Less than two months after forecasting “a long period of tranquility” for Europe in the pandemic, the World Health Organization’s regional chief warned this week that much of the continent was in the grip of a fresh Covid-19 surge after “brutally” sweeping away restrictions.

Hans Kluge’s volte face was spurred by the rapid spread of a highly infectious version of the Omicron coronavirus variant, known as BA.2. The strain has taken hold as people stop wearing masks and socialise more, prompting a jump in infections in at least 18 European countries, according to the WHO.

Experts predict North America will be hit by a similar resurgence within weeks, with some warning that sluggish vaccination and booster uptake among older groups in the US could leave it exposed to a bigger wave of hospitalisations than its European peers.

The Omicron sub-variant is estimated to be about 30 per cent more infectious than the original version but analysis by the UK Health Security Agency shows BA.2 cases are no more likely to result in hospitalisation than the original Omicron strain.

“With boosters waning and restriction easing, a second part to the Omicron wave was always likely but BA.2 has obviously exacerbated that,” said Dr Tom Peacock, a virologist at Imperial College London.

Chart showing that the BA.2 Omicron sublineage has displaced the original strain and is driving new surges in cases across Europe, with Denmark and the Netherlands now past their BA.2 peaks

Despite the upswing in infections, European countries have persisted in dropping restrictions.

“The way the UK and the rest of Europe is choosing to treat this is that it’s no longer about cases, it’s about hospitalisations and deaths,” said Peacock.

Hospitalisations have ticked up in countries whose BA.2 waves are most advanced, but the share of cases requiring hospital admission remains much lower than with pre-Omicron variants such as Delta. This reduction in rates of severe disease is partly due to high levels of immunity across the western world through vaccination and previous infection, along with the sub-variant’s intrinsically lower virulence.

From March 28, Poland will scrap most of its remaining restrictions, including compulsory indoor masking and self-isolation for those in households with people who test positive.

The Italian government still plans to end the country’s state of emergency at the end of this month, more than two years after it was first introduced — despite infections nearly doubling since early March to 188 daily cases per 100,000 citizens.

Earlier this week, Germany ended most nationwide legal restrictions, including vaccine passport requirements for trains and workplaces, even though it faces record-high caseloads. Scotland also reduced its self-isolation and testing requirements, despite a record number of Covid-19 patients requiring hospital treatment, while England will end free mass testing from next month.

Only Austria has opted to reimpose measures in response to the BA.2 wave, once again requiring the use of high-grade masks in indoor public settings from Wednesday.

“The feeling is that we’ve been through the worst of Omicron,” said Hajo Zeeb, professor of epidemiology at the University of Bremen. “The fear is less now that hospitals are becoming overloaded, but rather the issue of just simply the workforce being depleted by people who are sick at home.”

Zeeb said Germany faced a “bigger threat” from BA.2 than its neighbours because of lower vaccination rates among elderly, vulnerable groups. Despite the German parliament abolishing most legal measures, most German states have delayed ending restrictions, such as compulsory indoor mask-wearing, until early April.

Antoine Flahault, director of the Institute of Global Health at the University of Geneva, said France’s decision to lift mask mandates last week everywhere but health facilities and public transport was a mistake. The country was “not in a calm period” of the pandemic with infections running at 100,000 per day and the seven-day incidence rate up sharply to 928 per 100,000 people.

Chart showing that US vaccination uptake continues to lag behind its peers, especially for boosters

But Bruno Lina, a virologist in Lyon who advises the French government, said BA.2 did “not present a huge problem”. The country’s health service has capacity to handle the wave, experts say, given that Covid-19 hospitalisations have been declining for six weeks.

The WHO’s Kluge said on Tuesday that he was “optimistic but vigilant” about the trajectory of Covid-19 in Europe. The hope of many experts is that summer will offer a respite from the high infection rates since Omicron first emerged late last year.

“BA.2 is worrisome because it’s so tremendously contagious, but it’s running out of people to infect and the warmer months of summer are on the way, so we should still be able to get back to normal,” said Anna Odone, professor of public health at the University of Pavia.

However, concerns about the rapid spread of BA.2 are growing among health experts in the US, where federal and state authorities are lifting Covid-19 restrictions and vaccination rates lag behind many European countries.

A third of Americans have still not received two doses of a Covid-19 vaccine and just 29 per cent of the population has so far received a booster, according to data published by the Centers for Disease Control and Prevention.

“Our vaccine hesitancy and the rate at which we have managed to vaccinate and boost our higher risk population is lagging, and that is probably the number one thing that leaves us very vulnerable,” said Myoung Cha, president and chief strategy officer of Carbon Health, a primary healthcare provider offering Covid-19 treatments and vaccinations.

Anthony Fauci, Joe Biden’s chief medical adviser, said on Sunday he did not expect a “surge” in cases caused by BA.2 to require the reinstatement of tough social distancing restrictions.

But Cha said the fast removal of restrictions by authorities was worrying given the rapid spread of BA.2 in Europe and the likelihood it would do the same in the US.

“I worry that this will only add fuel to the virus,” said Cha. “This is the calm before another Covid storm in the US, which will be worse than it should be due to short-term and hopeful thinking.”



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