As we anticipated earlier, we will likely not experience a ‘second wave’ of Covid-19 infections.  Unfortunately, the reason why is that the first wave never went away.  Numbers are beginning to approach the early April numbers when social distancing measures were widely implemented.  Florida represents an interesting case.  It is a state whose lifeblood is dependent upon tourism dollars.  This combined with an elderly population appears to create a perfect storm.  Currently the prevalence (number of active cases at a specific time) is 10%.  Though Georgia and Alabama are not far behind at 9%. In the United States there is a general trend of younger people now becoming infected.  Mortality rates may well improve as this cohort experiences less serious disease.  Though I feel young people importing cases to FL may prove devastating to the state. I was in FL over the weekend and noted mask usage to be roughly 10-15% of the population with businesses making some effort to enforce social distancing measures and mask use though it appeared to be a gesture rather than an enforced policy.  It is obvious that there will be little ability to control spread there.  This will be especially problematic when it moves through larger retirement communities where local hospitals will be overwhelmed.  I realize the tone of this missive is not particularly positive so in that vein I will proceed at least being consistent.  Studies from China demonstrate that even in the population that developed Covid antibodies after infection (roughly 66%) they only maintained those antibodies for four months.  This negates the concept of immunity passports and conceptually deals a serious blow to vaccine efforts.  By presenting non infectious components of the virus to the immune system (Covid spike proteins or other epitopes) antibodies are developed.  However this does not present the entire virus to the immune system so we do not know exactly what level of T-cell involvement occurs.  Thus we may not get memory T-cell immunity and be fully exposed when B-cell antibody titers wane after four months.  Potentially we can give additional vaccines at intervals but this now becomes more complicated.  I will repeat my often mentioned mantra that we need an effective treatment on the road to herd immunity.  Be safe, continue to maintain social distancing measures.  The life you save may be your own.