The European Union is under pressure from some member countries like Spain and Portugal – as well as from growing population resistance to onerous regulations in numerous member countries – to shift its COVID-19 strategy from containment to living with the virus, writes MedicalBrief.
When the COVID-19 pandemic was first declared, Spaniards were ordered to stay home for more than three months. They were prohibited from going outside, even for exercise; children were banned from playgrounds, and the economy virtually stopped. Officials said the stringent measures prevented a full collapse of the health system and saved lives.
Now, reports The Associated Press, almost two years later, Spain is preparing to adopt a very different COVID-19 approach. With one of Europeʼs highest vaccination rates and its most pandemic-battered economies, the government is preparing to treat the next infection surge not as an emergency but an illness that is here to stay. Similar steps are under consideration in neighbouring Portugal and in Britain.
The plan is to shift from crisis mode to control mode, tackling the virus similarly to how flu or measles are dealt with; accepting that infections will occur and providing extra care for at-risk people and patients with complications.
Spanish Prime Minster Pedro Sánchez wants the European Union to consider similar changes.
“Within the next few months and years, we are going to have to think, without hesitancy and according to what science tells us, how to manage the pandemic with different parameters,” he said last Monday (17 January).
But the World Health Organization (WHO) said that it is too early to consider any immediate shift. And Dr Anthony Fauci, the top infectious diseases doctor in the US, said COVID-19 could not be considered endemic until it drops to “a level that it doesnʼt disrupt society”.
The European Centre for Disease Prevention and Control (CDC) has advised countries to transition to more routine handling of COVID-19 after the acute phase of the pandemic ends. The agency said more EU states, apart from Spain, will want to adopt “a more long-term, sustainable surveillance approach”.
More than 80% of Spainʼs population has received a double vaccine dose, and authorities are focused on boosting the immunity of adults with third doses.
Vaccine-acquired immunity, coupled with widespread infection, offers a chance to concentrate prevention efforts, testing and illness-tracking resources on moderate to high-risk groups, said Dr Salvador Trenche, head of the Spanish Society of Family and Community Medicine, which has led the call for a new endemic response.
COVID-19 “must be treated like the rest of illnesses,” Trenche told The Associated Press, adding that “normalised attention” by health professionals would help reduce delays in treatment of problems not related to the coronavirus.
The public also needs to come to terms with the idea that some deaths from COVID-19 ”will be inevitable”, Tranche said.
“We canʼt do on the sixth wave what we were doing on the first one. The model needs to change if we want to achieve different results,” he said.
The Spanish Health Ministry said it was too early to share any blueprints being drafted by its experts and advisers, but the agency confirmed that one proposal is to follow an existing model of “sentinel surveillance” currently used in the EU for monitoring influenza.
The strategy has been nicknamed “flu-ization” of COVID-19 by Spanish media, although officials say that the systems for influenza will need to be adapted significantly to the coronavirus.
For now, the discussion about moving to an endemic approach is limited to wealthy nations that can afford to speak about the worst of the pandemic in the past tense. Their access to vaccines and robust public health systems are the envy of the developing world.
Itʼs also not clear how an endemic strategy would coexist with the “zero-COVID” approach adopted by China and other Asian countries, and how would that affect international travel.
Many countries overwhelmed by the record number of Omicron cases are already giving up on massive testing and cutting quarantine times, especially for workers who show no more than cold-like symptoms. Since the beginning of the year, classes in Spanish schools stop only if major outbreaks occur, not with the first reported case as they used to.
In Portugal, with one of the worldʼs highest vaccination rates, President Marcelo Rebelo de Sousa declared in a New Yearʼs speech that the country had “moved into an endemic phase”. But the debate over specific measures petered out as the spread soon accelerated to record levels — almost 44,000 new cases in 24 hours, reported last Tuesday (18 January)
However, hospital admissions and deaths in the vaccinated world are proportionally much lower than in previous surges.
In the United Kingdom, mask-wearing in public places and COVID-19 passports will be dropped on 26 January, with Prime Minister Boris Johnson announcing that the latest wave had “peaked nationally”.
For some other European governments, the idea of normalising COVID-19 is at odds with their efforts to boost vaccination among reluctant groups.
In Germany, where less than 73% of the population has received two doses and infection rates are hitting new records almost daily, comparisons to Spain or any other country are being rejected.
“We still have too many unvaccinated people, particularly among our older citizens,” Health Ministry spokesman Andreas Deffner said.
AP said Italy was extending its vaccination mandate to all citizens 50 or older and imposing fines for unvaccinated people who go to work, while Italians are also required to be fully vaccinated to access public transportation, planes, gyms, hotels and trade fairs.
Associated Press article – Europe considers new COVID-19 strategy: Accepting the virus (Open access)
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WHO: COVID deaths in Europe could top 2.2m by March
Pandemic triggers biggest fall in life expectancy in decades — 29-country study
Portugal’s military key to making it the world’s most vaccinated country
China’s bid for Zero Covid: Economic pain, rights abuses and data manipulation