The Consequences of Europe's Relaxed Lockdowns

"There might be [open-air] transmissions occurring but they are rare."
"When you are in a club and there are hundreds of people dancing and breathing and yelling in a confined space -- that's a whole different ball game."
Dirk Brockmann, professor, Humboldt University, Berlin

"I was also expecting a scenario where the numbers would have stabilized, maybe a small rise."
"It would have been natural. But we don't see that for the moment."
Steven Van Gucht, virologist, head, scientific committee advising Belgium

"The virus continues to spread, in particular in certain regions ... but it's spreading with a decreased speed."
"Where we had tens of thousands of cases, about 80,000 new cases per day in March before the confinement, we estimate that we're now around about 1,000."
Jean-Francois Delfraissy, head, National Scientific Council, France

"This infection chain shows us again how quickly an infection can spread if many people come together in a small space."
"I appeal to everyone's personal responsibility to take this virus seriously and to continue to adhere to the distance rules and hygiene measures."
Stefan Majer, head, Health Department, Frankfurt

"There was this warning about the second wave, but we said this is not going to happen for several reasons."
"We still have social distancing and hygiene measures in place, and when we see larger outbreaks, hot spots, we immediately get in and control the virus."
Hendrik Streeck, virologist, Bonn University

Passengers wearing protective face masks are seen at Heathrow Airport, amid the coronavirus disease (COVID-19) outbreak in London on May 22, 2020. © Toby Melville, Reuters

Most European countries, after having initially enacted severe emergency measures to place their nations under protective lockdown with the World Health Organization's declaration of the SARS-CoV-2 global pandemic, and having seen the ravages that the virus has done, devastating their populations, overwhelming their hospitals, closing down businesses, creating mass unemployment, placing people in poverty, and creating economic havoc, are more than prepared to gamble with the fact that they have attained a measure of control, and it's time to re-open.

Economies across Europe are tentatively re-starting, tourism is being encouraged, schools are opening, businesses are re-hiring, people are emerging from lockdown with a palpable sense of relief. Authorities are counting on the re-opening not causing a return to the health threats the first and to date, only wave of COVID-19 caused when the virus was viewed as a new threat about which little was known. And even while the virus in some measure is under a level of control, not much more is known about its idiosyncracies at the present time either.

Despite which uncertainty, health authorities across Europe are slightly more optimistic that it can be managed and that flare-ups that are localized can be treated as containable hot spots. Sending children back to school, re-opening restaurants and bars, and even the sudden appearance of large protests haven't appeared to produce a virus resurgence of any great consequence. Among disease experts, many believe that behavioural changes, from handwashing to wearing of masks should continue as measures that aided in limiting the spread of the COVID virus.

Cities like Hamburg, Germany, above, will be opening to most countries in Europe, beginning this month.   Credit...Andreas Meichsner for The New York Times

They also maintain that banning large-scale events well into the future most likely will continue to stem infection by highly contagious people known as "super-spreaders" who many estimate have accounted for a great portion of viral transmission. Growing evidence the virus may turn out to be a seasonal visitor is seen to give some temporary relief, as well. And then there is the observed reality that the virus spreads readily in enclosed, crowded spaces, and rarely in the out-of-doors.

That general acknowledgement has primed Europeans to adapt accordingly now that warm weather has arrived, where in Rome, parks and alfresco restaurant tables accommodate people's choices, leaving indoor tables unoccupied. Confined indoor gatherings in Germany were seen to have led to small outbreaks in contrast to outdoor mass demonstrations protesting lockdown, where thousands have gathered in the absence of any consequences.

Fewer serious pneumonia cases have developed, attributable in part to new therapies in coping with the virus, leading Massimo Ciccozzi, head of the molecular epidemiology unit of the University Campus Bio-Medico based in Rome, to commit his lab to the study of how, why and whether the virus may have mutated. Evidence appears to point to the severity of infection being linked to "viral load"; consequently outdoor summer infections may be milder as a result. "It's like a huge, huge puzzle. Every day you find a piece", commented Dr.Ciccozzi.

The number of ICU patients in Italy has declined from 4,000 at the peak in early April to the present time with 400 patients in ICU, on a downward trickle daily since the beginning of May. With far fewer new infections to trace in Germany, many contact tracing teams have little to do. Belgium, one of the worst-hit countries in Europe, has seen hospitals being cleared of COVID patients, with doctors not reporting unusual spikes of flu-like symptoms.

Warnings of the potential of a dangerous second wave are on the minds of experts. International flights and tourism have been on hold for the most part, but both Spain and Italy, two of Europe's hardest-hit COVID victims, are both contemplating a return to robust tourism, to help build up their shattered economies. Should Europe manage the summer months without a major viral spike leaving people to relax their guard and revert to previous social mannerisms, risk could rise, warns Ranieri Guerra, an assistant director-general with the WHO, advising the Italian Health Minister.

"We have achieved a lot, with massive sacrifices. But the virus is still circulating", Mr. Guerra stated. As one of the only European countries with a noted uptick in daily cases since restrictions were lifted, France is uncertain what might have caused the setback, even while its National Scientific Council assures the overall trend sees a significant decline in case numbers.

In Bremerhaven, a late May church service saw a cluster of 44 infections emerge.While in Frankfurt where relaxed vigils saw a church congregation emerge with an outbreak of 200 cases, the church apologized for giving permission to its choir to perform without requiring face masks. Even so, some of Germany's top virologists predict that, thanks to its status as the most advanced in contact tracing, a second wave may be avoided altogether.

A Lisbon cafe back in business - with personal protection  Reuters

"The fact that we haven't seen major spikes so far tells us that confinement was only a part of the strategy to reduce the spread of this virus, and perhaps not the most important part", Camilla Stoltenberg, director general of the Norwegian Institute of Public Health stated, as someone who guided her country's pandemic response. "We should all have second thoughts about whether it was really necessary [closing Norway's schools, which she advised against]. We see now that after having opened schools, we haven't had any outbreak."