The second virus wave: How bad will it be as lockdowns ease?

The second virus wave: How bad will it be as lockdowns ease?
A serviceman of Belarus Ministry of Defence, left, and medical workers wearing protective gear are seen at a local hospital in Minsk, Belarus, Tuesday, May 5, 2020. Despite the World Health Organization's call for Belarus to ban public events as coronavirus cases rise sharply, President Alexander Lukashenko says the country will go ahead with a parade to mark the 75th anniversary of the defeat of Nazi Germany. (AP Photo/Sergei Grits)

From the marbled halls of Italy to the wheat fields of Kansas, health authorities are increasingly warning that the question isn't whether a second wave of coronavirus infections and deaths will hit, but when—and how badly.

In India, which relaxed its lockdown this week, health authorities scrambled Wednesday to contain an outbreak at a huge market. Hard-hit New York City shut down its subway system overnight for disinfection. Experts in Italy, which just began easing some restrictions, warned lawmakers that a new surge of infections and deaths is coming, and they urged intensified efforts to identify victims, monitor their symptoms and trace their contacts.

German Chancellor Angela Merkel said after meeting with the country's 16 governors that restaurants and remaining shops will be allowed to reopen in the coming weeks but that restrictions will be reimposed if new infections hit a certain level.

"There will be a second wave, but the problem is to which extent. Is it a small wave or a big wave? It's too early to say," said Olivier Schwartz, head of the virus and immunity unit at France's Pasteur Institute. France, which hasn't yet eased its lockdown, has worked up a "re-confinement plan" to ready for that second wave.

Many areas are still struggling with the first wave. Brazil for the first time locked down a large city, the capital of Maranhão state. Across the ocean, the number of confirmed coronavirus cases in Africa has shot up 42% in the past week. Infections were expected to surpass 50,000 there on Wednesday.

The second virus wave: How bad will it be as lockdowns ease?
People from the low-income neighborhood of Klong Toey wait to get tested for the coronavirus in Bangkok, Thailand, Wednesday, May 6, 2020. Thai health workers started testing community of about 1600 people of the Klong Toey area at a nearby Buddhist temple. (AP Photo/Gemunu Amarasinghe)

An Associated Press analysis, meanwhile, found that U.S. infection rates outside the New York City area are in fact rising, notably in rural areas. It found New York's progress against the virus was overshadowing increasing infections elsewhere.

"Make no mistakes: This virus is still circulating in our community, perhaps even more now than in previous weeks," said Linda Ochs, director of the Health Department in Shawnee County, Kansas.

The virus is known to have infected more than 3.6 million and killed more than 251,000 people, according to a tally by Johns Hopkins that all experts agree is an undercount because of limited testing, differences in counting the dead and concealment by some governments.

The U.S. has seen over 71,000 deaths amid its 1.2 million confirmed infections, and Europe has endured over 144,000 reported deaths.

The second virus wave: How bad will it be as lockdowns ease?
A female student wearing a protective face mask to help curb the spread of the new coronavirus checks temperature of her classmates at a high school in Wuhan in central China's Hubei province, Wednesday, May 6, 2020. Senior students returned to classes on Wednesday in the central Chinese city of Wuhan, the epicenter of the coronavirus pandemic, after no new cases or deaths were reported from the outbreak that had prompted a 76-day quarantine in the city of 11 million. (Chinatopix via AP)

"Burying both parents at the same time? It's hard," said Desmond Tolbert, who lost his mother and father in rural Georgia. Because they had the virus, he couldn't be with them when they died.

The researchers behind a widely cited model from the University of Washington nearly doubled their projection of deaths in the U.S. to around 134,000 through early August, in large part because of the easing of state stay-at-home restrictions.

President Donald Trump, with his eye on being reelected in November, is pushing hard to ease the social-distancing orders and resuscitate the U.S. economy, which has seen over 30 million workers lose their jobs in less than two months. Though the White House had signaled Tuesday that it would begin winding down the country's coronavirus task force, Trump tweeted Wednesday that it would continue "indefinitely with its focus on SAFETY & OPENING UP OUR COUNTRY AGAIN."

The second virus wave: How bad will it be as lockdowns ease?
Pensioner Jose Manuel Gonzalez, left, in attended by hairstylist Alberto Erce in a small hairdresser showing a banner to encourage people affected by lockdown to prevent the spread of the coronavirus, in Pamplona, northern Spain, Wednesday May 6, 2020. (AP Photo/Alvaro Barrientos)

Underscoring those economic concerns, the European Union predicted the worst recession in its quarter-century history, and the U.S. unemployment rate for April, which comes out Friday, is expected to hit a startling 16 percent, a level last seen during the Great Depression of the 1930s.

A century ago, the Spanish flu epidemic's second wave was far deadlier than its first, in part because authorities allowed mass gatherings from Philadelphia to San Francisco.

As Italy's lockdown eased this week, Dr. Silvio Brusaferro, president of the Superior Institute of Health, urged "a huge investment" of resources to train medical personnel to monitor possible new cases. He said tracing apps—which are being built by dozens of countries and companies—aren't enough to manage future waves of infection.

"We are not out of the epidemic. We are still in it. I don't want people to think there's no more risk and we go back to normal," said Dr. Giovanni Rezza, head of the institute's infectious-disease department.

The second virus wave: How bad will it be as lockdowns ease?
Health workers collect a nasal swab sample from a woman to test for the coronavirus in Bangkok, Thailand, Wednesday, May 6, 2020. Thai health workers started testing community of about 1600 people of Klong Toey slum at a nearby Buddhist temple. (AP Photo/Gemunu Amarasinghe)

Lothar Wieler, head of Germany's national disease control center, said scientists "know with great certainty that there will be a second wave" of infections but said Germany is well-prepared to deal with it. The country has been hailed for testing widely and has had one-fourth the number of deaths in Italy or Britain, which have smaller populations.

Britain has begun recruiting 18,000 people to trace contacts of those infected. British officials acknowledge that they should have done more testing and tracing earlier and could learn from South Korea, which brought its outbreak under control by rigorously testing, tracing and isolating infected people.

South Africa, which has years of experience tracking HIV and other infections, has more than 30,000 experienced community tracers at work. Turkey has 5,800 teams of contact tracers who have tracked down and tested nearly half a million people.

The second virus wave: How bad will it be as lockdowns ease?
People rest and exercising on park in Barcelona, Spain, Wednesday, May 6, 2020. Spain has implemented time slots for different groups like sport and exercise, for elders and for children, to control release of the population from lockdown while controlling the spread of coronavirus. Spain's government has extended the country's current state of emergency for another 15 days. Spain has recorded over 25,600 deaths from the new coronavirus. (AP Photo/Emilio Morenatti)

India was concentrated on the immediate drama around the market in the southern city of Chennai, which is now tied to at least 1,000 virus cases. An additional 7,000 people connected to the now-shuttered Koyambedu market are being traced and quarantined. Experts are worried about a health catastrophe in a country of 1.3 billion people with an already stressed medical system.

New confirmed daily infections in the U.S. exceed 20,000, and deaths per day are well over 1,000, according to the Johns Hopkins tally. And public health officials warn that the failure to lower the infection rate could lead to many more deaths—perhaps tens of thousands—as people venture out and businesses reopen.

"The faster we reopen, the lower the economic cost—but the higher the human cost, because the more lives lost," New York Gov. Andrew Cuomo sai d. "That, my friends, is the decision we are really making."

  • The second virus wave: How bad will it be as lockdowns ease?
    Guillermina de Figueredo, 72, wearing a protective face mask as a precaution against the spread of the new coronavirus, carries recycled newspapers on her head which she sells to merchants who use them as wrappers, in Asuncion, Paraguay, Tuesday, May 5, 2020. The government authorized the reopening of some businesses under a plan coined, "intelligent quarantine". (AP Photo/Jorge Saenz)
  • The second virus wave: How bad will it be as lockdowns ease?
    Medical workers take a break at a coronavirus mobile test site in Jakarta, Indonesia, Wednesday, May 6, 2020. The Indonesian Election Commission has decided to postpone preparations for Sept. 23, 2020, regional elections until at least December later this year after a number of organizers got sick with virus. (AP Photo/Dita Alangkara)
  • The second virus wave: How bad will it be as lockdowns ease?
    Migrant laborers and their family members, who arrived from Gujarat state on a train, wave from inside a bus as they prepare to leave for their native villages in their home state of Uttar Pradesh in Prayagraj, India, Wednesday, May 6, 2020. India is running train service for thousands of migrant workers desperate to return home since it imposed a nationwide lockdown to control the spread of the coronavirus. (AP Photo/Rajesh Kumar Singh)
  • The second virus wave: How bad will it be as lockdowns ease?
    Familihulp home healthcare worker Nathalie Deroost, wears a face mask to protect against the spread of coronavirus, as she speaks with her client, former truck driver Jerome Demeyer, 86, at his house in Bierbeek, Belgium, Wednesday, May 6, 2020. Belgium is relaxing some of its lockdown measures Monday. Business-to-business companies can open their offices to employees again and those taking public transport must wear a mask. (AP Photo/Francisco Seco)
  • The second virus wave: How bad will it be as lockdowns ease?
    People pass by wearing face masks to protect against the spread of the new coronavirus as ride along a street in Beijing, Wednesday, May 6, 2020. China on Wednesday reported just two new cases of the coronavirus and no deaths. (AP Photo/Mark Schiefelbein)
  • The second virus wave: How bad will it be as lockdowns ease?
    Homeless people sleep on a train at the Coney Island Stillwell Avenue Terminal Wednesday, May 6, 2020, in the Brooklyn borough of New York. (AP Photo/Frank Franklin II)
  • The second virus wave: How bad will it be as lockdowns ease?
    A fisherman casts into the surf Tuesday, May 5, 2020, in Huntington Beach, Calif. California Gov. Gavin Newsom's administration gave approval Tuesday to plans by Huntington Beach and two smaller cities to reopen beaches that fell under his order shutting down the entire Orange County coast after a heat wave drew large crowds to the shore. (AP Photo/Chris Carlson)
  • The second virus wave: How bad will it be as lockdowns ease?
    A banner in Italian reads: "If we open we go bankrupt!" as restaurant and bar owners protest against limited reopening in Milan, Italy, Wednesday, May 6, 2020. Hundreds of Milan bar and restaurant owners each placed an empty chair from their establishments in front of the Arco della Pace triumphal arc Wednesday in a protest demanding fiscal and other measures to help them survive the lockdown. Restaurants and bars can presently prepare take-away food and drinks for customers and will only open for sit-down clients from June 1. (Claudio Furlan/LaPresse via AP)
  • The second virus wave: How bad will it be as lockdowns ease?
    Relatives mourn while awaiting the removal of the body of Arlen Laranjeira Bezerra, 39, a victim of the new coronavirus and who died in circumstances still unknown after fleeing the emergency room of the Delphina Rinaldi Abdel Aziz Hospital in Manaus, Amazonas state, Brazil, Tuesday, May 5, 2020. Bezerra was admitted to the hospital to undergo treatment for COVID-19 disease and after escaping from the hospital at dawn, his body was found by family members approximately 200 meters from the hospital. (AP Photo/Edmar Barros)
  • The second virus wave: How bad will it be as lockdowns ease?
    Cars and trucks are driven on a relatively empty highway in Frankfurt, Germany, Wednesday, May 6, 2020. Due to the coronavirus a lot less traffic is seen during the day. (AP Photo/Michael Probst)

New York City Mayor Bill de Blasio warned on CNN that some states may be reopening too quickly.

"My message to the rest of the country is learn from how much effort, how much discipline it took to finally bring these numbers down and follow the same path until you're sure that it's being beaten back," he said, "or else if this thing boomerangs, you're putting off any kind of restart or recovery a hell of a lot longer."

Trump acknowledged the toll but argued that keeping the U.S. economy closed carries deadly costs of its own, such as drug abuse and suicides.

"I'm not saying anything is perfect, and yes, will some people be affected? Yes. Will some people be affected badly? Yes. But we have to get our country open and we have to get it open soon," he said during a visit to Arizona in which he did not wear a face mask.

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