Infectious Disease

Will there be a fourth wave of COVID-19 within the US?

March 01, 2021

2 min read

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Disclosure:
Frieden is President and CEO of Resolve to Save Lives, an initiative by Vital Strategies.

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After weeks of good news of falling case numbers, CDC Director Rochelle P. Walensky, MD, MPH, A recent press conference at the White House said the country had actually seen a spike in COVID-19 cases for three days.

Walensky warned that declines in case numbers and hospital admissions “may stall and possibly slow down to what is still very high”.

Tom Peace pullquote

“We at CDC see this as a very worrying shift in trajectory,” she said.

We spoke to the former CDC director Tom Frieden, MD, MPH, Resolve to Save Lives, President and CEO, on how the pandemic is progressing and the possibility of a fourth wave in the United States.

Healio: Is it correct to call it the “fourth wave”?

Peace: Yes, another surge in cases would be labeled a fourth wave as it is the fourth time since March 2020 that cases have occurred in the US. Virtually all of the US is currently seeing a downward trend in cases. This is likely because we have overcome the tremendous winter flood that happened when people were out on vacation and meeting inside. Many states are starting to lift restrictions because of this downtrend, but as the variants spread and people lose their vigilance, there could be another surge in cases in the coming weeks – causing a fourth wave.

Healio: Is it gonna happen?

Peace: Whether or not we have a fourth wave depends on how well we mask ourselves, limit and vaccinate the number of people we share the indoor air with. If we get this right, there won’t be a fourth wave.

Healio: What are the main factors that could determine whether there will be further increases in certain cases?

Peace: The first factor is how well we all collectively follow public health guidelines, including masking and physical distancing. This is especially important as businesses begin to open up and states relax other restrictions.

The second point concerns the distribution of vaccines. Currently supply is limited, but we need to make sure everyone gets a vaccine if they qualify. This includes tackling vaccine hesitation and ensuring historically marginalized communities are reached.

The third factor will be to ensure that low and middle income countries have fair access to vaccines. Although other countries are not vaccinated, there is a risk that new variants with the potential to evade current vaccines may emerge and make their way into the US. The US must move forward in partnership with WHO, COVAX and other countries to ensure the world is being vaccinated as soon as possible, including by scaling up manufacturing. Unhindered spread everywhere is a risk to people everywhere.

Healio: When can we get back to normal in the US?

Peace: If everything goes as planned, most of the population will be vaccinated this summer. In the fall, we should be able to resume activities such as going to the movies, dining, and concerts. However, COVID-19 is not going to magically go away. Certain guidelines will still be in place to reduce the risk of the disease and new variants spreading. This includes wearing masks, cleaning contaminated surfaces such as door handles and elevator buttons more regularly, and maintaining certain physical distances. This has the added benefit of reducing the spread of influenza and other infections.

This is an opportunity for society to build healthier and more resilient public health and basic services that will help prevent the spread of other diseases and reduce the risk of the next pandemic.

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