Europe is on track for a third “significant wave” of Covid-19 unless lessons are learned from the failure to safely reopen in summer, according to the expert leading disease monitoring across the continent.
In an interview with The Telegraph, Dr Bruno Ciancio, director of surveillance at the European Centre of Disease Control (ECDC), said the current resurgence was “predictable” as countries let their guard down after initial restrictions were lifted.
“In the summer, after we relaxed a number of measures, the virus came back,” he said. “This pattern will continue for quite some time, until basically we have a vaccine that can be targeted to a good part of the population - which is not coming anytime soon.
“We need to learn the lesson: we will bring the number of cases down, but as soon as the numbers are down, we really need to keep our alert very, very high.”
He added, though, that travel restrictions and border checks play only a small part - the issue in Europe was not just importations, but behaviour, surveillance and weak contract tracing infrastructure.
“The way to avoid future lockdowns and future significant waves is really to invest in the basic tools of public health,” Dr Ciancio added, referring to broad disease surveillance, rigorous contact tracing, widespread testing and investigations to identify the source of new outbreaks.
“This really is the basics of epidemiology… it is a clear survival strategy,” Dr Ciancio added. “We should not make, once again, the same mistakes that we made towards the end of summer.”
He warned that if countries ignore this approach - or adopt policies based on the idea of herd immunity, which is “not applicable” - they are likely to be pushed into a repeated cycle of damaging lockdowns.
Likening these to a “wide spectrum antibiotic”, which kills both dangerous and beneficial bacteria, Dr Ciancio said this outcome would erode public trust in government strategy.
“And we need to have the population working with us and with health authorities. We have to realise that this is a marathon, as vaccines will not arrive in time to have a significant impact on transmission anytime soon.”
But over the last month, as Europe failed to curb infections and instead cemented its position at the epicenter of the pandemic once more, countries including the UK, France and Germany have been forced to adopt this blunt tool for a second time.
According to the World Health Organisation, more than 1.3 million new cases were reported across the continent last week, a 33 per cent increase on the previous seven days and almost half of new cases globally. Fatalities also rose by more than a third, accounting for 30 per cent of new deaths worldwide.
But despite a sustained increase in 30 countries, fatality rates have not yet reached the levels seen in March and April, while Dr Ciancio said the latest ECDC data suggests hospitalisations were also around 35 per cent lower than in spring.
He cautioned, though, that “the situation is currently evolving” and “it's very likely” that hospital capacity will be stretched and deaths continue to rise without action.
“The resurgence, it's a bit more widespread, the virus is everywhere,” he added. “In spring, we had some hotspots and some countries were more affected than others. Here, we see a more homogeneous increase all over Europe, which I think is very concerning.”
As a result, areas which were largely unscathed during the first wave may not have built enough capacity in their health systems, including southern Italy but also eastern Europe.
In the Czech Republic, which largely escaped a surge of Covid in the Spring due to an early and strict lockdown, the case rate has now surpassed 1,500 per 100,000 people. Slovenia, Slovakia and Poland - where cases have doubled in the last fortnight - are also struggling.
“Probably some have reacted and increased their hospital capacity,” Dr Ciancio said. “But I think it's different if you have actually experienced it - if you have already trialled increasing demand for for ICU, for example, than if you haven't.”
The continent should also prepare for a “twindemic” of influenza and Covid-19, he added. While flu surveillance showed the southern hemisphere had remarkably few cases during their winter months, Dr Ciancio believes Europe should prepare for the worst.
“We cannot rely on this hope that the situation in the northern hemisphere will resemble what happened in the southern hemisphere. The main driver of a very low influenza season in the southern hemisphere was that this really coincided with the time where the public health measures were very strict.
“We are not in that situation now in much of Europe,” he said, adding that a double whammy of flu and Sars-Cov-2 could push health systems beyond their “ceiling”.
But ending on an more optimistic note, Dr Ciancio suggested that Christmas will not be cancelled - as long as countries take “very fast action” now.
“It will not be a Christmas made up of travels around the world and big gatherings,” he said. “It may be smaller in terms of gatherings, but it can still be equally enjoyable and meaningful - so long as we reduce significantly transmission rates now.”