The man who gave UK early warning explains how to beat second wave
The lead expert at the body co-ordinating Europe’s response to the Covid-19 pandemic says he expects to see a “continued resurgence” of cases across the Continent this winter, but is “optimistic” that deaths will not spike again dramatically.
In an interview with The Daily Telegraph, Sergio Brusin, principle expert at the European Centre for Disease Prevention and Control (ECDC), said the “horrible scenes” witnessed as the virus overwhelmed hospitals in March and April were unlikely to be repeated because of improved healthcare capacity and planning across Europe. “The resurgence in cases will go for quite a few months. [But] it will probably never get to the same level as the first big wave in spring”, he said.
“Although we’ve seen hospitalisations going up in some countries, it is not anywhere near the situation in March and April. ICUS are not clogged, and health services now have much better planning and response times. So, I am optimistic we will not see the big, horrible scenes we saw in March and April but we will see a lot more cases.”
He added that widespread adoption of social distancing, and countries’ ability to react to local outbreaks meant there was unlikely to be a repeat “of big national lockdowns”.
“I don’t see the need for moving back to a full suppression strategy. That was justified when the ICUS and hospitals were full, but that is not the case now,” he said. “As long as hospitals can cope, there is no need for such drastic measures.”
Mr Brusin, who oversees the ECDC’S surveillance and response strategies, is best known in the UK for warning in a television interview on March 9 that Britain was following Italy’s trajectory, and only had a “few days” to lockdown if it was to avoid a similar fate. The Prime Minister reacted two weeks later, on March 23, by which time community transmission of the virus was already widespread.
Mr Brusin would not be drawn on naming countries but said what separated states in Europe was the degree to which their pandemic plans were “up to date” and how quickly they were acted. Especially important was the degree to which national plans embraced strategies for “suppressing the virus” rather than just “mitigating” its impact. “Because most plans were geared towards flu, they were mostly mitigation plans. They didn’t have suppression tools, with measures like lockdowns and so on,” he said.
“In around 2016, the World Health Organisation came out with the concept of the famous Disease X; the idea we should plan flexibly for a novel pathogen. That was much closer to what we’re seeing with Covid-19, and the countries that bought into that kind of planning did have the suppression idea in their pandemic plans. The countries that implemented very tough measures early were the ones with better preparedness plans.”
The ECDC was set up to co-ordinate disease outbreak response in Europe after the 2003 Sars epidemic, and it has played a pivotal role in the response to Covid-19, mainly in the area of data and information sharing, but also in strategy. It recommended from the outset the route most western European countries have taken of ramping up social distancing and other containment measures according to how widely spread the virus is locally, as determined by widespread testing and contact tracing. Initially, Britain adopted a strategy of “contain, research, delay, mitigate” but it has now fallen broadly in line with the ECDC’S approach since the spring crisis.
The ECDC’S latest weekly dataset – used by countries across Europe to track the epidemic and, each Thursday, to adjust their international travel policies – shows infection rates across the Continent rose continuously for the 31 days to Aug 19. Confirmed case numbers were up in 18 countries, including the UK; hospital admissions were up in six; and deaths had risen in Belgium and Romania. Mr Brusin said a large part of a country’s ability to keep cases numbers under control this winter would be determined by the behaviour of its population. “What is really driving the [current] resurgence is the fact that we have still quite a few gatherings of people. In most of the countries where the resurgence is significant, it comes mostly from weddings, bars and discos; places where quite a lot of people are mixing. It is also relevant that a lot of the new cases are among young people. They are less vulnerable, but they will pass it to older groups. There is a particular need to protect the vulnerable.”
On the current crisis, he said that Europe could have been hit by a far more lethal pathogen than Covid-19. “In a way, we were lucky. It’s nothing like the 1918 Spanish Flu or smallpox and cholera in the 1800s. The problem is we didn’t take very seriously the plans of Disease X. This is something that, in the future, I think we are going to take much more seriously. If we had been able to do that from the beginning, to have quick co-ordinated and planned measures, probably it wouldn’t have been so bad.”