Hi Tech : Can we stop the inevitable winter surge of COVID-19?

Temperatures are dropping, nights are getting longer, the end of the year holidays are approaching, and the science is clear: the pandemic is far from over. A long dark winter awaits us.

The number of new coronavirus cases per day in the United States soared from less than 40,000 in early September to more than 100,000 in early November. The country now confirms more episodes in a single day than China reported at the start of the pandemic. “We may be turning around, but not in a good way,” said Julie Swann, a health systems expert at North Carolina State University.

Although a winter surge of COVID-19 is now inevitable, experts warn that the number of infections and deaths the season will bring is not yet set in stone, and its magnitude depends on what we do from now on; hundreds of thousands of lives could be at stake.

“To say that a rise is inevitable may sound fatalism,” said William Hanage, an epidemiologist at Harvard’s TH Chan School of Public Health. “But the fact that a significant increase cannot be avoided does not mean that size is inevitable.”

If the United States continues to relax social distancing restrictions and mask-wearing requirements, up to 500,000 more Americans could die from COVID-19 by the end of February, according to scientists at the Institute for Health Metrics and Evaluation (IHME). its acronym in English) of the University of Washington. That is in addition to the approximately 240,000 deaths from COVID-19 that the country has already registered.

Even if we take substantial collective action, the number of deaths due to the coronavirus could exceed 100,000 between now and February 28, the IHME researchers noted. “We have passed the point of being able to control the virus,” said Christopher Murray, director of the institute and leader of the modeling work. “There are too many active cases.”

Scientists warned for months that the virus that causes COVID-19 could be seasonal, making it easier to spread in the cold winter months, just like influenza and pathogens that cause the common cold.

Experience has shown that SARS-CoV-2 is capable of spreading even when temperatures rise. This summer, there were outbreaks at an overnight camp in Georgia, a hockey rink in Florida, and various prisons in California. However, according to specialists, there are countless reasons why the coronavirus would spread even more quickly in the winter.

Some are due to the biology of the virus itself. Studies have shown that SARS-CoV-2 has more resistance in cold conditions than in warm conditions. When exposed to temperatures of 80 degrees Fahrenheit and 65% relative humidity, more than half of viral samples break down in just 90 minutes. But when the temperature drops to about 50 degrees, with 40% relative humidity, the virus can survive on surfaces for more than 24 hours.

Cold weather also affects human behavior. When the temperature drops, it becomes less comfortable to spend time outdoors, where the risk of infection is significantly lower than indoors. “The virus loves poorly ventilated indoor spaces,” Hanage noted. “Good fans can be helpful, but they’re not as good as being outside.”

Epidemiologists are also deeply concerned about the upcoming Christmas season and the ensuing family gatherings in which members of different households are likely to meet indoors and celebrate, without face masks, for hours. Experts fear these celebrations could accelerate outbreaks, which would be particularly dangerous for older family members, who face a higher risk of developing a severe case of COVID-19. “Indoor mask use is extremely important, especially if you’re at a multi-generational family meal,” Hanage said. “But of course people have to take them off to eat.”

Recent increases in coronavirus cases prompted England, France, Greece, Spain and other European countries to reinstate the lockdowns. For experts, it is further proof that a winter increase in the US is almost certain.

Worldwide, the pattern of coronavirus infections has largely mimicked the usual trajectory of pneumonia outbreaks, with a high concentration of cases in South America during the summer, followed by a peak in Europe beginning about a month. before the United States, according to IHME researchers.

Although the arc of pneumonia cases in the United States varies from state to state, it generally reaches a low in August and a high in the first weeks of February, Murray noted.

The silver lining is that over the past eight months, doctors have made progress in treating hospitalized patients with COVID-19. That means more people will survive. However, a COVID-19 patient who survives a hospitalization is still occupying a bed that will not be available to someone fighting cancer, trying to recover from a stroke, or fighting their own battle against coronavirus. “We are already seeing some hospitals overflowing, and they will continue to fill up,” said Dr. Michael Mina, an infectious disease specialist at Harvard.

All of this can make one feel like giving up. If a peak in winter is already underway, is it worth trying to combat it? Mina and others emphasize that the answer is a resounding yes. Waiting for herd immunity to arrive, either through an effective vaccine or through natural exposure to the virus, is not the answer, he stressed. It’s like watching an enemy drop bombs on our houses and thinking, “Well, eventually they’ll run out.” “If this were a real war that was killing 200,000 people, we would be building bombers and missiles,” he stressed.

A missile will not stop the coronavirus, but the widespread use of epidemiological tools could: rapid tests that can be administered at home would change the rules of the game. So would solid contact tracing and a concerted effort to resist isolation fatigue and distance yourself from those who do not share a home.

Simply making people wear masks every time they leave their homes would reduce infection rates by 25%, experts say.

“Informed infection control does not mean sanitizing all foods and not going to the grocery store,” Hanage said. “It means going only indoors where there is a high compliance with the use of face masks and avoiding close contacts, closed spaces and crowds.”

And here’s a little ray of hope: If we commit to living differently with the virus, then we might alter its projected course, warned Nicholas Reich, a professor at the University of Massachusetts at Amherst who has been developing models of the transmission of the virus. virus for the Centers for Disease Control and Prevention (CDC).

“It is really difficult to forecast an outbreak – especially a pandemic – months in advance, because a lot depends on how we respond as a society,” he said. “The only thing that is inevitable here is that it is difficult to influence human behavior, and the isolation fatigue is real.”

To read this note in Spanish, click here