The Omicron Shift in Europe: Pandemic or Endemic?

LONDON – In Britain, France, Spain and other European countries, politicians and some public health experts are calling for a new approach to the coronavirus pandemic born of both daring and resignation: illness becomes part of everyday life.

Governments are seizing a time when their populations have experienced less severe disease and, in some cases, a drop in the number of new cases daily after weeks of record growth. And they are moving their mitigation policies away from the emergency.

In Spain, for example, Prime Minister Pedro Sánchez said last week that citizens “should learn to live with it, as we do with many other viruses,” and said the country should adjust the national approach to align more closely with how it handles influenza epidemics. Olivier Véran, the French Minister of Health, recently said that the high level of infection and the high rate of vaccination in France could “perhaps” mean that this would be the last wave.

The change comes even as the World Health Organization this week warned against treating the virus like seasonal flu, saying it was too early to make the call. Much of the disease remains unknown, the WHO said. And an increase in the number of cases caused by the Omicron variant is still hitting the continent, while the population of much of the world remains vulnerable due to a lack of widespread vaccination, and other variants are still likely to. occur.

Still, proponents of the ‘learning to live with’ approach point out that the latest wave of cases is different from the early days of the virus in several important ways, including a widely vaccinated population in parts of Europe, particularly in Europe. The West, and a much lower hospitalization rate.

The sentiment is evident in the evolving policies the UK government has adopted since the start of this year, a radical departure from the ‘war footing’ the country’s health service preached in December.

The changes include shorter isolation periods and the elimination of pre-departure testing for people traveling to England – in large part because Omicron was already so widespread that testing has had a limited effect on its spread.

There have been concrete signs that Britain may be turning a corner. As of Friday, 99,652 new cases were reported, a notable drop from the 178,250 cases reported on the same day last week.

“This cannot be an emergency forever,” Graham Medley, professor of infectious disease modeling at the London School of Hygiene and Tropical Medicine, told BBC Radio 4 this week. He added that the end of the pandemic was likely to occur in phases rather than appearing as “an active moment” when it can be declared over.

In the midst of this change, messages to the public have varied, often in a confusing fashion. Advice can be ubiquitous, with some politicians declaring the last wave over and others advocating a gradual return to normalcy – while many experts warn of all the unknowns and the potential for new variations.

Peter English, a retired communicable disease control consultant, said that for many UK public health experts and scientists the debate had moved away from blockages to common sense mitigation measures. Most are now promoting measures such as mandatory masking in public places and legislation on ventilation standards.

“There had been a dispute over zero Covid and the attempt to eliminate the virus through restrictions,” he said. “I think we’ve lost that argument. I think by letting it spread to the extent that it did, it will be very, very difficult to put the genie back in the bottle.

From that point of view, he said, “we’re going to have to live with the fact that it’s rampant.” But, he added, “Endemic doesn’t mean no big deal,” and he urged caution against the idea of ​​just “learning to live with it” without mitigation measures in place.

One of the biggest concerns in England has been the intense pressure the virus is putting on the National Health Service, or NHS. But some of the immediate concerns that UK hospitals could be overwhelmed with patients in this latest wave have started to fade.

Matthew Taylor, the head of the NHS Confederation, a membership organization for hospital heads, said on Wednesday that “unless things change unexpectedly, we are close to the national peak of Covid patients at the hospital”.

In Spain, a new surveillance system is being created to take effect once the current increase in cases wears off, and the country has also recently relaxed its isolation rules. But Madrid’s push for Omicron to be treated more like the flu has been criticized by some doctors and professional associations, as well as the European Medicines Agency, which says the virus still behaves like a pandemic.

In France, infections still have an upward trend, with nearly 300,000 new cases of coronavirus reported per day this week, nearly six times more than a month ago. But President Emmanuel Macron, who faces a presidential election in April, chose to keep minimum restrictions in place and instead focused on urging the French to get vaccinated.

Mr Macron’s government has dismissed accusations that it has given up on reducing the number of cases, including in schools, which on Thursday faced widespread strikes by teachers concerned about class safety.

Mr Véran, the French Minister of Health, who tested positive for the coronavirus on Thursday, said authorities were closely monitoring data from Britain to determine whether France was nearing its own peak.

Germany is several weeks behind some of its European neighbors in the face of an increase in infections. It reported 80,430 new cases on Tuesday, breaking a record set in November. But independent scientific experts have not advised the government to impose further restrictions despite a broad consensus that the number of infections will continue to rise.

Christian Drosten, the country’s most famous virologist, noted that Germany would most likely have to switch to endemic treatment for the virus eventually.

“Let’s put it this way: we shouldn’t open the door completely,” he said last week in a podcast interview. “But in some areas we have to open the door a bit to the virus. “

Italy is also grappling with some of the highest daily infection rates since the start of the pandemic. But in recent weeks, he has tightened restrictions, making vaccines mandatory for those 50 and over, including requiring a health pass to use public transport.

A spokesperson for Italy’s health ministry said the country was “still in a delicate phase” and recent daily increases in the number of cases continued to put pressure on intensive care units. Italian scientists have tended to agree that it is too early to declare the situation endemic, even though the time has come “to start thinking about the new normal” of coexistence with the virus, said Fabrizio Pregliasco, a virologist at the University of Milan.

This kind of caution is evident among a wide range of medical professionals and researchers across Europe, some of whom appealed this week in the British Medical Journal for better coordination in approaching the pandemic. They argued that there was still an urgent need to “reduce infections to avoid overwhelming health systems and protect public life and the economy.”. “

“Even under the most optimistic assumptions,” they wrote, “let Omicron run potentially devastating risks unfettered.”

In England, hospitalizations are still very high in some regions, especially in the northeast, and illness among healthcare workers continues to strain the system.

England must take a “thoughtful and managed approach” to the pandemic, “while reflecting on what our new normal will look like,” said Saffron Cordery, deputy managing director of NHS Providers, the organization of staff members of English health.

But, she added, it was clear the country had started to develop a way of life through several waves of the virus. With many uncertainties yet to come, she said it would be wrong to view this moment as an inflection point.

“Rather than being a 100-meter straight-line sprint to the finish line of Covid,” she explained, “it’s more of a longer-term cross-country run through all kinds different terrains before arriving at this destination. “

Elisabetta povoledo contributed to reports from Rome, Christopher F. Schuetze from Berlin and Aurelien Breeden from Paris. Raphael Minder also contributed to the report.

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