Europe reported 22 cases of Mpox in May, prompting the World Health Organization (WHO) to urge people in high risk communities to get vaccinated if possible. 

WHO Europe director Dr Hans Kluge said that the virus is still in circulation, particularly affecting men who have sex with men. He added that people in high risk groups can also protect themselves from getting infected by following preventative measures. 

“There are things you can do – get vaccinated against Mpox if vaccines are available, limit contact with others if you have symptoms, and avoid close physical contact including sexual contact with someone who has Mpox,” Klugo told a WHO Europe briefing on Tuesday. 

In addition to the Mpox update, the Kluge addressed the health emergency situation in Ukraine after the Nova Kakhovka dam was destroyed three weeks ago, long COVID, and extreme heat in Europe. 

“Mpox resurgence not surprising”

Countries including the US, the UK, Spain, Belgium, and the Netherlands are seeing an increase in Mpox cases in the past few weeks. Health officials in Los Angeles and Colorado have issued alerts and launched vaccination campaigns to protect those in high risk groups, while London has extended the vaccination programme for Mpox due to the spike in cases in the city. 

Requesting those at high risk to remain vigilant and protected, Dr Catherine Smallwood, WHO Europe’s senior health emergency officer, said extreme vigilance is necessary, especially during the summer when travelling is at its peak. 

“As we enter this period of the Pride celebrations and the travel across the region, we need to remain extremely vigilant at that population level to catch early signs of disease,” she said. 

Adding that the current resurgence is not a surprise, Smallwood explained that the learnings from the outbreak in 2022, with thousands of new cases being reported every day across the continent, were immense. 

“We took a lot of time to look at why that was happening, and look at the factors that determined not only the rise in infections, but also the decline. And we understood that certainly it was linked to increased travel, particularly around June months, where there was a lot of travel to Pride events for the first time during the pandemic.”

The clear policy response to tackle Mpox, she said, is to continue investing in an elimination strategy. “We have the benefit here in Europe of not having an animal reservoir of the virus. It means stopping sustained human to human transmission is quite possible. And that’s what we implore member states, countries in the region to look into doing.”

Extreme weather events killed 16,000 in 2022

Referring to a recent report on the impact of global warming on Europe, Kluge warned that in the coming years, extreme heat in the continent will be a norm rather than an exception. 

The World Meteorological Organization (WMO) and the Copernicus Climate Change Service (C3S*) jointly released their annual State of the Climate in Europe 2022 report on 19 June. 

The report states that Europe is the fastest warming region in the world, “warming twice as much as the global average since the 1980s”. In 2022, high-impact weather and climate events have killed over 16,000 persons, of which around 99.6% were attributed to heat waves. 

“Extreme heat in the summer months is becoming the norm, not the exception,” Kluge said, adding that the high temperatures greatly increase the risk of wildfires across the continent.

He pointed out that parts of Spain and Portugal recorded temperatures over 40 degrees Celsius last year between June and August. “So look out for each other during the summer months by checking in on your elderly relatives and neighbours, limiting outdoor activity when it’s very warm, staying hydrated, keeping your home school, and allowing yourself time to rest alongside an increased recent risk of extreme heat.”

In addition, Kluge also mentioned that WHO Europe will be co-hosting the first Indoor Air Quality Conference in Berne, Switzerland, in September, 2023, with the Institute of Global Health. The conference will aim to make a case for monitoring and improving air quality inside buildings, in order to prevent transmission of respiratory infections.

Ukraine’s health risks compounded by dam disaster

Three weeks since Ukraine’s Nova Kakhovka dam gave in, the region remains susceptible to high risk of water borne diseases. Around one million people are without safe, clean water. 

“All kinds of communicable diseases due to the contamination of drinking water are a major public health risk there… We had already prepositioned supplies, testing kits etc which we could mobilize to provide to local authorities,” said Dr Gerald Rockenschaub, regional emergency director at WHO Europe.  

Expressing concern over the risk of leaving people behind, especially in areas like Mariupol and Donbas where the WHO still does not have access to provide healthcare services, Kluge said the agency has been calling for an international humanitarian corridor in the region for over a year to reach people living in these areas. 

“We are working together to beef up surveillance particularly for what we call ‘water borne diseases’ which include diseases like cholera, typhoid, hepatitis etc… We have been calling for an international humanitarian corridor for over a year now [to address] the lack of access to people in areas such as Mariupol and Donbass where still WHO does not have access and are very concerned that people are being left behind.”

Spotlight on Long COVID in transition plan

Although the WHO has declared an end to the pandemic, long COVID continues to remain a huge challenge to people and experts alike. According to the latest data from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, nearly 36 million people across western European may have experienced long COVID in the first three years of the pandemic, Kluge said. 

“That’s approximately one in 30 Europeans over the past three years. That’s one in 30 who may still be finding it hard to return to normal life, one in 30 who could be suffering in silence left behind as others move on from COVID-19,” he said. 

“We are listening to the calls from long covid patients and support groups and raising awareness of their plight, but clearly much more needs to be done to understand it.”

The WHO Europe released “The transition from the acute phase of COVID-19: Working towards a paradigm shift for pandemic preparedness and response in the WHO European Region” on 12 June, detailing the regional strategy in dealing with COVID-19 and its after effects in Europe in the coming years. 

While emphasizing on the importance of individuals getting vaccinated according to their risk status, the document also outlines the structural and sustainable changes that need to be made in order to bolster up the resilience of health systems in the region. 

“Some of these measures are very, very clear, but for member states, governments, public health authorities, the real message here is that this is not the time to pack up and move away from COVID-19,” Smallwood said. 

“Right now, we have a huge opportunity to invest in and sustain the gains made…We need to right-size those COVID response operations into day-to-day public health operations, public health services.” 

Image Credits: National Institute of Allergy and Infectious Diseases (NIAID).