Two Peaks or Not Two Peaks?

“We have made truly remarkable progress in moving our nation forward.” So claimed the Vice President of the United States, Mike Pence, at a coronavirus press briefing on the 26th of June. Oliver Lamb considers the veracity of this assertion, exploring the different test positivity rates across the USA. This article also discusses the significance of a recent coronavirus outbreak at a meat-packing plant in Germany, while assessing the severity of the situation in Iran.

But the mere fact of the briefing – the first in two months – indicated that all was not well. The United States is, in absolute terms, comfortably the worst-hit country by coronavirus, having recorded over 2.6 million cases and 128,000 deaths. Lockdowns had been eased after the pandemic peaked in April, but now the curve is bending the wrong way again. Several states are reporting record daily case numbers, and, on the day of the briefing, the nation as a whole registered a record 42,000 infections.

This can partly be attributed to increased testing, but the percentage of tests coming back positive has also risen, suggesting that the virus is becoming more prevalent in the population. In mid-June the test positivity rate for the United States was 5%, the level recommended by the World Health Organisation for easing a lockdown. That number has now crept back up to 6%. For nine states it is above 10%, and in Arizona it is nearly a quarter.

This is backed up by data showing that hospitalisations are rising in several states. Some have warned that healthcare systems may be overwhelmed.

Whether the rise in cases qualifies as a second wave is unclear. A true second wave would see infections spike in an area that had already been struck, but the current resurgence is being driven by the south and west, which have hitherto suffered relatively few cases and deaths. Meanwhile, cases in the hard-hit northeast are continuing their downward trajectory.

Whatever the semantics of the situation, things are bad enough that some restrictions are being reimposed. The governor of California, Gavin Newsom, has ordered bars to close in Los Angeles and six other counties. In Texas, Governor Greg Abbott has closed bars and cut restaurants’ maximum indoor seating capacity from 75% to 50%; Mayor Esmeralda Moya of Galena Park, a town near Houston, has imposed an overnight curfew. In Florida, Governor Ron DeSantis has banned bars from serving alcohol, and Mayor Francis Suarez of Miami has warned that he may implement a stay-at-home order. All of this has happened in the past week.

The daily death toll has so far remained steady. Given the lag of several weeks between infection and death, that may change. However, Dr. Robert Redfield, the director of the Centers for Disease Control, says the surge in cases is being driven by those aged 18-34, who are far less likely to die from the virus. That offers hope that deaths may stay low.

The US is not the only country experiencing a second peak. COVID-19 struck Iran in late February before peaking in late March. Throughout April and May shops, parks, religious venues, restaurants, cafés and museums and historical sites reopened one by one. Since May, however, the virus has rebounded.

President Hassan Rouhani attributes the rise to increased testing, and this undoubtedly forms part of the explanation. Although, as in America, a rise in the test positivity rate suggests a genuine resurgence of the disease. That conclusion is reinforced by the spike in the daily death toll to well over 100 per day.

It is not hard to work out why this happened. A poll conducted by the health ministry in early June found that only 40% of Iranians were adhering to social distancing, down from 90% earlier in the year; and 32% were following the rules on self-isolation, down from 86%. Offices, banks and transport systems have been packed with people.

Events in America and Iran have not been repeated elsewhere. Europe and China, which are lifting restrictions after passing through serious epidemics, have seen no widespread resurgence of the virus.

Nevertheless, there have been several local outbreaks. At a single meat-packing plant in the German state of North Rhine-Westphalia, over 1500 workers tested positive. On the 23rd of June, two nearby districts were locked down.

On the 28th of June, the Chinese government quarantined 400,000 residents of Anxin county, 90 miles south of Beijing, after eighteen cases were reported in two weeks. Parts of Beijing itself are under restrictions after an outbreak that is believed to have started in the huge Xinfadi food market.

Perhaps these incidents might have turned into a full-fledged second peak, if not for rapid and severe interventions. Perhaps they still will. But the United States and Iran can serve as warnings to politicians and the public not to take their eyes off the ball.

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