Virtually from the onset of the pandemic, public health boffins around the world, mindful of the deadly follow-up wave of the Spanish Flu in the northern hemisphere autumn of 1918, were warning countries that even if they managed to suppress the virus, the danger of a second strain was incredibly real. And now it seems that second wave has come to fruition⍝. Australia, which had pretty much contained the spread of coronavirus by early June in all states and territories, has seen a renewed spike of infections in metropolitan Melbourne and a reimposition of border lockdowns by other states in the Commonwealth. In addition, another Covid cluster is currently emerging  in a pocket of south-west Sydney.

Elsewhere there are even more concerning trends of new flare-ups. In Covid-19 ravaged Europe, Portugal was until recently thought to be an exemplar of sorts on how to handle the pandemic and minimise its harmful impact. While neighbours Spain and France had been beset by rapid rates of infection and steepling mortality counts in the earliest phase of the pandemic’s first wave, Portugal by April was coping comparatively well. The republic’s small population (about 10.25 million) no doubt aided the authorities’ efforts to fight the pandemic, but this was counterbalanced by inherent drawbacks – an elderly population (3rd highest population of over 80s in Europe) and underfunded health system (just 4.2 critical care beds per 100.000 people). Portugal’s centralised system of government and the early implementation of measures—locking down public places and events—was key to the country’s success in slowing the pace of infection, reflected in the comparative death rates [‘How Portugal became Europe’s coronavirus exception’, (Paul Ames), Politico, 14-Apr-2020, www.politico.com].

European country	Per capita mortality from coronavirus
Portugal 🇵🇹	3%
Spain 🇪🇸	>10%
Britain 🇬🇧	12%
France 🇫🇷	15%
(as at mid-April 2020)	{Ames}

(Source: Reuters/ Rafael Marchante / File Photo)

Portugal’s relative success at that time, 18,091 confirmed cases of coronavirus and 599 deaths, was also attributed to a unified political approach—opposition and government working towards the common goal of tackling the pandemic—and to  the self-discipline of Portuguese people in faithfully adhering to the stay-at-home guidelines during the crisis (Ames). The situation in Portugal now sits at 46,818 confirmed cases and 1,662 deaths (14-Jul-2020) – the result of the reopening of economic activity and relaxation of restrictive measures [‘How Sweden and Portugal Went from Pandemic Role Models To Record Infections’, (Marina Velasco), Huffington Post, 11-Jul-2020, www.huffpost.com]. This surge in virus numbers is centred around the capital Lisbon.

Next door Spain is currently confronted with two new very serious cluster points in the north of the country. Galicia region (the northwest) and autonomous Catalonia (the northeast) have both imposed a second lockdown after the earlier easing of restrictions due to a similar upsurge in infections [‘Coronavirus: Spain imposed local lockdown in Galicia’, BBC News, 05-Jul-2020, www.bbcnews.com] . The timing of the spike is not good, especially as Spain and Portugal have just reopened their common border at the start of July.

🔺 Before the second strain: as of around 1st May Portugal had the Iberian bragging rights for best at weathering the coronavirus storm sown up (Source: www.ft.times)

Israel is another country whose fortunes with the pandemic have ebbed in recent weeks – going from “model nation fighting the novel coronavirus to a small, isolated country whose citizens face a long, deadly summer locked down”. An early, enforced lockdown saw Israel hold its fatalities to only 271 by May, with Israeli prime minister Netanyahu proclaiming it “the safest country on earth”. Two months later everything has gone pear-shaped in Israel, virus cases are spiking concurrently with a cratering economy and 23% unemployment (all adding to Netanyahu’s pre-existing political woes). The head of Israel’s public health service has quit in protest, frustrated by the government’s handling of the crisis – alleging a hesitant, disjointed, stop-start approach from the government (“six wasted weeks”), and equally worrying, a Trump-like reluctance by the prime minster to heed official public health expert advice✥. Adding his voice to the chorus of critics of the government’s approach, President Rivlin has commented that “Israel has failed to develop a clear and coherent doctrine to combat the coronavirus” [Noga Tarnopolsky, ‘“The Second Wave” of COVID Hits Israel Like a Tsunami’, Daily Beast, 10-Jul-2020, www.thedailybeast.com].

Ashdod, one of Israel’s virus hotspots
(Source: www.timesofindia.com) 🔻

PostScript: “Second wave-ism”✪ and relaxed response mode⊡
In fact “second wave” contagion seems quite a global prospect at the moment. Other countries such as Germany, Singapore, South Korea and China have all managed to contain the first wave outbreak in their respective countries, only, as restrictions on movement and travel get lifted, to be hit afresh with subsequent clusters of local infections [‘New Covid-19 clusters across world spark fear of second wave’, (Emma Graham-Harrison), The Guardian, 27-Jun-2020, www.theguardian.com].

(Image: Getty Images)

﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀﹀
⍝ Professor Nick Talley (Australian Journal of Medicine) refutes the view that Australia is experiencing a “second wave” of the virus, contending that the current outbreak is actually the “real first wave”
✥ over a six-week period the number of confirmed cases multiplied by 499%; currently (14-Jul-2020) Israel has confirmed 40,632 cases and 365 deaths from the pandemic
✪ the concept of what constitutes a virus second wave is not a definitive or consensual  one – “no precise epidemiological definition” (Harvard School of Public Health). It can be applied to “anything from localised spikes in infection to a full-blown national crisis” – so some medical experts avoid the term itself (Graham-Harrison)
⊡ epidemiologists worry that “social distancing fatigue” arising from being in lockdown for extended periods can contribute to pockets of new infections emerging