How Europe can exit the COVID-19 public health emergency

Moving into the third year of the COVID-19 pandemic, as Europe’s winter gives way to spring, it may be tempting for exhausted governments and societies alike to wish the pandemic over.

The recent surge of the highly transmissible omicron variant has led to half of the WHO European region’s 200 million confirmed COVID-19 cases recorded within the last three months. Despite this massive surge in cases, high population immunity, driven largely by successful vaccination drives, has kept hospital intensive care units manageable and case-fatality rates down. In many places now, widespread COVID-19 testing, the use of masks and any physical distancing requirements appear to be a thing of the past.

In other parts of WHO’s European Region, however, where vaccination rates among populations vulnerable to severe COVID-19 disease is low, omicron has often proven merciless. Moreover, given that the SARS-CoV-2 virus is continually evolving, it is entirely likely new variants of concern will emerge.

So let’s be clear: there is absolutely no room for complacency. Lockdowns may be behind us, but the impact the pandemic is having on health is most certainly not.

The omicron variant currently accounts for more than 99% of new COVID-19 infections in WHO’s European Region (see Figure 1). Moreover, a combination of factors is contributing to a new resurgence in COVID-19 morbidity in several countries (see Figure 2) – a public health burden that could have high costs if the focus on ending the global emergency is allowed to drift. Omicron’s more competitive sub-lineage, known as BA.2, is gaining ground, spurred by the relaxation of social measures and the lifting of physical distancing and mask requirements.

While higher levels of population immunity have meant that very high infection rates have not led to severe public impacts where vaccination uptake is low, waning immunity is a significant concern among older people or those with immune deficiencies. We cannot allow high levels of COVID-19 exposures among those whose lives would likely be at risk if they were infected.

At the same time, we must recognize that different parts of the world, including countries within WHO’s European Region, are at different points in the pandemic’s trajectory. This recognition allows countries to strategise better and plan for the longer term amid what will continue to be a protracted public health challenge. Achieving a scenario where the pandemic itself dwindles and eventually fades away, even as COVID-19 remains with us, can happen only if we do the right thing, right now.

So, based on WHO’s COVID-19 Strategic Preparedness and Response Plan for 2022, here's what needs to happen in our European Region to help everyone exit this public health emergency:

COVID-19 will not simply vanish. And too many previous surges have swept governments and societies into often desperate policies that are not sustainable in the long term. The socioeconomic consequences of such policies have been severe, jeopardizing education, for example, and pushing millions of people into poverty. Drawing upon the often-painful lessons of the past two years, however, there is now a chance to get the upper hand by maximizing the opportunities we currently have to protect people and livelihoods.

If implemented as a package, the above measures will strongly contribute to ending the COVID-19 public health emergency. Countries will be better able to control transmission, regardless of emerging variants, without having to impose severe societal restrictions.

In the longer term, we must do more for the women, men and children who face the lingering consequences of their COVID-19 infections. We still do not know enough about how or why long COVID affects certain people. This needs to change in 2022. We cannot leave behind the needs of approximately 10-20% of people who experience persistent symptoms after 12 weeks following SARS-CoV-2 infection.

It is therefore necessary to impart a triple message of hope, vigilance and solidarity:

Hope, underpinned by significant investments in health systems and resources, to strengthen the ability of countries to achieve genuine universal health coverage.

Vigilance, in the shape of better surveillance and infectious disease response, including the urgent scale-up of COVID-19 vaccination, preventive measures and access to antivirals.

Solidarity, exemplified by governments and health actors better engaging the public as vital partners in our efforts – both amid the ongoing crisis and beyond.

These three elements must be combined if we are to collectively seek a way out of the current pandemic situation and, crucially, become better prepared for the next.