An action plan for pan-European defence against new SARS-CoV-2 variants

COVID-19 cases are very high across Europe. Current measures not reducing virus spread sufficiently, and new SARS-CoV-2 variants emerging. The B.1.1.7 B1.351 variants, first identified in the UK South Africa, respectively, have to many European countries.1European Centre for Disease Prevention ControlRapid increase of a variant with multiple spike protein mutations observed United Kingdom. Dec 20, 2020. ECDC, Stockholm2020Google Scholar, 2Grove Krause T Ny status på forekomsten af cluster i Danmark. Jan 2, 2021. Statens Serum Institut, Copenhagen2021Google 3Volz E Mishra S Chand M et al.Transmission Lineage B. 1.1. 7 England: Insights from linking epidemiological genetic data.medRxiv. 2021; (published online 4.) (preprint)https://doi.org/10.1101/2020.12.30.20249034Google 4Davies NG Barnard RC Jarvis CI al.Estimated transmissibility severity novel Variant Concern 202012/01 England.medRxiv. 2020; 26.) (preprint)https://doi.org/10.1101/2020.12.24.20248822Google 5Callaway Could COVID undermine vaccines? Labs scramble find out.https://www.nature.com/articles/d41586-021-00031-0Date: 8, 2021Date accessed: January 19, 2021Google Scholar Although biological properties these yet be characterised, data suggest they higher than original variant.6Abbott Funk CMMID Working GroupLocal area reproduction numbers S-gene target failure.https://cmmid.github.io/topics/covid19/local-r-sgtf.htmlDate: 7Public Health EnglandInvestigation variant: 202012/01. Technical briefing document on variant. Public England, London2021Google These viral could effective number R population. In case B.1.1.7, estimates 1 about 1.4 no change population behavior.3Volz If true, countries that succeeded or less will confronted wave despite current measures.8Priesemann V Brinkmann MM Ciesek al.Calling pan-European commitment rapid sustained reduction infections.Lancet. 397: 92-93Summary Full Text PDF PubMed Scopus (52) Google 9Alwan NA Burgess RA Ashworth al.Scientific consensus pandemic: we need act now.Lancet. 396: e71-72Summary (148) Once more contagious has established itself, stabilising infections become increasingly difficult. Despite availability vaccines, production meet demand roll-out vaccination programmes take months. Countries manage their adverse impact several months come. With slowly increasing immunity evolutionary selection pressure virus, emergence continue, potentially leading perhaps even which existing vaccines effective. Such quickly exacerbate crisis, long before enough people vaccinated. While awaiting experimental understand decisions made, actions taken immediately contain variants. prevent selective advantages, hospital admissions increase. A surge lead breakdown health-care systems. countries, hospitals can longer deliver care usual quality all patients. Many intensive units already beyond capacity, non-urgent procedures been postponed weeks Delayed diagnosis compromised delivery other diseases poses additional health risks, just patients COVID-19, but whole Health-care professionals frontline workers working under extreme conditions most past year, this had severe physical mental health. like cases, overwhelm bring systems breaking point. Ensuring burden is alleviated while safeguarding system sustainability critical importance. Adequate support crucial forces might require funds. Containment mitigation challenging rise infectious Assuming does 1.4, then allowing it without behaviour mean double every week. Major efforts necessary back down regain control. Acting widely means those same major strongly reduce slow establishment B.1.1.7. Europe needs now delay any further SARS-CoV-2,8Priesemann particularly absence final data. clear plan immediate action public formulated since increased infectivity likely continue arise. We possible core panel. guiding principle as strong advantages health, society economy. joint make each national local effort impactful safeguard Europe.8Priesemann ScholarPanelCore EuropeAchieve maintain low prevention strategy•Define targets rekindle motivation: clearly define met lifted explain rationale behind them; convincingly convey fight against pandemic collective interest citizen; ensure adequate social economic need.•Act early: implement spike.•Reduce contacts: few different possible; improve home-office schooling; small, stable bubbles, groups at home work should preferred over alternating contacts.•Prevent contagion by individual such distancing, hygiene, face masks, ventilation, use filters, avoiding closed crowded spaces staying when experiencing symptoms; provide FFP2 masks who cannot home.Monitor spreading variants•Test, trace, isolate, support: enforce mandatory isolation confirmed encourage preventive quarantine suspected cases; affected individuals families.•Screen test preventively: offer tests schools workplaces cost detect outbreaks early protect people; testing capacity demand; waste-water surveillance surges.•Increase sequencing PCR-based detection variant, well SARS-CoV-2.Stop borders vulnerable•Reduce travel within borders, cross-border travelers; required 24h 7–10 days after travel; anyone arriving transmission suspicious variants.•Improve protection of, for, elderly vulnerable groups; foster exchange successful strategies speed up progress.Increase efficacy pace vaccination•Speed vaccination: vaccine supply, delivery, allocation mutual learning international cooperation; coordinate scale vaccines.•Monitor among vaccinated potential reinfection deficient management soon possible.•Answer urgent questions through research ways regimes optimise logistics, willingness using countries.Further details available appendix. Achieve strategy •Define home. Monitor •Test, SARS-CoV-2. Stop •Reduce progress. Increase •Speed countries. Further restrictions last, become, depleted people's psychological, social, resources become. Where stricter measures, utmost importance heavy burdens receive financial support, justly distributed, services cope bereavement, isolation, loss income, fear, alcohol drug misuse, insomnia, anxiety result lockdown strategies. Contextual factors, factors affecting risk perception, must also considered. principles avoid importing spread, molecular surveillance. earlier effectively act, relaxed. All types ought coordinated synchronised Every (ie, R) counts, reduces duration strict proportionally. This Correspondence was way directly indirectly supported, funded, sponsored organisation entity. RB founder shareholder MEGENO ITTM. SC reports grants Roche Janssen personal fees Euroimmun, unrelated Correspondence. authors declare competing interests. Signatories listed authors’ translations online. Download .pdf (.36 MB) Help pdf files Supplementary appendix Genomic pandemicsAdvanced techniques undoubtedly provided valuable information biology evolution Never nearly 30 000 nucleotides so closely considered scientists, experts, politicians alike. But application varied, risking an insufficient response rapidly changing pandemic. Full-Text