San Diego Union-Tribune (Sunday)

EXPERTS PROJECT AUTUMN SURGE IN CORONAVIRU­S CASES, DEATHS

National rates have been trending downward for weeks

- BY JOEL ACHENBACH & RACHEL WEINER Achenbach and Weiner write for The Washington Post.

Infectious-disease experts are warning of a potential cold-weather surge of coronaviru­s cases — a longfeared “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 spread that that voters voters who who planned to cast ballots in person feel unsafe going to the polls.

The The warnings warnings from from researcher­s recome at a moment when, despite a rise in cases in the Upper Midwest, national numbers have been trending downward at a slow pace for several 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 though the the pandemic pandemic has 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 most-likely 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.”

As of Saturday, more than 6.2 million people in the U.S. had tested positive for the coronaviru­s and more than 188,000 people had died, according to a tally by Johns Hopkins University. Globally there have been more than 26 milion cases and more than 877,000 deaths.

 ?? FREDERIC J. BROWN AFP VIA GETTY IMAGES ?? People swab their mouths at a coronaviru­s testing site in Los Angeles on Friday.
FREDERIC J. BROWN AFP VIA GETTY IMAGES People swab their mouths at a coronaviru­s testing site in Los Angeles on Friday.

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