Beware claims of the second wave evangelists

A focus on localised outbreaks and the R rate can take us away from the bigger pandemic picture

Glee isn’t quite the right word for it. But there’s something unsettling about the way some commentators and even scientists jump on any information that points to impending coronavirus disaster. The R rate has shot through the roof in Islington! Outbreak in Germany! The second wave is about to crash down upon us, Lord have mercy on our souls.

Sweden, my normally uncontroversial motherland, is again at the front of this battle between the Pollyannas and the pessimists. Because of its more laissez-faire strategy, it must be finally proven to be either a triumph or a catastrophe. The truth is somewhere in between. Charts of newly recorded cases in Sweden or maps of new cases per 100,000 population look bad, as if that country is suffering a plague out of proportion with the rest of the continent. But look at a chart showing admissions into Swedish intensive care with Covid-19 and you’d think the epidemic was pretty much over – sharply falling from its peak in mid-April to under 200 people nationwide today.

The answer to this confusion lies in testing. Starting from a low base, the Swedes have now doubled tests, and so have started picking up large numbers of mild cases that previously went undetected. Case numbers look bad, but hospitalisations and deaths continue to come down. They have no excess deaths compared with what would be normal for this time of year.

The real story across Europe has been that, despite country after country opening up, none has yet been hit by a genuine second wave. There have been big local outbreaks, such as in a meat-processing plant in Gütersloh in Germany and in Lisbon, but while they have understandably caused concern and led to local lockdowns, there have not been national surges or significant increases in hospitalisations or deaths.

For lockdown critics, this is actually an inconvenient datapoint – one major argument against lockdowns was that they would simply delay the pain, and when countries opened up again their epidemics would quickly catch up. But if countries like Denmark can return to near-normal without seeing a second surge, with schools and restaurants open, no masks and relaxed one-metre social distancing, their early lockdown policy looks highly effective.

We don’t know what the seasonal effects are (this could be just a summer holiday from the virus) but for now in Europe the feared second wave does not look imminent. In the UK we too have opened up significantly, but despite panicked front pages showing crowds of sunbathers in May and crowds of protesters in June, the trends have all continued downwards.

In the US it is even harder to parse real information from politics. There, Covid-19 has been subsumed into the all-encompassing political war, so the apparent surges in mostly Republicanrun southern states are being talked up by Democrats as the death-knell of Donald Trump’s hopes of re-election, while Trump flatly denies the reality of any second wave and puts it all down to increased testing.

It is pretty clear that, unlike Sweden, states like Texas and Arizona are experiencing a real surge in infections – we know that because hospitalisation numbers and the percentage of positive test results are going up, not just the case numbers. But at 29million residents, Texas is the equivalent of a large European country; at 2,324 deaths it has so far been less badly hit than Germany on a per capita basis. Its epidemic wave is still getting going, but it has a long way to go before it is even comparable to the terrible death tolls seen in New York and New Jersey.

There are good grounds to hope that the “sunbelt states” may never reach these levels, even as their residents gather indoors to escape the heat in the summer months. The proportion of young people testing positive is much higher – in Arizona, people aged 20-44 account for nearly half of new cases, and in Florida the median age for new cases has dropped from 65 in March to 35. That will mean that a much smaller proportion of these new cases lead to deaths. Testing is more widespread and local flare-ups such as at a meatpacking plant in Texas and a nightclub in Miami have been identified. We know a lot more than we did in March, and authorities are better prepared.

If you want to stay sane in the coming months, one good principle is to pay attention to the metric the latest coronavirus disaster story is based on. If it only refers to case numbers or the R rate, be a little sceptical; hospitalisations and deaths are the things we all want to avoid, so they are the numbers that ultimately count.