Lesson not learned: Europe not prepared when second wave of viruses hits

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The second wave of coronavirus infections in Europe hit long before the flu season even began, with intensive care wards filling up again and bars closing. Making matters worse, authorities say, is a widespread case of “COVID fatigue”.

Record daily infections in several eastern European countries and strong rebounds in the hard-hit west showed that Europe had never really crushed the COVID-19 curve as hoped, after the spring lockdowns.

Spain declared a state of emergency for Madrid this week amid mounting tensions between local and national authorities over virus containment measures. Germany has offered soldiers to help with contact tracing in the new hot spots. Italy imposed masks on the outside and warned that for the first time since the country became the European epicenter of the pandemic, the healthcare system faced “significant critical issues” as hospitals were filling up.

The Czech Republic’s ‘Farewell Covid’ party in June, when thousands of Prague residents dined al fresco at a 500-meter-long table on Charles Bridge to celebrate their victory over the virus, seems painfully naive now that the country has the highest per capita infection rate on the continent, at 398 per 100,000 population.

“I must make it clear that the situation is not good,” Czech Interior Minister Jan Hamacek admitted this week.

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Epidemiologists and residents are pointing fingers at governments for failing to seize the summer lull to properly prepare for the expected fall attack, with tests and ICU staffing still extremely short. In Rome this week, people lined up for 8-10 hours to get tested, while frontline doctors from Kiev to Paris once again found themselves performing long and short shifts in overcrowded wards. .

“When the state of alert was abandoned, it was time to invest in prevention, but it was not done,” lamented Margarita del Val, expert in viral immunology at the Severo Ochoa Molecular Biology Center, which is part of the main Spanish research body, the CSIC. .

“We are in the fall wave without having solved the summer wave,” she said this week in an online forum.
Tensions are mounting in cities where new restrictions have been reimposed, with hundreds of Romanian hotel workers protesting this week after Bucharest once again closed restaurants, theaters and dance halls in the capital.

“We have been closed for six months, the restaurants have not worked and yet the number of checkouts has increased further,” said Moaghin Marius Ciprian, owner of the popular Grivita Pub n Grill who participated in the protest. “I’m not a specialist but I’m not stupid either. But from my point of view, we are not the ones responsible for this pandemic. ”

As infections increase in many European countries, some – including Belgium, the Netherlands, the United Kingdom, Spain and France – are diagnosing more new cases every day per capita than the United States, according to seven-day moving averages of data maintained by Johns. Hopkins University. France, with a population of around 70 million on Friday, reported a record 20,300 new infections.

Experts say the high infection rate in Europe is largely due to expanded testing that produces many more asymptomatic positives than in the first wave, when only patients could be tested.

But the trend is alarming nonetheless, given that the flu season hasn’t even started, schools are open for in-person learning and the cold weather has yet to push Europeans indoors, where the infection can spread more easily.

“We are seeing 98,000 cases reported in the past 24 hours. This is a new regional record. This is very alarming, ”said Robb Butler, executive director of the WHO regional office for Europe. While part of this is due to the increase in testing, “it’s also concerning in terms of the viral resurgence. ”

It’s also concerning given that many countries still lack the testing, tracing and treatment capabilities to deal with a second wave of the pandemic while the first wave never really ended, said Dr Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical. Drug.

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“They should have used the time it took to put in place really robust support systems to ‘find, test, trace, isolate’. Not everyone has done it, ”McKee said. “If they had, they could have identified outbreaks as they emerged and really went looking for the sources. ”

Even Italy is in trouble, after winning praise from the international community for taming the virus with a strict 10-week lockdown and instituting a cautious and conservative reopening, aggressive screening and contact tracing when travelers on vacation summer have created new groups. Anesthesiologists have warned that without further restrictions, intensive care units in Lazio around Rome and in Campania around Naples could be saturated within a month.

As it stands, Campania has only 671 hospital beds intended for COVID-19, and 530 are already occupied, said Campania governor Vincenzo De Luca. Half of Campania’s 100 ICU virus beds are now in use.

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

The ICU alarm has already sounded in France, where employees of Paris public hospitals staged a protest this week to demand more government investment in the staffing of ICUs, which they say have failed. not significantly increased capacity even after France was criticized during the initial outbreak.

“We have not learned the lessons of the first wave,” said on BFM television Dr Gilles Pialoux, head of infectious diseases at Tenon hospital in Paris. “We are chasing (the epidemic) instead of getting ahead of it. ”

There is good news, however. Dr Luis Izquierdo, deputy director of emergencies at Severo Ochoa Hospital in Madrid said that at least now doctors know which therapies are working. At the peak of the epidemic in March and April, the hardest-hit doctors in Spain and Italy threw all the drugs they could think of on patients – hydroxychloroquine, lopinavir, ritonavir – with limited success.

“Today we hardly use these drugs anymore because they have virtually no effect,” he said. “So in that sense we had a win because we know so much more now. ”

But treating the virus medically is only half the battle. Public health officials now face an upsurge in anti-mask protests, virus deniers and residents who are simply tired of being told to keep their distance and refrain from hugging loved ones .

The WHO this week has shifted gears from medical advice to fight infections to psychological advice on how to push virus-weary Europeans to guard their guard amid ‘COVID fatigue’ sweeping the continent .

“Fatigue is quite natural. This is to be expected where we have these protracted crises or emergencies, ”said the WHO butler.

WHO issued new advice this week for governments to consider more social, psychological and emotional factors when deciding on lockdowns, closures or other restrictions – a nod to some on the ground who say the mental health lockdowns’ toll is worse than the virus itself. .

This data, said Butler, “is going to become more important because we need to understand what restrictions we can put in place that will be maintained and enforced, and acceptable to our populations.”

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