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History of SARS, flu a guide to whether coronavirus will have a second wave

Posted April 23, 2020 6:15 p.m. EDT
Updated April 23, 2020 6:23 p.m. EDT

The head of the United States Centers for Disease Control and Prevention predicts COVID-19 could come back stronger and deadlier in the fall. Coinciding with the start of the traditional flu season, the novel coronavirus would create a massive strain on the medical system.

"We can not allow a new wave to occur," says Dr. Mark Cameron, an immunologist and clinical researcher at Case Western Reserve University in Ohio. Cameron lived through a pandemic and a second wave while working at Toronto General Hospital during the SARS outbreak in 2003.

Cameron says the second wave of that virus happened in a matter of weeks, when Toronto officials eased restrictions too fast, particularly with the use of personal protective equipment by medical workers. SARS, which is also a coronavirus, can provide us with a history lesson on how to deal with our current virus.

"If you take these measures off too early the virus gets a chance to re-emerge, and the impact is devastating," says Cameron.

Whether COVID-19 makes a comeback because restrictions are lifted too quickly or it makes a comeback as a seasonal issue like the flu is tough to predict.

The 1918 Spanish Flu pandemic came in three waves: the spring of 1918, the fall of 1918 and the winter of 1918. In that instance, the second wave was the deadliest, and the third wave lasted until the summer of 1919. That outbreak happened during World War I and shared one similarity with how we live, "It was around a two-year pandemic, and what factored into that pandemic, like modern times, was travel," according to Cameron.

While the past shows us pandemics can come in waves, this one is more of a challenge to scientists.

"There is still so much we don’t know," says Dr. Pia MacDonald, an epidemiogist who works for the Research Triangle Institute in the Research Triangle Park. She’s not convinced COVID-19 will come in waves, "I wouldn’t even use the word comeback. It’s here," she told us.

MacDonald says we continue to learn from COVID-19. What is frustrating to experts is answers we think know one week about the virus are proven wrong a couple of weeks later.

"I’m very nervous," says MacDonald about the current pandemic. She adds, "There are a lot of questions out there that keep me up at night."

Both MacDonald and Cameron say COVID-19 is unlike anything we’ve seen before. The reason: people can have the virus, have no symptoms and spread the virus unknowingly. "COVID-19 is writing its own story," says Cameron.

Scientists disagree on whether we’ll see waves of this coronavirus or that it simply will become part of our "new normal" until a vaccine is found. However, they do agree current restrictions need to be lifted slowly and carefully and not until the new case counts start dropping over a long period of time.

"When we do think about lifting the social distancing, the one thing we know is working, when we lift that, do we have the necessary resources in place to manage what comes next?" says MacDonald on how we move forward and try to reduce the chance of massive, second wave.

Cameron, relying on history with SARS, says we can’t let history repeat itself with this coronavirus.

"We have to avoid a second wave. It is absolutely critical, because if one emerges anywhere in this country the clock is reset to zero," he said.

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