The new coronavirus wave appears to be dividing European countries into two leagues: those that, in spite of the uptick in infections, are keeping their hospitals under control, and those that aren’t. The data suggest that the places with more than 75 to 80% of their total populations are vaccinated are better resisting this new rise in cases. Others, meanwhile, with just 10 percentage points fewer in terms of immunizations, have had to resort to drastic measures given the imminent collapse of their healthcare centers. That said, the numbers from some countries, such as Belgium – which has vaccination rates similar to those of Spain – and the strength of the new wave (with the reach of the newly detected variant, omicron, still to be determined), suggest that caution is needed given the rise in hospitalizations in certain Spanish regions. In Aragón and Navarre, for example, the number of hospitalizations due to Covid-19 has doubled in the last month.
Infections on the continent have started rising at different times and at different speeds. In the Baltic countries, Bulgaria and Romania, cases seem to have peaked and are falling according to the dynamic that has been seen at other times during the pandemic. In Slovakia, Slovenia, Austria and the Netherlands, new positives have risen to levels that have not been seen in the last two years. Germany has also registered a record in infections and the volume of Covid patients has once again affected the normal running of healthcare centers. In Spain, Italy and Denmark, cases have risen later and for now, are doing so at a lower velocity.
In recent months, the number of hospitalizations has been an even more important indicator, given that the vaccines are preventing serious illness and infections alone do not reflect the genuine magnitude of the wave. This figure is worrying in some countries. In Bulgaria, for example, the situation is critical: 100 of every 100,000 inhabitants are hospitalized due to Covid-19 – practically double the figure in the worst moment of the pandemic in Spain after last Christmas. In Slovakia and Slovenia, which are headed toward a peak in terms of cases, hospitalizations have been growing for weeks and are currently at 45 per 100,000 inhabitants. These numbers are close to those of the worst moment in that country too, seen during last winter.
Also showing worrying trends are Slovakia (55 hospitalizations per 100,000 inhabitants), Czech Republic (49) and Poland (44). In the Netherlands, Denmark, Italy, Portugal and Spain, hospitalizations are also growing, although apparently at a slower speed. In none of these countries has the incidence of hospitalizations exceeded 10 per 100,000 inhabitants so far.
In this scenario, what role are the vaccines playing? Poland and Denmark represent a good example. The incidence of new infections is similar, but Polish hospitals are seeing six times more Covid-19 patients than those in Denmark. It is likely that the extraordinary capacity of Denmark to detect nearly all of the cases that there are (the country has a positivity rate of 2.4% compared to 24% in Poland) is having an influence, but the difference in vaccine coverage in these countries is also a factor: in Denmark, 76% of the population has received two doses; in Poland, the figure is barely 50%.
This pattern is clear in other countries: the higher the vaccination rate, the lower the incidence in hospitals. This can be seen in the following graph: countries such as Slovakia, Slovenia and Hungary, with roughly 50% of the population vaccinated, have a higher number of hospitalizations than countries with greater coverage such as the Netherlands and Belgium, which have already inoculated more than 70% of inhabitants.
It should be noted that these countries with fewer vaccinated residents have suffered larger waves of infections (as indicated by the size of the point on the graph), and this has caused a higher number of hospitalizations. But it is also true that in countries with similar numbers of cases, hospitals have suffered more where there is a lower vaccination coverage, something that can be observed when France and Denmark are compared.
Enric Álvarez, a researcher at the Computational Biology and Complex Systems group in Barcelona, explains that “in countries with 75% or more of the population vaccinated it appears that incidence rates close to 1,000 cases per 100,000 inhabitants over 14 days are not being reached, something that is occurring in countries with 10 points fewer, such as Austria, Slovakia and Slovenia. On the opposite side is Denmark, which is [the country that Spain] is likely to most resemble.”
For now, it is clear that the countries with more people vaccinated have emptier hospitals, given that people are experiencing less-serious cases of Covid-19. As epidemiologist Óscar Zurriaga explains, “it might not appear to be a huge difference, but going from 65% to 80% vaccinated is millions of people, a huge amount of citizens. What’s more, they are not always distributed by age in a homogenous way like in Spain – this allows for the circulation to not be focused in particular age groups.”
Spain – below on the right in the graph above – is a good example of this relationship. But there are exceptions, such as Belgium, which with 75% of the population vaccinated has the same number of hospitalizations per 100,000 inhabitants as Austria. That’s to say, if the incidence doubles, there is inevitably a rise in the number of patients in hospitals.
The vaccine alone is not enough to explain these differences. Firstly, because its effectiveness is reduced with time. “There are a number of different scenarios for the fall in effectiveness,” explains Álvarez. “If the vaccines continue with a descending trajectory when it comes to slowing transmission, it is clear that the situation in terms of infections and hospitalizations can rise once more.”
Seasonal behavior is also important: places where the cold weather arrives first, such as in central Europe, are seeing people spending more time indoors, and it is easier for infections to happen there. And finally, as Ortiz points out, “the relaxation of measures, which has taken place much faster in other countries, has had a massive influence in some infection curves.”
The gradual relaxation of these restrictions in Spain no doubt has also had an influence on the fact that its situation is far from those of other European countries. What’s more, the high vaccination coverage could be avoiding a new wave of hospitalizations.
Even so, the situation is one of tense calm and in recent weeks the data has gotten worse in the majority of Spain’s regions, which are in charge of their coronavirus restrictions, healthcare systems and vaccination programs. In Aragón and Navarre, hospitalizations have doubled in the last four weeks. In Catalonia, in the last week the incidence data has worsened among those aged between 60 and 80, something that has caused a significant increase in hospital occupation.
“The fact that there are regions that are rising is the proof of something that we already knew: the vaccine is not enough to eliminate transmission,” Zurriaga explains. “That is why it is not convenient to rely on the third dose for everything: if it stopped transmission, it would be a key factor, but this is not the case. Three concepts continue to be key: ventilation, masks and vaccines.”
Even taking these rises in the indicators into account, the situation is far from what it was a year ago. Catalonia, for example, has an incidence of cases that is comparable to that of October 2020, more than 220 cases per 100,000 inhabitants over the last 14 days. At that time, with rising infection rates, the region was reporting more than 1,500 Covid-19 patients. Now that figure is practically half, at 720. The Basque Country had 520 patients at the time, with a curve that is similar to the one it has now, but currently has just 224 coronavirus patients, which is less than half.
‘We just sleep and hope we don’t perish’: 2m in Tigray in urgent need of food – UN | Hunger
At least 2 million people in the northern Ethiopian region of Tigray are suffering from an extreme lack of food, with the 15-month conflict between rebel and government forces pushing families to the brink, the UN’s emergency food agency has found.
In the first comprehensive assessment the World Food Programme (WFP) has carried out in Tigray since the start of the war, 37% of the population were found to be severely food insecure, meaning they had at times run out of food and gone a day or more without eating.
Families were found to be “exhausting all means to feed themselves”, with 13% of Tigrayan children under five and almost two-thirds of pregnant and breastfeeding women suffering from malnutrition.
“Before the conflict we were eating three times a day but now even once a day is difficult. I was borrowing food from my family but now they have run out. We just sleep and hope we do not perish,” Kiros, a single mother of six children living on the outskirts of the region’s capital, Mekelle, told researchers.
The assessment, which was based on face-to-face interviews with 980 households in accessible parts of Tigray, was carried out from mid-November until mid-December.
However, researchers were unable to travel to areas where fighting is impeding humanitarian access. Moreover, since the assessment was carried out, the needs of the region are thought to have become even more acute as no aid convoy has reached Tigray for about six weeks.
“This bleak assessment reconfirms that what the people of northern Ethiopia need is scaled up humanitarian assistance, and they need it now,” said Michael Dunford, WFP’s regional director for eastern Africa.
“WFP is doing all it can to ensure our convoys with food and medicines make it through the frontlines. But if hostilities persist, we need all the parties to the conflict to agree to a humanitarian pause and formally agreed transport corridors, so that supplies can reach the millions besieged by hunger.”
Across northern Ethiopia, where fighting has raged in the regions of Afar and Amhara as well as Tigray, WFP estimates that 9 million people are in need of humanitarian food assistance, the highest number yet.
In Amhara, hunger has more than doubled in five months, it says. In Afar, where fighting has intensified in recent days between the Tigray People’s Liberation Front and forces loyal to the prime minister, Abiy Ahmed, recent health screening data showed malnutrition rates for children under five were at 28%, far above the standard emergency threshold of 15%.
Since the conflict erupted in November 2020, it has been difficult for the UN and other humanitarian organisations to gauge the level of need in Tigray due to a lack of on-the-ground access and telecommunications. The UN has accused the federal government of preventing food and essential medical supplies from coming into the region in a de-facto blockade. The government denies this.
On Wednesday, the International Committee of the Red Cross (ICRC) said it had made its first delivery of medical supplies to Mekelle since last September. The drugs are understood to have included enough insulin supplies to last about a month, after medics at the Ayder referral hospital raised the alarm over severe shortages.
Dr Tedros Adhanom Ghebreyesus, director of the World Health Organization, recently accused Abiy’s government of imposing a “hell” on Tigray by denying entry to medical supplies.
“It is a huge relief that this first shipment is reaching hospitals,” said Apollo Barasa, health coordinator at the ICRC delegation in Ethiopia. “This assistance is a lifeline for thousands of people, and I can’t emphasise enough how crucial it is that these deliveries continue.”
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The EU Agency for Asylum on Friday said the number of asylum applications in November 2021 was the second-highest in five years, narrowly below the level in September. About 71,400 applications for international protection were lodged in the “EU+” (EU, plus Norway and Switzerland) in November 2021, up by nine percent from October. “This was the second-highest level since 2016,” it said.
Protests flare across Poland after death of young mother denied an abortion | Abortion
Protests are under way across Poland after the death of a 37-year-old woman this week who was refused an abortion, a year since the country introduced one of the most restrictive abortion laws in Europe.
On the streets of Warsaw on Tuesday night, protesters laid wreaths and lanterns in memory of Agnieszka T, who died earlier that day. She was pregnant with twins when one of the foetus’ heartbeat stopped and doctors refused to carry out an abortion. In a statement, her family accused the government of having “blood on its hands”. Further protests are planned in Częstochowa, the city in southern Poland where the mother-of-three was from.
“We continue to protest so that no one else will die,” Marta Lempart, organiser of the protests, told Polish media. “The Polish abortion ban kills. Another person has died because the necessary medical procedure was not carried out on time.” All-Poland Women’s Strike has called on people across the country to picket the offices of the ruling Law and Justice party (PiS) and organise road blockades in the coming days.
Agnieszka was first admitted to the Blessed Virgin Mary hospital in Częstochowa with abdominal pain on 21 December. She is said to have been in the first trimester of a twin pregnancy when she arrived and was in “a good physical and mental shape”, according to her family, who said her condition then deteriorated.
On 21 December the heartbeat of one of the twins stopped and, according to Agnieszka’s family, the doctors refused to remove it, quoting the current abortion legislation. They waited several days until the second foetus also died. A further two days passed before the pregnancy was terminated on 31 December, according to the family.
A priest was then summoned by hospital staff to perform a funeral for the twins, the family said.
The family say that the doctors refused to terminate the pregnancy earlier, citing Poland’s abortion legislation. “Her husband begged the doctors to save his wife, even at the cost of the pregnancy,” Agnieszka’s twin sister, Wioletta Paciepnik, said on Tuesday.
After the termination, Agnieszka was moved from the gynaecological ward and her health continued to deteriorate. Her family suspect that she died of sepsis but the cause of death was not identified in a statement released by the hospital.
Shortly after her death, a statement by her family accusing the hospital of neglect was published on Facebook, alongside a distressing video of Agnieszka’s last days.
Agnieszka’s death marks the first anniversary of the 2021 ruling that declared abortion due to foetal abnormalities illegal. Abortion can now only be carried out in cases of rape, incest or if the mother’s life and health are in danger.
Her death comes after that of a woman known as Izabela last September, who died after being denied medical intervention when her waters broke in the 22nd week of her pregnancy. Her family claim the 30-year-old was refused an abortion or caesarean section and that the hospital cited the country’s abortion laws. An investigation found that “medical malpractice” led to Izabela’s death and the hospital was fined. Soon after, an anonymous man from Świdnica in south-west Poland came forward to share that his wife, Ania, died in similar circumstances in June last year.
While “selective abortion” is possible in the case of a twin pregnancy, it is unclear whether aborting an unviable foetus to save its healthy twin is permitted by the new abortion legislation. The Polish court has not referenced the questions raised by this situation, presented by opposition senators last year, in the new legislation.
“We want to honour the memory of my beloved sister and save other women in Poland from a similar fate,” Paciepnik said in a video appeal. The case is now being investigated by the regional prosecutors in Katowice, who also investigated the case of Izabela.
The family are represented by Kamila Ferenc, from the Federation for Women and Family Planning, who confirmed that an autopsy of Agnieszka’s body has been ordered by the court.
According to a statement from the hospital, Agnieszka tested positive for Covid before her death, although she tested negative twice when first admitted. “We stress that the hospital staff did all the necessary actions to save the patient,” the statement read. The hospital did not respond to the Guardian for a request for comment.
‘We just sleep and hope we don’t perish’: 2m in Tigray in urgent need of food – UN | Hunger
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