Planning for a second wave pandemic of COVID-19 and planning for winter
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COMMENTARY
Planning for a second wave pandemic of COVID-19 and planning for winter A statement from the Association of Schools of Public Health in the European Region John Middleton1 • Henrique Lopes2 • Kai Michelson3 • John Reid4 Received: 1 August 2020 / Revised: 4 August 2020 / Accepted: 12 August 2020 Ó Swiss School of Public Health (SSPH+) 2020
A second wave of COVID-19? There is no clear definition of a ‘second wave’ of COVID19. Many countries are grappling with resurgences in different forms. ASPHER suggests a second wave could be defined as: a resurgence of the incidence rate during a pandemic, which cumulatively presents an exponential increase in the number of cases of the disease in a given time period and specific territorial zone. This exponential increase follows from the disappearance or near disappearance of cases of the disease and may be influenced by a new behavioural characteristic of the infectious agent or a modified characteristic from another already known (Middleton et al. 2020).
A perfect storm ASPHER believes northern hemisphere countries should expect a second wave of the COVID-19 pandemic, from the autumn (IHME 2020; Academy of Medical Sciences 2020). Countries face a perfect storm of resurgences of COVID-19, a severe flu season, pandemic unmet long-term health needs, some induced by lockdown, additional deaths from cold-related conditions and additional disease related to severe economic breakdown. In planning for these
& John Middleton [email protected]
problems, we must assume there is no political will for full lockdowns, no herd immunity and no effective widely available vaccines and antiviral treatments (Middleton et al. 2020).
Second wave COVID-19 Non-pharmaceutical measures which have been applied across the globe in the first wave will be the major part of our response including: enhanced localised surveillance, test and trace, face masks, physical distancing, shielding of vulnerable individuals, quarantine of affected persons and bans on mass gatherings. Adequate stockpiles of personal protective equipment (PPE) are needed for health and care systems (Academy of Medical Sciences 2020). All will need to be delivered at an intensity and scale not previously achieved.
Planning for a severe flu season Countries need to plan to deliver an enhanced programme of flu vaccination to protect vulnerable patients, in the expectation of severe seasonal flu. Children’s immunisation programmes must achieve high coverage (Academy of Medical Sciences 2020; CDC 2020). Health and care staff must be vaccinated to protect themselves and their patients (Van Hems et al. 2011).
1
Association of Schools of Public Health in the European Region, Wolverhampton University, Wolverhampton, UK
Planning for winter
2
Unit of Public Health, Healthcare Sciences Institute, Universidade Cato´lica, Porto, Portugal
There is excess winter mortality across Europe, not necessarily related to absolute temperature levels. Cold housing is present in many c
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