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ABC News June 3, 2020

Mass protests could lead to another wave of coronavirus infections

WATCH: Doctors expect to see more COVID-19 cases after protests

As thousands of demonstrators continue to protest the killing of George Floyd, health experts are worried that a second wave of COVID-19 infections could be sparked by the mass gatherings.

"What we have here is a very unfortunate experiment going on with COVID virus transmission," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

While there's lower risk for the virus to be spread outdoors, especially in a moving crowd, many of the weekend's protests culminated in police officers shooting tear gas and using pepper spray and protesters lighting fire to cars and buildings. Smoke, tear gas and pepper spray cause coughing, Osterholm explained, and coughing aerosolizes the virus, increasing the risk that it will spread.

PHOTO: Tear gas fills the air as protesters rally outside the White House against the death in Minneapolis police custody of George Floyd, in Washington, D.C., May 31, 2020.
Jonathan Ernst/Reuters
Tear gas fills the air as protesters rally outside the White House against the death in Minneapolis police custody of George Floyd, in Washington, D.C., May 31, 2020.
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"If people say 'well, these are healthy folks,' we know that at least a third of COVID patients are asymptomatic according to the CDC," added Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases.

The risk is even more pronounced when factoring in the more than 5,600 demonstrators who have been arrested, according to The Associated Press.

Not only are jails crowded indoor spaces, but protesters sat in vehicles at close range for an extended period of time, which increases the risk for onward transmission of the virus, Osterholm explained.

A 1918 a military parade sparked the second wave of flu infections

If history is any indication of how this might play out, we need look no further than the 1918 flu pandemic. In September of that year, after the first wave of spring flu infections subsided, Philadelphia decided to proceed with a military parade, which drew a crowd of 200,000. Within a day, every hospital bed in the city was filled and within six weeks more than 12,000 Philadelphians were dead, according to The Washington Post.

PHOTO: In this Sept. 28, 1918, photo provide by the U.S. Naval History and Heritage Command the Naval Aircraft Factory float moves south on Broad Street escorted by Sailors during the a parade meant to raise funds for the war effort, in Philadelphia.
U.S. Naval History and Heritage Command via AP
In this Sept. 28, 1918, photo provide by the U.S. Naval History and Heritage Command the Naval Aircraft Factory float moves south on Broad Street escorted by Sailors during the a parade meant to raise funds for the war effort, in Philadelphia.
MORE: Photos: Moments of peace, unity you may not have seen in George Floyd protests

On Monday, mayors and governors urged demonstrators to stay home, and if they do go out, to wear a face mask and maintain social distancing.

"We don't want people out there where they might catch this disease or spread this disease," New York Mayor Bill de Blasio said at a Monday press conference.

"There's no question there's a danger [that] this could intensify the spread of the coronavirus just at a point when we were starting to beat it back profoundly," he said.

How mayors and public health departments are responding

Although government officials have warned demonstrators about the health risks posed by protesting during a pandemic, only a few have offered actionable guidance about the role COVID-19 testing can play in preventing the virus from spreading.

"If you were out protesting last night, you probably need to go get a COVID test this week," Atlanta Mayor Keisha Lance Bottoms said during a Sunday news briefing, "because there's still a pandemic in America that's killing black and brown people at higher numbers."

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Since most people who are infected with coronavirus develop symptoms within 14 days of being infected and can spread the disease days before they feel sick, the window to get tested and avoid infecting others is small.

Getting tested within the next seven days might not be realistic depending on where you live, explained Dr. Jeanne Marrazzo, division director of infectious diseases at University of Alabama Medicine.

"Testing sites are still not set up in our most vulnerable community settings," Marrazzo said, pointing to poor and rural areas, particularly in the Deep South.

PHOTO: A police officer sprays protesters during a march against the death in Minneapolis police custody of George Floyd, in Brooklyn, New York, May 30, 2020.
Jeenah Moon/Reuters
A police officer sprays protesters during a march against the death in Minneapolis police custody of George Floyd, in Brooklyn, New York, May 30, 2020.
MORE: Journalists covering George Floyd protests face attacks from police, advocacy groups say

"If you are out protesting and return home, you may want to quarantine for a while," said Dr. Simone Wildes, an infectious disease specialist at South Shore Health. "You don’t know what you are going to bring home to your parents, grandparents, other members of the family who might have underlying conditions that place them at higher risk."

New York City's health department stopped short of telling protesters to get tested within a certain timeline, although the department did post to Twitter recommendations for how demonstrators could reduce their risk of spreading COVID-19.

Plan to protest? Here are tips to reduce the risk of spreading #COVID19:
✔️Wear a face covering
✔️Wear eye protection to prevent injury
✔️Stay hydrated
✔️Use hand sanitizer
✔️Don't yell; use signs & noise makers instead
✔️Stick to a small group
✔️Keep 6 feet from other groups

— nychealthy (@nycHealthy) May 30, 2020

"Health is our top priority, and with more testing capacity now available, we're inviting anyone who has participated in a demonstration over the past few days to come get tested at one of the more than 150 locations across the city," said Patrick Gallahue, a spokesperson for the New York City Department of Health and Mental Hygiene.

The health department website includes a tool for finding the NYC testing site nearest to you.

PHOTO: People hold signs as they protest and mourn the death of George Floyd in Houston, May 30, 2020.
Mark Felix/AFP via Getty Images
People hold signs as they protest and mourn the death of George Floyd in Houston, May 30, 2020.

The next two weeks are going to give us a better sense about whether case counts will rise, according to Osterholm.

"Hospitalizations could be 20 days away before you really start seeing that picking up," he noted.

Of course, those timelines assume that people who get sick will get tested. They also assume that protests will start to diminish.

Continuing protests "could take transmission into a whole other week," Osterholm said.

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