conspiracy theories and false information, deny reality and otherwise convince the struggling masses that this can all just magically go away.