- Is the US heading for a second wave of coronavirus infections?
- How do you define a ‘second wave’ of infections?
- Are second waves inevitable as states reopen?
- Is it safe to travel to a place – Texas or Florida – that’s having an increase in cases?
- Is it safer to be somewhere New York, where the number of cases is still high but transmission is falling, or somewhere Florida, where there are fewer cases but transmission is on the rise?
- How do we know that a rise in reported cases isn’t simply due to an increase in available tests?
- What is the lihood that second waves in states Texas and Florida will carry over to other states?
- Are you concerned about second waves in cities that have seen protests over recent weeks?
- Are there still concerns that a second wave will happen in the fall?
- Coronavirus Second Wave? Why Cases Increase
- Are the spikes in coronavirus cases due to more coronavirus testing?
- Tracking Coronavirus Surges
- What is herd immunity from the coronavirus?
- Why us again? Italy suffers disproportionate toll in second COVID wave
- DEATHS PER CAPITA
- HEALTH CUTS
- WHO on a coronavirus second wave, lockdowns and how the world responded to the pandemic
- Were we generally underprepared for a pandemic? The WHO was criticized for calling a pandemic too late. How would you respond to that criticism?
- Has there been any difference between countries with a history of pandemics and those that haven't?
- Is it fair to say that there was a bit of confusion about what countries were meant to do? Were you surprised that lockdown became the preferred measure for such a wide range of countries?
- We'll be living with this for years to come? Because the end is not particularly clear
- How much more do we actually know about the virus? And does that mean we're in a better position to deal with things in the next six months?
- How would you assess these warnings of a second wave?
- As we open up economies and schools, is a rise in cases inevitable? How do you weigh those risks?
- There have been rising conspiracy theories around the coronavirus. Is that something that you factor into your advisory?
- And finally, how worried are you about other threats, perhaps more familiar threats rising over the next six months and contributing to more public health disasters?
Is the US heading for a second wave of coronavirus infections?
States and cities across the US are continuing to reopen, despite states such as Texas and Arizona reporting an increase of cases since Memorial Day. These reopenings, along with ongoing protests, have raised concerns about a “second wave” of infections.
How do you define a ‘second wave’ of infections?
Elaine Nsoesie In an epidemic curve, the number of cases go up, peak, and start going down. After that, if you have a consistent increase over a short period of time – some people have been using 14 days – that could be described as a second wave.
David Rubin I think of a second wave as a true recurrence of widespread community transmission. When [places] reopen, you’re going to get some increased transmission, but I don’t think increased transmission alone is a second wave.
It’s becoming fairly clear that there are about four epicenters in the country right now that are starting to coalesce: the south-west, the state of Texas, the state of Florida, and then the lower mid-Atlantic – South Carolina and North Carolina.
Whether it’s a first wave or a second wave following a ripple, these are kind of semantics.
Are second waves inevitable as states reopen?
Rubin No. Certainly increased transmission is, but you can avoid a second wave. Places Colorado are doing extremely well right now [Editor’s note: Colorado’s stay-at-home order expired on 26 April]. Colorado public health folks had good messaging on how people [can adapt] their individual routines and be vigilant around moments of [potential] transmission.
At the end of the day, it comes down to community norms and routines. If everyone is just trying to go back to normal and not face the inconveniences – mask-wearing and avoiding large gatherings – then the risk for a second wave goes up.
Nsoesie There’s a lot happening in the US. Because it’s summer, people are going out, and then you have the protests and all types of gatherings are happening. It looks there’s a very good chance that most states are going to see a second wave.
But it’s not inevitable. New Zealand might be a good example of a place that can reopen safely without experiencing a second wave.
Is it safe to travel to a place – Texas or Florida – that’s having an increase in cases?
Jessica Justman I would certainly think very carefully before traveling to these places. If you go, you would want to be particularly careful with staying 6ft apart from people, hand-washing and not touching your face. All of these things remain really important. You don’t want to be in a place where lots of people are not wearing masks.
Stores in New York have started to open as part of the city’s ‘phase one’ reopening plan, which began on Monday. Photograph: Shannon Stapleton/Reuters
Is it safer to be somewhere New York, where the number of cases is still high but transmission is falling, or somewhere Florida, where there are fewer cases but transmission is on the rise?
Rubin The safest thing now is wearing your mask on the subway, [avoiding] overpacked indoor locations, being discerning about which restaurants you go to, washing your hands.
That’s the safest thing, no matter where you live.
I’ll give a personal example: at the beginning of this epidemic, as we started to understand that temperature and humidity were important to mitigating transmission, we left my 86-year-old mother down in south Florida, because we knew that the first wave came through, it would be safer for her down there.
But as Florida started to reopen, and New York started degrading its case counts, we flew her back up here. I made that decision my knowledge that New York is much safer than other areas of the country right now.
How do we know that a rise in reported cases isn’t simply due to an increase in available tests?
Rubin Take a look at the testing positivity rate. If it’s just about increased testing capacity, your test positivity rate goes down because you’re flooding the market with tests.
Because you’ve had so many tests, the number [of total cases] go up.
So when you see increasing case numbers and decreasing test positivity rates, that suggests the test, and it’s just an artifact of testing capacity.
What is the lihood that second waves in states Texas and Florida will carry over to other states?
Justman There’s much less air travel now, so the chance of a second wave in some states carrying over to other states is lower. Is there total isolation? No, but there’s a lot less travel.
Are you concerned about second waves in cities that have seen protests over recent weeks?
Justman Yes, but the risk of a second wave with the lifting of restrictions and even with the protests may be offset by the fact that more people wear masks.
Rubin The demonstrations occurred outside, and in an area New York City, where you had already degraded your cases pretty significantly, you might see a bump, but I don’t think it will be a second wave. I suspect that areas that have been doing well [at lowering transmission] will continue to do well.
Nsoesie States and cities can be more proactive. Instead of waiting for people to start showing up at hospitals, we could provide resources so that people who’ve been at the protests can get tested early, and if they’re infected, start contact tracing as soon as possible.
Are there still concerns that a second wave will happen in the fall?
Nsoesie We know that we have higher cases of influenza starting in the fall, and that’s one of the reasons why we would expect an increase in [coronavirus transmission] the fall. More people tend to spend time indoors compared to now, when people are out in parks and open spaces.
Justman We’re still trying to figure out how sensitive the virus is to temperature and humidity. It’s hot in Texas now but we are seeing an increase in new cases. This virus is not wilting away in very hot, humid settings.
During the Spanish flu, it started in the spring and came back with a vengeance in the fall and winter. So everybody is bracing for that.
I think a modest second wave is coming, and then contact tracing and other measures will be put in place to get on top of it. The real question is what’s going to happen in the fall. That’s why there’s a huge push to get vaccine trials running.
Elaine Nsoesie, assistant professor of global health, Boston University School of Public Health
Jessica Justman, professor and attending physician in the division of infectious diseases at the Columbia University Irving Medical Center
David Rubin, director of PolicyLab at Children’s hospital of Philadelphia and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania
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Coronavirus Second Wave? Why Cases Increase
- Lisa Lockerd Maragakis, M.D., M.P.H.
When the coronavirus pandemic began early in 2020, experts wondered if there would be waves of cases, a pattern seen in other virus pandemics.
The overall pattern so far has been one of increasing cases of COVID-19, with a surge in the summer and a larger one in the fall.
Some locations that saw a high number of coronavirus infections early on, followed by a decline, are having a “second wave” of increased cases.
What will the future hold? Lisa Maragakis, M.D., M.P.H., an infectious disease specialist at Johns Hopkins Medicine, sheds light on what we know now about COVID-19 in communities and why the numbers of infections increase during certain times.
Human behavior is the major factor. State and local governments, as well as individual people, differ in their response to the pandemic. Some follow COVID-19 precautions, such as physical distancing, hand-washing and mask-wearing. Others are not as prescriptive in requiring these measures or in restricting certain high risk activities.
In some cities, towns and communities, public places are closed or practicing limitations (such as how many people are allowed inside at one time); others are operating normally. Some government and community leaders encourage or even mandate mask wearing and physical distancing in public areas. Others say it is a matter of personal choice.
However, the relationship between those precautions and cases of COVID-19 is clear: In areas where fewer people are wearing masks and more are gathering indoors to eat, drink, observe religious practices, celebrate and socialize, even with family, cases are on the rise.
Also, places where people live or work closely together (multigenerational households, long term care facilities, prisons and some types of businesses) have also tended to see more spread of the coronavirus. Coronavirus outbreaks at nursing homes and “superspreader” events — gatherings of people where one infected person or more transmits the virus to many others — continue to occur.
Are the spikes in coronavirus cases due to more coronavirus testing?
No. During a surge, the actual number of people getting sick with the coronavirus is increasing. We know this because in addition to positive COVID-19 tests, the number of symptomatic people, hospitalizations and later, deaths, follows the same pattern.
Infectious disease expert Lisa Maragakis explains why COVID-19 cases are surging across the United States and important preventative steps to halt coronavirus transmission.
As communities began to reopen bars, restaurants and stores during the spring and summer of 2020, people were understandably eager to be able to go out and resume some of their regular activities.
But the number of people infected with the coronavirus was still high in many areas, and transmission of the virus was easily rekindled once people increased their activities and contact with each other.
Medical experts urged reopening communities to continue diligent COVID-19 precautions, including physical distancing, hand-washing and mask-wearing, and monitoring for symptoms.
Unfortunately, the combination of reopening and lapses in these infection prevention efforts has caused the number of coronavirus infections to rise again.
Tracking Coronavirus Surges
There is a delay between a policy change such as reopening businesses or relaxing occupancy limits in a community and when the effects of this change show up in the COVID-19 data.
An increase in the number of COVID-19 cases or hospitalizations will not be seen a week or even two weeks later.
It seems to take much longer, perhaps as many as six to eight weeks, for effects of a policy or widespread behavior change to appear in the population-level data.
When a person is exposed to the coronavirus, it can take up to two weeks before they become sick enough to go to the doctor, get tested and have their case counted in the data.
It takes even more time for additional people to become ill after being exposed to that person, and so on.
Several cycles of infection must occur before a noticeable increase shows in the data that public health officials use to track the pandemic.
So when an area relaxes precautions, the effects of that change will take a month or more to be seen. Of course, surges also depend on the behaviors of people when they start moving around more.
If everyone continues to wear masks, wash their hands and practice social distancing, reopening will have a much lower impact on transmission of the virus than in communities where people do not continue these safety precautions on a widespread basis.
Learn why it takes several weeks of gathering data to determine if the COVID-19 infection rate is rising or falling.
In the beginning of the pandemic, some people wondered: Will the coronavirus go away in the summer? Unfortunately, a substantial spike during the hot summer months in the U.S. made it clear that this was not the case.
Other respiratory illnesses, colds and influenza (flu), are more common in the colder months. Now that fall is here, we are seeing a dramatic increase in COVID-19 across the U.S.
In colder months, people gather indoors and this is a risk for further transmission of the virus.
When the coronavirus first appeared in the U.S. in early 2020, it started with a very small number of infected people, so it took longer to spread. Now that the disease is widely distributed, with many unknowing coronavirus carriers in many different areas of the country, the risk of transmission is widespread.
Fall and winter in the Northern Hemisphere means inclement weather in many areas, with more people spending time indoors. Several holidays take place around the end of the calendar year, and people who celebrate them want to gather, travel, and visit friends and family.
Also, after many months of canceled activities, economic challenges and stress, people are frustrated and tired of taking coronavirus precautions. All these are factors that are driving surges and spikes in COVID-19 cases.
What is herd immunity from the coronavirus?
Herd immunity is a public health term that refers to the fact that, when enough people in a community have immunity from a disease, the community is protected from outbreaks of that disease.
Infectious disease experts at The Johns Hopkins University explain that about 70% of the population needs to be immune to this coronavirus before herd immunity can work. People might be immune from the coronavirus, at least for a while, if they have already had it, but we don’t know this yet. A widely available, safe and effective vaccine may not be available for months.
Without a vaccine, most doctors and scientists agree that a herd immunity approach of letting the virus “take its course” is not acceptable. Letting the coronavirus circulate freely among the public would result in hundreds of thousands of deaths and millions more people left with lasting lung, heart, brain or kidney damage.
Researchers are currently trying to determine if, and for how long, people are immune from the coronavirus after recovering from COVID-19. If it turns out that immunity only lasts for a while, people could get COVID-19 again, resulting in even more death and disability.
Check symptoms. Get vaccine information. Protect yourself and others.
Doctors, clinics and hospitals recognize that more COVID-19 surges are ly to occur. They are working with manufacturers to stock up on equipment, and they are continuing their policies for protecting patients and staff members.
Here’s what you can do now:
- Continue to practice COVID-19 precautions, such as physical distancing, hand-washing and mask-wearing.
- Stay in touch with local health authorities, who can provide information if COVID-19 cases begin to increase in your city or town.
- Make sure your household maintains two weeks’ worth of food, prescription medicines and supplies.
- Work with your doctor to ensure that everyone in your household, especially children, is up to date on vaccines, including this year’s flu shot.
What you need to know from Johns Hopkins Medicine.
Why us again? Italy suffers disproportionate toll in second COVID wave
By Crispian Balmer, Angelo Amante
ROME (Reuters) -In late November doctor Maurizio Cappiello visited more than 130 patients in the emergency room of Cardarelli hospital, in the southern Italian city of Naples. More than two-thirds had COVID-19.
A man places a sticker outside a pharmacy reading “COVID-19 rapid test, result in 15 minutes” where medical staff carry out swab tests, as the government prepares to bring in further restrictions over the Christmas period amid the spread of the coronavirus disease (COVID-19) in Rome, Italy, December 14, 2020. REUTERS/Guglielmo Mangiapane
The virus which was limited mainly to Italy’s industrial north during the first wave in the spring was now also ravaging the poor south, overwhelming its fragile public health system.
“Despite our efforts it was impossible to help them as we would have wanted and to transmit a sense of humanity, we tried to be fast and concentrate on the most critical,” Cappiello, a top official at Italy’s national ANAAO-ASSOMED doctors’ union, told Reuters.
Campania, the populous region around Naples, numbered just 430 coronavirus deaths by June 15. The total has now risen to more than 2,300 as Italy’s overall death toll has overtaken Britain’s to become the highest in Europe.
The first Western country to be hit by the virus in March, Italy won plaudits for seemingly getting its outbreak under control by the summer. Now questions are once more being asked about why more people apparently die of COVID-19 in Italy than in other wealthy nations.
Among explanations often put forward are its elderly population; a social structure in which the young often live with the old, exposing them to the virus; an underfunded health system; and a lack of preparedness and organisation.
“During the summer, when daily cases were low, we failed to recruit more staff and made no plan to reorganise,” the Naples doctor Cappiello said.
DEATHS PER CAPITA
According to Worldometers data, Italy has registered 65,011 COVID-19 fatalities since February, against 64,170 in Britain, 57,911 in France and 47,624 in Spain – three other European nations badly battered by the disease.
On a per capita basis, Italy lies 37th in the world for number of cases, but 4th when it comes to deaths, with 1,076 COVID fatalities per million people. This compares with 943 in Britain, 886 in France and 924 in the United States.
The only European Union state with a higher per capita death ratio is Belgium on 1,546 – the worst in the world.
Countries count COVID deaths in slightly different ways and medical experts cautioned against drawing hasty conclusions, saying a clearer picture would only emerge when excessive death figures for the whole year became available.
But officials acknowledge Italy has suffered more than most, and pin the blame largely on the fact that it has many elderly citizens who have proved especially vulnerable.
According to Eurostat data for 2019, Italy had the oldest population in Europe, with 22.8% of its people aged over 65. It also ranks as one of the countries with the highest life expectancies worldwide – 83 years.
But doctors say that while Italians live a long time, they are not especially healthy. A 2017 report by the Osservatorio Nazionale health association said 71% of over-65s had at least two underlying health conditions. Almost half of this age-group took at least five different medicines a day.
“There is a very dangerous nexus between the high number of elderly people here and (the high number of) health conditions. We are paying a very, very high price for this,” Health Minister Roberto Speranza told La7 television channel.
The first wave of the pandemic, which accounted for roughly 35,000 lives, was concentrated in the north, where some emergency wards were swiftly overwhelmed – a problem that pushed up the death toll as doctors were forced to decide who they could treat, and who they had to push away.
Doctors hoped that knowledge gained from the initial contagion would help them sharply reduce fatalities in any new outbreaks. However, as the second wave sweeps over the whole country, Stefano Centani, professor of respiratory illnesses at Milan University, said the death rate remained elevated.
“Sadly we don’t seem to have made much progress. Perhaps we have even done worse. This will have to be analysed,” he said.
Prolonged underfunding of the public health service was probably partly to blame, he said.
“We are paying for 20 years, maybe more, of constant cuts to health resources…When this pandemic exploded all our problems were exposed.”
Speranza also bemoaned spending cuts introduced more than a decade ago to try to help contain a ballooning national debt.
“The biggest problem is a lack of doctors. You can buy masks, respirators and protective clothing on the international market but you cannot buy doctors, and you cannot buy nurses, you cannot buy personnel,” he said.
“In Italy, for 15 years, we have had a rule that blocked spending on personnel at 2004 levels minus 1.4%. This is incredible.”
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WHO on a coronavirus second wave, lockdowns and how the world responded to the pandemic
ABC News recently spoke to WHO spokesperson Dr. Margaret Harris to discuss the organization's response to the pandemic, whether countries took the novel coronavirus seriously enough, fears of a second wave and why lockdowns became the preferred means of dealing with the biggest public health emergency in a century.
The interview below has been edited and condensed for clarity.
Were we generally underprepared for a pandemic? The WHO was criticized for calling a pandemic too late. How would you respond to that criticism?
Harris: This is something that people don't really understand. The important issue is: does it constitute a “public health emergency of international concern” under the international health regulations?
There are three criteria for determining whether something is a public health emergency of international concern: Is it something we've not come across before? Was it an international spread? And is it something that needs the international community to be galvanized, to be made very aware and very ready and work together to stop?
We were advocates of always trying to strike a balance, trying to keep our society functioning, but functioning safely.
If it meets those three criteria, then a committee, called the Emergency Committee, who have been pulled together — they're all independent experts — to assess the information about whatever the event is (it doesn't necessarily have to be a pathogen, it can be other things) come together, they look at the evidence and they decide whether or not they think it constitutes a public health emergency of international concern. They are the ones that make these recommendations that I was referring to before. And they also are the ones who recommend to the director general that he or she declares that [emergency]. We don't declare a “pandemic.”
Now, on March 11, the spread of the outbreak was so great, had gone so widely and there was wide community transmission in more than two regions. So it met the epidemiological definition of a pandemic.
But that was about characterizing it; that was not about declaring it. Unfortunately, that concept of declaring a pandemic is very much rooted in people's memory from the old flu days when it was true.
So it's pretty confusing.
Declaring the public health emergency was actually meant to prevent it becoming a pandemic. If you go back to Feb. 4, Dr. Tedros [Adhanom, the WHO director general] gave warnings. “You must do these things,” he said.
“You must get ready now. You must get your health systems ready. You must organize your contact tracing. You must get your laboratories ready. You must get your testing ready.
Because if you don't, this is going to come and overwhelm your systems.”
Looking back, it just makes me weep, honestly.
In this Jan. 25, 2020, file photo, medical staff members work at the Wuhan Red Cross Hospital in Wuhan, China, while wearing protective clothing to help stop the spread of a deadly virus which began in the city.
Has there been any difference between countries with a history of pandemics and those that haven't?
Harris: There's been quite a difference in how seriously they took it. SARS did affect a lot of countries. That didn't reach the community transmission level we see in almost every country on the planet at the moment with COVID-19.
That was really almost a dress rehearsal for many of those countries, and they took those lessons very, very seriously. China revamped its public health infrastructure after SARS. They set up the China Center of Disease Control (CDC). They have very large public health units in every city.
They have strong surveillance; they've got a strong laboratory network.
Africa's interesting in that people were very , “Oh, well, the minute they get to Africa, you know, it's going to sweep here and kill everybody.” And yet there has been some very large outbreaks, South Africa notably. But they have been able to bring it down.
One of the theories about why they seem to have done better than many of the more developed countries or more developed areas is that they, too, have a very strong public health infrastructure. They understand infectious disease outbreaks. They have very fresh memories of what infectious disease outbreaks can do and they take it seriously.
Is it fair to say that there was a bit of confusion about what countries were meant to do? Were you surprised that lockdown became the preferred measure for such a wide range of countries?
Harris: It's certainly interesting in that, when Wuhan did it we were , “Wow, you'd have to have a society that's very accepting of stringent measures to be able to do that successfully.” And yet countries that were culturally, socially, very, very different from Wuhan did it, and did it successfully.
And to me, that shows that the people got it, got that it was a very serious matter. They kind of took on a sort of wartime mentality that we had to do this together. We have to work together. We have to stop this thing. But I think, unfortunately, that has backfired a little and that people feel now, you know, “OK, it's peace time, we're now free, we're liberated.”
Passengers disembark after their flight landed at Wuhan's Tianhe International Airport in China's central Hubei province, Sept. 16, 2020.
We'll be living with this for years to come? Because the end is not particularly clear
Harris: That's right. And so the question I get every day is “When is this going to be over?” [Another] question I get all time is “When are we going to get the vaccine?” … Implicit in that question is “When is it going to be over?” Because now people believe that once the vaccine is rolled out, it's going to be over.
But in fact there are very few things that have been completely stopped by vaccination. If we get a vaccine with adequate efficacy and safety, it will certainly bring the transmission down and it will make it more controllable. But the vaccine alone isn't going to stop it.
Lab technicians handle capped vials as part of filling and packaging tests for the large-scale production and supply of the University of Oxfords COVID-19 vaccine candidate, AZD1222, on Sept. 11, 2020, at a manufacturing facility in Anagni, Italy.
How much more do we actually know about the virus? And does that mean we're in a better position to deal with things in the next six months?
Harris: Quite a few people yourself are asking what's changed since we characterized it as a pandemic. And I would say our knowledge. We know so much more about this virus.
We know so much more about what it does to our bodies, who it harms most, who is most ly to be vulnerable to it. It's not simply a matter of your age. It's a matter of your underlying conditions.
So we're learning so much more about how this virus interacts with us, what it does to us and also what we could do to mitigate its effects. Care is much, much better. Identifying who's ly to get into trouble early is happening much better, and then ensuring that you stop their illness progressing to the severest endpoint where it's so difficult to rescue them from death.
The vaccine alone isn't going to stop it.
We also have much better ideas about transmission. We now know that there are a large number of people who are asymptomatic or that people can infect others before they develop symptoms. That information wasn't apparent right at the beginning, but that does definitely change what sort of advice you give to people about protective measures.
That's why there's been more emphasis on use of masks, especially when you're in close contact.
Because indeed, if you may think you're perfectly healthy, you are unaware that you are infected with the virus, and yet you could be infecting others, especially if you're in close contact with them in closed, poorly ventilated environments. If you're wearing a mask, that will limit the chances of that happening considerably.
How would you assess these warnings of a second wave?
Harris: I've been saying quite all through the summer, the water's up to our necks already. This idea that you'd get a break in summer has not been a helpful message, because people did believe this notion. I think it came really from thinking that the coronavirus is flu, and flu is very much a winter, cold weather virus.
So regardless of why, whether it was our behaviors or not, this virus didn't go away in the summer. And, unfortunately, people sort of did behave as if it had gone away and it hadn't, and that's why numbers have been steadily increasing since the middle of June.
A teacher with protective mask speaks to pupils in a classroom in Brequigny high school in Rennes, western France, on Sept. 1, 2020, on the first day of the school year amid the COVID-19 epidemic.
As we open up economies and schools, is a rise in cases inevitable? How do you weigh those risks?
Harris: We were advocates of always trying to strike a balance, trying to keep our society functioning, but functioning safely.
So working and building a strategy that allows people to live and work and, yes, go to school, but safely.
So not thinking that there's just one sort of silver bullet, one thing you do and then it's done, but understanding we need to change because this isn't going to be the last one.
You know, we are highly susceptible to transmissible — particular respiratory — pathogens because of the way we crowd together, because our societies have evolved into highly urban societies.
We have never been so urbanized as we are now.
And every continent, including Africa, has more people living in large cities, and we are increasingly living in smaller and more poorly ventilated spaces.
We found that misinformation spreads even more quickly than the virus itself.
We have to try to find a way to live safely with this virus, to keep society functioning, keep work going, keep the economy going.
We keep hearing that we are these sort of health bullies are stopping the economy. Not at all.
We are just saying, “Manage a society in a way that prevents a virus this from destroying your most productive, cutting the heart your community, but keep on with your activities in a safe way.”
It's not easy — that takes a lot of negotiation; that takes a lot of understanding, a lot of working and a lot of commitment to change. But it can be done.
There have been rising conspiracy theories around the coronavirus. Is that something that you factor into your advisory?
Harris: Oh, yes. We found that misinformation spreads even more quickly than the virus itself. And we've had an extraordinary number of myths.
It is frightening, though, because some of these myths kill. People believe things drinking bleach. They do it, they die. At one point [there was a rumor that] raw alcohol, rubbing alcohol, would kill it.
So people drink this stuff. They died.
This kind of misinformation is lethal, particularly when it comes to things vaccination. I think of vaccine preventable diseases in children: Most of the deaths we're now seeing in children under 5 are from vaccine preventable diseases. Misinformation around vaccines, making parents frightened to vaccinate their children, is leading to child deaths.
Members of the medical staff treat a patient who is wearing helmet-based ventilator in the COVID-19 intensive care unit at the United Memorial Medical Center on July 28, 2020, in Houston.
And finally, how worried are you about other threats, perhaps more familiar threats rising over the next six months and contributing to more public health disasters?
Harris: Well, certainly we are very concerned about people not being able to access health care and health services for all the other illnesses, particularly the non-communicable diseases, things the cancer, heart disease, strokes, all these things that people continue to have.
You know, we haven't seen the numbers, but we did a survey recently on a lack of access to essential services. It was very, very concerning that people are not using hospitals because they are frightened to go.
But also they don't wish to be burdening the health system, knowing that the health care workers were working so hard and were so pushed to look after people with coronavirus.
So, indeed, much of what we've been saying and one of the reasons for keeping transmission low is so that the health system isn't only dealing with COVID.
If you could keep the transmission down, then you could do all the other things that could make your hospital function for all the other things. Women are still having babies. Children still need care, too.
You don't want the surveillance services to only be looking for COVID.
And you're quite right, malaria, for instance, is something we're very concerned about. When somebody has malaria, the minute they have a fever, the advice is actually go to the hospital. Now, the advice with COVID is actually stay where you are. So it's quite a balance.
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