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Boris Johnson will speak to Donald Trump and the Queen this week, even though No 10 continues to insist he is not doing any government work while he recovers from coronavirus at Chequers.
Epidemics of infectious diseases behave in different ways but the 1918 influenza pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated – albeit more mildly – in subsequent flu pandemics.
How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.
Is there evidence of coronavirus coming back elsewhere?
This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a sudden resurgence in infections despite being lauded for its early handling of the outbreak.
Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged in cramped dormitory accommodation used by thousands of foreign workers with inadequate hygiene facilities and shared canteens.
Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.
What are experts worried about?
Conventional wisdom among scientists suggests second waves of resistant infections occur after the capacity for treatment and isolation becomes exhausted. In this case the concern is that the social and political consensus supporting lockdowns is being overtaken by public frustration and the urgent need to reopen economies.
The threat declines when susceptibility of the population to the disease falls below a certain threshold or when widespread vaccination becomes available.
In general terms the ratio of susceptible and immune individuals in a population at the end of one wave determines the potential magnitude of a subsequent wave. The worry right now is that with a vaccine still months away, and the real rate of infection only being guessed at, populations worldwide remain highly vulnerable to both resurgence and subsequent waves.
The prime minister will speak to the US president on Tuesday afternoon to thank him for his best wishes for his recovery but he will also take the opportunity to talk about the G7’s efforts to combat the virus.
He will also have a telephone audience with the Queen later this week, probably on Wednesday or Thursday, after missing several weeks because of his illness.
Johnson has also been making calls to government ministers as he seeks updates on the response to the virus, amid continuing criticism of the effort to get personal protective equipment to the NHS and care homes as well as the failure to ramp up testing to promised levels.
His spokesman told a Westminster briefing: “The prime minister is continuing his recovery at Chequers and isn’t formally doing government work.
“He has been receiving updates from No 10 on the coronavirus response and has spoken with the first secretary of state and senior members of his team.
“Yesterday he sent a message of condolence to Justin Trudeau after the very sad loss of life in the shooting in Canada.
“Later today, at around about 2pm, he will be speaking with President Trump.”
Johnson went to Chequers to recuperate after spending a week in hospital, including three days in intensive care, when his breathing deteriorated.
He has been off work for just over two weeks, with Dominic Raab, the foreign secretary and first secretary of state, deputising for him in the meantime.
During his absence, there have been complaints of a power vacuum and criticism over key issues such as how the UK will eventually try to ease the lockdown.
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