The omicron shift in Europe: pandemic or endemic?

Governments are seizing a moment in
which their populations have experienced less severe illness and, in some
instances, a drop in new daily cases after weeks of record growth. And they are
moving their mitigation policies off emergency footing.

In Spain, for instance, Prime Minister
Pedro Sánchez declared last week that citizens would “have to learn to live
with it, as we do with many other viruses,” and said that the country should
adjust the national approach to more closely align with how it handles
influenza outbreaks. Olivier Véran, the French health minister, said recently
that France’s high level of infection and strong vaccination rate could “maybe”
mean this would be the final wave.

The shift comes even as the World Health
Organization cautioned this week against treating the virus like the seasonal
flu, saying it was too soon to make that call. Much about the disease remains
unknown, the WHO said. And a surge in cases driven by the omicron variant is
still battering the continent, while the population of much of the world
remains vulnerable because of a lack of widespread vaccination, and more
variants are still likely to arise.

Still, advocates of the “learn to live
with it” approach point out that the latest surge in cases is different from
the early days of the virus in several important ways, including a largely
vaccinated population in parts of Europe, especially in the West, and a far
lower rate of hospitalization.

The sentiment is evident in the evolving
policies that the British government has adopted since the start of this year,
a stark departure from the “war footing” that the country’s health service
preached in December.

The changes include shorter isolation
periods and the elimination of pre-departure tests for people traveling to
England — largely because omicron was already so prevalent that the tests had a
limited effect on its spread.

There have been some concrete signs that
Britain may be turning a corner. There were 99,652 new cases reported Friday, a
notable drop from the 178,250 cases reported on the same day last week.

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“It can’t be an emergency forever,”
Graham Medley, a professor of infectious disease modelling at the London School
of Hygiene and Tropical Medicine, told BBC Radio 4 this week. He added that the
end of the pandemic was likely to occur in phases rather than appear as “an
active point in time” when it can be declared to be over.

Amid this shift, the messaging to the
public has varied, often in confusing ways. The guidance can be all over the
map, with some politicians declaring the latest wave over and others advocating
a gradual return to normalcy — all while many experts express caution about all
of the unknowns and the potential for new variants.

Peter English, a retired consultant in
communicable disease control, said that for many public health experts and
scientists in Britain, the debate had shifted away from lockdowns to
common-sense mitigation measures. Most are now encouraging measures like
mandatory masking in public settings and legislation for ventilation standards.

“There had been an argument about zero
COVID and trying to eliminate the virus through restrictions,” he said. “I
think that we’ve lost that argument. I think that by allowing it to spread to
the extent it has, it will be very, very difficult to put the genie back into
the bottle.”

From that perspective, he said, “we’re
going to have to live with it being endemic.” But, he added, “endemic doesn’t
mean not serious,” and he urged caution against the idea of simply “learning to
live with it” without mitigation measures in place.

One of the biggest concerns in England
has been the intense pressure that the virus puts on the National Health
Service, or NHS. But some of the immediate concerns that Britain’s hospitals
could become overwhelmed with patients during this latest wave have begun to

Matthew Taylor, head of the NHS
Confederation, a membership organization for the heads of hospitals, said
Wednesday that “unless things change unexpectedly, we are close to the national
peak of COVID patients in hospital.”

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In Spain, a new monitoring system is
being created to come into effect once the current surge in cases ebbs, and the
country also recently relaxed its isolation rules. But Madrid’s push for
omicron to be treated more like the flu has been criticized by some doctors and
professional associations as well as by the European Medicines Agency, who say
the virus is still behaving as a pandemic.

In France, infections are still trending
upward, with nearly 300,000 newly reported coronavirus cases a day this week,
almost six times as many as a month ago. But President Emmanuel Macron, who is
facing a presidential election in April, has opted to keep minimal restrictions
in place and focused instead on urging the French to get vaccinated.

Macron’s government has rejected
accusations that it has given up on reducing the number of cases, including in
schools, which faced widespread strikes Thursday by teachers concerned with
classroom safety.

Véran, the French health minister, who
tested positive for the coronavirus Thursday, said authorities were keeping a
close eye on data from Britain to ascertain whether France was nearing its own

Germany is several weeks behind some of
its European neighbours in confronting an uptick in infections. It reported
80,430 new cases Tuesday, breaking a record set in November. But independent
scientific experts have held off advising the government to impose new
restrictions despite widespread agreement that infection numbers would continue
to rise.

Christian Drosten, the country’s most
famous virologist, noted that Germany would most likely eventually have to move
to treating 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 to the virus a bit.”

Italy, too, is grappling with some of
the highest daily infection rates since early in the pandemic. But in recent
weeks, it has tightened restrictions, making vaccines mandatory for those 50
and older, including requiring a health pass to use public transportation.

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A spokesperson for the Italian Health
Ministry said that the country was “still in a delicate phase” and that the
recent daily surges in cases continued to put pressure on intensive care units.
Italian scientists have tended to agree that it is too early to declare the
situation endemic, even if the time had come “to start thinking about the new
normal” of coexisting with the virus, said Fabrizio Pregliasco, a virus expert
at the University of Milan.

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

“Even under the most optimistic
assumptions,” they wrote, “letting omicron run unfettered risks potentially
devastating consequences.”

In England, hospitalisations are still
very high in some areas, particularly in the northeast, and illness among
health care workers is still straining the system.

England needs to take a “thoughtful,
managed approach” to the pandemic “while thinking about what our new normal
will look like,” said Saffron Cordery, the deputy CEO for NHS Providers, the
membership organization for England’s health staff.

But, she added, it was clear that the
country had started to develop a pattern of living through several waves of the
virus. With much uncertainty still ahead, she said it would be misguided to
think of this moment as an inflection point.

“Rather than being a 100-metre
straight-line sprint down to the finish line of COVID,” she explained, “it’s
more of a longer-term cross-country run through all sorts of different terrains
before we get to that destination.”

©2022 The New York Times Company

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