April 9, 2020

COVID-19: No indication at EU/EEA level that peak of epidemic has been reached, says ECDC

The European Centre for Disease Prevention and Control (ECDC) published the eighth update to its Rapid Risk Assessment on COVID-19 on 8 April.

According to the ECDC, overall, large increases in COVID-19 cases and deaths continue to be reported from the EU/EEA countries and the UK. In addition, the European all-cause mortality monitoring system showed all-cause excess mortality above the expected rate in recent weeks in Belgium, France, Italy, Malta, Spain, Switzerland and the United Kingdom, mainly in the age group of 65 years and above.

The report noted that the number of new cases and new deaths reported daily appears to have decreased slightly in a few EU/EEA countries recently. However, these trends should be interpreted with caution, said ECDC, as many EU/EEA countries are currently only testing severe or hospitalised cases. The report added that despite early evidence from Italy and Austria that the number of cases and deaths are declining, there is currently no indication at EU/EEA level that the peak of the epidemic has been reached.

According to the report, based on data from EU/EEA countries, 32% of the diagnosed cases have required hospitalisation and 2.4% have had severe illness requiring respiratory support and/or ventilation. Meanwhile, the crude fatality rate was 1.5% among diagnosed cases and 11% among hospitalised cases. The report concurred that the likelihood of hospitalisation, severe illness and death increases in persons over 65 years of age and those with defined risk factors including hypertension, diabetes, cardiovascular disease, chronic respiratory disease, compromised immune status, cancer and obesity.

Further, in several EU/EEA countries with available data, between 9% and 26% of all diagnosed COVID-19 cases are in healthcare workers. There are also increasing reports of COVID-19 outbreaks in nursing homes across Europe. 

In the present situation, where continuous spread of the virus can be expected, the ECDC’s assessment is that:

  • the risk of severe disease associated with COVID-19 in the EU/EEA and UK is currently considered moderate for the general population and very high for populations with defined risk factors associated with elevated risk;
  • the risk of increasing community transmission of COVID-19 in the EU/EEA and the UK in the coming weeks is moderate if mitigation measures are in place, and very high if insufficient mitigation measures are in place;
  • the risk of health and social care system capacity in the EU/EEA and the UK being exceeded in the coming weeks is considered high with mitigation measures in place and very high if insufficient mitigation measures are in place.

The ECDC said, in the current situation, a strong focus should remain on comprehensive testing and surveillance strategies (including contact tracing), community measures (including physical distancing), strengthening of healthcare systems and informing the public and health community. 

The report noted that transmission will continue until a population protection threshold is reached unless the incidence of infections is reduced to a very low level in a given setting. Current estimates suggest that no EU/EEA country is close to achieving the necessary population protection threshold, according to the report. “This means that sustained transmission of the virus is to be expected if current interventions are lifted too quickly”, the ECDC cautioned. 

The report noted further that considerations for de-escalation should take into account the fact that the reported new infections on any given day reflect the measures that were in place around one week earlier, while the deaths reported on any given day reflect the epidemiological situation and measures in place two to three weeks earlier.

The ECDC concluded that, based on the available evidence, it is currently too early to start lifting all community and physical distancing measures in the EU/EEA and the UK.

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