Omicron’s transformation in Europe: pandemic or endemic?

LONDON – In Britain, France, Spain and other countries across Europe, politicians and some public health experts are pushing a new approach to the coronavirus pandemic of audacity: that disease has become a staple of everyday life.

Governments are seizing a moment when their populations have experienced less serious illnesses and, in some cases, a drop in new daily cases after weeks of record growth. They are moving their mitigation policies off the contingency grounds.

In Spain, for example, Prime Minister Pedro Sanchez declared last week that citizens “must 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 flu outbreaks. . Olivier Veran, France’s health minister, said recently that France’s high level of infection and strong vaccination rate “may” mean that this will be the last wave.

The shift comes as the World Health Organization this week warned against treating the virus like seasonal flu, saying it was too early to make that call. The World Health Organization said much about the disease was still unknown. The significant increase in cases driven by the Omicron variant continues to hit the continent, while populations in much of the world remain at risk from widespread under-vaccination, and more variants are still likely to emerge.

However, advocates of the “learn to live with” approach point out that the recent surge in cases differs from the virus’ early days in several important ways, including the largely vaccinated population in parts of Europe, particularly in the West, and the rate of hospitalizations Much less.

This sentiment is evident in the evolving policies the British government has adopted since the beginning of this year, in a stark departure from the “war floor” heralded by the country’s health services in December.

Changes include shorter isolation periods and the cancellation of pre-departure tests for people traveling to England – in large part because Omicron was already so widespread that testing had a limited impact on its spread.

There have been some tangible signs that Britain may be on its way around. 99,652 new cases were reported on Friday, a marked decrease from the 178,250 cases reported on the same day last week.

“It can’t 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 epidemic was likely to occur in phases rather than appearing as an “active point in time” when the epidemic could be declared over.

In the midst of this shift, messages to the public have varied, often in confusing ways. Guidance could be all over the map, with some politicians declaring the latest wave over while others have called for a gradual return to normal life – all while many experts express caution about all the unknowns and the possibility of new variables.

Peter English, a retired infectious disease consultant, said that for many public health experts and scientists in Britain, the debate had shifted from lockdown to common sense mitigation measures. Most of them now encourage measures such as mandatory concealment in public places and legislation on ventilation standards.

“There has been an argument about zero covid and trying to eradicate the virus through restrictions,” he said. “I think we’ve lost that argument. I think by letting it spread to the point where it has gotten, it would be very difficult to put the genie back in the bottle.”

From this perspective, he said, “we have to live with it being endemic.” But he added that “settlement does not mean not being serious,” and urged caution against the idea of ​​”learning to live with it” without taking mitigation measures.

One of the biggest concerns in England has been the severe strain the virus is placing on the National Health Service, or NHS, but some immediate fears that British hospitals may be overwhelmed by patients during this latest wave are beginning to subside.

“Unless things change unexpectedly, we are close to the national peak of hospitalized Covid patients,” Matthew Taylor, president of the NHS Consortium, a membership organization for hospital heads, said on Wednesday.

In Spain, a new surveillance system is being set up that will come into effect as soon as the current increase in cases subsides, and the country has also recently relaxed its isolation rules. But Madrid’s pressure to treat Omicron like the flu has been criticized by some doctors and professional associations, as well as by the European Medicines Agency, which says the virus is still behaving as a pandemic.

In France, infections are still trending higher, with nearly 300,000 coronavirus cases reported each 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 minimal restrictions in place and instead focused on urging the French to get vaccinated.

Mr Macron’s government rejected accusations that it had given up on reducing cases, including in schools, which faced widespread strikes on Thursday by teachers involved in classroom safety.

Mr Veran, the French health minister, who tested positive for coronavirus on Thursday, said authorities were closely monitoring data from Britain to ascertain whether France was nearing its peak.

Germany is several weeks behind some of its European neighbors in the face of a surge in infections. It reported 80,430 new cases on Tuesday, breaking the record set in November. But independent scientific experts have refrained from advising the government on imposing new restrictions, despite widespread agreement that the number of infected people will continue to rise.

Christian Drosten, the country’s most famous virologist, has indicated that Germany will likely eventually have to treat the virus as endemic.

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

Italy, too, has been struggling with some of the highest daily infection rates since the pandemic began. But in recent weeks, restrictions have tightened, making vaccinations mandatory for those 50 and over, including requiring a health permit to use public transportation.

A spokesman for Italy’s health ministry said the country was “still at a sensitive stage”, and that recent daily increases in cases continued to put pressure on intensive care units. Italian scientists tend to agree that it is too early to declare the situation endemic, even if it is time to “start thinking about the new normal” for living with the virus, said Fabrizio Brigliasco, a virologist at the University of Milan.

That kind of caution is evident among a wide range of health professionals and researchers across Europe, some of whom issued a call this week in the British Medical Journal for better coordination in dealing with the pandemic. They argued that there was still an urgent need to “reduce infection to avoid overburdening health systems and protect public life and the economy.”. “

“Even under the most optimistic assumptions, allowing Omicron to operate without restrictions could lead to disastrous consequences,” they wrote.

In England, hospitalizations are still very high in some areas, Especially in the NortheastIllness among health care workers continues to strain the system.

Saffron Cordery, executive vice-chairman of Providers for the NHS, a membership organization for Health Staff England, said England needed to take a “considered and managed approach” to the pandemic, “while considering what our new normal would look like”.

But, she added, it is clear that the country has begun to develop a lifestyle through several waves of the virus. With the uncertainty still ahead, she said it would be a mistake to think of this moment as an inflection point.

“Instead of sprinting in a 100-meter straight line all the way to the finish line in Covid,” she explained, “it’s more of a long-term cross-country race across all kinds of different terrain before we get to that destination.”

Elisabetta Povoledo Contributed to reporting from Rome, Christopher F Schwitz from Berlin and Aurelien Briden from Paris. Raphael Minder Also contributed to the preparation of reports.

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