Now the eight-day wait…
Photo by FRED TANNEAU/AFP via Getty Images
If Europe has a strategy to stop the spread of Covid-19, it’s keeping it well hidden.
France’s President Emmanuel Macron has vowed not to go back to the dark days of national lockdown, preferring instead to “live” with the coronavirus disease, but his government is
struggling to halt a jump in cases. France reported more than 10,000 new cases in 24 hours over the weekend, a grim postscript to its decision to cut the required quarantine for positive cases in half to seven days.
It’s 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. Prime Minister Pedro Sanchez has also ruled out national lockdowns, but messy public-health disagreements between Madrid and regions such as Catalonia — and an initially lax approach to nightlife — have worsened a post-lockdown surge in cases. Taking population into account, the seven-day average rate of new cases in France and Spain is above the U.S.’s.
British cases aren’t too far behind, hitting their highest level since May.
Not a Good Look
Cases are rising fast in Europe, though hospitalizations and deaths remain low
Source: European Center for Disease Prevention and Control
Note: 7-day rolling average, as of Sept. 11
warning this is the start of a “second wave.” We’re not there yet in terms of deaths and hospital admissions, which remain well below the virus’s April peak. For now, the bulk of new cases seem to be asymptomatic or mildly symptomatic young adults.
Still, young people don’t live in a vacuum, and infections are spreading to those who are older and more vulnerable. The drive to get adults back into the office and kids back into classrooms, however laudable, is
accelerating the virus’s spread. Estimates of the reproduction rate from Bank of America suggest it’s above 1 in all big European countries bar Germany, meaning one infected person will on average spread it to more than one other person. Doctors warn of a rough winter ahead without a vaccine.
Winter Is (Still) Coming
Weekly new hospital admissions per 100k people
Source: European Center for Disease Prevention and Control
That’s why filling gaps in the testing, tracing and isolation of cases will be crucial in breaking chains of transmission over the next few months. Europe is testing far more than at the start of the pandemic, with the share of tests coming back positive at 10% or below, but the allocation of resources is still pretty woeful.
The opening of the testing floodgates to almost any suspected case has overwhelmed laboratories. Tales of waiting as long as eight days for a result in France, or the reported backlog of almost 200,000 tests in the U.K., are a farcical counterpoint to the countries’ headline-grabbing political targets of 1 million or more tests per week. They’re a drag on public confidence and on the economy, given the need to self-isolate while waiting for the results. No wonder people often ignore stay-at-home rules.
Testing the Waters
Positive tests as a percentage of overall tests
Source: Our World In Data
Note: Rolling 7-day average, as of Sept. 6
The tracing part of the equation has also flopped. Digital tracing apps designed to easily track potential transmissions from one positive case have failed to attract a critical mass of users in some countries. The U.K. has yet to even launch its
redesigned version. Human tracers are struggling with a decline in contacts identified per positive case — in France, it’s currently around 2, while in Spain, the
figure is about 3. This is needle-in-a-haystack territory.
There is room to expand testing capacity, or at least dole out resources more efficiently. More mobile laboratories and drive-thru options would help. Testing teams should target populations that need them most — such as symptomatic cases or care workers — while reserving a more bazooka approach to cluster zones or high-incidence areas. Clear and simple rules on when testing is actually necessary might prevent a too-hasty rush to test in schools or offices.
There could also be more experimentation with “
pooling” multiple samples that are tested at the same time in order to save resources or alternative types of testing methods, such as usingsaliva samples, though there’s a risk of more false negatives.
Needles in Haystacks
The average number of contacts traced per positive case in France is falling
Source: Sante Publique France
Note: Data from week ending July 19 (week 29) to week ending Aug. 23 (week 34)
On the contact-tracing front, better organization, more training and more outreach are needed. More hiring is one thing — France is recruiting 2,000 additional contact tracers — but it should be accompanied with robust training asthe jobrequires working with local
communities and collecting sensitive information people may not
want to share. If digital apps don’t gather steam, 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 flag more potential cases (and clusters).
Sure, this is only one piece of the broader virus puzzle. Face-masks and social distancing are still critical. But it’s remarkable what an effective testing policy can do. In France’s northwest Mayenne region, where a flare-up of cases was successfully curbed last month, mass testing was rolled out alongside a target of delivering results within between 24 to 48 hours. Why not simply aim for this turnaround time nationally? It might make those “no more lockdown” promises a little easier to keep.
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