“There is no space to relax measures but to reinforce them” | Society

A crowded street, this Monday in Barcelona.
A crowded street, this Monday in Barcelona.Emilio Morenatti / AP

The head of the WHO group of large pathogens, Richard Peabody, has specialized in the coronavirus in Europe, a continent that has experienced two very different waves of the pandemic, with great differences in terms of their impact. Peabody responds by questionnaire to this interview.

Question. Europe has had more deaths in the second wave of covid than in the first. Isn’t it shocked that we said that the current wave was softer?

Reply. So far we have had about 20 million cases and around 450,000 deaths in the WHO European area, with more than four million cases in November alone. Last week, and four in a row, the incidence fell in the region, but even so, the European region represents 40% of cases, and 50% of all new deaths in the world. It should be borne in mind that although the confirmed deaths from covid-19 have exceeded the previous figures, the excess mortality over the forecast in many countries has not been as high in autumn as it was in spring. We believe that the excess mortality recorded throughout Europe corresponds to deaths from covid and that, therefore, in spring there were more deaths than those reported, while in autumn the difference between the real and those reported will be smaller. Fatality rates are not constant and can change significantly during the pandemic, for example if it is discovered that there are many more mild cases than are detected. The capacity of national surveillance systems may change, and testing strategies change. Furthermore, fatality may be different between countries for demographic reasons, for example, due to the difference in the structure of the population pyramid or the status of the pandemic. The social and public health measures that each one has adopted have been critical to their control.

P. Did you expect this evolution? And if they did, what steps could have been taken?

R. The WHO has already warned several times of the risk of outbreaks after the summer. That there are increases or decreases at this time of the pandemic is inevitable, because the future of its evolution depends in each country on the measures taken by governments and individuals. The ones we know work, including physical distance, testing, contact tracking, and so on, have been kept. If the spread were to accelerate, new decisions would have to be made tailored to the local context. The goal is to keep transmission controlled so that outbreaks do not develop into community spread. Local and national authorities must take decisive action to stop any outbreak, but the battle is not going to be won until everyone does their part. Vaccination will be a very important contribution to the arsenal that we already have to control covid-19, but in the short term what is needed is that we maintain all the public health measures that we know work.

P. You said that the cases are going down little by little. Should we expect the death rate to go in the same direction?

R. Yes, we hope that the death toll will take the same path several weeks late. In recent weeks we have seen great progress in Europe with the application of measures that, although difficult, have reduced the transmission of the coronavirus. Lowering the total number of cases relieves pressure on health systems, which can then prepare to adequately care for those who are ill. Slowing the speed of spread also means that the most vulnerable can be better protected and that there will therefore be fewer people infected in the time left until prevention and treatment measures arrive. When put in place correctly, public health measures can prevent infections, reduce hospitalizations, and save lives.

P. Do you trust to save, healthily, Christmas?

R. We are heading into a period characterized by two of the aspects that have propelled this pandemic: mass travel and social gatherings, so there is no space to relax the measures, but to reinforce them. The infection rate in Europe remains high, and the epidemiological situation may rapidly worsen. If we want to enter 2021 on the right foot, we will have to take advantage of what we learned in the summer.

P. Most countries are making very strict decisions, but it seems that not everywhere is working in the same direction or with the same results. Is there a biological or health reason for it?

R. The virus has not changed significantly in the way it is transmitted or caused by disease. The outbreaks or decreases in cases are not part of the natural cycle of the virus, but rather the effect of measures taken by countries and people. Public health and social measures have been of critical value in reducing deaths. Measures must be applied based on the intensity of transmission and the responsiveness of health systems. WHO has provided detailed indicators and thresholds for countries to assess in a systematic way. When deciding what measures to impose, decision-makers must also consider the impact on society and individuals. The measures have to have a time frame, be periodically reviewed and applied at the most local level possible. All countries face a delicate balance between saving lives, maintaining economic well-being, and preserving quality of life. There is no single model that works for everyone. To be successful, each country must adopt a strategy that is scientifically based and culturally acceptable.

Information about the coronavirus

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