Lesson not learned: Europe unprepared as 2nd virus wave hits

Europe’s second wave of coronavirus infections has struck prior to flu season even started, with intensive care wards filling again and bars shutting down. Making matters worse, authorities say, is a widespread case of “COVID-fatigue.”

Record high daily infections in a number of eastern Europe and sharp rebounds in the hard-hit west have clarified that Europe hardly ever really crushed the COVID-19 curve as hoped, after springtime lockdowns.

Spain this week declared circumstances of emergency for Madrid amid increasing tensions between local and national authorities over virus containment measures. Germany offered up soldiers to greatly help with contact tracing in newly flaring hotspots. Italy mandated masks outdoors and warned that for the very first time because the country became the European epicenter of the pandemic, medical system was facing “significant critical issues” as hospitals fill up.

The Czech Republic’s “Farewell Covid” party in June, when thousands of Prague residents dined outdoors at a 500-meter (yard) long table over the Charles Bridge to celebrate their victory over the virus, seems painfully naive given that the country gets the highest per-capita infection rate on the continent, at 398 per 100,000 residents.

“I must say clearly that the problem isn't good," the Czech interior minister, Jan Hamacek, acknowledged this week.

Epidemiologists and residents alike are pointing the finger at governments for having didn't seize on the summer lull in cases to get ready adequately for the expected autumn onslaught, with testing and ICU staffing still critically short. In Rome this week, people waited in line for 8-10 hours to get tested, while front-line medics from Kiev to Paris found themselves once again pulling long, short-staffed shifts in overcrowded wards.

“When the state of alarm was abandoned, it was time to invest in prevention, but that hasn’t been done,” lamented Margarita del Val, viral immunology expert with the Severo Ochoa Molecular Biology Center, part of Spain’s top research body, CSIC.

“We are in the fall wave with no resolved the summertime wave,” she told an online forum this week.

Tensions are rising in cities where new restrictions have already been re-imposed, with a huge selection of Romanian hospitality workers protesting this week after Bucharest once more turn off the capital’s indoor restaurants, theaters and dance venues.

“We were closed for half a year, the restaurants didn’t work yet the quantity of cases still rose,” said Moaghin Marius Ciprian, owner of the favorite Grivita Pub n Grill who took part in the protest. “I'm not a consultant but I'm not stupid either. But from my point of view it’s not us that contain the responsibility because of this pandemic.”

As infections rise in many European countries, some - including Belgium, Netherlands, the uk, Spain and France - are diagnosing more new cases each day per capita compared to the United States, according to the seven-day rolling averages of data kept by Johns Hopkins University. On Friday, France, with a population around 70 million, reported an archive 20,300 new infections.

Experts say Europe's high infection rate arrives in large part to expanded testing that's turning up a lot more asymptomatic positives than through the first wave, when only the sick could easily get a test.

However the trend is however alarming, given the flu season hasn’t even begun, schools are open for in-person learning and the winter hasn’t yet driven Europeans indoors, where infection can spread more easily.

“We’re seeing 98,000 cases reported in the last 24 hours. That’s a new regional record. That’s very alarming,” said Robb Butler, executive director of the WHO’s Europe regional office. While part of this is because of increased testing, “It’s also worrisome regarding virus resurgence.”

It’s also worrisome given many countries still lack the testing, tracing and treating capacity to manage another wave of pandemic when the first wave never really ended, said Dr. Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine.

“They should have been using the time to set up place really robust ‘find, test, trace, isolate’ support systems. Not every person did,” McKee said. “Had they done that, then they could have recognized outbreaks because they were emerging and really gone for the sources.”

Even Italy is struggling, after it won international praise for having tamed the virus with a strict 10-week lockdown and instituted a careful, conservative reopening and aggressive screening and contact-tracing effort when summer vacation travelers created new clusters. Anesthesiologists have warned that without new restrictions, ICUs in Lazio around Rome and Campania around Naples could possibly be saturated within per month.

Since it is, Campania has only 671 hospital beds destined for COVID-19, and 530 are already occupied, said Campania Gov. Vincenzo De Luca. Half of Campania’s 100 ICU virus beds are actually in use.

For now, the situation is manageable. “But if we get to 1,000 infections a day and only 200 persons cured, it’s lockdown. Clear?” he warned this week.

The ICU alarm has recently sounded in France, where Paris public hospital workers staged a protest this week to demand more government investment in staffing ICUs, that they said haven't considerably increased capacity even after France got slammed during the initial outbreak.

“We did not learn the lessons of the first wave,” Dr. Gilles Pialoux, head of infectious diseases at the Tenon Hospital in Paris, told BFM television. “We are running after (the epidemic) rather than getting before it.”

There is the right news, however. Dr. Luis Izquierdo, assistant director of emergencies at the Severo Ochoa Hospital in Madrid said at least now, doctors really know what therapies work. During the peak of the epidemic in March and April, doctors in hardest-hit Spain and Italy threw every drug they could think about at patients - hydroxychloroquine, lopinavir, ritonavir - with limited success.

“Now we hardly use those drugs because they hardly have any effect,” he said. “So in this sense we've had a victory because we realize a lot more now.”

But treating the virus medically is merely half the battle. Public health officials are actually working with a surge in anti-mask protests, virus negationists and residents who are simply just sick and tired of being told to keep their distance and refrain from hugging themselves.

The WHO this week shifted gears from giving medical advice to combat infections to giving psychological advice about how to nudge virus-weary Europeans to maintain their guard amid “COVID-fatigue” that is sweeping the continent.

“Fatigue is completely natural. It’s to be expected where we've these prolonged crises or emergencies,” said the WHO’s Butler.

The WHO this week put out new advice for governments to consider more social, psychological and emotional factors when deciding on lockdowns, closures or other restrictions - a nod for some in the field who say the mental health toll of lockdowns is worse compared to the virus itself.

That data, Butler said, “will probably become more important because we have to understand what restrictions we can put in place which will be sustained and adhered to, and acceptable to our populations.”