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Europe is learning to stop worrying and live with the coronavirus. But some countries are taking different paths to chart their return to normal.
The number of cases is skyrocketing again, thanks to the highly transmissible Delta variant. But that worries EU leaders less as vaccines keep hospitalizations and deaths well below last year’s levels.
This means EU leaders are changing their view of the virus, looking more at hospitalization rates rather than the number of cases to assess its spread.
“200 is the new 50”, German Minister of Health Jens Spahn declared last week, referring to the country’s long-running weekly benchmark of 50 new cases per 100,000 people as critical. Berlin’s higher threshold reflects the fact that infections now lead to far fewer hospitalizations.
Italy, likewise, said this month it would give more weight to hospitalizations in determining whether to implement new restrictions.
Indeed, Europe has entered a new phase of the pandemic, but political leaders are grappling with a new set of unknowns: the effect of vaccines; the risk of several variants; and a potential spike in serious illness. At the same time, Europeans desperately want to get back to normal – and their leaders want to revive economic growth.
“Europe is in a pretty precarious position,” said Christopher Dye, an epidemiologist at the University of Oxford. “We have had great success in… the deployment of the vaccine. But this level of immunization is not yet high enough to prevent many people from still getting sick and many people still dying. ”
Amid the surge in cases caused by Delta, many countries are struggling to find the right balance. Some, like France and Italy, are taking a more cautious approach, requiring proof of vaccination for certain professions as well as for many activities. The UK has gone in the opposite direction and lifted all restrictions last week as if the pandemic was over. Meanwhile, public health experts continue to emphasize caution.
As Hans Kluge, WHO European Regional Director, recently warned: “We are far from being out of the woods.
The new normal
The Netherlands and the UK are two examples of how policymakers are tackling new mathematics.
In July, the reproduction rate of the virus (“R”) in the Netherlands reached its highest level of the pandemic. Prime Minister Mark Rutte told reporters his government had made an “error in judgment” by lifting the restrictions too soon. But that spike in cases barely reduced hospitalizations, thanks to the country’s relatively high vaccination rate, with nearly 70% having received at least one dose of the vaccine.
The UK, meanwhile, has effectively become a petri dish for the Delta variant: the country’s cases are higher now than in the fall of 2020, reaching over 47,000 new cases on July 20 – the next day. from the day the government lifted almost all restrictions on coronaviruses. But widespread immunization has reduced the number of deaths, even as hospitalizations have dropped from around 900 to nearly 6,000, straining the health system.
Experts also warn that catching coronavirus carries other risks, namely “long COVID.” Up to a third of patients who exhibited symptoms of COVID-19 that were not severe enough to require hospitalization still had persistent health issues. This condition has up to 200 possible symptoms.
“It’s a serious disease, we don’t fully understand it,” said Lawrence Young, virologist and professor of molecular oncology at the University of Warwick. “It puts enormous pressure on individuals [and] on the quality of their life, as well as on health services.
The jab is the thing
Europe’s best tools to emerge from the pandemic are vaccines. The problem now is that too few people are getting it.
European Commission President Ursula von der Leyen said on Tuesday that the EU had reached its goal of 70 percent of vaccinating adults, although that figure actually only applies to those who have received at least one dose. But the trend that worries policymakers is that the demand for vaccines is declining.
“Now is not the time to be complacent and let our guard down,” Health Commissioner Stella Kyriakides wrote in a statement.
Most alarming is that the countries of the East – including Bulgaria, Romania and Croatia – are lagging behind. These countries have so far avoided an increase in the number of cases caused by Delta, but public health experts warn that it may only be a matter of time.
Angel Kunchev, the Bulgarian national epidemiologist, said he expected the Delta variant to “dominate the epidemiological situation” in the coming weeks. Only 16 percent of the Bulgarian population have been fully immunized, he noted, with 18 percent of the adult population having received a dose. And this despite the fact that there are no longer any supply constraints.
Kunchev blamed the low rates on “mistrust and skepticism” of vaccines.
Likewise, Vili Beroš, the Croatian Minister of Health, blamed “anti-vaxxer propaganda on social media” as one of the reasons why less than half of adults in his country have had at least one injection. , and noted that only 60 percent of the ministry’s own employees are vaccinated.
A new wave of cases in these countries could be devastating, especially since many of these regions already had some of the highest death rates in the EU at the start of the pandemic.
“I am not optimistic about the situation in our country… the sick and hospitalized will have higher death rates than in Europe,” Kunchev told the Sofia Globe.
With the number of regions in Europe lagging behind in immunization, public health officials are stepping up their efforts and changing course.
The challenge for some is that the rapid development of coronavirus vaccines – combined with the controversy surrounding the Oxford / AstraZeneca jab – has led people to have “more questions” about vaccines, according to Siddhartha Datta, regional disease adviser vaccine-preventable and immunization programs at the World Health Organization’s regional office for Europe.
He also cautioned against blaming people who have questions about vaccines: Although some adamantly refuse to be vaccinated, healthcare professionals can often answer questions or doubts.
In Romania, where less than a third of adults have started a vaccination program, WHO Europe has helped design a smartphone-accessible chatbot to give people more information about vaccines to fight hesitation.
Meanwhile, the Delta variant, which is between 40 and 60% more contagious than the original coronavirus strain, has upped the ante everywhere. Its rapid spread prompted experts to raise the herd immunity threshold, which had been estimated to be around 70%. French scientists at the Institut Pasteur now put the figure at 95%, while modeling by the German Robert Koch Institute (RKI) estimates a rate of around 85% is needed to keep cases and hospitalizations low .
It is highly unlikely that the EU will be able to vaccinate so many people based on current trends; and it is also uncertain whether 70 percent of the world will even be vaccinated by the end of next year.
Scientists fear that these gaps in vaccination provide “the ideal breeding ground for generating new variants – especially variants of the virus that may be more resistant to the vaccine,” said Young, a virologist at the University of Warwick.
The new normal
It may be the end of the pandemic, but that doesn’t mean it’s normal life.
Instead, scientists at RKI believe that increased vaccine coverage and natural immunity turn a pandemic into endemic in Germany, but eradication of the virus and herd immunity are out of reach. Instead, countries should focus on reducing the number of severe cases.
François Balloux, professor of biosciences at University College London, feels justified in his prediction that the pandemic would end by the middle to the end of 2021. But at the “end”, Balloux means that the virus “will go to an endemic state in most parts of the world and will remain in circulation around the world with the ~ 200 other seasonal endemic respiratory viruses, ”he tweeted.
“The coronavirus is here to stay,” Oxford’s Dye agreed. He supports the French approach, such as maintaining social distancing and wearing a mask; requiring health and social workers to be vaccinated; and requiring proof that people are doubly trapped before entering a public space.
In contrast, British Prime Minister Boris Johnson’s decision to reopen the country almost to normal has sparked enthusiasm among public health experts. But the UK has yet to see serious consequences beyond a slight increase in hospitalizations and deaths. And scientists don’t know what to make of the recent drop in new infections in the UK. Some see it as a positive signal, while others warn that fewer cases could simply be the result of people being tested less frequently, schoolchildren on vacation, or a fall after a spike in European Championship matches. football organized in Great Britain.
Questions about managing the virus evolve, but don’t get any easier. On the one hand, debates on immunization mandates are intensifying, while some countries are considering immunizing adolescents.
The biggest risk, however, is what happens when people stop talking about the virus, Dye said.
“People want to move past this dominant thing in their minds and get their lives back,” Dye said. “They don’t want to talk about it every day. When it starts to happen … in a way, we learn to live with it. But the opportunity to make important and different decisions, from a political point of view, will also begin to fade. “
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