Explainer: What’s behind the Covid-19 resurgence in Europe and Central Asia, and how may travellers protect themselves?

• The World Health Organization’s head of Europe warned that infections in Europe and Central Asia was of “grave concern”
• He said the lack of vaccine coverage and relaxation of public health measures were to blame
• Health experts in Singapore noted that the infection rates in Europe were comparable to Singapore
• Singapore travellers, however, may wish to take extra precautions before heading to Europe

SINGAPORE — Europe and Central Asia are facing a surge in Covid-19 cases due to insufficient vaccine coverage and the relaxation of public health measures, raising alarm bells of a new wave of the pandemic this coming winter.

Dr Hans Kluge, head of Europe with the World Health Organization (WHO), presented a grim outlook last Thursday (Nov 4), warning that the pace of transmission was of “grave concern”.

Singapore’s Health Minister Ong Ye Kung said at a news conference this week by the national Covid-19 task force that the Ministry of Health is closely monitoring the situation there.

He noted that the infection rates in many European countries under Singapore’s vaccinated travel lane scheme were comparable with the rate here, but drew a contrast with some Southeast Asian countries where the situation is stabilising.

Health experts in Singapore are of the view that travellers on the travel lane scheme, who must be fully vaccinated, are likely to contract only a mild form of Covid-19 should they be infected.

Since around mid-October, cases have been rising sharply in several countries including Germany, Romania and Russia, where cases surpassed previous highs set around December last year.

The soaring cases have prompted debate on whether to reintroduce public health measures ahead of the Christmas holiday season.

Dr Kluge warned last week that projections indicate that staying on this trajectory could lead to another half a million Covid-19 deaths in Europe and Central Asia by Feb 1 next year, adding that the spread was also exacerbated by the more transmissible Delta variant of the virus.

“We are at another critical point of pandemic resurgence. Europe is back at the epicentre of the pandemic, where we were one year ago,” he said in a statement.

What’s causing the surge in infections?

Dr Kludge gave two reasons: Lacking vaccine coverage and the relaxation of public health and social measures.

While eight countries in Europe and Central Asia have fully vaccinated more than 70 per cent of their population, vaccine uptake in many countries in the Baltics, Central and Eastern Europe are still low.

Beyond vaccines, countries also have to continually test, contact trace, ventilate indoor spaces and enforce physical distancing to curb the coronavirus spread, Dr Kludge said, raising concern that some European countries are still easing their public health measures.

Professor Tikki Pangestu, a former director of the WHO’s research policy and cooperation department in Geneva, said that the surge in cases was to be expected.

“I don’t think it’s any worse than in the past and was sort of expected as the summer holidays end and we move into colder months in Europe with more people indoors,” he told TODAY.

Dr Leong Hoe Nam, an infectious disease specialist from Rophi Clinic in Singapore, said that the coronavirus survives and transmits better in the cold.

He added that the rise has also been fuelled by a loss of immunity against the coronavirus. Antibodies from Covid-19 vaccines fade over time, which is why a booster shot after the first two doses is increasingly seen as crucial to be properly protected from the Sars-Cov-2 coronavirus that causes Covid-19.

Which European countries are at the worst stage of their outbreaks?

Germany on Thursday reported a record 50,196 new infections, the fourth day in a row that it has posted a fresh daily high. 

Austria, Belarus, Croatia, Greece, Iceland, Montenegro, the Netherlands, Norway, Russia, Slovakia, Slovenia and Ukraine are similarly at or near the peak of their infection curve, based on a rolling seven-day average of daily reported cases compiled by wire news agency Reuters.

Why is this of concern to Europe and the rest of the world, including Singapore?

The jump in cases becomes a problem when it places health systems under strain or when a large part of the population is unvaccinated and therefore more likely to develop severe illness.

Hospitalisation rates are higher and rise quicker in countries with low vaccine uptake.

Bulgaria, where only about a fifth of the population is fully vaccinated, has had the world’s most deaths per capita in the past seven days.

Although Europe and Central Asia are at near-record levels of Covid-19 cases, new deaths are only at about half their peak levels. 

Professor Dale Fisher, an infectious disease expert at the National University Hospital in Singapore, said that the rising cases in these countries were to be expected as they head into the winter months.

“Transmission of mild asymptomatic disease does not matter. It cannot be helped. We need to protect the vulnerable and prevent severe disease, hospitalisations and deaths — all of which are provided for by vaccination.”

Professor Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection, noted that the infection rates in these countries are not significantly different from Singapore. 

Most of these countries also include in their daily reports the people who have tested positive using antigen rapid tests, whereas Singapore includes such cases only after they have tested positive through a confirmed polymerase chain reaction test.

“As such, it is probably much more likely that the Singaporean travellers will be infected in Singapore than in Europe,” Prof Tambyah said.

Dr Leong said that the resurgence of cases in Europe and Central Asia partly reflects how people became complacent and disregarded masks and physical distancing as their countries began easing restrictions.

“The wave that is happening would happen to Singapore and any other country. Think Australia and New Zealand (where cases have also recently gone up). We have to continue with a measured reopening or we will have the same issues.”

What precautions can Singapore travellers take?

The vaccinated travel lane is for travellers entering Singapore and they must check the entry requirements of their destination country when planning their trip.

On Wednesday, the Embassy of Denmark in Singapore said that travellers from Singapore will now have to serve at least four days’ quarantine in Denmark. 

This comes after Singapore was removed from a European Union (EU) list of countries where travel restrictions are lifted.

Health experts contacted by TODAY stressed that fully vaccinated Singapore travellers are less likely to develop severe illnesses and that the infection rates in Europe are comparable to Singapore.

However, for travellers who are nervous about getting infected, they recommended the following:

• Wear a high-filtration face mask, even if not required to in the other country
• Get a third dose of a Pfizer-BioNTech and Moderna Covid-19 vaccine before travelling
• Avoid crowded indoor places
• Maintain personal hygiene and safe distancing

What are the various governments doing to tame this surge in cases?

In mid-October, Latvia announced a month-long lockdown, becoming the first country in Europe to reimpose far-reaching restrictions in the midst of the new wave of infections.

Other countries have reimposed similar measures aimed at boosting flagging vaccination rates.

The Danish government, which in September was the first in the EU to lift all remaining coronavirus restrictions, on Monday proposed reinstating the use of a digital “corona pass” to be presented to gain entry to indoor bars and restaurants there.

In Germany, three political parties presented a draft law on Monday that would amend existing legislation to allow for measures such as compulsory face masks and physical distancing in public spaces to continue to be enforced until next March.