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Is A 4th Wave Of The Pandemic On The Horizon? As States Open, COVID-19 Cases Rise


In many parts of the U.S., people can now dine indoors, go to the movies or a bowling alley or work out at the gym. The TSA is seeing more than a million people a day pass through airports. So perhaps we shouldn't be surprised that coronavirus cases are rising. About 70,000 new U.S. cases were reported yesterday alone. That's almost a 20% jump over two weeks ago. And newer, more contagious variants of the virus are spiking in different states. Bill Hanage is a professor of epidemiology at Harvard.


BILL HANAGE: Hi, Ari. It's good to be here.

SHAPIRO: How worried are you that we're entering a fourth wave of this pandemic?

HANAGE: I really am quite worried indeed. It's clear, I think, that we are seeing increases in at least some states - not all states and not all at necessarily exactly the same time, but all of those things that you outlined are providing more opportunities for the virus, including these new variants, to transmit among us. And so I think we can expect that we are going to see at least localized surges in terms of infections.

SHAPIRO: Let's talk specifically about one of those variants, B.1.1.7, which originated in the U.K. and appears to be rising, especially in Florida. What's happening?

HANAGE: So B.1.1.7 - like you say, it was first identified in the U.K., and scientists there have studied it very carefully. It appears to be more transmissible than the virus that we have got used to, about 50% more transmissible, and also more dangerous, more likely to cause serious illness and death, given infection. So it's something we're really worried about.

SHAPIRO: But am I correct that the vaccines do appear to be effective against this strain?

HANAGE: That's absolutely right. And this is really important to remember. The vaccines that we've been using here, at least according to lab results, do appear to be giving good protection against all the variants of concern that we've got at the moment. Now, there may be some small reduction in efficacy but not enough to be really worried about. And that really needs to be made clear.

SHAPIRO: And so what concerns you about the B.1.1.7 variant?

HANAGE: The worrying thing about B.1.1.7 is that it's more transmissible. When you have something more transmissible, the worry is it can infect people more quickly, and so it can get into them before you're able to vaccinate them. That's why epidemiologists are more worried about more transmissible than the relatively small amounts of immune evasion when it comes to vaccines that we expect to be seeing from some of these other variants.

SHAPIRO: When you compare the daily coronavirus caseload right now to this time a year ago, it looks like it's higher. How much of that is because of better testing and so we're capturing more of the asymptomatic or mildly symptomatic cases that might be out there?

HANAGE: That's absolutely right. This time a year ago, there was a huge iceberg of undetected cases, which is never really recorded. We got better at testing, and that's why we saw the summer surge, you'll remember from last year. Again, we seem to have more cases, but that's because more of them were being detected. And now we have a pretty good handle on where the pandemic is. And we can be clear that cases are starting to increase again in multiple places.

SHAPIRO: We also, at this point, have more hospital capacity, more knowledge about how to treat the disease, vaccines, of course. I mean, do you think that could be enough to stave off another wave?

HANAGE: This is a complicated answer. While we are going to see cases increasing, the relationship between increasing cases and hospitalizations is going to change because some people, at least, have been vaccinated, and the vaccines are really good at preventing severe disease and death, so that's good. However, it doesn't take a large number of infections in the most vulnerable groups to cause serious problems. And of course, a lot of people still haven't received vaccinations. So if we were to go back to exactly how we were before, then, yeah, we would expect there to be a pretty large surge, and that would have effects on health care.

SHAPIRO: As you point out, the most vulnerable people were among the first in line to get vaccines. And so could you envision a scenario where we might see a huge spike in new cases but we don't see a corresponding spike in hospitalizations and deaths?

HANAGE: That can be envisioned. I would caution, though, that we have not managed to get vaccine into the arms of all of the most vulnerable. And like I say, it doesn't really take a huge number of them to be infected for them to be causing serious problems. One of the biggest, most recent spikes that we've seen has been in Michigan. And it's looking as if maybe in the most recent data, there's a little uptick in deaths as well. I don't want to get too far out ahead of my skis on that, but it's looking as if we are going to be needing to watch these very, very, very carefully in order to understand how the pandemic is changing.

SHAPIRO: Bill Hanage is an associate professor of epidemiology at Harvard's T.H. Chan School of Public Health.

Thank you for speaking with us.

HANAGE: Thank you. Transcript provided by NPR, Copyright NPR.

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