OVER THE next few years covid-19 will probably settle down as a seasonal disease, a lethal threat to the elderly and the poor in health, but to everyone else mostly a nuisance. However, as Europe is discovering, getting there will be perilous. The European Union is recording nearly a quarter of a million cases a day, more than at any time in the pandemic. Eleven months after vaccination first got under way, intensive-care wards in some regions are almost full. The World Health Organisation warned this week that 700,000 more Europeans could die by March.
Amid growing alarm, governments are once again locking down. Austria has become the first rich country to demand that all of its citizens must be vaccinated or face a fine; Germany may follow. Demonstrators are taking to the streets to protest against new restrictions, including in the Netherlands, Belgium and Italy. As the disease spreads, confusion reigns about what measures are justified in the campaign to slow it.
Dealing with the fourth wave begins with understanding what is causing it. Covid is surging in Europe because winter weather sends people indoors, where the virus spreads easily. In the EU slightly over 60% of the population over 12 years old is fully vaccinated. That leaves roughly 150m people unprotected, unless they have already acquired immunity from having survived an infection—as many have in Britain. It is a warning to places like China with large immunologically naive populations.
At the same time, immunity starts to wane from around ten weeks after the second dose. Booster shots are vital, but the EU has been slow to administer them. In Germany infections are doubling every 12 days. One reason is that, even now, only 8% have received a third dose, compared with 23% in Britain.
As so often in the pandemic, governments have been caught out by the exponential growth in cases. Because they are acting late, they must resort to more extreme measures. Protesters say their liberties are being trampled. Many of those who reject vaccination argue that the state has no right to coerce them.
Those arguments are flawed. Two years into the pandemic, it is clear that your behaviour really is your neighbours’ business. One reason is that you are more likely to infect other people if you are unvaccinated. Even if they are protected, some of them will fall gravely ill and die—albeit a small proportion. Also, if the state does nothing, the unjabbed will swamp the health service, causing a lot of deaths, including many that have nothing to do with covid. And more than one liberty is at stake. If governments have to resort to lockdowns to slow the spread of the disease,anti-vaxxers are depriving the vaccinated of freedom.
What makes government intervention hard is not the question of principle, but the practical business of being effective and proportionate: of knowing what works at what cost and how this varies from one country to the next. The aim is not to eradicate covid—that would be impossible—but to slow its spread so that cases are manageable. Flattening the curve in this way saves lives by protecting health systems and buying time to administer vaccines and procure powerful new anti-covid medicines, such as molnupiravir.
The easy steps are promoting handwashing and demanding mask-wearing in public indoor spaces. Both reduce the spread of disease, but neither impinges greatly on anyone’s freedom. Next comes accelerating boosters, which protect individuals and society at large by rapidly restoring the partial ability to block transmission. This should be simple, because vaccine hesitancy should not be a factor with those who have already been jabbed. Countries can also enforce existing measures, such as requiring vaccination or a negative test for access to public places.
That may not be enough to contain the surge in places like Germany and Austria, where most of these measures have been in force even as the disease has spread. In principle there is nothing wrong with demanding universal vaccination. In practice, however, it has enough drawbacks to give governments pause. A two-dose course will take weeks to become fully effective, even if anti-vaxxers comply. Austria is not requiring vaccination until February, when the wave is likely to be abating. In addition, if you believe that vaccination is a conspiracy by the state, compulsion only confirms your suspicions and attracts money and people to anti-vax campaigns. The policy could undermine faith in all vaccines for years to come. When, as in some European countries, government policies have failed, the only emergency brake is the misery of more lockdowns. ■
All our stories relating to the pandemic can be found on our coronavirus hub. You can also find trackers showing the global roll-out of vaccines, excess deaths by country and the virus’s spread across Europe.