How likely is a deadly second wave of COVID-19 ?

Dominic Giannini 11 May 2020 18
Archival image of women wearing surgical masks in 1919 during Spanish flu.

Women wearing surgical masks in 1919 during the Spanish flu pandemic. Photo: National Museum of Australia.

Australia has flattened the COVID-19 curve and managed to get transmission of the virus under control, but as winter approaches, Australians are being warned about a second outbreak that could be more deadly and spread more rapidly than the first.

Although the second wave of the Spanish flu – a common comparison point for COVID-19 – was much deadlier than the first, the circumstances around its spread might not be as relevant a century later, said ANU historian Professor emeritus Joan Beaumont, who has studied the post-war outbreak.

“In the case of the Spanish flu, what kept it going was the movement of people,” she said, referring to the large scale transits at the end of  WWI that exposed hundreds of millions of people to the virus.

“So far we have had the advantage of being able to close our borders and that is going to be the real challenge, of how you are going to open your borders and expose yourself to the possibility of reinfection.

“Many experts say that every pandemic is unique and that comparisons you can make are limited. There has certainly been a lot of similarity in terms of … the social responses.”

It’s often believed that the second wave of the Spanish flu pandemic was more deadly because the virus had mutated. But ANU infectious diseases expert Professor Peter Collignon says that’s not the case.

“The reason the Spanish flu was more deadly is because 80 per cent of people who died had bacterial infections, not the virus. In army studies, about 80 per cent of people who died had either pneumonia germs or staph or something called ‘group A strep’ in their blood,” he said.

“The reason people died in the Spanish flu was because of secondary infections and no antibiotics. Most people died on day 10; it was not sudden. They had an illness, got better and then got sick again.”

The risk of secondary infections is presenting itself as a problem in Australia right now, he said.

“COVID-19 may be different, but in ICUs at least, a large proportion – maybe 50 per cent of people – are getting secondary bacterial infections and they are the ones who are dying more often,” said Professor Collignon.

The virus – which would not in itself be deadlier during a second wave – could nevertheless cause more deaths in winter because of its ability to spread more quickly, similar to influenza and other respiratory diseases.

“That may be why it is so bad in Europe and the United States, because it’s spreading in winter and not being identified because such a large proportion of cases are mild or even asymptomatic,” said Professor Collignon.

Profile image of Professor Peter Collignon.

ANU infectious diseases expert Professor Peter Collignon says secondary bacterial infections were responsible for the majority of deaths attributed to Spanish flu, and to a certain extent, COVID-19. Photo: ANU.

However, the outlook here is more optimistic with measures that can readily respond to, and minimise, threats from major viral stimuli.

“So far most of the cases we have had in Australia are related to risk factors you can easily identify, and those risk factors, in general, have either been really well managed or removed,” said Professor Collignon.

Such risk factors include international travel and clusters of infections on cruise ships.

“A second wave is a question, but having said that, we have lots of testing, lots of follow up and lots of quarantining.

“I think we will see more cases in winter, but I think we will be quickly on top of them and will make the clusters small rather than large and that will stop the spread.”


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18 Responses to How likely is a deadly second wave of COVID-19 ?
Peter Major Peter Major 9:16 pm 10 May 20

There is always a probability, however given the low numbers over the total population (7000/25,000,000) I doubt a full blown second wave will eventuate if our international borders stay closed

HiddenDragon HiddenDragon 8:17 pm 10 May 20

“…. that is going to be the real challenge, of how you are going to open your borders and expose yourself to the possibility of reinfection.”

This is ultimately a question of it, not when – unless we are to completely alter the direction of our services-dominated economy, which has come to rely so heavily on international movements of people.

Corey Karl Corey Karl 5:51 pm 10 May 20

I imagine $25m would have gone a long way with the existing hospitals.... considering the pop up still isn’t even operational

    Darren Bryant Darren Bryant 7:53 am 11 May 20

    Corey Karl $25m is the operating cost and it’s not operating yet

Toni Brooks Toni Brooks 12:38 pm 10 May 20

Its more then keeping the borders closed which let's be honest They never really closed. Closed means no one in or out which we know people were still coming and going. Just at a much lower rate. People also need to keep up with the social distancing and rules in place. Instead, what I'm noticing is that people seem to have forgotten there is a pandemic going on. Australia is not 100% in the clear or rid of COVID-19. If people do not follow the rules, it WILL flare up yet again.

    Hamish Lardi Hamish Lardi 4:18 pm 10 May 20

    Toni Brooks is any country 100% in the clear? The question that will emerge is. Was it worth destroying our way of life, the economy, mass job layoffs, bankruptcy, reduction in medical care for treatable diseases, increased suicide and potential mass starvation to save the elderly?

    Toni Brooks Toni Brooks 4:30 pm 10 May 20

    Hamish Lardi you need to actually read what was written. You can follow the rules, and be safe while providing safety to others. Opening the community back up depends on it. Thinking otherwise is not only arrogant, it's selfish which is what puts people in danger to begin with.

    Hamish Lardi Hamish Lardi 5:53 pm 10 May 20

    Toni Brooks I read what you wrote. Though do you think businesses/people can keep lockdown/ social distancing rules forever when they aren’t making money?

    Anne AnytimeCheerful Anne AnytimeCheerful 8:18 pm 10 May 20

    Toni Brooks , I agree we should keep practicing social distancing. If people follow that well, might not end up forcing everything be closed. A bit like those international arrivals, they didn't obey the 14 days quarantine guidelines, ended up quarantine can no longer take place at home. Also some say we are safe with CovidSafe. But it's not a vaccine - it's an efficient contact tracing app!

    Tina Newsome Tina Newsome 2:36 pm 11 May 20

    Technically the borders are closed. I have no issue with the current arrangement. Only citizens or residents are allowed back in and they are put into quarantine under guard for 14 days, so I'm not entirely sure how you think they're going to spread the virus. If we lockdown for too long thousands will face economic ruin. The impact of that will be far greater than any pandemic.

    Toni Brooks Toni Brooks 5:05 pm 11 May 20

    Tina Newsome I'm guessing you didn't read what I wrote. I didn't say anything about staying closed. They are in fact letting individuals in who are not residents or citizens. Yes, it's with approval and limited, but it is happening. Yes they are required to self isolate. No this is not happening 100% of the time.

    What I did say though is people need to follow the rules and social distancing. People though are not. And if they do not, it will cause further spread and could escalate the situation. What I am noticing is that people are not in fact following the social distancing rules and acting as if nothing is going on. If people are not smart about this and ignore the rules, it will flare up yet again.

    Tina Newsome Tina Newsome 5:13 pm 11 May 20

    Toni Brooks actually quarantine is now happening 100% of the time, as they are given a police escort to their hotels. The only exception i am aware of was for some rich couple in WA, which I wasn't very happy with. I agree with you about following social distancing rules. I just know that I'm doing what I'm supposed to and while I wish everyone else would, it is not my job to police them 🤷‍♀️

Lynn Stape Lynn Stape 11:59 am 10 May 20

Lets hope we never have to find out if a second wave will be worse.

Rob Thomas Rob Thomas 11:04 am 10 May 20

You have to realize that in 1918 they didn't have the range or quality of retail options available to us now.

Carole Ford Carole Ford 10:23 am 10 May 20

Let's hope we have learnt from history. 🤨🥺😳✌️

Cary Elliot Johnson Cary Elliot Johnson 10:17 am 10 May 20

Well responded to from a world class Professor.

Jane Woodrow Jane Woodrow 8:27 am 10 May 20

It’s not winter in Europe, it was the most beautiful spring when I was there in March and April.

Shaun Hoy Shaun Hoy 7:29 am 10 May 20

Simple. Keep the borders closed.

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