Can vaccination prevent new lockdowns in Europe? (EN)

Back in January, in the second part of this post, I anticipated that EU countries were facing an imminent, devastating third wave of the pandemic over the coming months, driven by the more contagious mutations of the virus. I also wrote that the vaccines roll-out, even if proceeding according to plan (which it hasn't, mainly due to AstraZeneca's failure to supply on its contract with the EU), would not be able to help flatten the curve - they were simply too little, too late for this wave.

In the meantime, much of the talk in Europe has been about gradually lifting restrictions introduced at the beginning of winter. 

But one and a half month later, as more and more countries see again their infections and deaths going up again (below figure from ECDC) and their hospitals under strain, the tone is changing and re-confinement is back on the table across Europe.

The lingering question is: would a faster vaccination have helped significantly mitigate this new wave of the pandemic, so as to avoid renewed lockdowns? 

It's a legitimate question, especially as one compares with the UK, which, having achieved a much higher vaccination rate than continental Europe, is seeing its case count fall and is preparing to emerge from lockdown.

And linked to this, what is the level of vaccination where one can hope to see, if not 'herd immunity' (which we know requires around 70% of people to be immune), at least a meaningful impact on the virus propagation, a noticeable 'flattening of the curve' without the need for tough lockdown-type restrictions?

By looking at the available evidence from different countries with different levels of vaccination and at different points in the pandemic wave, the answer to the first question is, sadly, that even a flawless vaccination rollout wouldn't have avoided the need for fresh lockdowns in Europe.

The answer to the second question is more complicated and depends on a number of other factors (e.g. how many people in a given country already have some immunity after having been infected with covid in the earlier waves), but it points to a level of vaccination that EU countries are very unlikely to reach before summer. So if vaccination can help Europe re-open safely and broadly, this might only be the case from next autumn.

As Britain's cheating on vaccines is revealed, the EU has a duty to react (EN)

There isn't much to add to CNN's revelations about UK's contract with AstraZeneca (AZ) for on covid-19 vaccines, but it's worthwhile summarising the main facts:

• The British authorities have been apparently trying to keep the deal with AZ as a national security secret, but inadvertently made it available online back in November last year.
• UK's contract with AZ is very similar to EU's contract, in particular with regard to the "best reasonable efforts" clause. 
• UK's contract with AZ is officially dated one day after EU's contract with the company.
• The British contract also mentions that vaccines can be delivered from production sites in the EU, just like the EU contract also lists production sites in the UK.

In brief: no significant difference between the two contracts, whether in respect to the "best reasonable efforts" clause, to the time of concluding the contracts (only a day's difference, with EU's the earlier one) or to the sourcing of the promised supply.

These are explosive revelations and the implications deserve a discussion.

On vaccines, Europeans are shooting themselves in the foot... again (EN)

After the European Commission's blunder on invoking - even briefly for a couple of hours last Friday - Article 16 of the Northern Ireland protocol, which offered a golden opportunity to the UK to pressure the EU into making further post-Brexit accommodations, the Europeans are again scoring an own goal in the vaccines saga.

This time it's not so much about Brussels, but about national leaders and authorities.

The decision by several countries (Germany, France, Portugal, Sweden, Austria, Poland, Belgium... and counting) to limit the use of the Oxford/AstraZeneca covid vaccine to those under 65 (or even under 55 in one country), compounded by statements such as this one by French president Emmanuel Macron, is a big mistake and an act of self-harm on many levels.

It is wrong on the facts. It undermines the EU vaccination strategy and the countries' own vaccination efforts. And it weakens the legal case that the EU has against AstraZeneca for non-performance of their contract to supply vaccines.

Who is the bully now? (EN)

Since I posted yesterday about the escalation of the covid vaccine row between the EU and the UK, events have taken an even uglier turn.

There is no doubt that the EU is on the defensive after its blunder Friday on the Irish border, even if it reversed it within hours (see a more elaborate explanation in my yesterday's post... not such an outrage really, but an extremely bad move politically). But the humiliation of the EU that is feasted in British media and partly across the continent these days doesn't serve any good purpose. It is mostly driven by schadenfreude and fundamentally wrong. And the righteousness and hypocrisy of the British establishment are becoming unbearable.

The EU is presented as the villain from having attempted - in the face of a desperate shortage due to pharma companies reneging on their commitments - to protect its EU-made contracted vaccine supplies from the diversion to other countries. Meanwhile, the UK itself is operating a de facto export ban on AstraZeneca (AZ) vaccines manufactured on its territory, pretending that it has a right to monopolize the supply because it signed a contract earlier, notwithstanding AZ's contractual obligation to also supply the EU from its UK-based factories.

It now transpires that in addition to AZ having shipped EU-made vaccines to the UK last year, Pfizer also has been sending significant quantities to the US, while both companies are failing to deliver to the EU on their contracts. The EU is thus punished not for being slow, but for having leveraged its collective bargaining power to obtain the cheapest prices.

The UK "generously" offers to allow AZ to deliver vaccines to the EU... once it has finished inoculating all its adult population, sometime in autumn. Meanwhile the EU is entering the third wave of the pandemic with very low immunisation rates due to a combination of a slow start vaccination process across its 27 member states and insufficient delivery by the vaccine providers - Pfizer and AZ.

Righteousness and hypocrisy are in even sharper display when it comes to the Irish border. The EU is universally condemned for having announced (and quickly reversed) the activation of Article 16 of the Norther Ireland protocol of UK's Withdrawal Agreement, with a view to prevent backdoor export of vaccines to the UK. But that Article 16 is part of the protocol - so invoking it cannot be construed in any way as a breach of the protocol. Again, as I also wrote yesterday, getting anywhere near Article 16 was a political gaffe... but certainly not an "incredible act of hostility" as Arlene Foster presented it. If invoking Article 16 amounts to a quasi-declaration of war, why was it stipulated in the protocol in the first place?

What was, indeed, an incredible act of hostility were the UK Government's plans, last year, to override the Northern Ireland protocol by creating a different and contradictory legal framework through its proposed Internal Market act (abandoned in the meantime).

But why would British politicians, especially on the tory and DUP side, feign unlimited outrage? Part of the motivation is to change the narrative from last year and present the EU rather than the UK as untrustworthy to uphold its commitments. But more importantly, because they want to use this opportunity to abolish the Northern Ireland protocol altogether and wriggle out of the agreement that they ratified. 

Who is the bully now?

Make no mistake: the public shaming of the EU for the sin of having stood up for itself in the covid vaccines scandal - admittedly having got it wrong politically and subsequently backpedaling on the issue of controlling the Irish border - is not a legitimate reaction born out of genuine outrage. It is a deliberate drive to humiliate and bully the EU in the context of post-Brexit politics, with the ultimate aim to vindicate Brexit.

The dangerous escalation between the EU and the UK on covid-19 vaccines (EN)

The snowballing developments over the past few days, after AstraZeneca (AZ) announced a significant cut in its scheduled supplies of covid-19 vaccine to EU countries, have escalated to a war-like rhetoric between the UK and the EU, a raid by Belgian authorities at the AZ production site in Seneffe and the introduction of export controls on EU-manufactured vaccines. What's happening, really, and where is this coming from?

The narrative in the media about these events has been so far surprisingly simplistic and one-sided - not just in British tabloids like The Daily Mail, but also in usually much more sober outlets like The Guardian or the BBC and in many continental newspapers. It basically says that, due to its well-known bureaucratic heaviness, the EU was late to pass contracts with vaccine suppliers, slow with approving and distributing the jabs for use in its Member States and ineffective in the whole set-up of the vaccination campaign, which is in shambles. By contrast, the UK has been much nimbler with both purchases and approvals and as a result is way ahead of continental Europe with its vaccination efforts. Faced with a shortfall in vaccine supply, the EU has been throwing its weight around and trying to bully Britain into surrendering its own stocks. 

It's fair to say that, at least for the time being, the EU is losing the narratives' war.

The actual story, however, might be considerably more complicated. 

In this post I will present an alternative interpretation, largely based on information in the public domain, but also in part on speculation since some pieces of the puzzles are still missing. The near future may shed light on these aspects.

In a nutshell, my hypothesis is that the escalation is not simply due to the EU bureaucrats having 'lost the plot', but rather provoked by the conduct of AZ and of its CEO (which has been the immediate trigger for the crisis) and by perceived foul play from the UK on a very sensitive, politically explosive issue. 

All parties have made mistakes and the situation is getting out of hand. The stakes are huge and the logic is increasingly that of a zero-sum game, which risks durably poisoning the post-Brexit relations.

A statistically sound way to count the death toll from covid-19 (EN)

Mr. Lemaitre lives in Brussels, Belgium. He is 70 and five years ago underwent surgery for lung cancer. In mid-February his carcinoma recurred and he was admitted to hospital. Subsequently his condition worsened and in the beginning of March he entered a coma. Less than a week later, his temperature spiked and he was tested for the novel coronavirus. By the time the result came back positive, Mr. Lemaitre had already passed away.

Mr. Peeters lives alone in rural Flanders. His age is the same, 70, and he has a chronic heart condition. But he is in decent health otherwise and he makes sure to regularly visit his cardiologist. Good monitoring, a healthy diet and a quiet lifestyle could easily give him 10-15 more years of quality life, said his doctor. At the beginning of March Mr. Peeters had a couple of bad days, but then was better. He didn't worry too much, it had happened several times in the past and the doctor had adjusted his treatment in response. He would anyway see his doctor in two weeks for his regular appointment.
As the days pass, Mr. Peeters begins to stress about the coronavirus epidemic. He knows he is in a vulnerable category, at his age and with his chronic heart disease, so he limits his contacts and spends most of the time indoors, watching the news. The epidemic is growing in his region, with more and more cases reported every day. He knows stressing is not good for his heart, but cannot help it. He has another bad day and he takes meticulous notes of all the symptoms, to tell his doctor when he sees him in a couple of days.
Then one day and a half before his scheduled appointment, the government on TV announces a lockdown, aimed at slowing the spread of the virus. All non-essential outings are banned. All regular medical appointments are canceled. Mr. Peeters panics. During the night, he has a heart attack and by dawn is dead in his bed.

While Mr. Lemaitre and Mr. Peeters both died at about the same time, only one of them died due to the coronavirus. Mr. Lemaitre was already on his deathbed when he contracted the virus; it might have accelerated his demise, but it certainly wasn't the primary cause. On the other hand, Mr. Peeters' death is obviously caused by the coronavirus pandemic, even if he might not even have been infected; indeed, were it not for the cancellation of his cardiology appointment and for the stress of the situation, chances are Mr. Peeters would be happily tending to his garden in the spring sun, and for years to come.

Still, in the figures announced in the news bulletins, it's Mr. Lemaitre's death that is counted among the victims of the virus, and not that of Mr. Peeters.

Both Mr. Lemaitre and Mr. Peeters are fictional characters, but you get the point. As a real life example, I could refer to the hundreds of people who died in Iran after drinking methanol based on the false belief that it would protect them from the virus. Does the pandemic play a role in their deaths? Most certainly, but you will not find them counted among its victims. Also forgotten will be the lives lost due to the economic collapse provoked by the lockdown measures to stop the pandemic.
The covid-19 statistics that so many of us follow daily, which make the media's frontpages and determine the policy responses of our governments, are flawed.
Different countries count fatalities in different ways and test to various extents for the virus. We have no clue how many people are infected, how many recovered without ever being tested, and we only make guesses as to the death rate. Official or quasi-official estimates are multiples of the headline confirmed figures. We scratch our head at the widely diverging death rates in Italy (very high) and Germany (very low) - but we don't even know whether the data is comparable, given the differences in testing and in counting fatalities.
For all the talk about the science's comeback, about evidence-driven policies, in this unprecedented crisis our leaders are to a large extent flying blind. And the stakes couldn't be higher. The measures being taken these days are historic: state of emergency, lockdowns, border closures, huge fiscal packages to keep the economy - and indeed the society - afloat. One would wish that the figures informing these decisions would be reliable, statistically sound.

But is there any way to have accurate estimates of the death toll of the coronavirus?
The answer is yes, and it was used before - but not yet in this crisis.