Why is Europe yet again at the centre of the coronavirus pandemic? | Laura Spinney


Last week Europe registered 1.5m new cases of Covid-19 – a record – making it once again the centre of the pandemic. The UK is not exempt, and England will enter a new lockdown from Thursday 5 November. From the outside, it might seem the continent is in the grip of a second wave that is ramping rapidly towards its peak. But it is not one wave, it’s many local waves, and that is crucial in understanding how to rein it in and prevent the same thing happening again.

Though there is some tentative evidence that the virus itself has undergone a change since the summer, there is none to suggest that this change has affected either the transmissibility or the severity of the disease. Nor can the change explain the synchronous surges in all parts of the continent.

Experts believe that synchronicity is explained mainly by similarities in public health strategies, driven by a shared news space – the fact, for instance, that countries lifted their first lockdowns at roughly the same time, and that schools have been open across Europe since the beginning of this academic year – and also, perhaps, by a spell of cold weather at the end of September.

The American public health expert Anthony Fauci said recently that the United States was still grappling with the first wave of the pandemic, and the same could be said of Europe. European nations just dented it more profoundly in the spring.

The view of health experts now is that, for various reasons, Europe’s strategy for exiting its spring lockdowns failed. Either politicians ignored their advice, or the systems weren’t in place to implement it correctly. People’s goodwill and trust leached away as the pandemic dragged on, and when those experts started calling for stronger measures again this autumn – and the same exit strategy as before – politicians were even less willing to listen.

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The fault is not only the politicians’. Some governments may have done better than others in managing their epidemics, but all of them are trying to satisfy as many of their voters as possible – and of course, to stay in power. The misunderstandings that have landed us in this new chapter of misery belong to all of us. There are really only two of them, but they have done a lot of damage: an inability to grasp the notion of exponentiality, and the dangerous idea that you can simultaneously save lives and spare the economy.

An outbreak of Covid-19, if unchecked, grows exponentially or explosively – meaning it can be growing quietly before it suddenly appears to be out of control, and that it is always better to stop it as early as possible. Analyses of past pandemics, as well as economists’ assessments of this one – including a report published last month by the International Monetary Fund – all say the same thing: the cities, regions or countries that came down hard and early on the virus not only lost the fewest lives, they were also the most resistant economically.

What does this mean going forward? Public health experts agree that the first lockdown – as blunt or blanket as it was – was essential. Europe, like the rest of the world, was short on knowledge and equipment and needed to buy itself time. In most countries, those lockdowns drove infection rates down, but not as low a level as the experts would have liked. The virus was still circulating when they were lifted – that is, there was still community transmission – making fresh outbreaks inevitable. The optimal strategy for the next phase was therefore to impose precise, local lockdowns when those outbreaks were detected.

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This meant having an effective test and trace system in place, to find the outbreak, followed by a coordinated set of measures – such as restrictions on travel in and out, social distancing measures, protection of key workers – imposed locally to stamp it out. Importantly, support could be channelled to affected areas in a more targeted way, reducing the financial burden on the state.

The failure of this strategy wasn’t noticeable at first. Many of us enjoyed a relatively carefree summer. And yet infection rates were rising – not steadily, as the cliche goes, but exponentially. The return to school, university and work amplified the spread in September, and by October hospitals were sounding the alarm. Experts had been calling for stronger measures, including increased protection for the most vulnerable, for weeks by then, but they had largely been ignored. Fatigue had set in.

“If the politicians didn’t want to act then, it wasn’t because they hadn’t understood the situation, it was because they were convinced that French people weren’t ready to hear difficult messages,” says the epidemiologist and member of the French government’s scientific advisory council Arnaud Fontanet. The council had been accused of being alarmist in early September, and a petition had even circulated demanding its resignation.

In Belgium, which has one of the highest infection rates in Europe at the moment, the virologist and government adviser Marc Van Ranst pointed to Germany’s partial lockdown in a tweet on 29 October, commenting: “We could and should have done this six weeks ago.”

Trends are worrying across the continent now, including in countries such as Greece and the Czech Republic, where infection rates had been low until recently. Measures are tightening up everywhere. They differ from country to country, not only because the local context differs, but also because there is disagreement about what this next phase should achieve.

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Some scientists argue the new lockdowns must eliminate community transmission entirely before the exit strategy is implemented; others say that it’s sufficient to drive infection rates down by a smaller margin and the exit strategy will finish the job, allowing economies to breathe sooner.

The devil, as always, is in the detail. But the good news is that we’re better placed to implement that exit strategy now than in the spring. Testing rates vary but are pretty high across the continent. Contact tracing is better, though not as good as it could be. It’s mostly forward looking, designed to locate people who have been exposed to an infected person. We need more of the type that tracks backwards from that person to identify an outbreak’s source. Care has improved, hospitals are better equipped. Most of us have incorporated social distancing into our routines.

But – and it’s a big but – people are tired, poorer than they were a year ago and fed up. That’s why it’s so important that governments explain clearly why this exit strategy is the only feasible one – pointing to the countries large and small, rich and poor, island and not, that have pulled it off: Australia, Taiwan, Vietnam, New Zealand, South Korea, China. It’s also why everyone needs to get to grips with exponentiality, and with the idea that sparing the economy is a false economy. We have to contain the virus. All the alternatives are worse.

Laura Spinney is a science journalist and author. Her latest book is Pale Rider: The Spanish Flu of 1918 and How it Changed the World





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