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Winter is coming

Winter is coming

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As any "Game of Thrones" fan can tell you, the phrase "winter is coming" is not just a House Stark motto but a frequently invoked warning that a serious, easily overlooked threat is destined to arrive as temperatures drop. In the case of the George R.R. Martin books and the TV show based on them, the danger was not just failing to prepare for cold weather but for the rise of the "White Walkers" or living ice creatures. That was pure fantasy, of course, but the possibility that cooler weather carries with it a serious health threat is fact.

Flu season will soon be upon us, but that's only half the picture. During the last pandemic of a COVID-19 level magnitude, the 1918-1919 influenza pandemic, the outbreak first developed in the spring, became less severe in the summer and then came back in a so-called "second wave" with a vengeance in the fall.

The Centers for Disease Control and Prevention still offers details of what happened 102 years ago in the U.S. on its website: The second wave starts modestly at Boston military bases and then spreads like wildfire with infections between September and November accounting for the majority of pandemic-related deaths in the United States. It was only in December that public health officials warn Americans of the danger of passing the flu through coughing, sneezing and "nasal discharges." But the warnings are either not enough or too late. A third wave develops in the winter and continues through the spring of 1919. In the end, an estimated 675,000 U.S. lives are lost, but worldwide the final number is closer to 50 million.

That century-old lesson may be lost on some but not on health experts. New soon-to-be-published research out of Johns Hopkins University suggests that one of the reasons this summer's COVID-19 pandemic was not worse is that the virus is averse to warmer temperatures. Essentially, hot, wet weather dampened the spread. The problem is that the reverse is true: Cooler weather is likely to facilitate transmission. This shouldn't come as a shock. It happens with far less lethal respiratory illnesses like the common cold. In recent days, experts have warned Americans not to get complacent even as positivity rates and the total number of new cases have fallen. Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases, has been among them. Just recently he warned that Americans are going to need to "hunker down" through the fall and winter and that circumstances will worsen as states lift social distancing restrictions.

Let's face it. A lot of people are tired of this pandemic, tired of isolation and social distancing, tired of being tired — and one can hardly blame them. The start of school with many students going virtual has been the latest, unwelcome milestone. And yet the narrative has been: This will be over soon. Schools will soon be moving to in-person classes or at least a hybrid model, while businesses and even movie theaters fully reopen.

The solution is not sexy. It's not cutting-edge science. It's not even new as it echoes some of the very same advice ultimately given to Americans a century ago: Wear a mask, keep a safe distance, wash your hands frequently. Do these things faithfully and the cold weather may not matter. Keep doing them and perhaps a second lockdown won't be necessary. Do not let your guard down, as Dr. Fauci might say, and lives will be saved. We can't know for certain what the winter of 2020-2021 will bring but experience, expertise and even popular fiction counsels that precautions are in order.

The Baltimore Sun

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