The Covid Comeback: What's Different This Time?

Florida recently ordered a return to normal, with restaurants and bars reopening to 100% capacity. Such policies would lead one to believe that the worst is over. But in other parts of the world, and indeed in parts of the U.S., Covid-19 is very much on the rise, sparking fears of a “second” or even “third wave.” Can we expect the same in the U.S.? Is reopening a prelude to new rounds of shutdowns? Are lockdowns inevitable or are there other strategies that can avert such a resurgence of cases?

Observing countries abroad reveals three clear messages:

1. Covid-19 is growing again in places that had mostly subdued the virus. From Canada to the UK to Israel, cases have rebounded with variable timing and ferocity, and views from around the world warn against the dangers of reopening too far or too quickly.
   
   
2. Policy responses are different this time around. Strict nationwide lockdowns have been eschewed for more targeted measures, like locking down the specific regions that are experiencing outbreaks or limiting activities and gatherings where spreading is likely, such as at bars and weddings.
   
   
3. Avoiding stricter, wider-spread lockdowns is dependent on adherence to the basics of containing the virus: wearing masks, maintaining social distancing, using contact tracing to track infections early, washing hands, and limiting behavior that is likely to spread the virus. 

This week, The Factual took a deep dive on the state of Covid-19 cases worldwide using 47 articles from 32 outlets from across the political spectrum and around the world. We examine where cases are rising, why outbreaks may be different this time, and how the U.S. might be able to avoid a resurgence in the virus.

Source: Wall Street Journal

Cases Are on the Rise

While there are countries that still seem to be keeping the virus at bay — South Korea, Vietnam, Taiwan, and New Zealand — many countries are seeing rapid increases in cases, and experts are sure this isn’t simply a function of increased testing. In Europe, for example, the latest data from the European Centre for Disease Prevention and Control shows case counts clearly elevating in recent weeks in Austria, Belarus, Belgium, the Czech Republic, France, Hungary, Iceland, Ireland, Italy, the Netherlands, Portugal, Romania, Russia, Slovakia, Slovenia, Spain, Switzerland, Ukraine, and the UK. Regardless of whether you use the term “second wave,” these countries are experiencing resurgences in cases. 

Source: Statista

Further abroad, Israel has become the first advanced economy to fully reimplement a second nationwide lockdown after new case counts topped 5,000 per day. In Iran, where data has been suspect from the start, the rate of new cases is now the highest since February when the virus first hit. And while these renewed surges in Covid-19 cases are alarming, places like Brazil and and India are yet to see any significant let up in the rate of new infections and, together with the U.S., account for the countries with the most infections in the world.

The global variation in these trends is difficult to classify, but looking at specific cases for comparison can be instructive. How are countries reacting? And what lessons can the U.S. learn from their experiences?

How Are Countries Responding?

Across the board, countries are responding with varied but less extreme policies to stop the spread of the virus and lockdown the worst areas without shutting down entirely nationwide. 

Just weeks ago, Prime Minister Boris Johnson was encouraging people in the UK to return to work, but on September 22, he urged a return to working from home for those who can, set a new curfew on pubs, and mandated mask wearing in the hospitality industry — all amid rapidly rising case counts. Localized lockdowns are being considered in the north of the country but are already in place in other parts of Europe, like in Spain, where the government recently locked down 4.8 million of Madrid’s residents. 

Changes are also coming closer to the U.S. Quebec last week became the first province to reintroduce some restrictions, “closing restaurants, cinemas, and theaters, and forbidding household visits to friends or family, with some exceptions.” These tools are meant to act as a scalpel instead of the blunt instrument of a nationwide lockdown, a rationale well captured by German Chancellor Angela Merkel: “[w]e want to act regionally, specifically and purposefully, rather than shutting down the whole country again — this must be prevented at all costs.” 

Source: The Telegraph

As part of their responses, policymakers are left to contemplate where they went wrong when lockdowns were eased in the past, opening the door to a return to the virus. The reasons all follow a familiar pattern — opening too broadly and too quickly. 

Spaniards point to a rapid reopening after what had been stringent but successful lockdown: “[t]he return of nightlife and group activities — far faster than most of its European neighbors — has contributed to the epidemic’s resurgence.” 

In Canada, the uptick is tied to “private social gatherings, such as parties hosted by young adults, dinner parties and weddings” and “children returning to school, workplaces reopening and cooler weather that is driving people indoors.” Experts in Israel, the one advanced economy that has had to revert to a nationwide lockdown,  point to the rapid opening of schools and relaxed restrictions on mass gatherings, all part of a general complacency toward the virus, not least among government officials. In recognition of this, leaders are being more cautious this time around, with Israeli Prime Minister Benjamin Netanyahu and Boris Johnson warning that the renewed restrictions in their respective countries could for months.

How Is It Different This Time?

While these countries only represent a handful of country experiences, they are informative to U.S. policymakers and may help foreshadow the weeks and months ahead. It’s apparent that Covid-19 can readily resurge, but there are some things that might be different this time around. 

As many have pointed out, the death rate from Covid-19 has fallen significantly since the beginning of the pandemic. For one, health systems, here and in many places abroad, are better prepared to treat Covid-19 patients. We may be months from an effective vaccine, but we now have a range of medical strategies that seem to be limiting the worst symptoms of the virus, including the use of steroids, remdesivir (an antiviral drug effective in serious cases), and even slight physical adjustments (like that placing patients in a prone position can enhance oxygen intake). The reduction is also likely a result of more young people being infected recently, who are naturally less susceptible to the virus. Either way, a combination of these and other factors have indeed reduced the mortality rate substantially from this spring. However, complacency on this account could be dangerous, since rising case counts could overload health systems and lead to less effective treatment and higher death rates.

“Many of the new restrictions, however, look different to those imposed at the beginning of the pandemic. Rather than implementing uniform, nationwide regulations, many countries are now opting for more localized approaches.” - Time

More broadly, most governments now recognize that nationwide, strict lockdowns need to be reserved for only the most worrisome of circumstances. Blanket lockdowns were critical in the first months when testing was nearly nonexistent and cases were skyrocketing, but now we have the tools to wage a far more effective war against the virus through testing, contact tracing, and targeted restrictions, like those being implemented in the UK, Canada, and Spain. Rather than closing all of society, we now know we can target gatherings of people, indoor spaces with poor circulation, and industries with high person-to-person contact. When those measures fail to contain the spread, strict but geographically limited lockdowns may be necessary to stop surges. For example, Australia recently reversed a renewed spike in cases through a strict lockdown in Melbourne and limitations on interstate travel. While these moves still have ramifications, selective imposition of such measures can serve to blunt the economic damage from the pandemic and policy responses, which have wreaked havoc on low-income populations, small businesses, and the people who can generally afford foregone income the least.

“If countries are responding, slowing down their reopening, making targeted changes to slow the spread of the virus, hopefully we can keep things in check before it escapes onto that exponential growth pathway.”  - Dr. Peter Drobac/VOA News

The most important message will perhaps be the most difficult to learn and abide by. To avoid subsequent surges in the U.S. and lockdowns in response, continued vigilance is necessary in social distancing measures, mask wearing, hand washing, and general behaviors that limit dangerous person-to-person contact. Just as we’ve learned that the virus is better fought not with blanket restrictions, countries abroad are demonstrating that society can’t yet comprehensively open up. Evidence shows that those countries that ease restrictions too much or too quick are bound to see the pendulum shift quickly back in the other direction. As the Telegraph illustrates, “those countries which have the most relaxed lockdown restrictions are seeing more pronounced surges.” Success, for now, most likely looks like purposeful and continual everyday measures to keep case counts low and targeted lockdowns only where and when severe outbreaks emerge.

European countries, thus far, have shown an ability to address the uptick in cases without stringent, wide-reaching lockdowns. That is good news. But as places like Florida continue to remove restrictions, one can see that relaxing Covid-19 measures too far — or failing to place stringent-enough measures in the first place — can spur a rapid return for the virus. In many other countries, it already has.

Appendix

Below is a list of the articles used to inform this analysis. To learn more about how The Factual scored article credibility, visit out How It Works page.