Europe staggers as variants keep spreading
MILAN — The virus swept through a nursery school and an adjacent elementary school in the Milan suburb of Bollate with amazing speed. In a matter of just days, 45 children and 14 staff members had tested positive.
Genetic analysis confirmed what officials already suspected: The highly contagious coronavirus variant first identified in England was racing through the community, a densely packed city of nearly 40,000 with a chemical plant and a Pirelli bicycle tire factory a 15-minute drive from the heart of Milan.
“This demonstrates that the virus has a sort of intelligence. … We can put up all the barriers in the world and imagine that they work, but in the end, it adapts and penetrates them,” lamented Bollate Mayor Francesco Vassallo.
Bollate was the first city in Lombardy, the northern region that has been the epicenter in each of Italy’s three surges, to be sealed off from neighbors because of virus variants that the World Health Organization says are powering another uptick in infections across Europe. The variants also include versions first identified in South Africa and Brazil.
Europe recorded 1 million new COVID-19 cases last week, an increase of 9 percent from the previous week and a reversal that ended a six-week decline in new infections, WHO said Thursday.
“The spread of the variants is driving the increase, but not only,” said Dr. Hans Kluge, WHO regional director for Europe, citing “also the opening of society, when it is not done in a safe and a controlled manner.”
The variant first found in the U.K. is spreading significantly in 27 European countries monitored by WHO and is dominant in at least 10 countries: Britain, Denmark, Italy, Ireland, Germany, France, the Netherlands, Israel, Spain and Portugal.
It is up to 50 percent more transmissible than the virus that surged last spring and again in the fall, making it more adept at thwarting measures that were previously
effective, WHO experts warned. Scientists have concluded that it is also more deadly.
“That is why health systems are struggling more now,” Kluge said. “It really is at a tipping point. We have to hold the fort and be very vigilant.”
In Lombardy, which bore the brunt of Italy’s spring surge, intensive care wards are again filling up, with more than two-thirds of new positive tests being the UK variant, health officials said.
After putting two provinces and some 50 towns on
a modified lockdown, Lombardy’s regional governor announced tightened restrictions Friday and closed classrooms for all ages. Cases in Milan schools alone surged 33 percent in a week, the provincial health system’s chief said.
The situation is dire in the Czech Republic, which this week registered a recordbreaking total of nearly 8,500 patients hospitalized with COVID-19. Poland is opening temporary hospitals and imposing a partial lockdown as the U.K. variant has grown from 10 percent of all infections in February to 25 percent now.
Two patients from hardhit Slovakia were expected to arrive Saturday for treatment in Germany, where authorities said they had offered to take in 10 patients.
Kluge cited Britain’s experience as cause for optimism, noting that widespread restrictions and the introduction of the vaccine have helped tamp down the variants there and in Israel. The vaccine rollout in the European Union, by comparison, is lagging badly, mostly because of supply problems.
In Britain, the emergence of the more transmissible strain sent cases soaring in December and triggered a national lockdown in January. Cases have since plummeted, from about 60,000 a day in early January to about 7,000 a day now.
Still, a study shows the rate of decline slowing, and the British government says it will tread cautiously with plans to ease the lockdown. That process begins Monday with the reopening of schools. Infection rates are highest in people ages 13 to 17, and officials will watch closely to see whether the return to class brings a spike in infections.
While the U.K. variant is dominant in France, forcing lockdowns in the French Riviera city of Nice and the northern port of Dunkirk, the variant first detected in South Africa has emerged as the most prevalent in France’s Moselle region, which borders Germany and Luxembourg. It represents 55 percent of the virus circulating there.
Austria’s health minister said Saturday the U.K. variant is now dominant in his country. But the South Africa variant is also a concern in a district of Austria that extends from Italy to Germany, with Austrian officials announcing plans to vaccinate most of the 84,000 residents there to curb its spread. Austria is also requiring motorists along the Brenner highway, a major north-south route, to show negative test results.
The South Africa variant, now present in 26 European countries, is a source of particular concern because of doubts over whether the current vaccines are effective enough against it.
SURRY, Va. — When Charlome Pierce searched where her 96year-old father could get a COVID-19 vaccine in January, she found zero options anywhere near their home in Virginia. The lone medical clinic in Surry County had none, and the last pharmacy in an area with roughly 6,500 residents and more land mass than Chicago closed years ago.
To get their shots, some residents took a ferry across the sprawling James River to cities such as Williamsburg. Others drove more than an hour past farms and woodlands — the county got its first stoplight in 2007 — to reach a medical facility offering the vaccine.
At one point, Pierce heard about a state-run vaccination event 45 minutes away, No more appointments were available, which perhaps was for the best: the wait there reportedly could last up to seven hours.
“That would have been a daunting task,” she said, citing her father’s health conditions and frequent need to use the bathroom. “I could not have had him sit in a car and wait for something that might happen. We’re not in a Third World country.”
As the nation’s campaign against the coronavirus moves from mass inoculation sites to drugstores and doctors’ offices, getting vaccinated remains a challenge for residents of “pharmacy deserts,” communities without pharmacies or well-equipped health clinics. To improve access,” the federal government has partnered with 21 companies that run free-standing pharmacies or pharmacy services inside grocery stores and other locations.
More than 40,000 stores are expected to take part, and the Biden administration has said that nearly 90 percent of Americans live within five miles of one, from HyVee and Walmart to Costco and Rite-Aid.
But there are gaps in the map: More than 400 rural counties with a combined population of nearly 2.5 million people lack a retail pharmacy that’s included in the
partnership. More than 100 of those counties either have no pharmacy or have a pharmacy that historically did not offer services such as flu shots, and possibly lacks the equipment or certified staff to vaccinate customers.
Independent pharmacies that have traditionally served rural areas have been disappearing, casualties of mail-order prescriptions and more competition from chains like Walgreen’s and CVS with greater power to negotiate with insurance companies, according to Keith Mueller, director of the University of Iowa’s RUPRI Center for Rural Health Policy Analysis.
“There are a lot of counties that would be left out” of the Federal Retail Pharmacy Program, said Mueller, whose research center compiled the pharmacy data on the 400 counties. “In the Western states in particular, you have a vast geography and very few people.”
Challenges to obtaining a vaccine shot near home aren’t limited to rural areas. There is a relative dearth of medical facilities in some urban areas, particularly for Black Americans, according to a study published in February by
the University of Pittsburgh’s School of Pharmacy and the West Health Policy Center.
The study listed 69 counties where Black residents were much more likely to have to travel more than a mile to get to a potential vaccination site, including a pharmacy, a hospital or a federally qualified health center. One-third of those counties were urban, including the home counties of cities such as Atlanta, Houston, Dallas, Detroit and New Orleans.
Additionally, the study identified 94 counties where Black residents were significantly more likely than white residents to have to go than 10 miles to reach a potential vaccination site. The counties were mostly heavily concentrated in the southeastern U.S. — Virginia had the most of any state with 16 — and in Texas.
The shortage of pharmacies and other medical infrastructure in some of the nation’s rural areas highlights the health care disparities that have become more stark during the coronavirus pandemic, which has disproportionately affected members of racial minority and lower-income groups.
The former drug store in Surry
County, where about 40 percent of the residents are Black, is now a cafe. No one seems to remember exactly when the Surry Drug. Co. closed, but cafe co-owner Sarah Mayo remembers going there as a child. Now, she drives 45 minutes to a Walmart or CVS.
In January, Surry County officials saw vaccines arrive in other parts of Virginia that had more people or more coronavirus cases. Fearing doses might not arrive for months, if ever, they began to pressure state officials.
In a letter to the governor’s office, Surry joined with surrounding communities to express concerns about vaccine “equity,” particularly for low-income and other disadvantaged populations. Some of those communities said they had reallocated money to support vaccination efforts.
“The thing about living in a rural community is that you’re often overlooked by everybody from politicians right on through to the agencies,” said county Supervisor Michael Drewry.
Surry County Administrator Melissa Rollins wrote to the regional health district, stating that driving outside the county wasn’t practical for most residents. She said Surry was willing to sponsor a mass vaccination site, had devised a plan to recruit people who could administer shots and make sure that eligible residents would be ready.
The first clinic in Surry County was held Feb. 6 at the high school in the small town of Dendron. The school district was inoculating teachers and other staff members when officials with the county and regional health district staff learned of extra doses, prompting a rush to get the word out.
Surry already had a waitlist of eligible people through a survey it designed to reach vulnerable residents. It used its emergency alert telephone system, since internet access is spotty.
Pierce got the call and quickly headed out with her father, Charles Robbins. It was a 20-minute drive to the high school and a two-hour wait. Pierce, 64, also got a shot, along with about 240 other people that day.
Three more vaccination clinics have been held in the county. And the regional health district had administered 1,080 doses there as of March 2. The number makes up the majority of doses that county residents have received, although several hundred received their shots outside of the county.
All told, about 1,800 county residents have received at least one dose. That’s about 28 percent of the population and was almost twice the state’s average rate. About half the people who’ve received vaccines are Black.
The Virginia Department of Health said that vaccine distribution has been based on population and COVID rates. But moving forward, the department said it’s considering tweaks to ensure more geographical and racial equity.
Pierce and her father were relieved to get their second shots in late February. But she said Surry’s rural character placed it at a disadvantage in the beginning.
“I have close friends, people who are essential workers, who’ve had to go as far away as an hour to get a shot,” she said. “You shouldn’t be marginalized by your ZIP code.”