EDINBURGH, Scotland — This spring, when Western Europe became an epicenter of the coronavirus pandemic, countries imposed strict lockdowns: In France, a person needed a permit to go shopping; Spain required children to stay indoors the entire day; in Scotland and Wales, people could go outside for a walk only once a day and had to stay within a five-mile radius. Thanks to this, European countries were able to not only flatten the Covid-19 curve but to also keep levels of infection very low.
But as the weeks went by, the pressure to reopen society grew. People wanted their prepandemic lives back. They wanted dynamic economies to protect their jobs; they wanted their children educated in schools; they wanted nights out at the pub and visits to their friends. And they really wanted summer vacations.
Tourism and travel, it turns out, is one of Europe’s particular problems. Tourism accounts for some 600 billion euros (more than $700 billion) of the European Union’s gross domestic product. It provides nearly 12 million people with employment directly and another 15 million people with indirect employment. And the summer holiday is a veritable European institution, made only more central to many people’s lives by the advent of low-cost air travel.
So this summer, with the virus tamped down to what many governments considered “acceptable” levels — the U.K. Joint Biosecurity Center, for example, has suggested that an acceptable incidence for Britain is 1,000 symptomatic new cases per day — countries started to reopen and people began to travel. Britons and Germans wanted to escape to the beaches; Spaniards and Greeks wanted to see their tourism economies kept alive.
But, predictably, cases are starting to increase. Spain now has about 3,500 new coronavirus cases per day, up from fewer than 700 at the end of May. Germany saw 1,445 new infections one day this week, the highest number of daily infections in more than three months. This should be a cause for serious concern. The recent experiences of Israel and the state of Victoria in Australia show that even a handful of daily new cases can easily become hundreds and thousands.
The rise in infections in Europe seems particularly linked to activities like barhopping, clubbing and partying among younger people, as well as the rush to welcome international visitors and reopen tourism and its related activities. A “super-spreading event” at a club in the Spanish city of Córdoba resulted in 91 people testing positive.
“We faced a lot of pressure from the tourist industry because it’s one of the main economic sectors of Spain,” Dr. Jacobo Mendioroz, the director of the committee responding to Covid-19 in Catalonia, told Time. (Tourism accounts for around 15 percent of Spain’s G.D.P.) Greece is looking to tighten lockdown again after a spike in cases following the return of foreign visitors. In the week after the country opened its borders in early July, more than 100 tourists tested positive for Covid-19.
As tourists move around the various countries in the European Union (and the recently departed Britain) that are in varying stages of easing lockdown, cross-infection across borders continues to occur, making it a whack-a-mole game that is impossible to win.
The only way to stop constant increases in the coronavirus is to eliminate community transmission and to use robust test, trace and isolate policies to continue catching imported cases and clusters as they emerge. New Zealand, Taiwan, Cuba and Rwanda have each pursued this kind of maximum suppression through strict border measures and have largely returned to normal public life.
Stopping community transmission requires mandatory, enforced quarantine for incoming travelers and testing before release. Europe could do the same and cooperate across countries toward this goal so that intra-European travel and tourism can continue when a safe bubble can be built.
What would this actually look like?
Lockdown measures can bring case numbers low enough that testing and tracing can break chains of transmission. European countries have already taken a severe economic and social hit to contain Covid-19, but to finish the job and truly crunch the curve they need to build up massive diagnostic capacity, to be able to run large, fast and accurate testing services. This is a difficult project but not impossible: Germany has done it fairly successfully.
But here’s the less fun part: European countries need to introduce serious limitations on nonessential travel until safe travel bubbles can be built among countries where the virus is low. The virus moves when people move. This does not mean borders need to be closed. But people need to be tested on arrival in a new country and then again five days later. There has to be enforced isolation until two negative tests at least five days apart. (Frankfurt, Berlin and Hamburg airports have already introduced compulsory testing on arrival from higher prevalence countries and note that it is working well.)
Yes, this will probably interfere with plans to enjoy the beaches of Marbella. But the summer, while infection rates still remain relatively low, is the only time to make this work.
Going into winter with hundreds of cases per day means risking a steep rise once temperatures cool, schools reopen and people head back indoors. It means risking a second round of national lockdowns, which would be catastrophic for mental health and for economies. (And let’s leave aside the question of whether or not it will actually be possible to get people to comply the second time around.)
Scotland and Northern Ireland have looked ahead at the coming winter, and made a concerted plan to minimize community transmission to avoid a serious resurgence of the virus by using the summer to drive cases as close to zero as possible and to reopen cautiously. But neither nation has control over its borders because they are parts of the United Kingdom. So both now face a stream of incoming infections from England and Wales, which are behaving more like the rest of Europe, as well as from people returning from holidays abroad and not abiding by government advice to isolate for 14 days.
The internal issues within the United Kingdom provide a glimpse of how the rest of Europe works. Because of Europe’s economic and social integration, and freedom-of-movement laws within the European Union, a strategy to stop community transmission of Covid-19 requires cooperation among European leaders who each commit to national measures to drive infections low in a concerted and coordinated way, to regularly share information about progress, and to enforce strict checks on international travel.
Working to stop community transmission might seem like a dream, but after having bent the curve so significantly — and taken the hardest step of lockdown measures — why not crunch the curve fully? Stopping community transmission is the only path to stop the constant resurgence of the coronavirus, to reopen schools fully and safely and to avoid repeated national lockdown-and-release cycles over the next 18 months. That should be a lot more important than this summer’s vacation.
Devi Sridhar (@devisridhar) is a professor and chair of global public health at the University of Edinburgh.
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