#15,470
After a horrendous spring, the EU/EAA and UK saw a dramatic drop in COVID-19 cases over the summer, with case reports reaching their nadir in early July. Since then, however, the region has reported a steady increase in cases (see chart below) and is poised to go into the fall and winter with cases on the rise.
While a younger demographic is reportedly being infected in most European countries - resulting in a lower fatality rate than last spring - the trend over the past 60 days is concerning, and so today the ECDC has published their 12th RRA (Rapid Risk Assessment) on COVID-19.
The complete 27-page PDF report is chock full of data, graphs, charts, and maps and is well worth the download. I've only reproduced the executive summary below:
Rapid risk assessment: Increased transmission of COVID-19 in the EU/EEA and the UK – twelfth update
Risk assessment
24 Sep 2020
In this update, we analyse the risk posed to the general population, vulnerable individuals, and healthcare provision by the current increase in COVID-19 case notification rates observed in the EU/EEA and the UK.
Executive summary
Epidemiological developments
COVID-19 case notification rates have increased steadily across the EU/EEA and the UK since August 2020, but this is not having the same impact in all countries. In several countries the observed upsurge correlates with increased testing rates and intense transmission among individuals between 15 and 49 years of age. In such countries most detections concern mild or asymptomatic cases. However, in a number of other countries, the upsurge coincides with high or increasing notification rates in older individuals and, consequently, an increased proportion of hospitalised and severe cases. The observed increased transmission levels indicate that the non-pharmaceutical interventions in place have not achieved the intended effect, either because adherence to the measures is not optimal or because the measures are not sufficient to reduce or control exposure. In addition, the vulnerability of the population to infection remains high, as available data from seroprevalence studies suggest that the level of immunity in the population is <15% in most areas within the EU/EEA and the UK. The current epidemiological situation in many countries is concerning as it poses an increasing risk of infection for vulnerable individuals (individuals with risk factors for severe COVID-19 disease, such as the elderly) and healthcare workers, particularly in primary care, and calls for targeted public health action.
What is the risk being assessed in this update?
In this update, we analyse the risk posed to the general population, vulnerable individuals, and healthcare provision by the current increase in COVID-19 case notification rates observed in the EU/EEA and the UK.
In countries observing stable and low notification rates, and low test positivity, the risk of COVID-19 for the general population and for healthcare provision is low, based on a low probability of infection and low impact of the disease. Regarding vulnerable individuals, the overall risk is moderate based on a low probability of infection and very high impact of the disease.
In countries observing high or sustained increase in notification rates, or high test positivity, but with high testing rates and transmission occurring primarily in young individuals, the risk of COVID-19 is moderate for the general population and for healthcare provision, based on a very high probability of infection and low impact of the disease. However, the risk of COVID-19 is very high for vulnerable individuals, based on a very high probability of infection and very high impact of the disease.
In countries observing high or sustained increase in notification rates, or high test positivity, and an increasing proportion of older cases, and/or high or increasing COVID-19 mortality, the risk of COVID-19 is high for the general population, based on a very high probability of infection and moderate impact of the disease.
However, the risk of COVID-19 is very high for vulnerable individuals, based on a very high probability of infection and very high impact of the disease.
Options for response
Preparing for a scenario of widespread transmission - Several countries appear to be now progressing from limited local community transmission towards sustained community transmission. This requires a strong response, focused on both containment and mitigation measures. Geographic areas that did not experience widespread transmission during the first wave may have a higher level of population susceptibility and be less prepared to address the increasing demand for healthcare. Therefore, public health efforts should focus on strengthening healthcare capacity to manage potentially high numbers of COVID-19 patients.
Key target populations - The current epidemiological situation calls for focused public health actions tailored at:
- controlling transmission among older children and adults younger than 50 years of age
- protecting medically vulnerable individuals
- protecting healthcare workers, particularly those involved in providing primary care.
Non-pharmaceutical interventions (NPI) - Until a safe and effective vaccine against COVID-19 is available, NPIs will continue to serve as the main public health tool to control and manage SARS-CoV-2 outbreaks. However, several NPIs can have a negative impact on the general well-being of people, the functioning of society, and the economy. Therefore, their use should be guided by the local epidemiological situation, with the overall goal of reducing transmission and protecting the most vulnerable individuals in society.
Testing strategies – Testing strategies have evolved over the course of the epidemic and should now focus on more widespread testing in the community, prevention of nosocomial transmission, rapid identification and containment of outbreaks and identification of infectious cases to prevent further transmission. Easy access to testing and timeliness of testing is critical for the effectiveness of measures such as contact tracing and isolation of cases.
Contact tracing - Rapid identification, testing regardless of symptoms, and quarantine of high-risk contacts remains one of the most effective measures to reduce transmission. ECDC also recommends the testing of low-risk exposure contacts regardless of symptoms in high-risk settings (e.g. nursing homes), to enable early identification of secondary cases and initiate further contact tracing.
Quarantine - Fourteen day quarantine is recommended for persons who have had contact with confirmed SARS-CoV-2 cases. This can be shortened to 10 days after exposure, if a PCR test at day 10 is negative.
Maintaining strong messaging to promote compliance with key protective behaviours - Risk communication messages should emphasise that the pandemic is far from over, and that the SARS-CoV-2 virus continues to circulate within the community. The overarching messages proposed by ECDC earlier in the pandemic remain valid: ‘This is a marathon, not a sprint’; and ‘We must not drop our guard’. People’s behaviour continues to be the key to controlling the pandemic.
Risk communication for younger people - Reduced compliance by younger people to protective measures is of increasing concern. Communication campaigns specifically targeting young people should ideally be based on insights gained through behavioural research in order to ensure that the messages resonate with and are acceptable to the target population. It is essential that young people see themselves as part of the solution, and that they are actively engaged in strategies to control the pandemic as well as in the recovery effort.
Protecting mental health - While the fall in COVID-19 cases over the summer months and the accompanying lifting of some restrictive measures may have provided respite, the ongoing return to high incidence rates and the consequent potential for a re-imposition of restrictive measures in some countries is likely to lead to renewed stresses. The mental health of people who have had COVID-19 is another issue of concern, with evidence indicating high rates of psychological ill health after physical symptoms have cleared.
Download
Increased transmission of COVID-19 in the EU/EEA and the UK – twelfth update - EN - [PDF-1.61 MB]
