Northwest Arkansas Democrat-Gazette
Europe again experiencing surge of virus
Region nears 2 million cases, 27,000 deaths in single week
Europe has again become the epicenter of the coronavirus pandemic, a development fueled by slowing vaccination rates, spreading misinformation and loosened restrictions. With cases and deaths surging across the continent, countries are again considering lockdowns and debating whether vaccines alone are sufficient to curb the coronavirus spread.
Close to 2 million cases of covid-19 were reported last week in Europe — the “most in a single week in that region since the pandemic started,” Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said during a Friday news briefing. At the same time, the continent reported almost 27,000 deaths — a figure that represents more than half of the world’s covid-related deaths last week, he said.
“Some European countries are now reintroducing restrictions to curb transmission and take the pressure off their health systems,” Tedros said. “No country should be in this position, almost two years into the covid-19 pandemic.”
Europe was one of the first regions in the world to begin vaccinating its population. However, misinformation has contributed to lagging vaccination rates in some countries — for instance in Bulgaria, where conspiracies have spurred resistance to the shots.
To decrease the number of unvaccinated people, nations have taken different measures.
In Austria, one of Central Europe’s least-vaccinated nations, proof of vaccination or recent recovery from the virus is required in order to enter events with 25 or more people, hotels, hairdressers, and many dining and enter
tainment venues, according to the government. Italy last month enforced a vaccination mandate on its public and private workforce.
“It’s another reminder, as we have said again and again, that vaccines do not replace the need for other covid-19 precautions,” Tedros said. “Vaccines reduce the risk of hospitalization, severe disease and death. But they do not fully prevent coronavirus transmission.”
The result has been countries returning to some of the pandemic’s early- days restrictions.
Austria’s government announced Friday that it would meet this weekend to discuss lockdown measures for unvaccinated individuals. The Netherlands — which saw an unprecedented 33% increase in cases over the week — announced western Europe’s first partial lockdown of this winter, with three weeks of restrictions for shops, sports and catering that apply to all people, regardless of their vaccination status, the BBC reported.
“I’m seeing the storm clouds gathering over parts of the European continent,” Britain’s Prime Minister Boris Johnson said in a broadcast while encouraging people to get booster shots. “And I’ve got to be absolutely frank with people, we’ve been here before. We remember what happens when the wave starts rolling in.”
German lawmakers are mulling over legislation that would pave the way for new measures. Austrian Chancellor Alexander Schallenberg announced Friday that unvaccinated people in two regions will be able to leave home only for specified reasons starting Monday, and he is considering implementing similar measures nationwide. But he has said he doesn’t want to impose the restrictions on those who got vaccinated.
Austria is seeing one of the most serious outbreaks in Western Europe, along with Germany, which has reported a string of record-high infections in recent days.
“We have a real emergency situation right now,” said Christian Drosten, the head of virology at Berlin’s Charite Hospital, which has started canceling scheduled surgeries.
Duesseldorf ’s university hospital said earlier this week that its intensive care unit is full, though many facilities are struggling more with staffing shortages than bed space.
Drosten said Germany must increase its vaccination rate of 67% further — and fast. But officials have balked at ordering vaccination mandates and want to avoid any blanket lockdowns.
Health Minister Jens Spahn indicated that Germany could improve its often lax enforcement of covidpass requirements.
“If my vaccination certificate is checked more often in one day in Rome than it sometimes is in four weeks in Germany, then I think more can be done,” Spahn said recently.
The Netherlands is in a similar bind. The country announced the highest daily tally of new cases since the pandemic began Thursday, hospitals are warning that the situation could get worse, but officials are reluctant to clamp down too hard. Amid these concerns, organizers in Utrecht said they couldn’t in good conscience bring tens of thousands of people together to greet Santa at the annual Sinterklaas party that’s beloved by children.
Cities in Germany, by contrast, went ahead with outdoor Carnival celebrations this week — but the head of Cologne’s party, Carnival Prince Sven I., canceled public appearances after testing positive.
HERD IMMUNITY
Since the earliest days of the pandemic, there has been one collective goal for bringing it to an end: achieving herd immunity. That’s when so many people are immune to a virus that it runs out of potential hosts to infect, causing an outbreak to sputter out.
Many Americans embraced the novel farmyard phrase, and with it, the projection that once 70% to 80% or 85% of the population was vaccinated, the virus would go away and the pandemic would be over.
Experts at the U.S. Centers for Disease Control and Prevention have set aside herd immunity as a national goal.
The prospects for meeting a clear herd- immunity target are “very complicated,” said Dr. Jefferson Jones, a medical officer on the CDC’s covid-19 Epidemiology Task Force.
“Thinking that we’ll be able to achieve some kind of threshold where there’ll be no more transmission of infections may not be possible,” Jones acknowledged recently to members of a panel that advises the CDC on vaccines.
Vaccines have been quite effective at preventing cases of covid-19 that lead to severe illness and death, but none has proved reliable at blocking transmission of the virus, Jones noted. Recent evidence has also made clear that the immunity provided by vaccines can wane in a matter of months.
The result is that even if vaccination were universal, the coronavirus would probably continue to spread.
“We would discourage” thinking in terms of “a strict goal,” he said.
To Dr. Oliver Brooks, a member of the CDC’s Advisory Committee on Immunization Practices, it was a sobering new message, with potentially worrisome effects.
With just 58.5% of all Americans fully vaccinated, “we do need to increase” the uptake of covid-19 shots, said Brooks, chief medical officer of Watts Healthcare in Los Angeles. Unfortunately, he said, Jones’ unexpected admission “almost makes you less motivated to get more people vaccinated.”
Brooks said he worries that as the CDC backs off a specific target for herd immunity, it will take the air out of efforts to increase vaccination levels.
And if public health officials stop talking about the “herd,” people may lose sight of the fact that vaccination is not just an act of personal protection but a way to protect the community.
A public tack away from the promise of herd immunity may also further undermine the CDC’s credibility when it comes to fighting the coronavirus.
On issues ranging from the use of masks to how the virus spreads, the agency has made some dramatic about-faces over the course of the pandemic. Those reversals were prompted by new scientific discoveries about how the novel virus behaves, but they’ve also provided ample fuel for covid-19 skeptics, especially those in conservative media.
“It’s a science-communications problem,” said Dr. John Brooks, chief medical officer for the CDC’s covid-19 response.
“We said, based on our experience with other diseases, that when you get up to 70% to 80%, you often get herd immunity,” he said.
But the SARS-CoV-2 virus didn’t get the memo.
“It has a lot of tricks up its sleeve, and it’s repeatedly challenged us,” he said. “It’s impossible to predict what herd immunity will be in a new pathogen until you reach herd immunity.”
The CDC’s new approach will reflect this uncertainty. Instead of specifying a vaccination target that promises an end to the pandemic, public health officials hope to redefine success in terms of new infections and deaths — and they’ll surmise that herd immunity has been achieved when both remain low for a sustained period.
“We want clean, easy answers, and sometimes they exist,” John Brooks said. “But on this one, we’re still learning.”
Herd immunity was never as simple as many Americans made it out to be, said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center at the University of Pennsylvania and an expert on the challenges of communicating science to increasingly skeptical — and often conspiracy-minded — people.
It’s an idea that emerged about a century ago from the field of livestock medicine. Epidemiologists now calculate it with a standard equation. But like many tools that model a complex process with math, it makes some simplifying assumptions.
For instance, it assumes an unrealistic uniformity in the behavior of individuals and groups, and in the virus’s ability to spread from person to person.
So it doesn’t reflect the diversity of population density, living arrangements, transportation patterns and social interactions that make Los Angeles County, for instance, so different from Boise County, Idaho. Nor does it account for the fact that Boise County, where less than 35% of adults are fully vaccinated, gets no protection from Los Angeles County’s 73% vaccination rate among adults.
“Humans are not a herd,” Jamieson said.
Public health leaders would have been better served by framing their vaccination campaigns around the need for “community immunity,” she said. That would have gotten people to think in more local terms — the ones that really matter when it comes to a person’s risk of infection, she added.
Changes in the coronavirus itself have also made herd immunity a moving target.
The calculation that produced a herd immunity estimate of 70% to 85% rests heavily on the innate transmissibility of the coronavirus. But with the emergence of new viral strains like the alpha and delta variants, the virus’ ability to jump from person to person has escalated dramatically in the past year.
In addition, herd-immunity calculations presume that when people gain immunity, they remain immune for a known period of time. But it’s become clear that neither vaccination nor natural infection confers lasting protection. Booster shots or a “breakthrough” case might, but for how long is still unknown.
That’s just the way science works, said Raj Bhopal, a retired public health professor at the University of Edinburgh who has written about the maddening complexity of herd immunity.
For any agency engaged in public messaging, “it’s very hard to convey uncertainty and remain authoritative,” Bhopal said. “It’s a pity we can’t take the public along with us on that road of uncertainty.”