Countries across Europe have almost completely eased up on preventive, control, and restrictive measures put in place to check the spread of Covid-19 since the inception of the catastrophic pandemic in late 2019 and inflicting over 100 million cases in the EU/EEA countries alone.
After nearly two years of national lockdowns to control the pandemic, countries understandably and excitedly embraced opening up.
Previously restrained life activities have rapidly moved from what was referred to as a new normal to the real normal, including major sporting events, such as the recently ended 2022 UEFA European Women’s Football Championship and the Qatar 2022 FIFA World Cup, musical concerts, travels, and so on.
The Qatar 2022 FIFA World Cup has fully regained its pre-pandemic vibrancy. Spectators are enjoying and cheering at the World Cup finals between the French and Argentine national men’s football teams. The usual social distancing seemed no longer of any concern in these public gatherings.
What are the infection prevention and control (IPC) consequences of this apparently rapid normalcy?
Although reliable data remain scarce, scientists and epidemiologists have modelled a positive upward trend in the spread of Covid-19 infection in several European countries following the rapid opening of socio-economic activities.
The wearing of masks in public places, social distancing, handwashing, and the use of alcohol hand rubs are now only encouraged or voluntary. Legal enforcement looks like a distant past across Europe.
Some countries have completely opened up, leaving every aspect of the IPC precautionary measures as voluntary. The danger of the spread of disease is that when the preventive and control actions are voluntary and not enforced by law, regulations, or even by an active campaign, only a small minority of the population tends to adhere, usually among the medically vulnerable individuals with other underlying conditions. New infections have been observed to be driven by the emerging Covid-19 virus variants.
Reasons for continuing adhesion to preventive and control measures often vary among individuals and may be due to the need to continue protection as a result of other underlying health problems to characteristically behavioural personal choices, and self-enforced social discipline and/or norms.
What are the symptoms of infection with emerging virus variants?
Although new Covid-19 variants have emerged, the symptoms are still the same or very close to the familiar ones, with different degrees of variation, and include:
- Fever
- Cough
- Sore throat
- General weakness, fatigue and muscle pain
- Loss of smell and taste
Some individuals may still be asymptomatic, that is, showing no signs of the disease while carrying and, in other cases, spreading the virus.
Data from some European countries also suggest that an infection by the new variants is less likely to lead to hospitalisation, particularly among persons classed as fully vaccinated members of the population. Hence, some countries allow only fully immunized individuals as part of the entry requirements, although this seems increasingly unenforced in many parts.
It is also critical to avoid what has been referred to in IPC circles as campaign or enforcement fatigue, where indifference sets in or even outright opposition to IPC measures and/or campaigns. Human behavioural impact must be assessed and considered to maintain a good and consistent outcome.
What are the observed case situations in parts of Europe?
As a part of ongoing European health policy measures, a joint European Centre for Disease Prevention and Control (ECDC, an agency of the European Union) and World Health Organisation (WHO) report on the new Covid-19 infections in the European Region in week 47/2022 showed a decrease of 3.5% (871,728) in newly confirmed Covid-19 cases and a reduction of 35.2% (2,238) of new deaths reported by national authorities. Although this is a significant reduction from the previous situation, it shows that Covid-19 is still very much around, and preventive measures should be encouraged.
There is a wide ongoing variation in infection levels among European countries. Some of the variations have been attributed to a lack of or inadequate surveillance and real-time data reporting. There is also the emerging challenge of separating the high annual winter flu and Covid-19 infection mixtures.
Among eight countries that reported test positivity rates weekly, the highest observed level was >20%. Four countries (Finland, France, Hungary, and Sweden) had increased test positivity compared to the previous week, one country had a decrease (Iceland), and three remained stable (Germany, Luxembourg, and the Netherlands). More recent data still indicate high variability in infection and hospitalisation in various countries.
Although increases are being recorded with a mixture of high flu levels, the overall picture is still highly variable among European countries.
What is the situation in hospitals and intensive care units (ICUs)?
High variability also exists in data from various ICUs. Data from eighteen countries in the last two weeks under review were mixed. New hospital admissions due to Covid-19 increased compared to the previous week. Infection decreased in ten countries and remained stable in four (Estonia, France, Greece, and the Netherlands).
In the 12 countries reporting over the same two weeks, new ICU admissions due to Covid-19 had increased in four countries compared to the previous week (Estonia, France, Latvia, and the Netherlands), decreased in five (Greece, Lithuania, Luxembourg, Spain, and Ukraine,) and remained stable in one (Ireland).
How many SARS-CoV-2 variants or the Omicron virus are recognised in Europe?
Virus sequencing and identification are ongoing exercises among EU and EEA member states, and new variants are still being added to the existing list. So far, the following six viral variants have been actively monitored and reported to the ECDC database:
- Omicron BA.2
- Omicron BA.2.75
- Omicron BA.4
- Omicron BA.5
- Omicron BQ.1
- Omicron XBB
The disease manifestation in infected patients may appear similar, despite their inherent structural differences.
The viral sequencing work is regularly ongoing in various countries, so new ones are likely to continue to be added as the virus fights back against control measures through its built-in genetic mutation mechanisms.
This is a main reason to have continuous, not continual, effective IPC measures in place, including the application of alcohol, handwashing, rubbing with alcohol-based products, social distancing where appropriate, intelligent use of masks in crowded and enclosed places, and surface disinfection with appropriate agents.
What does the future hold for IPC?
The key question some have asked is, “Are countries over-relaxing rules too quickly?” This suggests an epidemiologically arguable gradual opening with active encouragement and support of testing and precautionary hygiene measures, including regular handwashing with soap and water, use of alcohol hand rubs, such as SARAYA’s Alsoft VB with broad spectrum antiviral efficacy, maintaining the practice of social distancing, and wearing appropriate face masks, particularly in crowded places or rooms when with people outside our social bubbles.
Evidence from several countries continues to show an upward trend in key statistical measures, such as new infections, infection rates, and hospitalisation. A compounding effect from a severe seasonal winter flu is also recognised in some EU countries, including the UK. Hence, there is a need to maintain and enhance existing multimodal hygiene to continue protecting the entire population.
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Publication Date:March 01, 2023
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Category:Outbreak
