- Anthony Fauci said this week that there’s “virtually no chance” the coronavirus will be eradicated this summer.
- During a Senate hearing on Tuesday, he warned that a devastating resurgence of the virus could come if states reopen prematurely.
- A group of US experts outlined three scenarios for what future waves of coronavirus infections will look like during the next 18 to 24 months.
- The worst of the three scenarios involves a second, larger wave of coronavirus infections this fall and winter – an outcome Fauci has said is “inevitable.”
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Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, believes a second wave of coronavirus infections is “inevitable.”
In an NBC interview on Saturday, Fauci said the virus “is so transmissible, and it is so widespread throughout the world, that even if our infections get well controlled and go down dramatically during the summer, there is virtually no chance it will be eradicated.”
Researchers agree that it’s unlikely the pandemic will end until a majority of the human population becomes immune to the virus. How it will continue to spread and the pattern in which case numbers rise and fall over time are less clear, however.
In a report published April 30, researchers at the Centre for Infectious Disease Research and Policy (CIDRAP) laid out three scenarios for what the next 18 to 24 months might look like. The projections apply to the temperate Northern Hemisphere, which includes the US, though the study authors said “similar patterns could occur in the in global south.”
The worst-case scenario of the three involves a second, larger wave of infections this fall and winter. The researchers suggested this is the most likely outcome and said states should prepare for it.
Here are three charts that show what future waves of COVID-19 cases could look like.
Scenario 1: Repeating, smaller waves of infections
In this scenario, the first COVID-19 wave happening now would be followed by a series of smaller waves throughout the summer and beyond. Those waves would bring a lower number of infections than the US and other countries are currently experiencing. However, they would persist over the next 18 to 24 months before gradually diminishing.
The authors noted that the geographic areas in which these subsequent waves would grow depends on the measures various places put in place to encourage social distancing, and how those restrictions eventually get rolled back.
Scenario 2: A second, larger wave of infections this fall
The worst – and most likely – of the three scenarios is one in which the first wave is followed by a larger wave in the fall or early winter. After that would come one or more smaller subsequent waves in 2021.
Fauci warned policymakers during a Senate hearing on Tuesday that the country will see a potentially devastating resurgence of the coronavirus if states and localities relax social distancing without heeding federal guidelines.
That would mirror what happened during the 1918 Spanish influenza pandemic and the 2009 H1N1 flu.
A second wave of infections with an even higher peak would require US states (and other countries in the Northern Hemisphere) to reinstitute mitigation measures like lockdowns, the researchers wrote.
“States, territories, and tribal health authorities should plan for the worst-case scenario,” they added.
Scenario 3: A ‘slow burn’ of ongoing transmission
The final scenario suggests that this first wave of coronavirus infections is the biggest we’d see. Then in the coming months, the COVID-19 pandemic would shift into a “slow burn” of ongoing transmission and new cases.
“While this third pattern was not seen with past influenza pandemics, it remains a possibility for COVID-19,” the report says.
This possibility would mean that states likely wouldn’t need to lock down again, although we’d still see many more cases and deaths.
‘There is no crystal ball’
The CIDRAP experts’ conclusions are based on an examination of multiple models that predict future coronavirus impacts, as well as research about how COVID-19 spreads and data from past pandemics.
The coronavirus outbreak shares important similarities with influenza pandemics, like the 1918 Spanish flu (which infected 500 million people worldwide), which makes it a solid model for comparison. That’s because both viruses spread via droplets that people emit when coughing, sneezing, or talking, and they can be transmitted even when infected people show no symptoms.
But even given that historical context, experts still aren’t sure what to expect from the coronavirus, since this new virus spreads more easily than the flu does. An average person with the coronavirus infects between 2 and 2.5 new people, a metric known as the R0 value. Seasonal influenza’s Ro value, by contrast, is about 1.3.
“There is no crystal ball to tell us what the future holds and what the ‘end game’ for controlling this pandemic will be,” the report authors wrote.
Of course, the report’s three scenarios would change if a vaccine gets developed more quickly than expected. But the authors noted that a vaccine probably won’t become available for a long time – the earliest it’s expected is in 2021.
“We don’t know what kinds of challenges could arise during vaccine development that could delay the timeline,” they added.