Texas A&M Expert: As Coronavirus Pandemic Enters New Phase, Expect Spikes In Cases
A downward trend in new coronavirus cases and deaths in the United States — and a rapid decline in some hotspots — are good signs as the pandemic enters a new phase, according to a Texas A&M University expert, but the pandemic is far from over.
In Texas, where people have started to return to restaurants, retailers and salons under a phased reopening plan, expect to see an uptick in cases as people begin to resume close human-to-human activity, said Dr. Gerald Parker, director of the biosecurity and pandemic policy program at the Bush School of Government and Public Service.
“That should not necessarily frighten us, but we’re going to have to monitor it very closely to make sure that if we see what might appear to be a dangerous spike in new cases, that we jump in very quickly and try to interrupt transmission,” Parker said.
Parker, who also is the associate dean for Global One Health, served as the principal deputy assistant secretary within the Department of Health and Human Services’ Office of the Assistant Secretary of Preparedness and Response. At the Bush School, he’s one of the pandemic scholars who forewarned of an impending pandemic years ago. Now with more the 1.7 million positive cases and 100,000-plus deaths over the course of the COVID-19 pandemic, the United States may be beginning to turn a corner, Parker said, but the virus is still widespread — and could be with us through next spring, or longer.
“We have to learn how to live with the virus,” he said. “It’s not going to go away.”
A New Phase Of Containment
Lacking a national overarching strategy on COVID-19, Parker has proposed viewing the pandemic in a series of five phases.
The United States has already passed the first containment phase, which began in January when the virus began to spread in China. The Department of Health and Human Services declared a public health emergency and the president invoked travel restrictions, among other efforts to slow virus transmission to the United States while public health officials prepared to contain and isolate cases once the virus arrived in our communities.
By mid-March, Parker said, the country’s ability to contain the virus was overwhelmed, moving it into a mitigation phase. Non-pharmaceutical interventions like school closures, stay-at-home orders and social distancing requirements slowed the spread in communities and decreased the burden of severe disease.
The country is now entering what Parker considers Phase 3 — a new phase of containment, which in the absence of a vaccine, will be heavily reliant on a “test, trace and isolation capability.”
“We know a lot more about who’s vulnerable, who are the at-risk populations, than we knew even a month ago, so that gives us knowledge as to how to mitigate risk,” Parker said. “And so we’re safer than we were to begin reopening our economy and industry.”
“We’re going to find a ‘new normal’ at some point, and we’re not quite sure what that will be, but we’re not going back to the normal of December 2019 for quite some time.”
In Texas, Gov. Greg Abbott announced a formal reopening plan that began May 1. Businesses including restaurants, retailers, salons, movie theaters, bars and child care centers have been allowed to reopen, with capacity restrictions. Parker said it’s a “measured and responsible” approach, adding that each community will need to move at a slower or quicker pace to reopen safely, which will require an investment in public health to monitor hospital capacity, administer tests and perform contact tracing.
Social distancing and community mitigation measures have succeeded in decreasing the peak in the curve, perhaps even flattening it, Parker said, by cutting down on transmission through person-to-person contact.
But as Texans begin to re-engage in their communities, Parker said he has concerns that people will relax into ignoring mitigation efforts like maintaining six feet of distance between others in public, wearing masks and avoiding large gatherings.
“We are lifting the shelter-in-place orders, we’re not lifting the importance of physical separations, community mitigation and individual responsibilities. I do worry about complacency,” Parker said. “Just because the most severe shelter-in-place orders are lifting, [some people think] we’ve conquered the virus, and we haven’t.”
“We’re going to find a ‘new normal’ at some point, and we’re not quite sure what that will be, but we’re not going back to the normal of December 2019 for quite some time,” he said.
Learning From History
It’s impossible to know for sure how the coronavirus pandemic will evolve, but history can tell us a lot, Parker said. Although it’s dissimilar from the flu, it is a novel respiratory virus impacting a naive immune population similar to influenza viruses that caused pandemics in the last century. So far, SARS-CoV-2 is behaving like past pandemics caused by the influenza viruses of 1918, 1957, 1968 and 2009.
These pandemics were all associated with second and even third waves, he said. The 1918 flu pandemic began in the spring and saw a catastrophic second wave that fall, followed by a third wave in the spring of 1919.
“We don’t know if this coronavirus will act similarly, but we must plan and anticipate that we might have a second wave in the fall, probably about the same time that we experience seasonal influenza that we have every year,” Parker said. “We could have a third wave in the spring, as well.”
Spikes in positive cases are expected throughout the summer too, Parker said, and aggressive public health actions will be needed to prevent those from becoming “dangerous increases.”
Parker is optimistic that treatment options will become available soon. Clinical trials for the antiviral drug remdesivir show promise for treating critically ill COVID-19 patients, he said, and more than 100 vaccine candidates are in various phases of development across the world.
It generally takes more than a decade and well over a billion dollars to develop a new vaccine, Parker said, and a new vaccine for the novel coronavirus — which he thinks could realistically start to become available within 18 to 20 months — would be a new record.
For now, Parker is mostly focused on the future as the state moves into unchartered territories building extensive contact tracing and testing efforts to prepare for the fall and experts begin to assess how to prevent future pandemics.
He expects the COVID-19 pandemic will warrant a commission similar to the 9/11 Commission Report following the Sept. 11 terrorist attacks. “It is essential that we have a non-partisan analysis that points to what needs to be done to prepare for future infectious disease outbreaks,” he said.
“COVID-19 has revealed that emerging infectious diseases with pandemic potential are indeed a national security issue,” Parker said. “This experience has confirmed the importance of public health preparedness, but it’s also uncovered geopolitical issues, as well, and problems in our supply chains and a dangerous vulnerability on our whole economy that go beyond public health.”
Along with preparing to deal with health crises domestically, investments in international development and global health security will be “absolutely essential,” he said, especially in low-income countries to support public health and animal health institutional capacities to stop future outbreaks at their source where they most often occur.
“There are already people looking back and pointing fingers, but that to me is counterproductive,” Parker said. “There will be a time for after action review, and it’s what we do in the future that’s most important.”
Media contact: Caitlin Clark, firstname.lastname@example.org