The ominous surge of a second covid wave worldwide

Managing covid has often seemed such an insurmountable public health challenge that government pronouncements sometimes sound like an election manifesto. In March, British Prime Minister Boris Johnson was pledging to stick with the science; in the past few weeks, he has been ignoring calls for a 14-day lockdown from his top scientists, who believe the country needs a “circuit-breaker” so that hospitals are not overwhelmed. In India, various observations have had an air of omniscience. In mid-September, Indian Council of Medical Research director general Balram Bhargava said, “We distributed the curve in a way that… we didn’t have a huge peak at all.” This may have been intended to inspire confidence, but sounded more like over-confidence.

Try as we must at a personal level, avowals of social distancing to flatten the infection curve have seemed akin to New Year resolutions to lose weight. Much of Europe and the US are once again seeing an exponential surge. America has reported 500,000 new cases in the past week. A Mexican mayor in a town across the border from Texas is contemplating a temporary ban on visitors from the US. This would seem a delicious irony—if the accompanying report did not mention patients being airlifted from El Paso, Texas, where hospital capacity has hit its limits. Italy has once again ordered the closure of movie and concert halls and gyms. And, the northern hemisphere is not even into its most severe cold weather yet.

The culprit is fatigue with social distancing. Photographs of people holidaying unmasked in Europe this summer, or Novak Djokovic leading a troop through a nightclub in Belgrade in June, were omens of an impending second wave. Google and Apple’s mobility data showed that European mobility rose by as much as 30% to 40% this summer, while it remained subdued in most of Asia. But, photos making the rounds of large crowds at markets from Kolkata to Bengaluru suggest the potential for so-called super-spreader events, where a few highly infectious people infect large numbers at crowded gatherings. As Gautam Menon, an epidemiologist and professor at Ashoka University, says, “The consequences of any laxity in enforcing distancing measures (during Durga Puja in Bengal) will be apparent some three weeks later in a rise in hospital admissions and critical cases. A similar situation is likely to unfold during Diwali.”

Still, India has come further in public health awareness, both in terms of hand-washing and wearing masks, than one would have predicted. The trouble is that the government’s communication and diktats have succeeded at ensuring that people wear masks, but have not emphasized the necessity of wearing them over one’s mouth and nose—rather than, jugaad-style, under the mouth or around the neck like a cowboy’s bandanna. Also not communicated on those inescapable phone messages is that the relative risk of contracting the virus indoors in an air-conditioned office/home is much higher than being in a room with all the windows open and with ceiling and table fans circulating the air—or, better still, meeting friends in a park or on a terrace. Last week, I listened to the manager of a multinational bank irritably justify the need for customers to download the controversial Aarogya Setu app, as the Reserve Bank of India mandates. A more effective measure would be to retrofit this bank’s offices to let windows open, or move employees’ desks into this branch’s large and airy lobby area, open on one side to the street.

I had a similarly surreal conversation about increasing air circulation by simply switching fans on with the manager at an Udupi restaurant. Being a stand-up joint in Bengaluru, most of it is open to the street, which helps. The manager said customers would complain that it was chilly. (It was 26 degrees Celsius.) I couldn’t help notice that the security guard, who used to ably ensure that customers and delivery people alike sanitized their hands, had his mask below his mouth.

And, months after the pandemic started, my count of Uber cars with an inexpensive plastic screen separating driver from passenger would suggest that they are in a minority. A company with a market cap of $60 billion ought to do more to help drivers and passengers stay safe.

Around the world, the huge second wave underway will weaken our battle against the virus even after a vaccine is deployed. The first generation of vaccines are not expected to have anything close to 100% efficacy. Vaccination drives could be in a foot race against galloping infection rates at the other end of a long winter ahead. And, if the past several months are any indication, our fatigue with social distancing will only increase once news of a vaccine arrives.

I am a covid bore because I reported on the severe acute respiratory syndrome outbreak in Hong Kong in the spring of 2003. Consequently, I believed from the beginning of this covid pandemic that wearing masks and maintaining social distancing would work best in East Asia, where people have followed these practices over the past decade-and-a-half, even if they had a mere common cold. And, so it has proved from Korea to Taiwan and even to much less developed Vietnam, where new infections increased from one case on Monday to three on Tuesday. These countries are called Asian miracle economies for many reasons—strong social discipline and superior public healthcare being two of them.

Rahul Jacob is a Mint columnist and a former Financial Times foreign correspondent.