Why the second wave of the coronavirus will be different from the first wave | NOW


Since the number of corona infections has risen sharply from the end of July, the words “second wave” are also becoming more common. All experts seem to agree that this is not yet the case. But when do we speak of a second wave and what is different about the second wave compared to the first?

“No, as far as I am concerned, the second wave is no different from the first”, says GGD director of public health Sjaak de Gouw. “If we assume that the characteristics of the virus are no different, it means that if you ingest the virus you will not react differently than in February or March.”

De Gouw does think that the curve of the number of infections “will never follow the same course” as last spring. The number of suspected corona infections rose rapidly to 270,000 people in February and March.

The word is probably important according to De Gouw. You never know for sure exactly how many people are carrying the corona virus. There is also a margin of uncertainty in the current estimate of the more than 30,000 infectious people in the Netherlands, but according to the GGD director there is an important difference compared to last spring.

“In nursing homes we have set things up differently in terms of hygiene. Much more protective equipment is used and there are more protocols. In addition, we are now testing everyone with complaints across the country, where we did not do so in February and March. Then we had a lot. infected people are not in the picture because of a different test policy. By conducting good source and contact research, we try to stop a second wave. ”

“During the first wave, people were not tested in the hospital until they had been walking around coughing and spluttering for two weeks”

Ernst Kuipers, chairman of the National Acute Care Network

Ernst Kuipers, chairman of the National Network Acute Care, also thinks that the many tests in the run-up to a second wave can make a big difference compared to the first wave. “You want to detect people well before they have symptoms and have been able to spread the virus everywhere. During the first wave, people were not tested in the hospital until they had been coughing and spluttering for two weeks.”

“We can do that differently now, but then people must be prepared to have themselves tested. You now hear stories that people actually had complaints, but were still on holiday with their parents. If you continue with complaints. , then there is nothing different compared to last time. Then you should not be surprised that at some point the brakes are fully pressed. ”

Ernst Kuipers, chairman of the National Acute Care Network. (Photo: Pro Shots)

More is now known about coronavirus

If we have the same number of infections at any time as during the peak of the first wave – Kuipers does not exclude that from happening – then that does not automatically mean that there are the same number of patients in the hospital or in intensive care (ic).

“At the time we knew almost nothing about the disease. We had some information from China and a little bit from Northern Italy, but in the meantime we can make a much better estimate of who would benefit from a hospital or IC admission.”

“In addition, some of the COVID-19 patients can benefit from monitoring and help from the ICU team if they are still on a regular hospital ward. This can prevent people from having to go to the IC”, continues the chair of the IC. Rotterdam Erasmus MC.

The time that patients spend in hospital or in intensive care can also be shorter due to other treatment methods. Blood thinners prevent thrombosis in the lungs and dexamethasone counteracts inflammation. As a result, patients need oxygen less quickly and they are less likely to end up in the ICU, Diederik Gommers, chairman of the Dutch Association for Intensive Care (NVIC) previously told NU.nl.

“All those things add up,” concludes his Rotterdam colleague Kuipers. “As a result, it may be that with the same number of infections, fewer patients are in hospital and also less long.”

Virus composition is no different

What is hardly different from the first wave is the composition of the corona virus. “Viruses mutate, that’s in fact their way of life”, explains Eric Snijder, professor of medical microbiology at the Leiden University Medical Center (LUMC).

“Mutating a virus can go in three directions: better, worse or almost the same. And the latter group is the most common, small changes that are caused by accidental errors but make little or no difference”, says Snijder.

The genetic information of the current virus is more than 99.9 percent identical to that of the virus from February and March. On average, there are six to eight changes on 30,000 building blocks from the original Wuhan virus. Many of those changes saw we already in the Netherlands in February and March. “

Are we already at the beginning of the second wave?

Finally, the question of whether we are at the beginning of the second wave.

“I am not saying that we are at the beginning of a comparable wave, but I do see that if you extrapolate the current numbers of infections and hospital and IC admissions (continued in a graph, ed.) You have to wait for the moment. that we say: now we have reached the level that we can no longer have it in healthcare, “says De Gouw.

“From July 7, there is a sharp increase again, if you extend that number of months linearly, you will again be at 30,000 to 40,000 infections per day. That is why it is important to maintain the 1.5 meters and that people are approached. This ensures that the curve will look different than in the spring. ”

Kuipers also points to the rapidly increasing current number of infections. “These numbers have all the signs of a second wave, regardless of the semantics and the discussion about what that exactly is. We now have double the number of hospital patients from two weeks ago. If you extend that, you will increase to 150 ic in a few weeks. recordings. ”

“It is also absolutely possible that another 1,400 COVID-19 patients will be in the ICU”, Kuipers warns. “It is important that we do everything possible to contain the virus very quickly on all sides.”


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