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Cities and countries in Europe are now reinstituting COVID-19 safety protocols as a second wave of the disease emerges. Thomas Coex / Getty Images
  • Experts say a loosening of COVID-19 regulations has led to a second wave of the disease in Europe.
  • A number of countries and cities are now considering or instituting lockdowns again.
  • Experts say leaders in the United States can learn lessons from Europe on how to try to dampen the effects of COVID-19 in the fall and winter.

France and the United Kingdom have recently set records for daily COVID-19 cases.

The city of Madrid has announced it’s going back into lockdown to stem its latest resurgence of the novel coronavirus.

While responses to COVID-19 have varied from country to country, experts say that Europe has been more aggressive in general at handling the spread of the disease.

However, the loosening of lockdown restrictions late this summer in Europe is now resulting in a new wave of the pandemic.

“Several European countries acted quickly during the pandemic to institute lockdown measures. Some measures were quite strict. Spain confined children under the age of 14 to their homes for 6 weeks. Italy required individuals to print out a certificate declaring a valid reason for leaving home. France limited outdoor exercise to 1 hour once a day and limited walks to within 1 kilometer of an individual’s residence,” Eric Yager, PhD, an associate professor of microbiology at the Albany College of Pharmacy and Health Sciences in New York, told Healthline.

“A second wave of COVID-19 across Europe is due primarily to the relaxation of these lockdown measures, increased public laxity with nonpharmaceutical interventions (wearing masks, distancing), and the fact that the majority of the population remains vulnerable to infection.”

Brooks B. Gump, PhD, MPH, a professor of public health in the Falk College at Syracuse University in New York, agreed.

He noted that some of this increased laxity is due to simple human nature.

“There are certainly policy differences that will likely drive the timing of this second wave. However, it is going to be mostly a factor of fatigue from isolation, dropping positivity rates in past months that drops perceived susceptibility (and drives more lax behaviors), and movement into confined spaces,” Gump told Healthline.

“These are the behaviors that are then guided further by overlaying policies such as closures, testing, tracing, etc. So, you must deal with the virus using basic epidemiological approaches, but also using our extensive knowledge of factors that drive human health behaviors.”

In response to this second COVID-19 surge, many European countries and cities are considering another round of quarantines and lockdowns.

In addition to Madrid, United Kingdom Prime Minister Boris Johnson said that new restrictions may be needed to face a second wave while the city of Liverpool and surrounding towns in northern England have already been placed back on lockdown.

That targeted approach will likely make sense for many countries, said Ben Alsdurf, the U.S. healthcare practice lead at TLGG Consulting, a consulting firm that advises pharmaceutical and life sciences companies such as Bayer.

“Europe can learn from how [New York City] has begun to identify pockets of spread and neighborhoods within the city that are driving the spread,” Alsdurf told Healthline. “It is only with such a targeted approach that we can begin to tailor mitigation strategies to specific high-risk community needs… as we see being done for instance with the orthodox Jewish community in New York.”

“Italy has given us a strong model to follow — rigorous masking with a strong test and trace infrastructure can slow the spread of COVID,” he added. “Even as its neighbors’ rates have risen, Italy’s have remained relatively low thanks in large part to the success of these efforts, and the collective willpower born out of the memory of how dire the situation was during that first wave.”

There are lessons to be learned from the history of past pandemics, too.

“During the 1918 pandemic, those cities that acted quickly and comprehensively still experienced an increase in infections, albeit at rates lower than cities that failed to act,” Yager said.

“We see that today with COVID-19 in those countries whose initial response to the virus was deemed a success (e.g., Australia, South Korea). Until the percentage of individuals immune to the virus increases to the level necessary for herd immunity there will continue to be community spread.”

If second waves of COVID-19 are to some degree inevitable, what can the United States learn from what Europe has experienced?

“European countries were able to reduce community transmission of COVID-19 more significantly than in the United States, and thus the spread we are seeing now is those same ways of transmission bouncing back in the same areas. Whereas in the U.S. we have had more of a rolling burden of COVID-19 with additional peaks,” Alsdurf said.

“What many don’t want to acknowledge is that cases did not lull for a few months because the virus was gone. They lulled because we unanimously decided to put our health and safety first with robust social distancing and quarantines. The second we give up on that determination is the second that cases begin to rise again, as we’ve already started to see across the globe,” he added.

Brooks concurred, noting that even during this second wave, Europe’s numbers are much lower than those of the United States and its rolling pandemic.

“The key factor when heading into the periods of increased risk is the positivity rate heading in. This is like the embers that are fanned by the changes such as opening up or moving activities inside,” he said.

For instance, the United States has an overall positivity rate right now of 4.8 percent, compared to about 2.7 percent for England and 1.9 for Italy.

As a result, “we can certainly expect a bigger wave than Europe — and, given current trends, with an approximate lag of 3 to 4 weeks behind them. We can still beat this back, but, I’m not hopeful,” Brooks said.

“It would take a significant re-alignment of effort. We have not approached this with nearly enough aggressive action. All the classic epidemic control measures still work. You just need to follow them and not try to cut corners. Our positivity rate is high because we have not been coordinated and aggressive in our response.”

However, experts say it’s unlikely that the United States will take aggressive action such as a second lockdown.

“A true lockdown — something along the lines of what Italy did early on — would certainly be an effective measure in combating COVID-19. Whether communities would adopt such a strategy at this point seems rather doubtful,” Dr. Richard Pan, a Democratic state senator from California, told Healthline.

“The great challenge of battling a pandemic is that it only takes a small number of people ignoring the rules to ruin any progress that has been made to date,” he said.