The European Centre for Disease Prevention and Control (ECDC) continues to warn of a resurgence of Covid-19 cases in Europe and calls on Member States not to lower their guard (see EUROPE 12505/2). However, in its risk assessment published on Thursday 2 July, the EU agency expresses its opposition to travel restrictions within and to the Schengen area of free movement of persons.
For the good news, the ECDC notes that fewer and fewer cases are being notified in Europe (down 12% between 16 and 30 June). However, the centre adds that Community transmission is still reported in most EU/EEA countries, the United Kingdom and EU candidate and potential candidate countries. In addition, some countries are reporting a resurgence of observed cases or large localised outbreaks.
Do not let your guard down
In this context, the ECDC concludes that the overall risk of Covid-19 is “moderate” for the general population and “very high” for at-risk populations in countries that do not apply physical distancing measures. Specifically, the centre considers that people at risk have a high probability of infection, with a very high impact of the disease, while others have a high probability of infection, but a low impact of the disease. The risk of transmission is considered high if no tracking system, testing strategy and contact tracing are in place and non-pharmaceutical interventions are reduced.
“We all need to continue our efforts to avoid increases in transmission and protect those population groups at risk of severe disease. A robust monitoring framework and expanded testing and contact tracing strategy are crucial components in an effective response”, commented ECDC Director Andrea Ammon.
“Inefficient” travel restrictions
At the same time, the ECDC states that it “does not consider travel restrictions within and to the Schengen area as an efficient way to reduce transmission within the EU”. According to the agency, EU transmission is already taking place in the EU/EEA and data from the European surveillance system (TESSy) show that in June 2020, only 3% of confirmed cases were likely infected in a country different from the reporting country.
However, the ECDC qualifies its risk assessment by pointing out important gaps and uncertainties in the available epidemiological and clinical information on Covid-19, such as the proportion of moderate and asymptomatic cases, transmission during the incubation and recovery period, and risk factors for severe disease other than age.
The agency also adds that it has not received information from all EU countries on their national testing strategies, which makes it unclear whether increases in cases, if any, are due to better testing strategies or not.
Authorisation for Remdesivir by the end of the week
In parallel, the European Commission is continuing its discussions with the pharmaceutical industry in anticipation of a future treatment and/or vaccine against Covid-19. A spokesperson for the institution said this on Thursday, July 2, after the U.S. government announced that it had obtained assurances from Gilead that it would receive 500,000 full treatments of Remdesivir.
In early clinical trials, this drug reduced the length of hospital stays for coronavirus patients by about 4 days, but did not have a significant impact on mortality or viral loads in the bloodstream.
“Commissioner Kyriakides has numerous meetings with the pharmaceutical industry, including Gilead. We are discussing with this company the possibility of reserving sufficient quantities of doses for Member States”, the spokesperson said, pointing out that this drug - initially intended to combat the Ebola virus - could obtain a European marketing authorisation “by the end of this week” (see EUROPE 12501/6).
On the number of doses that the EU could reserve, the spokesperson indicated that the EU would most certainly take into account current or prospective needs on the basis of hospital admissions.
As for other promising treatments, the British Recovery study - involving a total of 12,000 patients - showed in mid-June that dexamethasone (a steroid) reduced mortality in patients on mechanical ventilation. However, the combination of the antiviral drugs lopinavir and ritonavir, used against the AIDS virus, has no beneficial effect in patients hospitalised for Covid-19 and not on mechanical ventilation, the study concluded on June 29. (Original version in French by Sophie Petitjean)