Rapid risk assessment: Assessing SARS-CoV-2 circulation, variants of concern, non-pharmaceutical interventions and vaccine rollout in the EU/EEA, 10 June 2021

Risk assessment

Summary

Although SARS-CoV-2 transmission remains widespread in large parts of the EU/EEA, most countries report declining trends in 14-day COVID-19 notification rates, hospital and intensive care unit (ICU) occupancy, and mortality. Many countries have initiated partial lifting of different non-pharmaceutical interventions (NPIs) that aim to reduce the degree of citizens physical contact and mobility. Since January 2021, EU/EEA countries have reported an increase in the number and proportion of SARS-CoV-2 cases of variants of concern (VOC) associated with increasing transmissibility and/or severity, with Alpha (B.1.1.7) the current dominant variant across the EU/EEA. Estimates across the region show that a large proportion of the population across Europe still remains susceptible to SARS-CoV-2 and that population immunity is far from being reached. As of 3 June, the median cumulative vaccine uptake in the EU/EEA adult population (aged 18 years and older) had reached 46.2% for at least one vaccine dose and 22.3% for the full vaccination course. The highest level of vaccine uptake was observed among the elderly aged over 80, in which the uptake reached 80.5% for at least one dose and 66.3% for full vaccination coverage. For healthcare workers, the median level of at least one dose uptake was 87% and the median uptake for the full vaccination course was 65.2%. Increased vaccine supply has allowed countries to expand eligibility for vaccination to younger age groups.

Options for response

One of the main public health goals in the current phase of the pandemic is to reduce severe COVID-19 disease and mortality by ensuring full vaccination for risk groups, including the elderly and those with underlying medical conditions. COVID-19 vaccination campaigns should remain a priority for all countries and vaccine rollout should continue, and possibly be accelerated whilst tailored to ensure access for vulnerable, hard-to-reach and hesitant populations.

Countries with a favourable epidemiological situation and progress toward high vaccine uptake in priority groups may consider adjusting and phasing out their NPIs, following a careful assessment of their local situation. A comprehensive testing strategy to enable the timely detection of cases and a robust system for contact tracing should remain a priority for all public health authorities.

The emergence and spread of VOCs, that are potentially more transmissible or cause more severe disease or escape natural or vaccine-induced immunity, requires strong surveillance measures and enhanced measures to stop, delay or reduce the spread of these VOCs. To be able to confirm infection with a specific variant, timely sequencing of the whole SARS-CoV-2 genome, or at least the whole or partial S-gene for current variants is required.

The risk of introduction of new variants in the EU is closely related to the pandemic evolution, within, as well as outside, of the EU. Efforts to ensure more equitable access to vaccination globally can mitigate the risk of the emergence of new variants.

Introduction of SARS-CoV-2 by travel-related cases, including of new virus variants, can play a role in triggering increased community transmission of COVID-19, particularly when levels of transmission in the receiving locality are low. As such, carefully and rigorously implemented travel measures can have an impact on the introduction and further transmission of new variants of virus, or on re-introduction of any form of virus, if local levels of transmission are low. Travel measures, including the requirement to provide proof of a negative test before travel or on arrival and quarantine for incoming individuals can be tailored according to considerations of vaccination status and VOC circulation and should be coordinated internationally.

Although increasing vaccination coverage will mitigate the effect of replacement with more transmissible variants, decisions to ease measures need to be highly sensitive to the local context and include considerations about the current viral circulation, the prevalence of VOCs and the vaccination status. Modelling analysis shows that a significant increase in COVID-19-related cases in the EU/EEA remains possible if NPIs are relaxed too rapidly.

For events with the potential to give rise to mass gatherings, such as the UEFA Euro 2020, monitoring of the epidemiological situation and implementation of preventive and mitigation measures should be done with a coordinated intersectoral approach.

Risk communication strategies need to highlight the fact that the pandemic is not over yet. People should be well informed about the need to respect NPIs that remain in place and reminded of the importance of full vaccination coverage as an effective measure to protect against infection and severe disease in priority groups and control the future transmission of the virus.

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