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Public Health preparing for a possible second wave of COVID-19

History shows that the second wave of a pandemic could be worse than the first

Local Public Health officials are preparing for a second wave of the COVID-19 pandemic, even though they don’t know what – or if – to expect.

“Though case counts are currently declining in WDG and across Ontario, a second wave of illness is a very real possibility. WDGPH and partners across the health system must prepare for this possibility in order to ensure the community is kept safe,” says a report by Associate Medical Officer of Health Dr. Matthew Tenenbaum to be presented at a Wednesday meeting of the Wellington-Dufferin-Guelph Public Health board.

“WDGPH is using the coming months to plan for a possible second wave and ensure the agency has appropriate capacity to respond.”

History is being used to help predict what to expect. And history says expect some form of second wave.

“The best model for understanding how this pandemic may unfold is to look to previous influenza pandemics. There have been at least eight global influenza pandemics since the 1700s, with four having occurred since 1900. All eight pandemics were characterized by a second (and in some cases, third) wave of illness.”

The rate of transmission can change based on controllable factors, such as measures already put in place during the current pandemic, and non-controllable factors such as weather.

“Multiple future scenarios are possible, including one that features a larger second wave arriving in the fall or winter,” says the report.

The Center for Infectious Disease Research and Policy (CIDRAP) outlines several possible scenarios regarding the impact of COVID-19 over the course of the pandemic 

  • (1) A first wave in spring 2020, followed by a series of smaller waves over the following 1-2 years.

  • (2) A first wave in spring 2020, followed by a larger wave in the fall/winter (similar to the 1918 influenza pandemic). This may be followed by smaller subsequent waves. 

  • (3) A single wave in spring 2020, followed by ongoing transmission without a clear wave pattern. This remains possible, though it differs from what was observed during previous influenza pandemics.

“Preparing for COVID-19 requires WDGPH to be ready for any of these scenarios. Scenario 2 would have the greater impact and is the greatest cause for concern.”

Tenenbaum’s says the following actions are being taken in preparation for a possible second wave.

• Developing a robust action plan that spans all parts of WDGPH’s Incident Management System;

• Enhancing surveillance systems and identifying patterns that would alert the agency to when a second wave may arrive;

• Ensuring that WDGPH’s case management and data entry teams are adequately resourced to manage higher case volumes;

• Changing internal processes in order to take advantage of new digital solutions such as COVID Alert, the new provincial exposure notification app; 

• Migrating to the new provincial case and contact management system;

• Incorporating messaging about a second wave into WDGPH’s public communications;

• Supporting local partners with their preparedness efforts.

Of note, efforts have been made to better prepare for a second wave in congregate settings, such as long-term care homes, retirement homes and shelters.

“WDGPH established a Congregate Settings Team to support these facilities and ensure that they are adequately prepared for a second wave,” Tenenbaum said. “This team works in conjunction with local partners including the Ontario Health Teams, hospitals and the Ministry of Long-Term Care/Retirement Homes Regulatory Authority.”