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Covid-19: Europe could be headed for pandemic “endgame,” says WHO region chief

BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o205 (Published 25 January 2022) Cite this as: BMJ 2022;376:o205
  1. Owen Dyer
  1. Montreal

The rapid spread of the omicron variant of SARS-CoV-2 could see an end to the pandemic in Europe, with the variant likely to have infected 60% of people on the continent by March, the World Health Organization’s regional director for Europe has said.

“It’s plausible that the region is moving towards a kind of pandemic endgame,” Hans Kluge told Agence France-Presse on 23 January. Once the current wave subsides, he said, “there will be for some weeks and months a global immunity, either thanks to the vaccine or because people have immunity because of the infection, and also lowering seasonal risk.”

“We anticipate that there will be a period of quiet before covid-19 may come back towards the end of the year, but not necessarily the pandemic coming back,” Kluge said.

But Kluge said it is still too early to consider covid-19 endemic and warned that other variants could emerge to upset calculations. “There is a lot of talk about ‘endemic’ but endemic means that it is possible to predict what’s going to happen,” he said. “This virus has surprised us more than once.”

Given the variant’s rapid spread across Europe, Kluge said countries should focus on “minimising disruption of hospitals, schools, and the economy, and putting huge effort into protecting the vulnerable,” rather than imposing lockdowns.

Few European countries are closing down even as some see astronomical case numbers. Denmark reopened a range of public buildings last week on a day when it set a record for new infections. France’s government has promised to ease restrictions from early February, despite experiencing daily case numbers at least five times higher than in any previous wave.

Spain’s government is preparing to unveil a revamped approach to covid that is closer to its traditional flu surveillance model, a policy labelled “fluisation” (fluización) in the Spanish media. Prime Minister Pedro Sanchez said in a radio interview that given omicron’s milder nature, “we have to evaluate the evolution of covid from pandemic to an endemic illness.”

Omicron wave recedes in Africa and the US

Cases are surging in Russia and India as omicron takes hold, but in the US and across most of Africa the omicron wave is already receding. “Things are looking good,” the US presidential covid adviser Anthony Fauci told ABC News on Sunday. If trends continue on their current course, he said, “I believe that you will start to see a turnaround throughout the entire country.”

Africa is already emerging from its fourth, omicron driven wave, WHO’s regional director Matshidiso Moeti reported on 20 January. “While the acceleration, peak, and decline of this wave have been unmatched, its impact has been moderate, and Africa is emerging with fewer deaths and fewer hospital admissions,” said Moeti. While the continent’s case fatality ratio was above 2.4% in the three previous waves, with omicron it fell to 0.68%, she said.

But WHO director general Tedros Adhanom Ghebreyesus sounded a more pessimistic note at a 24 January press conference, in which he appeared to take aim at the comments of his agency’s Europe director. “It is dangerous to assume that omicron will be the last variant, or that we are in the endgame,” he warned. “On the contrary, globally the conditions are ideal for more variants to emerge.”

“Since omicron was first identified just nine weeks ago,” said Tedros, “more than 80 million cases have been reported to WHO—more than were reported in the whole of 2020.”

“Learning to live with covid cannot mean that we give this virus a free ride,” he said. “It cannot mean that we accept almost 50 000 deaths a week from a preventable and treatable disease.”

By failing to produce and equitably distribute vaccines for all, he said, countries had allowed the pandemic “to continue to drag on, lurching between panic and neglect.”

“We can end the acute phase of the pandemic this year—we can end covid-19 as a global health emergency, and we can do it this year,” said Tedros.

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