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How COVID is still hitting Europe hard and what the EU can do next

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By Alice Tidey
Medical staff attend to a patient at the COVID-19 ICU unit of the hospital in Bratislava, Slovakia, Nov. 23, 2021.
Medical staff attend to a patient at the COVID-19 ICU unit of the hospital in Bratislava, Slovakia, Nov. 23, 2021.   -   Copyright  Martin Baumann/TASR via AP

With nearly three-quarters of the European Union's population now fully vaccinated against COVID and the Omicron wave receding, countries have been rolling back restrictions.

But while wall-to-wall coverage of the pandemic has receded amid Russia's invasion of Ukraine, the disease is continuing to kill.

In the seven days to 27 March, more than 6,900 people lost their lives to COVID-19 in the EU/EEA, according to Our World in Data. In the preceding week, 33,000 people worldwide had died, 40% of which — 13,047 — were in the World Health Organization's (WHO) European region, which spans 53 countries stretching to Central Asia.

The global death toll now stands over 6.1 million with more than 1 million in the 31 countries of the EU/EEA alone.

"I think it's important to make clear that this pandemic is not over despite the fact that many restrictions are being lifted across a lot of higher-income countries," Rebecca Forman, a health policy consultant at the London School of Economics and Social Sciences (LSE), stressed to Euronews.

Free testing and mandatory self-isolation for suspected cases or people with mild symptoms have been dropped in a number of countries as have face mask requirements with some caveats such as on public transport or in medical facilities. The use of COVID passes — attesting that the holder has tested negative, submitted to a full course of vaccination or recovered from the disease — has been drastically reduced domestically.

This is largely down to the Omicron wave starting to draw back from Europe and the region's high vaccination rate.

More than 72% of the EU/EEA's population have now received two doses of the vaccines, with more than half also getting a booster shot. The numbers rise to 83.2% and 63.2% when only looking at people over the age of 18.

Vaccination rate might not be high enough

For Forman, cutting mandatory testing and self-isolation could mean "governments are making themselves more vulnerable to being blindsided by this disease again" and risk exacerbating inequalities once more with people not financially able to independently get tested and self-isolating likely to be most impacted by the disease.

Additionally, the high vaccination rate might just not be high enough.

"The problem is that today Omicron BA1 (strain) and even more so BA2 have a virological profile quite close to the measles virus which requires a vaccination coverage close to 95%," Anne Senequier, a researcher at IRIS, a think tank, told Euronews.

So the EU's vaccination rate "is good, but it is still not enough", she said.

And, as Vasco Ricoca Peixoto, a researcher at Portugal's National School of Public Health at the University of Lisboa, told Euronews, the BA2 strain of Omicron was quick to emerge, suggesting "the virus is mutating fast enough to reduce previous immunity from mass vaccination and boosters and from a large number of previously infected population".

"This is nothing like other common respiratory virus patterns. COVID is becoming one of the most infectious disease known to humans (R0 above 8) even with previous immunity," he added.

And Europe currently remains the epicentre of the pandemic, with most EU countries among the minority of nations worldwide painted a bright red in the European Centre for Disease Prevention and Control's (ECDC) 14-day incidence rate map, meaning there are at least 960 cases per 100,000 habitants.

This indicates European healthcare systems continue to be under important strain.

One dose, two doses, three doses... four doses?

Despite this, EU leaders barely addressed the pandemic at their last summit in Brussels on 24 and 25 March. The 11-page-long conclusions of their meeting devote just two paragraphs to COVID-19 to attest that leaders "reviewed coordination efforts" in response to the pandemic and "took stock" of progress in the deployment of international cooperation on global health governance, including on work to develop a future instrument to strengthen pandemic prevention, preparedness and response.

When the COVID-19 vaccines were first rolled out, health authorities worldwide emphasised that they were not a silver bullet against the disease and as high-income countries purchased the majority of available doses, many experts highlighted the pandemic would not be derailed until a significant proportion of the world's population were also inoculated.

The emergence of the successive, more transmissible variants has proven them right.

Despite its high vaccination rate, Europeans are still vulnerable to future variants which may be more virulent and even more vaccine-resistant.

"It's true that immunity on these first-generation vaccines is not very effective in terms of time. We saw this over the past two and a half months. Already, with the Omicron variant, we have an efficiency reduced to 50%," Senequier said. "It's good but we can see that it's not sustainable in the long term. There is still a need to generate second-generation vaccines."

This, of course, would mean that at some point in the near future, Europeans will once more have to receive a shot.

And the EU, which has so far pledged to donate more than 401 million doses to lower-income countries — 344 million have been delivered — could and should donate more, experts say.

The EU Commission told Euronews that "the EU has exported over half of the vaccines doses produced in Europe, over 2 billion doses, to 166 countries around the world".

"At this point over 50% of the world population is vaccinated and a large part of the doses necessary for these vaccinations were exported or shared by Europe. And we will do more."

"We will step up our effort to support Africa where vaccination is lower than in other parts of the world. Our aim is to ensure that 70% of the world's population is vaccinated by the middle of the year.

"To win the battle against this pandemic, it is crucial to speed up the vaccination campaigns everywhere. No one will be safe until everyone is safe," the spokesperson also said.

The EU's health sovereignty

Brussels and EU leaders, scarred by the first few weeks of the pandemic when medical shortages were rife, have meanwhile also pledged to attain strategic health sovereignty and to make healthcare systems on the Old Continent more resilient and innovative. This, in view to ensure it is better prepared to react to future epidemics and pandemics.

But so far, not much has been announced. France, which currently holds the rotating EU presidency, has unveiled a €1.5 billion funding for an Important Project of Common European Interest on Health which aims, among other things, to develop innovative and greener technologies and production processes for manufacturing medicines and to develop gene and cell therapies.

Yet the threat of more dangerous COVID-19 variants is real and this is compounded by climate change which enhances the risk of infectious diseases like COVID-19 as disease-carrying animals — such as mosquitos and other biting insects — increasingly venture outside their traditional habitats. while globalisation will do the rest, as it did for COVID.

When it comes to its preparedness for the current pandemic and what it can next unleash, Peixoto said the EU "should agree common minimum recommended measures for COVID-19 prevention. It's clear we still have something to gain from it as a whole, our economies, our health systems and our long term health."

"Definitely the EU must have the capability of creating, testing and producing its own vaccines for public health reasons and for autonomy," he also said.

But Senequier stressed that when it comes to health, no country or continent can be fully sovereign because "the medical field is very high-tech" and research requires a lot of investments. At best, the EU could secure production for some of the most used drugs for some of the most common diseases but it wouldn't be able to produce everything it needed itself.

Health systems should brace for more shocks

But the EU could make an inventory of who does what best — for instance, France is renowned for its medical research while Germany's chemical industry is among the world's best — and develop networks to tap into when another pandemic hits.

"There cannot be a common (sanitary) protocol in the region. We have different health systems," Senequier said. "The idea is to know what to do. Because what marked the beginning of COVID-19 in Europe is that everyone looked at each other dumbfounded, saying to themselves: "Damn, it's happening to us, and we're not prepared"," she said.

"Every crisis is always different and we're always a step behind. So today, to be able to come out with a protocol and say we're going to do it this way, because that's how it is, that would perhaps be one of the biggest mistakes to make because it would be too rigid to face up to the next crisis.

"I think that we will have to focus on flexibility, on the interconnection between the different EU countries to be able to deal with as much as possible. We won't be able to be perfect for the next crises, that's obvious, but in any case, we can start to try to capitalise on the capacities of each country and coordinate everything so that it's more fluid," she added.

Chief among that, of course, is deciding who to follow. COVID-19 showed that the ECDC did not have the appropriate resources to monitor and implement measures to tackle the pandemic at the European level while governments worldwide listened to the WHO but then relied primarily on their own national health authorities resulting in very different and disparate measures.

Additionally, Forman stressed, "it’s important to recognise that a shock to the health system doesn’t always come in the form of an infectious illness."

"We’re two years into this pandemic and we’ve seen how much stress that’s put on our health systems and now we’re seeing increased pressures on many European countries’ health systems due to the Russian invasion of Ukraine.

"These events demonstrate how important it is for our health systems to be resilient to shocks – whether they’re infectious outbreaks, conflicts, natural disasters, or anything else. And unfortunately, with climate change we’re likely to face even more of these ‘shocks’ going forward," she added.