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Feature Coronavirus Pandemic

Covid-19: Is a second wave hitting Europe?

BMJ 2020; 371 doi: (Published 28 October 2020) Cite this as: BMJ 2020;371:m4113

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  1. Mun-Keat Looi, international features editor
  1. The BMJ
  1. mlooi{at}

A relaxation of lockdowns and the public’s loosening of precautionary behaviours has seen recorded cases and deaths rise across Europe, and governments are now having to clamp down hard as their hospitals fill up once again. Mun-Keat Looi reports


Already suffering the world’s third worst covid-19 mortality per capita, Belgium is facing a steep rise in incidence, with more than 160 000 new cases since the beginning of September. The government has closed bars and restaurants, imposed a curfew from midnight to 5 am, and limited groups to no more than four people.

The country’s testing system has reached its capacity of around 65 000 tests a day, and testing is now restricted to patients with symptoms. Politico reported that in the week leading to 21 October there were more than 8000 new infections each day and a doubling in the number of covid-19 admissions to hospital.1


The government is considering extending the national state of emergency to 16 February. As of 17 October a strict 9 pm to 6 am curfew was imposed on Paris and eight other major cities, to last four weeks, after the country registered more than 30 000 cases in a single day. National media say hospitals in Dijon and Clermont have cancelled non-covid operations and staff holidays as they shift to emergency working, with television station France24 quoting doctors saying this wave is already “worse than the first.”


A sharp rise in cases this month has seen Germany take swift action. Curfews are now in place in Berlin, Munich, Frankfurt, Bremen, and Hamburg. Bavaria has been under a full lockdown since 20 October, with schools closed and residents asked to stay at home. Its Berchtesgaden county is one of the worst affected in Germany, with 250 new infections each day per 100 000 population. On 21 October Germany recorded 11 287 new cases—its highest ever daily total.


On 21 October Spain became the first European country to pass one million cases. In May it relaxed one of the world’s longest lockdowns, but the country has struggled to contain outbreaks. Madrid accounted for around a third of the country’s cases and remains in limited lockdown, with travel only for work, school, or medical reasons. Madrid’s regional leader has opposed pandemic measures, leading to the resignation of her public health lead, head of primary care, and hospital chief and to the national health minister’s consternation,2 one of the many political quarrels that are impeding containment measures. The government is considering a new national curfew while grappling with an underperforming test and trace system and a healthcare system that has long been hampered by austerity measures and is now buckling.


The republic became the first country in the EU to re-enter lockdown, imposing a six week “circuit breaker” on 22 October. Though deaths are down to single figures, total cases have risen by over 15 000 since the start of September, leaving the country’s test and trace system overwhelmed and forcing the health service to text more than 2000 people to ask them to trace their contacts themselves.3

Czech Republic

A second national lockdown began on 22 October after the country recorded nearly 12 000 positive tests in 24 hours and the deputy prime minister announced that he had tested positive. Having avoided the worst of the first wave, the republic now has the worst infection rate in Europe, necessitating the declaration of a state of emergency on 5 October. Prague has seen violent clashes between anti-mask protesters and police as the government has struggled to convince the public of the ongoing danger.

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