Before the arrival of safe and effective vaccines, dealing with Covid-19 in Europe was dominated by fear, uncertainty and blunt tools like lockdowns and travel bans to keep hospitals from being overrun. Countries with blanket curbs such as Israel, Austria and Denmark — whose leaders self-identified as “first movers” — wore their strict social-distancing rules like a badge.
This fear is back as the region struggles with breakout infections moving from East to West. Austria is sliding into lockdown, with its middling vaccination rate making it look more like a laggard than a leader. Neighboring Germany, where public health played second fiddle to politics this fall, is refusing to rule out another lockdown. Denmark, despite a high vaccination rate, is seeing record cases after lifting restrictions in September. (Less complacent Southern Europe looks better-placed for now.)
Yet excess optimism shouldn’t give way to excess pessimism: This latest wave is different. The winter will no doubt be rough for a region with a huge divergence in vaccination coverage, trust in institutions and quality of healthcare. Violence is already flaring up at the prospect of a longer pandemic than expected. But Europe has more tools at its disposal now to carve out a path for living with Covid.
The continent is swimming in vaccines but needs to aim higher to reach immunization thresholds. Epidemiologists reckon coverage should be above 85% to make a difference against the delta variant, and that is borne out by comparing daily cases with vaccine rates. Austria is a current poster child of how even a coverage of 66% can fail to stop intensive-care wards from filling up and death rates from hitting nine-month highs; its new compulsory vaccination policy, due in February, will be closely watched — though unlikely to be copied by other countries soon.
The example of Israel, whose overall vaccination rate is even lower at 64%, shows that booster campaigns can make a difference as protection wanes for those already immunized. The country has distributed third doses to 45% of its people, the second-highest rate in the world, according to Bloomberg data, after first targeting the elderly months ago; life is close to normal there again.
Europe has already kick-started booster campaigns for the over-65s but should expand access as soon as possible.
The caveat is that there is a limit to what vaccines can do without vigilance. The urge to abandon caution when cases are low, which is essentially what Denmark and other nations did this summer, is part of the problem. The country has since brought back masks and vaccine passports, which may not look like the old pre-pandemic “normal” but which offers sounder virus management for the long-term.
“These vaccines are authorized for prevention of severe disease and death — they’re not pandemic-enders,” David Nabarro, special envoy on Covid-19 for the World Health Organization, tells me. “My basic point to every country is that, if you really want to stop surges from happening, reduce the virus’ circulation.”
Oscillating between “freedom” and panic clearly doesn’t work for public health. Policy makers need to shift their communication away from crisis and fear — which likely becomes less effective over time anyway — and toward long-term risk management. Investment in primary care will also matter as the first port of prevention. For the vaccine-hesitant, better information strategies will be needed alongside coercion, says Yarden Vatikay, former head of Israel’s National Information Directorate.
This is going to be a tough winter, especially for countries with low vaccination rates, and the current wave is a reminder of our tendency to underestimate this virus. But we are better armed than we have ever been, reckons Elias Mossialos, a professor at the London School of Economics.
Non-vaccine treatments are around the corner, from pills to monoclonal antibodies. A combination of measures from booster shots to masks and vaccine passports may look nothing like our pre-pandemic world, but it offers a more sustainable way forward than the harsh methods once cheered by the first movers. Living with this virus is still an attainable goal.
Bloomberg
