We wait in anticipation for winter, as in the words of Barack Obama, “the world has changed, and we must change with it”.

Much has been speculated with regard to COVID-19, summer, winter and second waves. It is salutary to see what is happening globally in anticipation of what might yet happen here in Malta. So far, our public health measures have been successful in containing the virus, but as we inevitably open our borders to ensure our economy does not falter, we can expect new cases to enter our shores from abroad.

It has been speculated that summer might help to control COVID-19, but witness current events in Florida, the Sunshine State. It is currently summer in Florida, and temperatures there are in the low 30s°C. And yet, new cases and deaths are rising rapidly.

On the other hand, in the southern hemisphere it is winter in Australia, with temperatures between 13-15°C in Melbourne. Cases there are also rising, to the extent that inhabitants of Melbourne "must now wear masks when leaving their homes as Victoria, Australia’s second most-populous state, marked two weeks of triple-digit increases in new coronavirus infections on Sunday.”

Why does COVID-19 spike under such different temperature conditions? Clearly, temperature and ambient conditions may play a small role in viral spread but it is public health measures and these alone that serve to dampen viral spread. These include hygiene, masks and social distancing and avoiding crowding. Other factors are secondary and relatively minor.

Florida will not be helped by intransigence and poor leadership that fails to listen to the science: “Florida officials won't be 'prosecuting people' for not wearing masks as US coronavirus cases surge” succinctly proves the point. This inevitably leads to headlines such as: “over 40 Florida hospitals max out ICU capacity as Covid-19 cases surge across US.”

Iceland is a country with a population similar in size to ours, with a similar COVID success story and provides an interesting case study. The Icelandic Tourist Board website states: “The Icelandic government has issued rules and guidelines for passengers arriving in Iceland. Passengers can choose to be tested for COVID-19 or to go into quarantine for two weeks.”

Restrictions in Iceland are being slowly and incrementally released with “residents of fourteen non-EEA and Schengen states allowed to visit Iceland” and “travellers from Denmark, Norway, Finland, and Germany to be exempt from screening and quarantine requirements”, as these are considered very low-risk countries.

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With regard to the local scene, Malta is currently an attractive tourist destination with few cases and deaths. However, a spike in cases will put visitors off visiting the country and this will not only risk our health and strain the hospital but also further depress our economy. It really is “a risk balancing act – tourism competition using health leverage in the COVID-19 era”. We must therefore remain vigilant and continue our contact tracing of all detected cases and perhaps consider the Icelandic model for reopening. Demonstrating that the country continues to take serious COVID precautions will be an added incentive that may attract even more visitors, revive the economy and prevent further job losses.

Victor Grech is a consultant paediatrician

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