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COVID-19

Concerns grow in Europe over potential ‘second wave’ of coronavirus as lockdowns are eased

As several European nations begin relaxing their lockdowns following an initial peak in COVID-19 cases, attention is turning to how they can avoid a "second wave" of infections as social distancing is eased.

Concerns grow in Europe over potential 'second wave' of coronavirus as lockdowns are eased
People ride their bicycle through a bike lane in central Milan on May 4, 2020, as Italy starts to ease its lockdown. AFP

Italy and Spain — two of the hardest hit countries — have already started allowing people outside to exercise for the first time in nearly two months, and several US states are allowing businesses to reopen. 

In France, where confinement measures are set to lift on May 11, Prime Minister Edouard Philippe said there is a “fine line” between lifting restrictions on movement and avoiding a new surge in infections of a disease that has killed nearly a quarter of a million people globally.

“The risk of a second wave — which would hit our already fragile hospitals, which would need us to reimpose confinement and waste the efforts and sacrifices we've already made — is serious,” he said last week. 

Social distancing has proved effective in flattening the curve of new COVID-19 cases, buying health systems crucial time to recover and regroup. But it has also meant that a very small percentage of populations are likely to have been infected and thus developed immunity.

France's Pasteur Institute estimates that only around six percent of the country's population will have been infected by May 11th.

Even in virus hotspots in France, it is thought that no more than 25 percent of people caught COVID-19 during the pandemic's first wave.

This means that without a viable vaccine, experts say it is impossible to imagine life returning to normal any time soon.

Storekeepers asking for the reopening of shops and commercial activities gather for a flashmob protest on Piazza San Marco on May 4, 2020 in Venice, as Italy starts to ease its lockdown. AFP

Waiting game

“It will take several weeks or even several months to see the virus circulating again” at a high level, virologist Anne Goffard told France Inter radio.

A second wave of infections was likely, she said, “at the earliest at the end of August”.

But while experts are more or less united on the probability of a new spike in cases as lockdowns are eased, there is debate over how the second wave will compare with the first.

Some senior health officials — notably in Germany and the US — have warned it could bring even more infections than the March/April peak. Others are more optimistic that changes in personal behaviour could slow new cases.

Pierachille Santus, a lung expert based in Milan, said the second wave “will probably be smaller than the first” thanks to control measures.

It is not yet known how or if the novel coronavirus will respond to warmer weather. Other viruses tend to go dormant during summer months.

“There's probably a link (between the virus) and heat and humidity,” Jean-Francois Delfraissy, president of France's science council, said Monday.

“We're expecting a fairly peaceful summer,” he said, warning however that the virus could return forcefully towards the end of the year.

Even if businesses can reopen and people return to the streets, there are several ways of slowing the virus spread.

These include keeping your distance from others, avoiding touching your face, washing your hands, wearing a mask while in public — all habits people have, to some extent, picked up during the first wave.

One model run by the Public Health Expertise research group showed that such measures could reduce expected total COVID-19 deaths to 85,000 in France, compared with an anticipated 200,000 with no social distance or mask wearing.

Yet even in the best case scenario of new infections, hospitals are likely to be inundated with fresh patients.

'Mini-waves'

Other vital measures after lockdowns end are testing and contact-tracing — seeking out those new infections and isolating people they have been in close contact with.

Were countries able to ramp up their testing and tracing capacity, “we could have a series of mini-waves,” according to Didier Pitter, head of infection control and prevention at Geneva University Hospitals.

Governments will seek to limit the transmissions rate of COVID-19 (R0) to below one: that is, each infected person infects fewer than one other on average.

A study published last month in The Lancet showed that testing, contact tracing and isolating confirmed infections reduced R0 in the southern Chinese city of Shenzhen to 0.4. 

This helped the city avoid an outbreak such as the one that hit Wuhan, where the virus first emerged in December.

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COVID-19

Return of the health pass? How France plans to tackle new wave of Covid cases

With a sharp rise in reported cases in recent weeks, France appears to be in the middle of a new wave of Covid infections - so what measures are the government taking to control it?

Return of the health pass? How France plans to tackle new wave of Covid cases

Recorded case numbers in France are now over 90,000 per day, with 133,000 recorded in the past 24 hours – this is a long way short of the 350,000 weekly cases recorded in January but still the highest since May and representing a steady an increase of 67 percent on the previous week.

Hospital admissions are also on the rise – up 32 percent from last week.

So what is the French government doing about it?

Since March, almost all Covid-related restrictions have been lifted in France – the health pass is no longer required for everyday activities such as visiting a bar or going to the gym and face masks are now merely advised in all indoor locations. Only hospitals and other health establishments such as nursing homes still have mandatory rules on face masks and health passes.

For international travel, fully vaccinated arrivals from most countries – including the UK, US and the whole of the EU – need only to show proof of vaccination, while unvaccinated travellers need to show proof of a recent negative Covid test – full details HERE.

Health pass

A proposed bill from the health ministry that was leaked to French media talks about re-imposing some form of pass sanitaire (health pass) to get numbers under control.

Some caveats to add here is that the document is only a proposal at this stage and the government has explicitly rules out – for the moment – reintroducing the vaccine pass. The health pass can be used to show either proof of vaccination or a recent negative Covid test, so it is less restrictive for the unvaccinated.

The document suggests re-introducing a health pass for travel – both to and from France – not for everyday activities like going to a café.

Testing and contact tracing

The bill also proposes extending the software involved in contact tracing and the Covid testing programme until March 2023, although this is described as a ‘precaution’.

Testing remains available on a walk-in basis at most French pharmacies and by appointment at health centres and medical labs. Tests are free for fully-vaccinated residents of France who have a carte vitale. Those are only visiting France, who are not registered in the French health system or who are not vaccinated have to pay – prices are capped at €22 for an antigen test and €54 for a PCR test.

READ ALSO How tourists in France can get a Covid test

Masks

The Minister of Health, Brigitte Bourguignon, said she is “asking the French to wear masks on public transport once again” during an interview with RTL on Monday, June 27th and the Prime Minister Elisabeth Borne has also recommended this. She also recommended wearing a mask in all other enclosed crowded areas, as a “civic gesture.” However, she did not refer to the request as a government mandated obligation.

At present masks are not required, but are recommended, especially on busy services where it is impossible to practice social distancing. In recent days several public transport operators have changed their messaging from saying that masks are merely recommended to be ‘strongly recommended for the protection of everyone’.

Epidemiologist Pascal Crépey said: “In crowded trains, the risk of being in the presence of infected people is high. It would be a good idea for the population to wear the mask, to protect especially the most fragile and avoid massive infection rates.”

A recent poll for the Journal du Dimanche newspaper showed that 71 percent of people are in favour of making masks compulsory on public transport again.

Local measures

French local authorities also have the power to impose certain types of restrictions if their area has a particularly high rate of infections.

At present, none have done so, but Nice mayor Christian Estrosi has spoken in favour of possibly bringing back the vaccine pass over the summer.

Second booster shots

A second booster shot of the Covid vaccine is now available to all over 60s and anyone who has a long-term medical condition or who is otherwise at risk from Covid.

It is recommended that the government increase public messaging advising those in high risk groups to get the second booster shot. The medical regular HAS has advised combining second booster shots with the seasonal flu vaccine campaign in September and October.

France is not, at present, considering widening the campaign to the entire popular, but the EU’s vaccine commissioner Thierry Breton says that if necessary, there would be enough doses to cover the whole population.

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