Europe’s Long March Toward Living With Covid-19
Europe’s Long March Toward Living With Covid-19
"Living” with Covid-19 has been talked about since the pandemic first began: A moment when the coronavirus disease becomes part of everyday life, rather than an overpowering wave of cases and deaths that overloads hospitals and triggers society-crushing lockdowns. This so-called “endemic” phase would see Covid-19 look more like influenza, with regular vaccine campaigns and a focus on primary care. Not eradicated, but managed.
It’s a moment that’s been getting tantalizingly close for much of the European Union, after several deadly rounds with Covid that claimed the lives of almost 1 million people and dealt a blow to the continent’s pride in its well-funded public-health system. Cities like Paris and Rome are swarming once again with workers, diners and revelers. Masks are dangling from wrists rather than noses. Nightclubs are now back open, albeit with new health checks. Politicians in the UK and France are talking up more individual responsibility and fewer top-down rules.
Yet it’s also becoming clear that living with Covid will remain an elusive goal without a renewed boost to pandemic management, a more urgent focus on expanding vaccinations and clearer signals for people to keep their guard up when it comes to social distancing.
The reopening of Europe’s major economies is starting to hit a speed bump as cases rebound, with hospitalizations on the rise in Spain and France and restrictions now tightening in Lisbon and Amsterdam. The more contagious delta variant is ripping through the continent, exposing gaping holes in a vaccination campaign that’s caught up with the US but still has a lot further to go.
The speed of the variant’s spread matters. Existing vaccines offer protection and are clearly a game-changer: About 53% of the EU’s population has received at least one dose, which may explain why Covid deaths are still in decline. Yet coverage drops off dramatically for the under-50s. In Spain and France, about 10% of those aged 25-49 are fully vaccinated, versus over 40% for those aged 50-59. And in France, worryingly, the over-70s have around 70% coverage, versus 100% in Spain.
The more urgent question for a Europe desperate to live with Covid has to be how to improve vaccine take-up, not which restrictions people should pick and choose. France’s top vaccine official Alain Fischer told Le Monde last week that the speed of the delta variant’s spread would require vaccinating 90% of adults in France, depending on the efficacy rates of jabs. Apply that to the EU as a whole — where 70% of adults are due to receive at least one dose by the end of this month — and you have 150 million more adults in need of a jab (more than double France’s population).
Hence, the moral choices in this new phase of the pandemic are turning out to be more difficult than expected.
What in the UK is being talked up as “Freedom Day” — when all pandemic restrictions get lifted and individuals are given more room to make their own decisions — is rightly being presented as a different kind of approach to freedom in France, where President Emmanuel Macron on Monday announced mandatory vaccinations for health workers and potentially for all adults if vaccination rates don’t pick up fast.
This approach should also be extended beyond Europe’s borders. As the rich world begins to talk openly about booster shots, third doses and more ambitious vaccine coverage, the goal of living with Covid has to address the huge disparity with low-income countries, where only 1% of people have been given at least one dose.
Presenting Covid management as a purely domestic matter ignores the fact that Covid variants thrive in places where vaccine coverage is low. Travel restrictions to keep infections out are almost always mistimed and leaky. The delta variant was first identified in India, the beta in South Africa. Given Europe plans to become the world’s biggest Covid vaccine producer this year, it has a role to play in improving industrial production of vaccines and heeding US Treasury Secretary Janet Yellen’s call for more dose donations. Without that, Duke University’s Andrea Taylor estimates, the world won’t be vaccinated until 2023.
Other changes will come eventually. Health-care systems might not need permanently expanded pandemic beds, but they surely need better-paid staff and better-resourced primary care. Countries dependent on tourism like Spain and Italy might have to change course given two years of sub-par international travel flows still lie ahead. And more post-Covid investment will be needed to fund the recovery.
But right now, living with Covid should be seen as a goal at the end of a marathon rather than a sprint. Lifting restrictions needs to be a carefully-calibrated response to data, accompanied by a ramp-up in jabs. Freedom Day will come — but it’s not here yet.