COVID Cases Are Spiking Two Years Since the First Reported Case. Has Science Failed?

Two years ago, a disease emerged in the Chinese city of Wuhan that would change the world.

In December 2019, reports emerged from the city in Hubei province of people falling sick with a mysterious respiratory illness, which then quickly spread around the world.

Then in March 2020, the South China Morning Post reported on Chinese government data that suggested the first ever documented case of what had become known as COVID-19—a disease caused by a new coronavirus called SARS-CoV-2—may have been in a citizen of Hubei province as far back as November 17, 2019. It is still unclear who the first ever patient was.

24 months later, much of the world is still reeling from the effects of the respiratory illness that has infected more than 250 million people, caused more than 5 million deaths worldwide and at one stage saw over a billion people under some form of lockdown. In the U.S. alone there have been 47 million cases and over 760,000 deaths.

Some countries with access to mass COVID vaccination have had a taste of normality thanks to scientists creating safe shots at unprecedented speed. Yet the specter of fresh waves and lockdowns looms over some as cases spike once again in some areas, as shown in the chart below.

According to the U.S. Centers for Disease Control and Prevention, the seven-day moving average of COVID cases is the U.S. on the rise. A week ago, on November 9, average cases were at 74,745. As of November 14 they were at 80,823.

In Europe, Austria has just placed two million unvaccinated people into lockdown to curb a spike in cases. And German authorities have agreed on measures requiring unvaccinated people to get a negative COVID test before using public transport due to a rise in cases there, too.

"Almost 2 million cases of COVID-19 were reported in Europe last week; the most in a single week in that region since the pandemic started," World Health Organization director general Tedros Adhanom Ghebreyesus said on November 12. "No country should be in this position, almost two years into the COVID-19 pandemic."

This rise in cases comes after almost two years of on-and-off mandates and advice—in some regions—to wear masks, follow lockdowns, socially distance, and in the last year, get vaccinated.

Throughout the pandemic, deciding whether to follow scientific advice and impose restrictions has been a tough balancing act for politicians. For example, U.S. President Joe Biden faces a backlash from Republicans over his administration's vaccine mandates, which some argue impinge on personal freedoms.

And while there has been pushback against school mask mandates in California, Texas and Florida have been criticized for banning them.

So why are places that have followed this advice now once again seeing cases rise? Has the scientific consensus on how to tackle COVID changed, and do these new spikes suggest there have been mistakes along the way?

Newsweek spoke to experts about the challenges faced by scientists over the past two years, what the current situation means, and what we might expect going forward.

What's gone wrong and what's gone right

It is important to understand that the scientific consensus on any topic continually evolves over time, based on the available data.

As such, advice at the start of the pandemic differed to what we consider to be accepted advice now. Masks are one such example. At the start of the pandemic, people were advised by the U.S. Centers for Disease Control and Prevention not to wear masks unless they were sick.

"We have learned an enormous amount," said Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine. "We failed to appreciate the importance of airborne transmission. Indeed, some people seem to still be in denial about it. As a consequence, I and many others have changed our minds about the role of masks, which I'm now strongly in favor [of]."

Andrew Brouwer, a mathematical epidemiologist and modeler at the University of Michigan, echoed the point. He said that there is now "clear evidence" that masks work, adding: "It was a mistake to dissuade people early on from wearing masks, and an early emphasis on surfaces lead to unnecessary cleaning instead of a focus on ventilation."

Science communication, too, has left something to be desired throughout the pandemic. Public health strategy has been too narrow, serving "liberal upper-class blue areas" without being as creative when addressing rural red areas, according to Kate Grabowski, an epidemiologist and member of the Infectious Disease Dynamics Group at Johns Hopkins University.

She wonders if "maybe mask promotion campaigns rather than mandates would be better in some communities that are more resistant to government enforced intervention."

Anti-mask protests are still ongoing in the U.S., with a Maine group this week vowing to push back against a regional school board's mask mandate.

And the inability to tackle falsehoods about COVID, such as those spread online by conspiracy theorists, has also been a major hurdle. "The biggest threat on the science front has been the inability to deal with deliberate misinformation," said Theo Vos, professor of health metrics sciences at the University of Washington.

The winter resurgence

The global response to COVID has been imperfect, and it's true that cases are once again on the up in many countries as we head into winter. But the opinion of all scientists contacted by Newsweek is unanimous: masks still work, social distancing still works, vaccines still work.

So why are cases rising? There are a number of factors at play: A rise of the more infectious Delta variant; a loosening of restrictions over the summer; the fact that COVID is seasonal; and because, as scientists have repeatedly asserted, no vaccine is 100 percent effective in preventing cases. All of these factors mean COVID waves such as those in Europe right now are still very much a possibility.

"The vaccines' primary role is to prevent serious disease, hospitalization, death," said Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security. "COVID-19 is not something that is going to disappear from this planet. It cannot be eradicated, it cannot be eliminated.

We don't expect flu vaccines to eradicate flu forever. Indeed, we expect them to last only until the next flu season. It may be necessary to adjust our expectations for COVID in a similar way.

"We will have COVID-19 cases ebb and flow decades from now," Adalja added. "The goal is to make it tamer, to make it more like other respiratory viruses we deal with year in and year out with vaccines and medical countermeasures."

There's also the matter of breakthrough infections—cases in which people become sick with COVID despite having been fully vaccinated. We can expect such cases to rise as a proportion of infections overall, but only because there are so many vaccinated people—not because vaccines are failing.

"As vaccinated individuals are more numerous, the numbers of breakthrough infections will also rise," said Paul Wilmes, professor of systems ecology at the University of Luxembourg. "Therefore, cases may indeed rise with increasing vaccine coverage but the numbers of severe cases will be much fewer among vaccinated individuals."

In this context, he said, continued mask-wearing will remain necessary to protect the unvaccinated from infection "because they will now be majorly responsible for the possible overwhelming of healthcare systems."

While it is true that cases are rising in western Europe where vaccines have been available for months (64 percent of people in Austria are fully-vaccinated, for example), some of Europe's lowest cases per million people are in Portugal, Spain, and Italy, where 88, 80, and 73 percent of the population are fully-vaccinated, respectively, according to Our World in Data.

"The low levels in Spain seem to be a considerable extent due to both high immunization rates and high levels of mask wearing," said McKee.

The consensus is that vaccines work, and they remain crucial to saving lives.

Looking ahead

Winter resurgences might be in our future, but that doesn't mean nothing can be done.

As we approach 2022, Vos highlights the importance of making vaccines available in low-to-middle income countries, funded by rich countries, which could delay or reduce the emergence of new escape variants. "The costs of which will easily weigh up against the negative economic consequence of inaction," he said.

Vos added: "Mass produce drugs. Engage with those reluctant to take vaccine; many are not hardcore deniers but are influenced by social media in their circles."

Wilmes said people should continue to abide by hygiene measures as usual, avoid crowded spaces where cases are high, and "above all get vaccinated including getting a booster shot if this is offered by your healthcare provider."

McKee echoed the point: "Get [the vaccine] if you aren't already, get boosted if you [have], and avoid crowded unventilated spaces but, if you can't, wear a mask. It's really quite simple."

Two years on, then, COVID is still here, and it may be for a while. But this does not mean science has failed. While advice may have changed a little since the pandemic's beginnings, the consensus is clear: masks, social distancing and vaccines work.

Correction 11/17/21, 8:44 a.m ET: This article was updated to correct a reference to Australia instead of Austria.