EU more prepared for future outbreaks but coordination still key
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    EU more prepared for future outbreaks but coordination still key

    Press conference with Margaritis Schinas and Stella Kyriakides on preparing for a possible resurgence of COVID-19, credit: EU,2020

    The European Commission has presented a communication on short-term measures to strengthen EU’s health preparedness for new COVID-19 outbreaks.

    The Commission is applying lessons learned from the first months of the outbreak, when pro-active coordinated measures on EU-level were missing, but competencies have not changed and the member states are responsible for implementing the measures.

    The communication focuses on necessary actions needed to enhance preparedness, including testing and contact tracing, improved public health surveillance and widened access to medical countermeasures such as personal protective equipment, medicines and medical devices.

    Actions also include measures on healthcare surge capacity, non-pharmaceutical countermeasures, support to minorities and vulnerable persons, and activities to reduce the burden of seasonal influenza. Member states are among others recommended to stock-up flu vaccines and start vaccination earlier this season to avoid a “cocktail” effect of influenza and Covid-19.

    The communication was presented by Margaritis SchinasVice-President for Promoting the European Way of Life, and Stella Kyriakides, Commissioner for Health and Food Safety. At a joint virtual press conference (15 July), they both underlined that EU has come some way from the height of the pandemic but that the virus is still circulating, with localised new outbreaks in the member states.

    “We now know more about the virus but our duty is to remain vigilant and preventive to counter further possible outbreaks,” Schinas said. “Vigilance, preparedness and coordination are indispensable to prevent generalised outbreaks,” Kyriakides added. “Now is not the time to let our guard down.”

    Lessons learned

    The new short-term measures presented yesterday are based on the same division and competencies between the EU and the member states but the Commission is convinced that coordination on EU level will work better this time, drawing on the lessons learned until now. Some of the proposed measures still need to be described in more detail in the coming months.

    Schinas said at the press conference that it was no secret that there had been a lack of coordination during the first months of the pandemic. The communication gives some examples where it was missing, such as access to personal protective equipment, medicines and medical devices, export restrictions, border controls and the free flow of goods.

    “Coordinated solidarity at EU level via the Union Civil Protection Mechanism (UCPM) was also hampered or delayed, given that all countries faced the same type of shortages at the same time,” according to the communication.

    One of the key lessons learned was that, whilst physical infrastructure could be expanded, the most pressing need became the availability of healthcare staff that were competent within intensive care units.

    A worrying observation in the communication is that it is essential to ensure that, in critical shortage situations, the prioritisation of healthcare provision is done on the basis of guidance strictly based on medical criteria. Apparently, this was not done in some member states. ”About half of all fatalities in some countries were among the elderly, in particular in nursing homes.”

    The communication does not mention that in for example Belgium, residents of such homes made up 64 % of all Covid-related deaths or 6,200 persons. The majority of those people died in the home itself, without ever having been transferred to a hospital. In Sweden, an inspection aroused suspicions that infected residents at care homes were not assessed individually by a physician and received standard palliative care which risked accelerating their death.

    Lockdown strategies

    The commissioners declined to assess the effectiveness of the different strategies that were implemented by the member states when they imposed and later lifted lockdown restrictions. However, the communication states that, “In view of this economic and social impact, it is in the general interest to avoid large-scale lockdown measures in case of further outbreaks.”

    Rather, the response should have targeted and localised non-medical countermeasures, informed by research and evidence. In particular, the Commission opposes the reestablishment of “ineffective restrictions and internal EU border controls”.

    Any measures that imply restrictions on the movement of persons or goods within the EU should be used only in situations where it is strictly necessary. Such restrictive measures should be “coordinated and proportionate and non-discriminatory to address public health risks”.

    As regards the recent council decision on allowing non-essential travel into the EU from third countries that meet certain epidemiological criteria, Vice-President Schinas reminded that movement across EUs external borders is a member state competency.

    The country list is a dynamic list, based on criteria proposed by the commission, and is constantly reviewed. “It’s an achievement under the current circumstances,” he said. “With our guidance and advice, member states are coordinating as much as possible.”

    More coordination

    With member states already facing the risk of new outbreaks, the Brussels Times asked if the coordination on EU level of the measures in the communication will be improved. Schinas referred to the factsheet which summarizes all the measures in the communication. The Commission will monitor the implementation of the measures and make adjustments where necessary.

    Commissioner Kyriakides admitted that coordination and implementation of Commission recommendations have been a great challenge. The Commission has faced the challenge by organising regular meetings with the health ministers of the member states. ”We have been coordinating closely with them for the last three months.”

    In the meetings, about 25 in total, every single recommendation was discussed in advance to enable the member states to implement them. “Did they implement them in the same way?” she asked rhetorically. “No, because the member states found themselves on different stages of the pandemic curve and the situation on the ground was different.”

    “Can we do it better?” Yes, she replied. The communication takes the coordination a step further now when the number of new cases is increasing.

    On 28 May, both Commissioners presented a new health programme, EU4Health, as part of EU’s recovery plan. to strengthen health security and prepare for future health crises. The new health programme will remain within the framework of the existing EU treaty where competency for health is a national responsibility but the Commission did not exclude future treaty changes.

    Update: The council updated today the list of third countries for which member states should gradually lift travel restrictions at the external borders. As of 16 July, the list includes the following 13 countries: Algeria, Australia, Canada, Georgia, Japan, Morocco, New Zealand, Rwanda, South Korea, Thailand, Tunisia, Uruguay, and China (subject to confirmation of reciprocity).

    M. Apelblat
    The Brussels Times