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Review
. 2021 Sep:8:100185.
doi: 10.1016/j.lanepe.2021.100185. Epub 2021 Jul 30.

A look into the future of the COVID-19 pandemic in Europe: an expert consultation

Emil Nafis Iftekhar  1 , Viola Priesemann  1 , Rudi Balling  2 , Simon Bauer  1 , Philippe Beutels  3 , André Calero Valdez  4 , Sarah Cuschieri  5 , Thomas Czypionka  6 , Uga Dumpis  7 , Enrico Glaab  2 , Eva Grill  8 , Claudia Hanson  9 , Pirta Hotulainen  10 , Peter Klimek  11 , Mirjam Kretzschmar  12 , Tyll Krüger  13 , Jenny Krutzinna  14 , Nicola Low  15 , Helena Machado  16 , Carlos Martins  17 , Martin McKee  18 , Sebastian Bernd Mohr  1 , Armin Nassehi  8 , Matjaž Perc  19 , Elena Petelos  20 , Martyn Pickersgill  21 , Barbara Prainsack  22 , Joacim Rocklöv  23 , Eva Schernhammer  24 , Anthony Staines  25 , Ewa Szczurek  26 , Sotirios Tsiodras  27 , Steven Van Gucht  28 , Peter Willeit  29
Affiliations
Review

A look into the future of the COVID-19 pandemic in Europe: an expert consultation

Emil Nafis Iftekhar et al. Lancet Reg Health Eur. 2021 Sep.

Abstract

How will the coronavirus disease 2019 (COVID-19) pandemic develop in the coming months and years? Based on an expert survey, we examine key aspects that are likely to influence the COVID-19 pandemic in Europe. The challenges and developments will strongly depend on the progress of national and global vaccination programs, the emergence and spread of variants of concern (VOCs), and public responses to non-pharmaceutical interventions (NPIs). In the short term, many people remain unvaccinated, VOCs continue to emerge and spread, and mobility and population mixing are expected to increase. Therefore, lifting restrictions too much and too early risk another damaging wave. This challenge remains despite the reduced opportunities for transmission given vaccination progress and reduced indoor mixing in summer 2021. In autumn 2021, increased indoor activity might accelerate the spread again, whilst a necessary reintroduction of NPIs might be too slow. The incidence may strongly rise again, possibly filling intensive care units, if vaccination levels are not high enough. A moderate, adaptive level of NPIs will thus remain necessary. These epidemiological aspects combined with economic, social, and health-related consequences provide a more holistic perspective on the future of the COVID-19 pandemic.

Keywords: COVID-19; Delphi study; Europe; SARS-CoV-2; expert survey; group forecast; non-pharmaceutical interventions; policy advice; variants of concern.

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Conflict of interest statement

ENI, VP, SB, and SBM were supported by the Max Planck Society. VP received honoraria for lectures and presentations on COVID-19 mitigation strategies. PB was supported by the Epipose project from the European Union's SC1-PHE-CORONAVIRUS-2020 programme (grant agreement number 101003688), and consulting fees were paid to his institution by Pfizer and Pfizer Belgium. ACV was supported by the Ministry of Culture and Science of the German State of North Rhine-Westphalia and the German Federal Ministry of Education and Research. TC was supported by the European Union's Horizon 2020 research and innovation programme project PERISCOPE (grant agreement number 101016233). EGl was supported by the Luxembourg National Research Fund. EGr received fees from the German Board of Pharmacists for educational events on COVID-19 and is the president of the German Society for Epidemiology. MK was supported by ZonMw grants number 10430022010001 and number 91216062, and the European Union's Horizon 2020 research and innovation programme project CORESMA (grant agreement number 101003480). NL was supported by European Union's Horizon 2020 research and innovation programme project EpiPose (grant agreement number 101003688), and the Swiss National Science Foundation (project number 176233). MM is a member of UK Independent SAGE. SBM was supported by egePan 01KX7021. MPi was supported by the UK Economic and Social Research Council (ESRC) [ES/S013873/1; ES/T014164/1], the UK Medical Research Council (MRC) [MR/S035818/1], FWO, and Wellcome Trust [209519/Z/17/Z; 106612/Z/14/Z]. BP is a member of the Austrian National Bioethics Commission, and the European Group on Ethics in Science and New Technologies, advising the Austrian Government and the EU Commission respectively. Other research projects in the lab of ESz are partly funded by Merck Healthcare KGaA. All other authors have no competing interests to declare.

Figures

Fig 1
Fig. 1
Comparison of the COVID-19 pandemic in all countries of the WHO European Region (except for Turkey and Turkmenistan, as there was no appropriate data available in the data set). Countries are ordered from top to bottom with a decreasing cumulative number of COVID-19 related deaths per million people. The y-axis scale of the ridgeline plots is the same for all countries for reported deaths and incidence, respectively. Even though reported numbers are associated with wide uncertainty, the differences between countries and waves are evident. Data source: https://corona-api.com (Accessed: June 28, 2021).
Fig 2
Fig. 2
Comparison of the COVID-19 pandemic in a selection of European countries grouped by geographical proximity. Many differences in reported incidence, reported deaths and excess mortality can be observed. Even though reported numbers are associated with wide uncertainty, the differences between countries and waves are evident. Data sources: https://ourworldindata.org/covid-cases and https://ourworldindata.org/excess-mortality-covid (Accessed: June 29, 2021).
Fig 3
Fig. 3
Vaccination progress in Europe. a. Fraction of the population having received at least one dose of COVID-19 vaccines in Europe as of June 26, 2021. There are large differences in vaccination coverage. b. Reported incidence (lines) and reached vaccination milestones (triangles) since the start of vaccination programs. Data source: https://ourworldindata.org/covid-vaccinations (Accessed: June 29, 2021).
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