GP Insights # 417, 26 September 2020
Europe is experiencing a second wave of the COVID-19 infections after the countries in the region flattened the curve since May. Spain, France, and the UK are currently at the forefront of the second wave.
On 25 September, Spain imposed targeted local restrictions in response to the record 14,389 daily cases. In Madrid, which accounts for a third of its cases, residents in 37 areas are only allowed to leave their homes for work, school, or for medical reasons, and parks and playgrounds will be closed from 28 September.
On 22 September, the UK has announced fresh restrictions on social gathering in pubs and movement of people as the country reported 6,178 new coronavirus cases in this week, the highest figure since 1 May. In his speech, the UK Prime Minister Boris Johnson said "I am sorry to say that as in Spain and France and many other countries. We have reached a perilous turning point," and the country will consider employing stricter inspection in case of violations of the rules.
On 22 September, the COVID cases reported across Europe have reached a record high of 52,418 over a seven-day average, according to CNN analysis of Johns Hopkins University data. But there were just 556 new deaths reported, compared with a height of 4,134 daily fatalities (from 31,852 cases) from the seven-day average in the first wave in April.
What is the background?
First, rapid infections and low deaths. Measures such as social distancing and mask-wearing have become the norm in most European countries, and the latest spread of infection has been primarily among younger people, who are less likely to die if they contract the virus. However, fatigue with social-distancing rules and mask-wearing amongst the youth has also been the main driver of infections in this second wave. The health experts have also cautioned against the fast spread of infections amongst the people. In the first week of September, the biggest proportion of new cases was still among 25 to 49-year-olds, according to the World Health Organization's Europe director, Hans Kluge.
Second, the ability to respond has improved. Europe's hospitals are now better equipped for treating COVID-19 with more testing centers. Hospitals are better able to diagnose and treat the virus, meaning mortality rates for ICU patients in some European countries have dropped from about 50 per cent during the spring to roughly 20 per cent. However, the second wave before the flu season will substantially increase the burden on health services. In France, the number of people in intensive care has increased by 25 per cent than the first wave. The pressure on hospitals has also increased by the number of "long-haulers," those who are suffering adverse effects from coronavirus more than a month after they were ill. "Even in younger and fitter, people are having longer-term consequences beyond the initial infection, which has led to filling up of the hospitals to its fullest capacity. Spain has now opted for field hospitals that could work from a few hotels to provide for hospital care.
Third, the movement of people as the cause: The European governments and citizens wanting to avoid returning to the full-blown lockdowns of early 2020 have now relatively eased the travel. The tourism-dependent economies like Greece and Portugal had also resumed receiving travellers with ample precautions. However, replacing business closures and stay-at-home orders, which broke the pandemic's first wave in Europe, with the opening of restaurants and less ground inspection is faring for the second wave.
What does it mean?
From Madrid to the English Midlands, local interventions like restrictions on social gatherings and travel have arrested the upward curve, but the curve is on the rise again. Risking another damage to the economy through lockdown will not be something the countries will adopt. At the same time restrictions in the hyper-connected cities such as Madrid or London are unlikely to be effective, since thousands will continue to commute every day while transmission levels rise. In these scenarios, the second wave will potentially transit the countries to the summer months and be ready for another economic response. The EU recovery fund has been installed to return from the first wave and also prepare for another wave. The countries are dealing with fast-changing and conflicting evidence on how quickly new cases are translating into hospital admissions. It remains to be seen whether Europe will be the lesson one more time in flattening the second wave.