A look into the future of the COVID-19 pandemic in Europe: an expert consultation

Iftekhar, Emil N.; Priesemann, Viola; Balling, Rudi; Bauer, Šimon; Beutels, Philippe; Valdez, André Calero; Cuschieri, Sarah; Czypionka, Thomas; Dumpis, Uga; Glaab, Enrico; Grill, Eva; Hanson, Claudia; Hotulainen, Pirta; Klimek, Peter; Kretzschmar, Mirjam; Krüger, Tyll; Krutzinna, Jenny; Low, Nicola; Machado, Helena; Martins, Carlos; McKee, Martin; Mohr, Sebastian B.; Nassehi, Armin; Perc, Matjaž; Petelos, Elena; Pickersgill, Martyn; Prainsack, Barbara; Rocklöv, Joacim; Schernhammer, Eva; Staines, Anthony; Szczurek, Ewa; Tsiodras, Sotirios; Gucht, Steven Van; Willeit, Peter

doi:10.1016/j.lanepe.2021.100185

Cited by 84 publications

(71 citation statements)

References 161 publications

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“…This could be in part because the countries’ mortality profiles were primarily shaped in the early and late 2020–early 2021 waves, as 91% of the cumulative COVID-19 mortality across the EU was recorded by the end of spring 2021 [ 3 ]. Imbalances in population immunity may slowly change the mortality profiles in the short term and countries with a high vaccination coverage will face at worst moderate waves, whereas for countries with lower coverage more severe waves are expected [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Mortality From Coronavirus Disease 2019 Across the European Union Countries and the Effects of Vaccine Coverage

Ziakas

Kourbeti

Mylonakis

2022

Open Forum Infectious Diseases

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Background Mortality is a critical measure of disease impact. The European Union (EU) countries share the same regulatory framework but different implementation policies. Methods We extracted cumulative COVID-19 mortality data across the EU countries. We evaluated the 27 member states using the location quotient (LQ) to adjust for the expected mortality in the whole EU region, where an LQ <1 signifies a more and an LQ >1 a less favorable outcome. We categorized EU members into 3 distinct profiles based on their LQ estimates: favorable profile, LQ ≤0.9; unfavorable profile, LQ >1.10; and average profile, LQ between 0.9 and 1.10. We compared LQ estimates and profiles with the prevaccination era that ended in December 2020 with the COVID-19 vaccine rollout. Results Twelve member states had a favorable profile, 4 had an average profile, and 11 had an unfavorable profile. In quantitative analysis, an improvement (negative LQ difference) was noted across countries with higher vaccination coverage (median, 71% fully vaccinated vs 57% for countries with positive LQ differences). There was a significant negative association between the share of fully vaccinated and LQ changes (ρ = –0.62, P < .001) and a significant 4-month lag effect. After COVID-19 vaccines became available, 4 countries improved their profile and 5 moved to a worse profile. Conclusions There is significant variability in mortality and impact of COVID-19 between countries, even if they share the same regulatory framework. Extending immunization coverage may lead the transition to a more favorable profile, and alter the trajectory of COVID-19 mortality.

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Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Mortality From Coronavirus Disease 2019 Across the European Union Countries and the Effects of Vaccine Coverage

Ziakas

Kourbeti

Mylonakis

2022

Open Forum Infectious Diseases

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“…However, this threshold has been constantly shifted upwards as more infectious SARS-CoV-2 variants [26] or potential immune escape variants have emerged [27], and as vaccine-induced immunity is not distributed evenly across populations (i.e. differences between countries, difference by age groups, vaccine hesitancy), thereby maintaining high susceptibility to infection in specific groups of individuals [28]. Furthermore, while vaccines against SARS-CoV-2 are highly effective in preventing symptomatic COVID-19, they do not offer complete protection from infection and may not block forward-transmission entirely [29,30], thereby undermining a pillar of herd immunity.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, while vaccines against SARS-CoV-2 are highly effective in preventing symptomatic COVID-19, they do not offer complete protection from infection and may not block forward-transmission entirely [29,30], thereby undermining a pillar of herd immunity. While there is uncertainty about future developments of the pandemic, in an expert consultation paper, we have previously outlined key determinants and possible courses of the pandemic over the next years [28].…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence, waning, and correlates of anti-SARS-CoV-2 IgG antibodies in Tyrol, Austria: Large-scale study of 35,193 blood donors conducted between June 2020 and September 2021

Siller

Seekircher

Wachter

et al. 2021

Preprint

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Background: There is uncertainty about the seroprevalence of anti-SARS-CoV-2 antibodies in the general population of Austria, and about the extent to which antibodies elicited by vaccination or infection wane over time. Aim: To estimate seroprevalence, waning, and correlates of anti-SARS-CoV-2 IgG antibodies in the Federal State of Tyrol, Austria. Methods: We conducted a seroepidemiological study between June 2020 and September 2021, enrolling blood donors aged 18-70 years across Tyrol, Austria (participation rate 84.0%). We analysed serum samples for antibodies against spike or nucleocapsid proteins of SARS-CoV-2 with Abbott SARS-CoV-2 IgG assays. Results: We performed 47,363 serological tests among 35,193 individuals (median age 43.1 years [IQR: 29.3-53.7], 45.3% women, 10.0% with prior SARS-CoV-2 infection). Seroprevalence increased from 3.4% (95% CI: 2.8-4.2%) in June 2020 to 82.7% (95% CI: 81.4-83.8%) in September 2021, largely due to vaccination. Anti-spike IgG seroprevalence was 99.6% (99.4-99.7%) among fully vaccinated individuals, 90.4% (88.8-91.7%) among unvaccinated with prior infection, and 11.5% (10.8-12.3%) among unvaccinated without known prior infection. Anti-spike IgG levels were reduced by 44.0% (34.9-51.7%) at 5-6 months compared to 0-3 months after infection. In fully vaccinated individuals, they decreased by 31.7% (29.4-33.9%) per month. In multivariable adjusted analyses, both seropositivity among unvaccinated and antibody levels among fully vaccinated individuals were higher at young age (<25 years), higher with a known prior infection, and lower in current smokers. Conclusion: Seroprevalence in Tyrol increased to 82.7% in September 2021, with the bulk of seropositivity stemming from vaccination. Antibody levels substantially and gradually declined after vaccination or infection.

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“…On the other hand, easing their restrictions is morally unfair and illegitimate and could lead to adverse behavioral implications. Nonetheless, it would be irresponsible to ease restrictions indiscriminately for all persons, regardless of whether they are vaccinated, recovered, tested, or neither, as this would risk an enormous increase in infection rates and might overburden the healthcare system [ 6 ]. Considering this situation, we propose a tiered approach with easings for vaccinated and recovered individuals and mitigating measures for non-vaccinated or non-recovered individuals during this transition phase – for which we draw inspiration from measures implemented in Germany.…”

Section: Policy Options and Recommendationsmentioning

confidence: 99%

“…And despite all efforts to achieve global immunization equity (COVAX), some models show that especially poorer countries will have to wait a long time for sufficient vaccination coverage [ 4 , 5 ]. Second, there is a risk that the emergence of new virus variants could render current vaccines ineffective or drastically reduce their effectiveness [ 6 ], so that new vaccines would be needed—which would set the Covid-19 pandemic back to the stage of a global vaccine scarcity. Third, this transitional phase of vaccine scarcity can be viewed as a typical part of a pandemic.…”

Section: Introductionmentioning

confidence: 99%

Easing Restrictions During Vaccine Scarcity. How Mitigation Measures Help Tackling Associated Moral and Behavioral Challenges

Tretter¹,

Ehrlich²,

Ulmenstein³

2021

Public Health Rev

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Background: When vaccines became first available during the Covid-19 pandemic, their demand significantly exceeded their supply. In consequence, the access to vaccines, initially, was distributed unequally. At the same time, governments started easing pandemic restrictions for vaccinated and recovered persons and restoring their freedoms since their risk of transmitting the virus is significantly reduced.Evidence: We show that restoring freedoms for vaccinated and recovered persons – while upholding restrictions for the rest of the population – is morally unfair during vaccine scarcity. Further, it may yield unintended side-effects, including perverse incentives, growing rifts in society, and the expansion of marginalization.Policy Options & Recommendations: We recommend accompanying easing for vaccinated and recovered individuals by mitigation measures for those who are neither vaccinated nor recovered. We propose, first, to temporarily lift the same restrictions for negative-tested individuals, as for vaccinated or recovered people. Second, the state must ensure broad and easy access to testing for everyone – free of charge.Conclusion: If done right, these mitigation measures create (at least temporarily) equal access to freedom for everybody – solving the moral problem of unfair access to freedoms and counteracting possible negative consequences.

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A look into the future of the COVID-19 pandemic in Europe: an expert consultation

Cited by 84 publications

References 161 publications

Comparative Analysis of Mortality From Coronavirus Disease 2019 Across the European Union Countries and the Effects of Vaccine Coverage

Comparative Analysis of Mortality From Coronavirus Disease 2019 Across the European Union Countries and the Effects of Vaccine Coverage

Seroprevalence, waning, and correlates of anti-SARS-CoV-2 IgG antibodies in Tyrol, Austria: Large-scale study of 35,193 blood donors conducted between June 2020 and September 2021

Easing Restrictions During Vaccine Scarcity. How Mitigation Measures Help Tackling Associated Moral and Behavioral Challenges

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