November 12, 2021

expert reaction to media questions on the COVID-19 case numbers in Europe

A few journalists have asked today about the COVID-19 situation in Europe and how it compares to the UK.

Dr Julian Tang, Honorary Associate Professor/Clinical Virologist, Respiratory Sciences, University of Leicester, said:

“Different countries need to react as needed according to how the virus is behaving in their populations

“The virus/infection dynamics will differ between countries as they have different cultures, healthcare systems, levels of natural or vaccine immunity – as well as different levels of concern and practices related to social distancing, PPE (masking) – and also their diagnostic testing and test/track/isolation/quarantine capacities/facilities.

“Nevertheless, we know that Eastern European countries controlled the spread of the virus well during the early pandemic first wave but then experienced more severe second waves as they opened up early post-first wave – in 2020.

“With the emergence of the delta variant in 2021, we now know that this virus can readily bypass natural and vaccine immunity, and cause more symptomatic and severe infections in the unvaccinated.

“We also now know that the degree of spread/breakthrough infection and severe disease with the delta variant is less common with doubly (rather than singly) vaccinated people. So this may account for some of the higher COVID-19 cases and hospitalisations in some countries that have fewer people who have been doubly vaccinated.

“Finally, waning vaccine immunity will more readily allow breakthrough delta virus infections – and such vaccine immunity will wane more quickly in singly compared to doubly vaccinated individuals.

“All of these factors will contribute to the different viral dynamics that we are seeing across Europe – and it is reasonable for those countries to take the measures they feel most appropriate to control the virus in their populations.”

Prof Paul Hunter, Professor in Medicine, The Norwich School of Medicine, University of East Anglia, said:

“We are not behind Europe in this wave, they are behind us. We are not currently seeing a surge of the same magnitude as Europe at present largely because of the high case numbers over recent months which most of Europe missed out on. The key exception is Romania which have just had a large peak and which are now seeing a decline.

“This type of behaviour is typical of an epidemic infection as it becomes endemic. As a disease approaches its endemic equilibrium you get oscillations around the eventual equilibrium https://www.nature.com/articles/s41592-020-0856-2. So we can probably expect oscillations across Europe for a year or so yet. Some times the UK will be worse than Europe at other times Europe will be worse than us.”

Professor Lawrence Young, Virologist and Professor of Molecular Oncology, University of Warwick, said:

“A combination of insufficient vaccine uptake and the easing of restriction measures is contributing to a surge in COVID-19 cases in Europe. Vaccine hesitancy is a particular problem in Central and Eastern Europe driven by a lack of trust in the vaccine and in their government’s promotion of vaccination. Whether compelling individuals to get jabbed – either by lockdown measures for the unvaccinated or vaccine passports to access indoor spaces such as restaurants and shopping malls – will work is questionable and runs the risk of further alienating the public.

“Less mask wearing, more mixing indoors due to colder weather and waning immunity are also contributing to the high case levels in the UK. England has been slower to vaccinate adolescents than other countries in Western Europe and around the world and this has contributed to a high number of cases in school-age children and to the spread of infection in the wider community. While cases in the UK do appear to be slowly dropping, we still have the highest rate of hospitalisations in Western Europe and are now seeing more infection in the over 50s. Given Israel’s experience of the success of booster jabs in controlling the latest wave of infection and vaccination of 12 to 15 year olds, the hope is that we will continue to see a steady fall in cases and hospitalisations. But it’s a fine balancing act between the need to get on with vaccinations and the continued spread of the virus in the face of waning immunity exacerbated by the lack of control measures to limit virus transmission.”

Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:

“It is likely that many European countries are coming to the point where the UK was a few months back, in terms of some waning of immunity in the populations vaccinated earlier in the year. The UK rolled out a vaccination programme earlier than most countries, and therefore has experienced impact of waning immunity earlier. We can also look at Israel as an example here too, with their initial rapid vaccine rollout and booster campaign. The boosters here in the UK are clearly having an impact around hospital admissions and new cases in older populations.

“If European countries rapidly implemented booster programmes then this would increase the level of protection within their populations. However, we are seeing that while vaccines do a lot of the heavy lifting when it comes to keeping COVID-19 under control, other interventions are also required to prevent case numbers rising. To control the number of cases vaccines can be combined with other non-pharmaceutical interventions, such as improved ventilation in indoor settings and the wearing of facemasks. Countries can also consider reducing mixing of susceptible populations, for example by reducing capacity within indoor areas like theatres or cinemas. A full lockdown is an intervention of last resort, but there are many other factors that can be considered that (for example) still allow people to see friends and family.

“Many European nations, particularly in Eastern Europe, have much lower proportions of their populations vaccinated. The levels of vaccine hesitancy across many countries is a cause for concern. This is going to be a great problem for a very long time. There will be the immediacy of the burden of COVID-19 disease, along with knock-on consequences for other areas of health, particularly as we head through the winter of 2021/22. Beyond that, there will still be significant outbreaks of COVID-19.

“Where we see uncontrolled outbreaks, we also see emergence of new variants of interest and concern, and we really don’t want any new variants to become dominant and have a greater impact upon the effectiveness of our vaccines.

“Ultimately, the world cannot fully relax until the vast majority of the world is vaccinated. The combination of vaccine hesitancy and lack of access to vaccines is everyone’s problem.”

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

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