Statement – COVID-19: an update on the COVID-19 situation in the WHO European Region

Statement to the press by Dr Hans Henri P. Kluge, WHO Regional Director for Europe

15 October 2020, Copenhagen, Denmark

During a virtual press briefing, WHO’s Regional Director for Europe provided an update on the COVID-19 situation in the European Region amid a significant rise in cases.

Good morning, good afternoon,

These are, more than ever, pandemic times for Europe. But pandemic times do not necessarily mean “dark times”.

Today, I will take you through the epidemiological situation, the way we look at it, how we can address it proportionally and in a timely way, what we should avoid.

Let me start with the numbers. The fall/winter surge continues to unfold in Europe with exponential increases in daily cases and matching percentage increases in daily deaths.

The evolving epidemiological situation in Europe raises great concern: daily numbers of cases are up, hospital admissions are up, COVID-19 is now the fifth leading cause of death and the bar of 1000 deaths per day has now been reached.

The Region has registered the highest weekly incidence of COVID-19 cases since the beginning of the pandemic, with almost 700 000 cases reported.

Confirmed cases have now surpassed 7 million – moving from 6 to 7 million cases in just 10 days. Over the weekend, new records were reached with daily totals surpassing 120 000 cases for the first time, on both 9 and 10 October.

Does it mean that we are back to mid-March? No, we are not. Although we record 2 to 3 times more cases per day compared to the April peak, we still observe 5 times fewer deaths. The doubling time in hospital admissions is still 2 to 3 times longer. In the meantime, the virus has not changed; it has not become more nor less dangerous.

There are technical reasons for observing higher rates in daily contaminations, one certainly being the number of tests performed, with even higher testing rates among the younger ages. And there are reasons for lower mortality, which include the higher share of transmission among less vulnerable young people, itself a factor of mobility and unprotected contact among the younger age cohorts, who have better capacity to manage severe cases and avoid a fatal course in the illness.

These figures say that the epidemiological curve rebound is so far higher, but the slope is lower and less fatal for now. But it has the realistic potential to worsen drastically if the disease spreads back into older age cohorts after more indoor social contacts across generations.

So, what is ahead?

Projections from reliable epidemiological models are not optimistic. These models indicate that prolonged relaxing policies could propel – by January 2021 – daily mortality at levels 4 to 5 times higher than what we recorded in April.

But the same models show that simple measures – such as, for example, the systematic and generalized wearing of masks (at a rate of 95% from now, instead of the less than 60% we see today) together with the strict control of social gathering, whether in public or private spaces – may save up to 281 000 lives by 1 February across our 53 Member States in the Region.

Under proportionately more stringent scenarios, the model is reliably much more optimistic, still with slightly higher levels of morbidity and mortality than in the first wave, but with a lower slope – as if we should rather expect a higher and longer swell instead of a sharp peak, giving us more reaction time.

These projections do nothing but confirm what we always said: the pandemic won’t reverse its course on its own, but we will.

Proportional and targeted responses

Measures are tightening up in many countries in Europe, and this is good because they are absolutely necessary. They are appropriate and necessary responses to what the data is telling us: transmission and sources of contamination occur in homes and indoor public places, and within communities poorly complying with self-protection measures.

So, we need to be uncompromising with any locally adapted policy, demanding better self-protection and restricting larger gatherings.

The measures now in place (or proposed) are responses to what the situation is now, and they intend to anticipate any worsening situation. In brief, these measures are meant to keep us all ahead of the curve and to flatten its course. They are there to save lives from COVID-19 without risking lives due to other diseases and because of economic despair.

Any further “escalation” of measures would be the result of failure to comply with the preceding ones, and it is therefore up to us to accept them while they are still relatively easy to follow instead of resuming the path of severity, which many tragically suffered from last spring.

A question that comes to me with great insistence now is whether WHO/Europe is for or against “country lockdown”.

Let me be clear on that: I have repeatedly insisted in these press events that the pandemic of today is not the pandemic of yesterday, not only in terms of its transmission dynamic but in the ways we are now equipped to face it. Similarly, what we called “lockdown” 6 months ago is not what we would call it today.

In March, lockdown was a shutdown, where every corner of our society and economy was halted – no running businesses, no outings, no schools, no movement, and all borders closed. In March, lockdown was the default option because we were caught off guard.

Today, lockdown means a very different thing. It means a stepwise escalation of proportionate, targeted and time-limited measures. Measures in which all of us are engaged both as individuals and as a society together in order to minimize collateral damage to our health, our economy and our society.

Our message is that any nationwide tightening-up decision must consider both the direct risks and the collateral damage associated with the pandemic.

Mental health:

• Bring mental health care to the community.
• Address stigma and misinformation.

Gender-based domestic violence:

• We need to look out for each other.
• We need to keep social services running.

Collateral damage among students:

• We should do everything in our power to keep schools open.
• We need to put specific policies in place for at-risk children with special learning needs or health conditions.

Collateral damage prevention and management of other health events such as cancer, immunization and cardiovascular diseases:

• We need a dual-track health system response.

Economic vulnerability:

• We need safety nets to reach everyone in need – cut red tape, provide additional support services (including mental health).

Taking care of our exhausted health and other frontline workers:

• Survey, compensate them and act decisively.

All these risks are to be closely monitored with COVID-19 data monitoring.

We call upon governments and people alike to express empathy and engage in social dialogue with those most impacted by the restrictive measures so that hope, engagement and trust prevail among them.