(Bloomberg) – If Europe has a strategy to stop the spread of covid-19, it is hiding it well.
The president of France, Emmanuel Macron, has promised not to return to the dark days of national quarantine, preferring to “live” with the coronavirus, but his government is having a hard time stopping a rebound in cases. France registered more than 10,000 new cases in 24 hours over the weekend, a gloomy postscript to its decision to cut the quarantine required for positive cases in half, to seven days.
It is a similar story in Spain, the country with the most cases in Europe and the first to cross the barrier of more than half a million in total. President Pedro Sánchez has also ruled out national quarantines, but disorderly public health disagreements between Madrid and regions like Catalonia, and an initially lax approach to nightlife, have worsened an increase in cases. Taking the population into account, the seven-day average rate for new cases in France and Spain is higher than in the United States.
British cases are not far behind, reaching their highest level since May.
Austria is warning that it is the beginning of a “second wave”. We are not there yet in terms of deaths and hospital admissions, which remain well below the peak of the virus in April. For now, the majority of new cases appear to be asymptomatic or mildly symptomatic young adults.
However, young people do not live in a vacuum and infections are spreading to the elderly and most vulnerable. The drive for adults to return to the office and children to classrooms, commendable as it may be, is accelerating the spread of the virus. Bank of America’s estimates of the reproduction rate suggest it is above 1 in all major European countries except Germany, meaning that an infected person on average will transmit the virus to more than one person. Doctors warn of a harsh winter in which there will be no vaccine.
That is why filling the gaps in evidence, follow-up and isolation of cases will be crucial to breaking the chains of transmission in the coming months. Europe is running far more tests than at the start of the pandemic, and the positive test ratio is 10% or less, but the allocation of resources is still pretty sorry.
Testing is done everywhere, on almost any suspected case, and this has overwhelmed the labs. Waiting counts of up to eight days for a result in France, or the backlog of almost 200,000 tests in the UK, are an absurd counterpoint to the political goals of a million or more tests per week. It is negative for public confidence and for the economy, given the need to self-isolate while awaiting results. It’s no wonder that people often ignore the stay-at-home rules.
The tracking part of the equation has also failed. Digital tracking applications designed to easily track possible transmissions from a positive case have failed to attract a significant mass of users in some countries. The UK has yet to release its version redesign. Human trackers are grappling with a decline in positive case-identified contacts. In France it is currently around two, while in Spain the figure is around three. This is like looking for a needle in a haystack.
There is room to expand testing capacity, or at least distribute resources more efficiently. It would help to have more mobile and drive-thru labs. Test teams should focus on populations that need them most, such as symptomatic cases or social workers, while reserving a more aggressive approach for high-incidence areas or areas. Clear and simple rules about when tests are actually needed could prevent them from rushing to testing in schools or offices. There could also be more experimentation with ‘pooling’ multiple samples being tested at the same time to save resources or alternative types of testing. testing methods, such as using saliva samples, although there is a risk of more false negatives.
On the contact tracing front, you need better organization, more training, and more outreach. Increased recruitment is one thing – France is recruiting 2,000 additional contact trackers – but this needs to be coupled with solid training as this job requires working with local communities and collecting confidential information that people might not want to share. If digital applications do not catch on, other techniques could be tried such as “backward” contact tracing, in which new cases and their contacts are linked to events or places that could point to more potential cases (and clusters).
Sure, this is just one piece of the vast virus puzzle. Face masks and social distancing remain critical. But it is remarkable what can be achieved with an effective test policy. In the Mayenne region of north-western France, where the outbreak of cases was successfully stopped last month, massive tests were carried out and under the objective of obtaining results within 24 to 48 hours. Why not just target this response time nationwide? This would make those “no more quarantine” promises a little easier to keep.
Nota Original: An 8-Day Wait for Covid Test Results Is Mad: Lionel Laurent
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