Are we going to see a dreaded second spike in coronavirus cases? The question has a new poignancy after a week of mass protests where all pretence at social distancing seems to have gone out of the window. Life is getting back to normal, employment is sharply on the rise again and markets are soaring. Most notably of all, the distressing scenes in New York hospitals have ended as the virus appears in sharp decline there.
Nationally, across the US it is possible to detect a downwards trend in the number of new Covid-19 cases and deaths. The epidemic appears to have peaked in early April and tailed off since then – just as it has in Europe. But that isn’t the whole story. Drill down state by state and there is a very mixed picture. Study the graphs which the Washington Post has helpfully put online and you can put states into three distinct groups. Firstly, there are those states where the epidemic curve is clearly in decline and has been for some weeks. There are 15 of these. Most obvious is New York but others include Massachusetts, New Jersey, Pennsylvania, Illinois. Away from the North East, Colorado, Wyoming, Louisiana, Nebraska and Hawaii also fall into this category.
Then there are the states where the first peak has not yet significantly declined. There are 30 states which fall into this category, including California, Texas, Georgia, Ohio, Iowa, Kentucky, New Hampshire, Maine, Michigan, Maryland, Minnesota. Mississippi, West Virginia and Wisconsin. Most of these states have rolled back restrictions on movement and forced closures of businesses but did so before there had been any appreciable fall in cases. Currently there is no obvious trend either way.
But then there are six states which, worryingly, are showing a detectable second spike. In Florida, for example, new infections fell from over 1000 a day in early April to around 600 a day a month later. The state began to reopen on 4 May. Since then, however, new infections have climbed back to their previous peak, reaching 1419 on 4 June – the highest yet. It is a similar story in Arkansas, where cases had fallen from a peak of 402 on 22 April to 27 on 15 May before rising again to a new high of 450 on 6 June. In Vermont the epidemic seemed all but over on 12 May when zero cases were recorded. For three weeks after that cases remained low. But over the past week there has been a rebound, with 72 cases reported on 4 June. The other states with a discernible second spike are Alaska, Montana and Washington.
Is this a dire warning of what is to come? First it needs to be noted that none of these states had especially high peaks to start with. It would be a very different matter if New York started to show a second spike. Secondly, the number of reported cases does not necessarily reflect reality – it depends very much on the number of people being tested. It is a peculiarity of Covid 19 that there are huge numbers of asymptomatic cases – possibly as many as 80 per cent fall into this category – and that most of these are going unrecorded. Thirdly, there has been no sign of a second spike in badly-affected European countries – even though most have reopened much of their economies and have lifted restrictions on personal movement. Across the world, the only nations showing any kind of second spike are those which, like South Korea and Singapore, succeeded in suppressing the number of cases very early on. And even they haven’t seen much in the way of spikes.
Nevertheless, all eyes over the next few weeks are going to be on those US states which seemed to have suppressed the virus only for it to rebound.
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