Other European countries may follow the example of Austria, which entered a nationwide lockdown on Monday, as COVID-19 cases continue to surge across the region.

New COVID-19 cases increased by over 3,5 million in a single week, and deaths by over 50,000, according to the latest report from the European Centre for Disease Prevention and Control (ECDC). 

German health minister Jens Spahn grimly warned on Monday that, by the end of winter, Germans could either be “vaccinated, recovered or dead”. ICU beds in the country are under pressure as Germany recorded 45,326 new daily cases on Tuesday and 309 new deaths, according to the Robert Koch Institute. 

As civil protests mounted and debate raged across Europe over COVID certificates and vaccine mandates, WHO’s headquarters remained largely silent about exactly what policies countries should follow, saying primarily that countries should pursue a “risk-based approach.”   

However, WHO’s European Regional Director Hans Kluge has been more assertive on both, saying that along with more mask wearing, requiring a COVID pass for entry to entertainment or workplaces “is not a restriction of liberty, rather it is a tool to keep our individual freedom.” 

“In order to live with this virus and continue our daily lives, we need to take a ‘vaccine plus’ approach,” said Kluge in a statement on Tuesday.

“This means getting the standard doses of vaccine, taking a booster if offered, as well as incorporating preventive measures into our normal routines,” said Kluge. Only 48% of Europeans report wearing a mask indoors

Kluge also appealed to citizens to “do everything we can by getting vaccinated and taking personal protective measures, to avoid the last resort of lockdowns and school closures”.

“We know through bitter experience that these have extensive economic consequences and a pervasive negative impact on mental health, facilitate interpersonal violence and are detrimental to children’s well-being and learning,” he added.

After that, outright vaccine mandates should be a “last resort” but that a “legal and societal debate would be “very timely,” Kluge said in a weekend interview with the BBC.   

The WHO expects “high or extreme stress” on hospital beds in 25 countries, and “high or extreme stress” in intensive care units (ICU) in 49 out of 53 countries between now and 1 March 2022.

In the absence of urgent action, WHO’s sprawling European region, which extends from the United Kingdom to Russia and the Central Asian republics of the former Soviet Union, could see another 500,000 deaths by March, Kluge warned. 

Austria sets out the toughest vaccine mandates seen so far in Europe 

Austria’s 20-day lockdown – which has closed all but essential businesses and largely confined people to their homes – is necessary to safeguard the country’s public health system, according to Chancellor Alexander Schallenberg.

Describing the measure as “drastic”, Schallenberg said that the lockdown was the only way out of the current crisis.

Austria also intends to introduce mandatory vaccinations on 1 February, which Schallenberg told the CNN was necessary as around 33% of Austrians – almost two million people – were still unvaccinated despite a year of intensive vaccination campaigns. He said there were a number of reasons, including mistrust of science, and political campaigning against vaccinations, including by the Freedom Party, one of the three biggest parties in the country’s parliament. 

Schallenberg said those who refused to get vaccinated would face an “administrative fine”, although the amount has not yet been set, and that there is a precedent for this in other countries such as France and Italy in regard to certain groups of people, as well as compulsory smallpox vaccine mandates in the 1940s.

Cases in Austria, Netherlands and Belgium are currently among the highest in Europe – reaching or exceeding 1,400 new infections a day. However, Slovakia has the highest case rate per 100,000 people, while Slovenia and Czechia are also struggling.

Find more statistics at Statista

Vaccine rates below EU average in Switzerland, Poland and elsewhere 

Switzerland and Poland, in contrast, are seeing only about half as many new cases a day. But with vaccination rates in countries like Switzerland and Poland even lower than those in Austria, health authorities there are also bracing for increases in the months ahead.   

Even so, large protests against COVID-19 vaccine passes, lockdowns and vaccine mandates were held over the past weekend in at least seven European countries including Austria, Germany, Italy and France. 

They are also potentially super-spreader events as few protestors wore masks.  

Protests in the Netherlands and Brussels turned violent with protestors overturning and setting police vehicles afire, while police barricaded protestors and fired water cannons in response. 

ECDC  warns of ‘high and rapidly increasing’ case rate

The European Centers for Disease Control (ECDC) has described the current phase of pandemic as being characterised by “a high and rapidly increasing overall case notification rate and a slowly increasing death rate”, with countries with the lowest vaccination rates worst affected.

Twenty of the 29 EU countries reporting data on hospital and ICU admissions or occupancy reported increases by mid-November, according to the ECDC.

Latvia has been under lockdown since late October. In the first two weeks of November, Latvia’s COVID-19 mortality rate increased to 268.6 deaths per one million population, the third-highest in the European Union (EU) and the European Economic Area (EEA) after Romania and Bulgaria. Romania and Bulgaria also have the lowest vaccination rates in the region, at 38% and 25% respectively.

Path out of restrictions lies in high vaccination rate 

Meanwhile, a new discussion paper published by the Centre for Economic Policy Research suggests that, once a country has reached a high threshold of vaccinations, their effect on mortality is sufficient that governments do not have to adopt hard lockdown measures.

The economists tested whether the UK experience, which has a vaccination rate of 83,5% to 89,8% (two doses) across its four counties, and where deaths have remained low despite a surge in new infections and few social controls, could apply in other countries. 

By examining data from 208 other countries from early 2020 to this month, the economists – from the universities of Southern California and Tel Aviv, the Asian Development Bank and the Internals Monetary Fund – concluded that “in the presence of a sufficiently high share of inoculated individuals, governments can shade down containment measures, even as infections are still rampant, without significant adverse effects on mortality”.

The impact of vaccinations on mortality was so significant that the economists were confident that lockdown measures could be dialled down despite finding that vaccines’ impact on new infections was “insignificant”. 

Israel’s experience – booster campaign & learning from mistakes 

The paper also described how Israel’s attempts to remove its “COVID-19 pass” restrictions for entry to restaurants and other venues too early on led to surging caseloads over the summer – which peaked at world-record rates of new infections per capita in early September – or nearly 10,000 cases a day in a country of nine million people”.  

The country later reversed course, reimposing COVID-19 pass restrictions, mask mandates in closed spaces, and limits on venues, while launching a massive booster campaign.  

While “daily mortality was initially zero,” hospitalizations and also deaths increased by mid-September, as well,  “before receding to around seven daily deaths at the end of October”, according to the paper.

“The decrease in new infections since the mid-September peak is probably due to a vigorous booster campaign that raised total vaccinations to 180 per hundred individuals”, the paper argues.

That, along with the preferential treatment of vaccinated individuals in public events as well as continued restrictions on  international travel, probably played a lesser role in dimming the infection’s fires, they argue:

“Be that as it may, this opens the door for the hope that, following a sufficiently potent accumulation of vaccinations, infections are likely to recede as well.” 

Image Credits: CNN.