Experts project fall surge in cases, peak after election
Infectious-disease experts are warning of a potential coldweather surge of coronavirus cases — a long-feared “second wave” of infections and deaths, possibly at a catastrophic scale. It could begin well before Election Day, Nov. 3, although researchers assume the crest would come weeks later, closer to when fall gives way to winter.
An autumn surge in COVID-19, the disease caused by the novel coronavirus, would not be an October surprise: It has been hypothesized since early in the pandemic because of the patterns of other respiratory viruses.
“My feeling is that there is a wave coming, and it’s not so much whether it’s coming but how big is it going to be,” said Eili Klein, an epidemiologist at Johns Hopkins University School of Medicine.
The pandemic is already a dominant campaign issue, and even a spike in deaths might not apply much torque to the presidential race. But outbreaks in some states could bring pressure further down the ballot and conceivably affect turnout if there is so much community spread that voters who planned to cast ballots in person feel unsafe going to the polls.
The warnings from researchers come at a moment when, despite a rise in cases in the Upper Midwest, national numbers have been trending downward at a slow pace for weeks following the early summer surges in the Sun Belt.
Respiratory viruses typically begin spreading more easily a couple of weeks after schools resume classes. Although the pandemic has driven many school districts to remote learning, there is a broad push across the country to return to something like normal life.
The Labor Day holiday weekend is a traditional time of travel and group activities, and, like Independence Day and Memorial Day, could seed transmission of the virus if people fail to take precautions. And viruses tend to spread more easily in cooler, less humid weather, which allows them to remain viable longer. As the weather cools, people tend to congregate more indoors.
The coronavirus has a relatively long incubation period, and the disease progression in patients with severe illnesses also tends to be drawn out over several weeks. As a result, any spike in deaths will lag weeks behind a spike in infections. And the infection surges have consistently followed the loosening of shutdown orders and other restrictions.
A model produced by the University of Washington’s Institute for Health Metrics and Evaluation and published Friday forecasts a “most likely” daily death toll of 1,907 on Election Day, roughly double the current toll. Under the IHME forecast, the numbers would continue to rise until early December, peaking at more than 2,800 deaths daily.
By year’s end, 410,000 people in the United States will have died under the model’s mostlikely scenario. That’s more than double current fatalities. The model also produced best-case and worst-case scenarios — ranging from 288,000 to 620,000 deaths by Jan. 1 — depending on the degree to which people wear masks, adhere to social distancing and take other precautions.
“I firmly believe we will see distinct second waves, including in places that are done with their first waves. New York City, I’m looking at you,” said Andrew Noymer, an epidemiologist at the University of California at Irvine who studied the October surge in cases when the mild pandemic influenza virus circulated in 2009.
“I expect fall waves starting in mid-October and getting worse as fall heads into winter, and reaching a crescendo certainly after the election,” he said. “Some places will peak around Thanksgiving, some places will peak around Christmas, some places not until January and February.”
If that’s correct, the worst impacts will occur after the campaigning is over and the ballots have been cast. The exact timing may be moot in any case, said David Rubin, the director of PolicyLab at Children’s Hospital of Philadelphia, who contended that most people have already made judgments about how the candidates have handled the pandemic.
“I wouldn’t foresee anything happening between now and the election that would change the dynamics of the election,” Rubin said.
President Donald Trump’s approval rating has been remarkably consistent through the pandemic, noted Kyle Kondik of the University of Virginia Center for Politics. Though Trump lost some ground in May and June, he is no less popular than he was last fall, when the economy was strong and people could travel freely.
“There has been a little bit of erosion, but not a ton,” Kondik said. Of course, in a close election, even a small shift “could be a difference between victory and defeat.”
Rubin raised another possible consequence of increased viral transmission in advance of the election: Candidates could become sick.
“The candidates are campaigning. They’re mixing with people,” Rubin said. “I would not be surprised to see a couple people get sick, and whether that goes all the way to the presidential candidates could be a game changer. This virus has got pretty close to the president a couple of times.”