EU citizens in Western Europe are watching rising coronavirus cases and hospitalizations in the U.K. with increasing trepidation that the Continent may soon face a similar scenario.
But experts say they have no reason to panic — yet.
Factors such as waning immunity from vaccination have been cited as potential reasons for the U.K.’s exponential rise in cases. If that turns out to be the key driver of the latest wave of infections in the U.K., it would bode ill for countries in Western Europe that have similar levels of vaccination but are also seeing cases start to inch upwards.
Yet for many health experts, there is a more compelling overarching cause: the U.K. abandoning most public health measures.
“The differences are pretty clear. Britain is really slack on public health,” said Chris Dye, professor of epidemiology at the University of Oxford. By contrast, other countries in Western Europe have taken a more cautious approach that Dye called “vaccine plus plus” — widespread vaccination backed up by measures such as mask-wearing and coronavirus passports.
Dye is not alone in his assessment.
“The U.K. is an outlier, because it does have quite high coverage of vaccination — and is still having 45,000 cases per day,” said Quique Bassat, a pediatrician at the Barcelona Institute for Global health.
Yet after Britain marked “freedom day” in July, it was to be expected that there would be a “persistence of transmission as opposed to other countries which have maintained much more stringent preventive measures,” said Bassat.
Coronavirus passes, mandatory masking and limitations on gatherings are still commonly in place across much of the EU.
The situation has revealed a stark reality for the U.K. and the rest of the world: Vaccination is not a silver bullet. Driving home this message are recent increases in coronavirus cases in countries such as Belgium, Germany and the Netherlands after they lifted some restrictions.
While the situation in the U.K. is causing growing concern, across Central and Eastern Europe an even more frightening picture is emerging. In Romania and Bulgaria, the cause is even more obvious — vaccination rates of less than 35 percent that have allowed the highly infectious Delta variant to run rampant.
Freedom day
On July 19, as the seven-day average for new daily cases sat at over 45,000 a day, the U.K. government lifted most restrictions for England. Government mask mandates were removed, nightclubs reopened and advice to work from home fell away. Now, three months later, weekly averages for new cases are again at the 45,000-daily mark and hospital admissions are on the rise.
“The government has taken its foot off the brake, giving the impression that the pandemic is behind us and that life has returned to normal,” said Chaand Nagpaul, chair of the British Medical Association, on October 20.
Deepti Gurdasani, an epidemiologist at Queen Mary University London, said that there is “nothing at all mysterious about what happened in England.” The high levels of community infection resulted in “explosive growth” when schools re-opened in September, she said. “Everything that’s happening here was entirely predictable.”
Even in Scotland, where masks are still mandatory in many public spaces, cases are also rising. “I think that’s a very clear indication that mitigations need to be multilayered,” said Gurdasani. “If you have massive infection rates, like we have all across the U.K. now, masks alone are not sufficient.”
More broadly than public health measures like masking, the effect of vaccination coverage across the population has been highlighted by several experts.
Over the summer, when cases were rising in the U.K., they were also increasing in EU countries like Spain, France and Portugal. But that’s where the similarities ended. France, Spain and Portugal then saw a decline in cases, while the U.K. didn’t.
One of the reasons attributed to this is teen vaccination. In June, France began rolling out jabs for those aged 12 and over, with Spain and Portugal following suit.
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“In two or three weeks, [Spain] got about 70 percent of the teenagers vaccinated and that dramatically decreased transmission of the fifth wave precisely because it was affecting mostly the younger people,” said the Barcelona Institute for Global Health’s Bassat. The U.K. has been much slower, with the jab only being widely offered to teens from mid-September.
Waning immunity from the vaccine has also been accepted by many experts as a contributory factor to the current situation, with Neil Ferguson, director of Imperial College London’s MRC Centre for Global Infectious Disease Analysis, saying that the U.K.’s speedy rollout of jabs at the start of the year has meant it’s “more vulnerable” now.
Both Dye and Bassat believe that waning immunity has only a small role to play in the current situation. “I think the main effect is what you can see on the street,” said Dye.
What happens now?
The effect of the current situation in the U.K. on the country’s National Health Service could be dire. “I expect that the NHS will collapse,” said Gurdasani. “I don’t think the NHS is going to cope with winter.”
The British Medical Association’s Nagpaul and numerous other doctors have called for the implementation of a so-called Plan B. “It is wilfully negligent of the Westminster government not to be taking any further action to reduce the spread of infection, such as mandatory mask-wearing, physical distancing and ventilation requirements in high-risk settings,” he said.
In Central and Eastern Europe, where deaths are soaring amid low vaccination coverage, Russia, Romania, Bulgaria, Latvia and the Czech Republic have all brought back some measures.
Many experts believe that the U.K. needs to do the same urgently. If it doesn’t, it risks getting into the position where “it’s suddenly going to have to take these more severe measures,” said Dye.
This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.