EUROPE AT TIPPING POINT WITH COVID RUNNING RAMPANT, SAYS WHO

 The Guardian 7 January 2020 - by Joe Henley

© Provided by The Guardian Photograph: Massimo Percossi/EPA

Europe is at a tipping point in the course of the pandemic, the World Health Organization has said, warning that the coronavirus is spreading very fast across the continent and the arrival of a new variant has created an “alarming situation”.

Hans Kluge, the WHO’s Europe director, said that while the arrival of vaccines offered “new tools” to fight the virus, almost half the 53 countries in the region were reporting a seven-day incidence rate of more than 150 new cases per 100,000 people, while a quarter had recorded a more than 10% surge in cases over the past week.

Kluge said countries rolling out the Pfizer/BioNTech vaccine could be flexible on the gap between first and second doses, saying a balance should be struck between making the most of limited supplies and protecting as many people as possible.

Some countries including Britain are seeking to counter low vaccine supplies by extending the gap between first and second doses to up to 12 weeks, and by considering lower volume doses of some shots.

“It is important such a decision represents a safe compromise between the limited global production capacity at the moment, and the imperative for governments to protect as many people as possible while reducing the burden of any subsequent wave on health systems,” he said.

Proposals to prolong the gap between first and second dose have generated fierce debate among scientists, with both Pfizer and BioNTech warning that they have no evidence their vaccine would continue to be protective if the second dose was given more than 21 days after the first.

Siddhartha Datta, of the WHO’s vaccine-preventable diseases and immunisation unit, said the organisation acknowledged that some countries would face “exceptional circumstances”, but those choosing to prioritise first doses were “strongly recommended … to look into robust evidence” of the consequences.

The European region recorded more than 580,000 deaths from Covid in 2020, while the 27 countries in the EuroMOMO excess mortality monitoring project reported a threefold increase in excess deaths compared with 2018 and a fivefold increase over 2019.

Any signs of stabilisation or even decreased incidence in some countries “need to be taken with some caution” because the impact of the holiday period, with its family gatherings and relaxed physical distancing, was not yet known, Kluge said.

More than 230 million people in the region were living in countries under full national lockdowns, he said, with more countries set to announce new measures in the coming week as the more contagious British variant raises increasing alarm.

The mutation had been detected in 22 European countries, Kluge said, adding that while it seemed to produce no significant change in the disease itself – meaning it was “not more nor less dangerous” – its higher transmissibility was cause for concern.

“It is our assessment it may, over time, replace other lineages, as seen in the UK and increasingly Denmark,” he said. Without increased control to slow its spread, there would be an increased impact on already struggling health systems.

“This is an alarming situation,” he said. “For a short period of time, we need to do more than we have done and to intensify the public health and social measures to be certain we can flatten the steep vertical line in some countries.”

Basic measures such as mask wearing, limiting social gatherings, physical distancing and hand washing, along with testing, tracing and quarantine, must be intensified “to bring down transmission, lift the strain on Covid-19 wards and save lives”.

Kluge said progress on rolling out Covid vaccines was “varied but promising”, adding that the limited supply of jabs and increasing burden on hospitals meant health workers and at-risk groups “must be a priority” for vaccinations to avoid health systems collapsing.

Catherine Smallwood, WHO Europe’s senior emergency officer, said that although studies were still ongoing, there was “no indication for the moment” of any impact of the new strain on the efficacy of vaccines.