Europe’s Failure to Unite Against COVID-19
For Europe, the summer should have been the time to organize suppression or elimination efforts against the Coronavirus in preparation for an eventual second wave. Instead, European countries, including those still relatively unaffected by the pandemic, relaxed efforts and rules in order to allow travel and increased commerce. As a result of this uncoordinated easing, however, the pandemic has wracked Europe through the winter, forcing renewed lockdowns, severe travel restrictions, and more economic distress. Global public health requires significant levels of cooperation between states, and during this pandemic there have been extraordinary efforts at global cooperation on vaccines, genome mapping, and test kit distribution. However, there has been little to no coordination on state level suppression strategies. Even modest coordination between states on this effort, such as organizing common travel and testing rules within Europe, with an eye towards mitigating a second wave, would have made substantial progress in avoiding the current crisis.
State-level cooperation is essential for the world to successfully navigate the dangers of a pandemic. In the past, countries have collaborated on a number of global health issues, from eradicating smallpox to fighting ebola. In these situations, countries will tend to cooperate because the benefits were substantial and the costs relatively low. Even during the current pandemic, the relative successes of knowledge and technology transfers between nations happened because the incentives to do so easily outweighed the costs.
Coronavirus-related knowledge and technological transfers have been both vital and largely smooth, and have typically happened at the private level or between health institutions that are part of or have partnered with national governments. Barriers to these transfers were already minimal, due either to extensive prior contacts between partner organizations or the open nature of genomic data publishing. For example, the rapid development and global distribution of COVID-19 test kits, out of Germany and Thailand, because of already established working relationships between different national health departments and private labs.
Despite successfully combatting the first wave of COVID-19, European countries considered the cost of continuing mitigation strategies or switching to elimination strategies too great. Unlike many of the facilitated technological and information transfers, public health strategies affecting social or public life are subject, to varying degrees, to public and political pressures. In the United States, for example, public health officials became subjects of public scrutiny, conspiracy theories, and even outright threats of violence, affecting the formulation of state and federal health guidance and regulations. Anti-health ordinance protests and demonstrations appeared in France, the United Kingdom, and Germany.
National health strategies are also subject to the various unique political structures of countries. Germany’s federal state structure means that Chancellor Angela Merkel has consistently needed the approval of state ministers to coordinate national health regulations and ordinances. The United Kingdom has struggled to deploy a consistent strategy as politicians, rather than health experts, dictated the public health response. In contrast, Sweden’s Public Health Agency developed its Covid-19 strategy autonomously without similar pressures. Such drastic differences in how state health agencies operate and develop their strategies creates a significant barrier to effective intra-state coordination.
Given the relative costs of such strategies, the necessary coordination required to adapt successful measures across the European continent has moved further out of reach. Measures as relatively simple as Schengen Zone travel restrictions were never implemented because numerous member states responded differently to the demands of their economies. Initial overland border controls were relaxed or altogether removed. Countries dependent on tourism, even if they were relatively unaffected by the first wave, developed an uneven network of travel restrictions. The Netherlands performed no virus checks of incoming travelers, did not track tourists, and required masks only on public transportation with little distancing or public gathering enforcement. Greece tracked tourists, restricted overland access, had mask ordinances for stores, buildings, and public transportation, while requiring distancing in select social settings. None of the Schengen countries had the same limits on what constituted risk areas, meaning travelers from higher-risk countries could easily avoid restrictions by passing through more lenient states.
Ultimately, there’s little chance that the necessary collective action will take place. Governing bodies have too many costly variables to consider, and less developed countries may not have the infrastructure or capital necessary to cope with the lockdowns or strategies favored by wealthier western neighbors. Those wealthier nations are also unlikely to underwrite the kind of aid necessary to keep less developed nations afloat through long shutdowns.
But this doesn’t mean there are no options. Perhaps the only solution for now is the simplest: a common travel scheme, including incoming testing and quarantine standards with a shared infection rate target as the release lever for each state. Though logistically challenging, it is considerably more doable and practical as most European nations sit under some form of lockdown. The goal would be to reduce imported cases, maintain a common border testing regime as countries open up again, and ultimately build trust between neighboring states and institutions. Europe has the cross-institutional experience to at least do this. It’s not too late.