Will the second wave of Covid-19 cases in Europe mean a huge second death toll?

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European hospitals are now better equipped to treat Covid-19. Measures such as social distancing and wearing of masks have become the norm and the latest spread of the infection has mainly occurred among young people, who are less likely to die if they contract the virus.

Still, colder weather is starting to set in and flu season is approaching. The infection is spreading to older populations, and there are signs that people are tired of following the restrictions.

“Obviously, we don’t really have a way to stop Covid from circulating, other than lockdowns or social distancing measures etc., we don’t have a vaccine yet,” Michael Head, senior researcher in global health at The British University of Southampton, told CNN.

While he doesn’t expect deaths to reach the levels seen in the first wave, Head added: “We will see a lot of cases spread, we will see a lot of hospitalizations and a lot of burden on our service. health.“There will also be a large number of deaths. “

From young to old

Coronavirus cases reported across Europe reached a record high of 52,418 on a seven-day moving average on Tuesday, according to CNN analysis of data from Johns Hopkins University. But there have been only 556 new deaths reported, up from 4,134 deaths per day (out of 31,852 cases) compared to the seven-day average of April 10.

That compares to a seven-day average of 44,547 cases and 722 deaths Tuesday in North America, which has a population of 366 million compared to 750 million in Europe.

Hospitals are now better able to diagnose and treat the virus, which means that death rates for intensive care patients in some European countries have fallen from around 50% in the spring to around 20%, Head estimates.

But Bulgaria, Croatia, Malta, Romania and Spain have all seen sustained increases in death rates.

In the first week of September, the largest proportion of new cases was still among those aged 25 to 49, according to World Health Organization European director Hans Kluge. But there was also an increase in cases in the older groups, aged 50 to 79.

Head warned that the rise in cases “will at some point translate into infections in older populations which have higher death rates.”

“We are seeing a further increase in case rates in elderly and vulnerable populations in all European countries,” he said. “So it’s a very predictable pattern actually, that across the UK, France or Spain we’ve seen younger populations being affected, and then about four to six weeks later… we’re starting to seeing infected elderly people. “

The last stage of the Tour de France takes place in Paris & # 39;  Champs Elysées Sunday.

Head added that more cases in the community means more opportunities for the virus to enter institutions such as nursing homes, with “a sharp increase in outbreaks in nursing homes here in the UK, during the last month or so ”.

Burden on hospitals

The onset of flu season is also a “big concern” because of the potential burden on health services, Head said. France, which reported its largest daily increase of 13,498 cases last Saturday, saw the number of people in intensive care increase by 25% last week.

Deaths are not the only problem. The pressure on hospitals is also increased by the number of “long-haul”, those who suffer from the adverse effects of the coronavirus more than a month after their illness. “Even in younger fit people, we still see about 10-20% that have longer-term consequences beyond the initial infection,” Head said.

People sit outside in Chinatown, central London on Saturday.  The UK has introduced a 22 hour curfew for pubs and restaurants.

He said this would mean “new pressures on health services in the coming months and even years to come.”

Peter Drobac, global health physician and director of the Skoll Center for Social Entrepreneurship at the University of Oxford, told CNN it would be “irresponsible” if Europe allowed the death rate to return to levels of April.

He said that while “we haven’t detected any kind of seasonal pattern with this particular virus,” the real risk is that cold weather could force people to move indoors, where transmission is more likely.

While most countries now have greater testing capacity, Drobac said that “the increase in testing does not explain the increase in cases that we are seeing in most settings” since we are also seeing a higher percentage. high of tests come back positive.

“It is clear that we are losing control of this,” he said.

“We know enough about how the virus behaves – how it is transmitted, how to control it, how to treat it when people are infected – to be able to make sure that the second wave of infections is not on a devastating scale, because that’s ultimately what’s going to lead to more deaths, and that’s when health systems start to be overwhelmed. “

‘The Perfect Storm’

The approach to the second wave of infections varies across Europe. Leaders are trying to strike a balance between protecting public health and preventing catastrophic economic damage from national lockdowns.

Spain reported a record 14,389 daily cases last Friday. In Madrid, which accounts for a third of its cases, residents of 37 neighborhoods are only allowed to leave their homes to go to work, school or for medical reasons, and parks and playgrounds have been closed. of Monday.

Military tents were erected for patients at Gomez Ulla Military Hospital in Madrid, Spain on Friday.

The UK, which has reported its highest number of cases since April on Wednesday, has limited gatherings to six people and will close pubs and restaurants at 10 p.m. The Czech Republic, which has reported a record number of infections in coronavirus on Friday, reintroduced inner mask requirements earlier this month.

“Ultimately, the second wave is already present in many countries in Europe,” Drobac said. “Our actions over the next two weeks and throughout the winter will be critical in stemming the spread, but if we don’t get there soon, especially in countries like the UK, Spain and France for now, we will certainly see an increase in deaths. ”

A lab assistant organizes samples for Covid-19 testing at a laboratory in Neuilly-sur-Seine, outside Paris, on September 15.

Drobac said Europe must once again “flatten the curve” through social distancing and hygiene measures, as well as robust testing and contact tracing.

He believes that countries are “unlikely” to revert to the full national lockdowns that were a common approach in the spring, in part because of public resistance or fatigue with the restrictions. “I think it will be difficult to get political and public support for this. I think it will be difficult to apply and people are tired, ”he said.

“In many ways, we think winter could be a perfect storm. That’s why I wish I could have used our summer much better, to really crush the virus and make sure we were in a better position to do so. “

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