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Several European countries a few weeks ahead of the UK on the road out of lockdown have experienced local spikes in coronavirus infections, but all have maintained an overall downward trend in new daily cases of the virus.
Most governments, though, continue to warn of the real threat of a second wave of Covid-19 cases and to insist on the importance of physical distancing if the spread of the virus is not to pick up again as restrictions easer.
France
Phase two of the country’s exit begins next week after lockdown eased on 11 May, when people were allowed out of their homes without an approved reason, and when non-essential shops opened and some pupils returned to school.
Several dozen new coronavirus clusters, some with more than 50 cases, have been detected since. These have been linked to hospitals, abattoirs, hostels, schools and a funeral service. Officials are also seeking to test 400 people who attended an illegal football match in Strasbourg.
Epidemiologists have said that 1,000 new cases a day represents “a safe zone” for France. In recent days, between 200 and 400 cases have been recorded, with the R – or reproduction – rate at 0.77 in most of the country. “The virus is still there but the indicators are positive,” said Geneviève Chêne, head of France’s public health agency.
Germany
Angela Merkel, the chancellor, has been fighting a rearguard action against the premiers of the country’s 16 states, who have broad powers to decide on confinement measures and want to lift them faster than she would like.
Multiple new clusters have occurred since Germany’s comparatively soft lockdown began easing late April. Despite observing physical distancing, more than 100 people were infected after a Baptist church service in Frankfurt on 10 May.
More than a dozen also tested positive after a restaurant, in the northern town of Leer, opened again, while sizeable outbreaks have also occurred at Amazon logistic centres and in several meatpacking plants around the country.
One slaughterhouse in North-Rhine Westphalia found 270 of its 1,200 workers were infected, while a similar outbreak at another, in Bavaria, boosted the infection rate past 50 per 100,000 residents, the level at which local restrictions must be reimposed.
Officials in Berlin, where bars and restaurants reopened on 15 May, said this week the R rate of the virus in the capital had risen to 1.37 from below one. Nationwide, however, new cases have fallen to 400-600 daily, from a peak of 7,000 late March.
Spain
The country’s health emergency chief, Fernando Simón, warned again this week that the hard-won progress – new cases in Spain have fallen to about 400-500 a day from more than 7,500 at the peak – must not be taken for granted, saying an outbreak due to “a small, innocent party could be the start of another epidemic”.
Simón was speaking after six new cases were discovered in a small town in the south-east Spanish region of Murcia, apparently linked to an agricultural worker who went to work despite showing symptoms of the disease.
Spain also had an earlier spike in Lleida, Catalonia, after 20 people gathered for a birthday party, ignoring phase-one lockdown rules which stipulated gatherings of no more than 10 people. Four had the virus and ended up infecting the other 16.
Italy
The country had a big jump in cases in its hardest-hit region, Lombardy, after it lifted its strictest lockdown measures on 4 May, its second phase of the emergency. A week later new infections in the region had risen to 1,000 from a few hundred. Lombardy still accounts for most of the country’s 300-600 new daily cases, down from 6,500 daily in March.
Denmark
The first EU state to begin gradually exiting its lockdown, mid April. It said a fortnight later it had seen “no sign” of the pandemic accelerating, with the R rate remaining below 1. This month its chief epidemiologist said a second wave looked very unlikely. New infections are running at 30-60 a day, from a peak of nearly 400.
Epidemics of infectious diseases behave in different ways but the 1918 influenza pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated – albeit more mildly – in subsequent flu pandemics.
How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.
Is there evidence of coronavirus coming back in a second wave?
This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a sudden resurgence in infections despite being lauded for its early handling of the outbreak.
Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged in cramped dormitory accommodation used by thousands of foreign workers with inadequate hygiene facilities and shared canteens.
Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.
What are experts worried about?
Conventional wisdom among scientists suggests second waves of resistant infections occur after the capacity for treatment and isolation becomes exhausted. In this case the concern is that the social and political consensus supporting lockdowns is being overtaken by public frustration and the urgent need to reopen economies.
The threat declines when susceptibility of the population to the disease falls below a certain threshold or when widespread vaccination becomes available.
In general terms the ratio of susceptible and immune individuals in a population at the end of one wave determines the potential magnitude of a subsequent wave. The worry right now is that with a vaccine still months away, and the real rate of infection only being guessed at, populations worldwide remain highly vulnerable to both resurgence and subsequent waves.
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