What If Covid-19 and Flu Both Flare Up This Fall?

The second wave of Covid-19 could be worse, and there’s potential for a double whammy

Robert Roy Britt
Elemental
Published in
8 min readMay 4, 2020

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A photo of a woman wearing a mask looking out the window from her home.
Photo: Justin Paget/Getty Images

If the Covid-19 case curve continues to flatten and decline in the United States as hoped, the credit will go to physical distancing, improved hygiene awareness, and other preventive measures, experts say. But we should not presume the virus will be licked anytime soon. In fact, many infectious disease experts are worried about a comeback, a second wave, that could strike more quickly and harder than this initial wave of infections.

Worse, it could arrive just as flu season is ramping up, potentially exacerbating symptoms and causing fresh havoc for the health care system and the economy. “Once we start opening things back up, we’re going to have a lot of individual cases that are still brewing under the surface,” says Michael Mina, assistant professor of epidemiology at Harvard T.H. Chan School of Public Health, on an April 28 conference call. “If we don’t put out all the flames, then we’ll have this smoldering number of people that will all be able to ignite outbreaks at once.”

The math of a second wave could be much different, Mina explains. The initial outbreaks were isolated, starting mostly in a few cities, where one case might have led to four other infections, then 16. In a second wave, you could have, say, 100,000 cases at the start that spread all over the country and lead to 400,000 new infections, then 1.6 million, and so on.

The 1918-19 influenza pandemic offers a lesson on how viral outbreaks can come in waves, Mina says. The first U.S. outbreak was in March of 1918. The spread subsided that summer then resurged in the fall, creating a far deadlier second wave of infections. After a third wave during the winter and spring of 1919, some 675,000 Americans had died at a time when the total population was just a third what it is today.

Could a second wave come sooner than the fall?

While the 1918-19 pandemic was caused by the flu virus and therefore does not offer an apples-to-apples comparison to the coronavirus, Covid-19 is not the first coronavirus-caused disease to make waves. Exactly 17 years ago, “we were smack-dab between two…

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Robert Roy Britt
Elemental

Editor of Aha! and Wise & Well on Medium + the Writer's Guide at writersguide.substack.com. Author of Make Sleep Your Superpower: amazon.com/dp/B0BJBYFQCB