LONDON
Western European nations have recently recorded their highest daily increases in COVID-19 cases in months, which is likely to disrupt people’s summer plans.
The increase in cases of the omicron subvariants BA.4 and BA.5 has prompted calls for increased caution across Europe, which has relaxed almost all coronavirus restrictions.
“As countries across the European region have lifted the social measures that were previously in place, the virus will transmit at high levels over the summer,” said Dr. Hans Henri P. Kluge, the World Health Organization’s Regional Director for Europe, said in a recent remark.
Kluge said the latest COVID-19 increase has a similar pattern as seen in the last two summers and that the spread is down to two factors -- “the spread of a new variant, this time the sub-lineages of omicron called BA.4 and BA.5, and increased travel, gatherings and events held over the summer months.”
He pointed out that we should be worried about any increases seen in COVID-19 activity in Europe and that this is “a stark reminder that we are not yet out of the woods” and that “increasing incidence in people who are at risk of severe COVID-19 will lead to increased hospitalizations, more disruption to essential health services, and unfortunately may lead to excess deaths.”
“High population immunity and the choices made to lower risk to older people are key to preventing further deaths this summer,” said Kluge.
The first resurgence has been seen in Portugal, where BA.5 cases hit almost 30,000 a day earlier this month.
In the meantime, Italy has announced that it will keep quarantine rules in place following weeks of disagreement within the government and among health experts.
The country has seen a rise in COVID-19 infections and hospitalizations with a 60% hike in new infections in just seven days.
The UK is also going through its third major wave of COVID-19 infections, and according to figures which came out last week, more than 1.7 million people were estimated to have been infected, a 43% jump from the previous week.
Germany is expecting a fourth COVID-19 wave in the coming days, with the omicron sub- lineage becoming the dominant variant in the country.
In France, meanwhile, over 50,000 new cases on average are being reported every day, with the country set to review prolonging its COVID pass for international travel in and out of France until March 31, 2023.
Kluge said the latest increase in the number of COVID-19 cases in Europe is a confirmation that the pandemic is not over and that the “WHO continues to emphasize the importance of testing and surveillance so that we can track the virus, its spread and evolution.”
He stressed that this information and analyses remain “critical to effectively end the acute phase” of the pandemic.
BA.5 variant taking over
According to Steven Van Gucht, head of the Division of Viral Diseases at Sciensano, the Belgian national institute for public and animal health, the summer wave is largely driven by “the emergence of new variants at a time when there are no more social restrictions in society and vaccine-induced immunity is gradually waning.”
Part of the antibodies that were mounted against the original Wuhan strain vaccine or upon previous omicron infection “no longer recognize BA.5,” Van Gucht said.
This gives BA.5 an advantage to spread in the population,” since it is less likely to be inactivated by antibodies upon entry in the respiratory tract,” he added.
New vaccines underway
New vaccines based on the omicron BA.1 variant are underway for autumn. Some vaccines will also combine two different variants to broaden as much as possible the scope of our immunity.
“Vaccines will always lag behind the newest variants, as virus evolution is unpredictable and occurs quicker than vaccine manufacturing,” said Van Gucht.
But Kluge argues that “despite the emergence of new variants of concern, and although infections may occur among people who are vaccinated, the COVID-19 vaccines continue to protect people very well against severe disease.”
He said that “the highest priority in every country should therefore still be to ensure and provide the primary series and a booster dose to the highest-priority target population groups.”
Are the new subvariants more severe?
The European Centre for Disease Prevention and Control (ECDC) said last week that based on limited data, “there is no evidence of BA.4 and BA.5 being associated with increased infection severity compared to the circulating variants BA.1 and BA.2.”
But the ECDC also warned that rising cases can result in increased hospitalizations and deaths.
BA.5 might escape some of our antibodies, but this immune escape is partial, and “most people are still protected from severe disease thanks to previous vaccination or infection,” said Van Gucht.
“Part of our antibodies can still recognize BA.5 and also our cellular immune response (T cells) can most likely still protect us from severe lung damage,” he added.
Despite massive and uncontrolled infection waves in South Africa and Portugal, the number of hospitalizations and deaths remained relatively low.
This indicates that most people are “still relatively well protected against severe disease,” said Van Gucht.
Travel is a big risk factor
Science clearly shows that travel is a big risk factor when it comes to the spread of viruses and particularly highly transmissible viruses such as SARS-CoV-2.
Countries that adopted strict border control and travel restrictions were quite successful in limiting the spread of the virus.
Kluge advised that “whether countries relax or tighten measures, we can all do our part to protect ourselves and others by getting vaccinated and following some simple practices, like regular hand-washing, to reduce the risk of infection.”
In terms of any further lockdowns, Van Gucht argues that the social restrictions or other collective measures, including travel restrictions, will slow down the spread of the virus but “will not stop the spread.”
Despite this, Van Gucht thinks that we are unlikely to experience restrictions in the full sense in the coming summer weeks and that during autumn and winter, the focus will rather be on vaccination, testing, masking, and ensuring proper ventilation or air filtration of indoor spaces rather than closures or harsh travel or social restrictions.
“Our hope is that this will suffice to preserve the capacity of the health care system. We should however also humbly acknowledge that we cannot precisely predict the severity of the coming autumn and winter waves,” said Van Gucht.
Kluge confirmed that “further virus evolution and variants, including variants of concern, are expected because we continue seeing significant evolution between and within SARS-COV-2 variants.”
However, “the trajectory of this evolution remains uncertain, and the characteristics of future variants cannot yet be predicted,” he said.
