The Covid-19 epidemic, a "armed peace which always requires constant vigilance"

For several months, tourism has been picking up again, and Western countries such as the United States and European countries are easing the restrictions on entry to their territory put in place during the Covid-19 pandemic. What consequences can this intense resumption of tourist exchanges have on the pandemic? Should we fear a resurgence of the epidemic? The answers of Antoine Flahault, epidemiologist and director of the Institute of Global Health at the Faculty of Medicine of the University of Geneva.

After two years of strict travel restrictions and regulations (closed borders, mandatory quarantines, wearing a mask during flights, presentation of negative Covid tests and vaccination certificates…), many Western countries are reducing or eliminating the measures of protection as the summer season approaches.

Last May, the European Union removed the mask requirement for passengers on flights, citing “levels of vaccination and naturally acquired immunity”. France has reopened its borders to anyone, vaccinated or unvaccinated, provided they present a negative Covid test, while Italy has removed all entry restrictions for international travellers.

Across the Atlantic last Sunday, the United States lifted the requirement to present a negative Covid test before boarding a plane bound for the country, citing the widespread adoption of vaccines.

Some wonder if these decisions are not premature, given the unpredictability of the pandemic. Because two new sub-variants of Omicron – BA.4 and BA.5 – first identified in South Africa in early 2022, are spreading rapidly in Europe. The European Center for Disease Prevention and Control (ECDC) warns that while they do not appear to pose a higher risk of serious illness than other forms of Omicron, higher rates of transmission could lead to more hospitalizations and deaths.

Portugal has recently experienced an upsurge in infections and deaths caused by these new strains. France also reported an increase in infections and hospitalizations over the past week, also due to the subvariants. The circulation of SARS-CoV-2 has accelerated throughout the metropolitan territory, indicates Public Health France. The incidence rate has risen sharply in all age groups, as has the positivity rate.

So what consequences could international summer travel have on the trajectory of the pandemic?

France 24: What effects can we expect on the pandemic after a summer which will be marked by the increase in international travel and the easing or even the abolition of travel restrictions and protective measures?

Antoine Flahault : Scientific literature clearly shows that travel and population movement increase the spread of highly transmissible viruses like SARS-CoV-2. Prior to Omicron, countries that had adopted strict border control policies were quite successful in limiting the spread of the virus within their territory.

However, with the exception of China, most countries have now lifted these measures, which has likely led to an increase in the speed and intensity of the waves of Covid-19 around the world. As for vaccines, they prove to be ineffective in slowing transmission, but they manage to reduce the burden of Covid-19 in terms of hospitalizations and deaths.

Are we heading for a new wave of Covid in Europe this summer, as borders are open again and restrictions on travel, negative tests and vaccines are lifted?

We clearly see the first signs of a new pandemic wave in Western Europe, which seems to be mainly fueled by BA.5, one of the new sub-variants of Omicron, and BA.4, which has already triggered waves in South Africa and Portugal.

Another sub-variant, BA.2.12.1, is currently spreading in the United States and is also circulating in Europe, especially in the United Kingdom. The high mobility expected during the next summer season will not contribute to slowing down the circulation of these viral strains throughout the continent.

In your opinion, are there any measures that governments should continue to apply to international travel to reduce the risk of spreading Covid-19?

Most democracies have moved away from harsh restrictions, opting for more liberal approaches that allow people to protect themselves when they feel the need. It would be difficult to reimplement these past measures without convincing arguments.

Of course, if a highly transmissible and virulent strain emerges, there won’t be as much debate about whether to take strict action. But with the existing strains circulating, governments see no reason to continue applying most of the old measures, even if they have proven useful in the recent past.

At this point, where are we overall in our ambition to end the pandemic? The easing of government policies, especially in the United States and Europe, gives the impression that the pandemic is over, but is it really?

Vaccines and treatments have made all the difference in this pandemic. Before vaccines were widely distributed, we experienced a form of “medieval” response to the pandemic, with lockdowns and curfews.

Today, with the notable exceptions of China and North Korea, we have entered a much more modern phase of the pandemic, which allows people to resume most of their previous activities. However, this “armed peace” is fragile and requires constant vigilance by health authorities in terms of maintaining immunity within the community, as well as more targeted approaches to limit the spread among at-risk populations.

We hope we won’t go back to “medieval” style restrictions, but we can’t continue to live with high death rates.

What are the best ways to protect yourself during this season?

For most people, that means getting fully vaccinated with a booster or two and wearing FFP2 masks indoors and on public transport while avoiding eating and drinking. People should also prioritize outdoor activities and avoid social interactions.

Vulnerable people, over the age of 80, immunocompromised or unvaccinated suffering from pathologies, must plan easy access to Covid tests in the event of symptoms, and to effective antiviral drugs in the event of a positive test.

Article adapted from English by Pauline Rouquette. Find the original version here.

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