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‘Second wave’ is an unhelpful concept, top infectious disease expert warns

Dr Tom Frieden, former director of the US CDC, said the concept inaccurately 'implies that Covid-19 will act as the flu acts'

Dr Tom Frieden
Dr Tom Frieden Credit:  Joe Raedle/Getty Images

大发体育网站Using the term ‘second wave’ to describe a resurgence of coronavirus infections is “mistaken” and encourages dangerous misconceptions about the trajectory of the pandemic, according to one of America’s top infectious disease experts. 

大发体育网站Dr Tom Frieden, who served as director of the US Centers for Disease Control and Prevention (CDC) for eight years under Barack Obama, told The Telegraph that the term “implies that this [virus] will act as the flu acts”.

“We don't know that - it might, but it might not,” he said. “Basically we will have outbreaks as long as there is exposure.”

Instead he advocated a surfing analogy - peaks and troughs in cases should be described as “riding a wave”. 

Concerns about a second wave of infections originate from comparisons with flu, which were widespread in the early stages of the pandemic. Several countries, including the UK, have since been criticised for a perceived overreliance on pandemic influenza plans when tackling the coronavirus. 

‘Second wave’ is used to describe the ebb and flow of flu outbreaks because it is a seasonal disease. A combination of fewer people mingling inside, higher humidity and increased sunlight results in far lower transmission during the summer months. 

This trajectory was clear during the Spanish influenza pandemic, when the disease struck in several waves. The virus spread throughout the northern hemisphere during the spring of 1918, while cases dwindled in the summer. But in the autumn a second, far deadlier wave materialised. 

大发体育网站Some experts have warned that there could be a similar resurgence of coronavirus infections in the coming months. 

大发体育网站But Dr Frieden said that any spike in cases would most likely be triggered by the unsafe easing of lockdowns, without strategic testing, isolation of patients and contact tracing in place. There is currently little concrete evidence that Covid-19 is a seasonal illness. 

“We will have rebounds, as we've already had, if reopening is too soon,” he said. “And we will inevitably have cases in clusters, even with careful opening. But by using the ‘box it in strategy’, we can prevent cases from becoming clusters, clusters from upcoming outbreaks, and outbreaks from sending us back to the start again.” 

He added that ‘second wave’ was therefore a “mistaken concept”.

大发体育网站“It is just not the right metaphor for what's happening here,” Dr Frieden said. “I think of lockdowns as like riding a wave - you have to time it just right. If you’re surfing and you jump too soon, the wave hasn’t come. Too late and you get swamped.

大发体育网站“You have to ride it just right - which means that the lockdown has to be modulated for what's happening with the virus.” 

大发体育网站His comments have been echoed by other experts in the US, where dozens of states have reported an uptick in new infections in the last week, triggering widespread talk of a “second wave” of infections. 

“When you have 20,000-plus infections per day, how can you talk about a second wave?” Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said last week. “We’re in the first wave.”

In a wide-ranging Telegraph interview大发体育网站, Dr Frieden also suggested that there is a “false dichotomy” between controlling Covid-19 and protecting the economy.  “It's very clear that the places that have done a better job managing their outbreaks are going to do a better job recovering their economies,” he said. 

大发体育网站Dr Frieden, who led the US response to swine flu, Ebola and Zika while head of the CDC, has since become the President of Resolve to Save Lives, a $225 million five-year initiative to prevent epidemics and cardiovascular disease. 

大发体育网站But he has been vocal in his concerns that the CDC’s role has been curtailed by President Donald Trump’s administration during the US’ coronavirus response.

大发体育网站“In the nearly 75 years that CDC has existed, this sidelining has never occurred,” Dr Frieden told The Telegraph. “Fighting a battle without CDC at the decision table and at the podium is like fighting with one hand tied behind your back.”

He added that the organisation is publishing a lot of important data and analysis on their website, “but the scientists there are essentially not being allowed to speak to the public.

“I'm concerned that their ability to even publish scientific guidance may be getting interfered with,” Dr Frieden said. 

“Public health is sometimes seen as having failed in this response, but the truth is that leaders failed to follow public health advice. The countries and the places that have followed public health advice have had fewer cases, fewer deaths and less economic disruption.” ​

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