A familiar sight has emerged in Europe. Perturbed leaders forced to make a national address to introduce new restrictions to defeat a second wave of Covid-19.
Countries which hoped they had overcome the worst of the pandemic have been taken aback by the speed and ferocity of the resurgent virus. France, Germany, UK, Italy. The list goes on.
Europe is now on the precipice of an uncontainable Covid outbreak that could have dire economic and health consequences with many governments accused of failings – from rulemakers becoming rulebreakers to slow responses or missteps in improving testing.
The best performing countries have seen a minimum tenfold increase in infections since September 1, research by The National has shown. Some have experienced 20 or 30-fold increases.
Some countries have responded successfully, but others, notably Belgium, France and Britain, have found themselves in danger of being overwhelmed.
That has prompted very rapid U-turns in governments previously focused on kick-starting economies to ones now terrified of the prospect of hospitals becoming overwhelmed and a spiralling death toll.
So, what mistakes allowed the virus to get out of hand?
Summer
The European obsession with taking a summer holiday abroad has been a significant contributing factor in spreading the disease.
Soon after lockdown measures were relaxed in early June, the "mass movement" of holidaymakers began with British, Dutch, Germans and other northern Europeans heading southward. In some cases, they took the virus to countries that had been relatively untouched by the virus, such as Greece. In others, they brought infections back from places like Spain to low infection countries such as Germany or Austria.
"Anybody who drove down the motorways in France in August saw the lines of caravans moving south, almost like a migration of animals in Africa," said Martin McKee, Professor of European public health at the London School of Hygiene and Tropical Medicine.
In addition, Europe witnessed a migration of seasonal workers, mainly from the east and south, to help with the fruit and vine harvests in other areas.
Rulebreakers
The biggest loss of trust in Covid messaging has been the indiscipline among the establishment in adhering to the rules. In Britain, foremost was the prime minister's chief adviser Dominic Cummings, who travelled from London to Barnard Castle in northern England in what many saw as a flagrant breach of at least the spirit of the law. One lawmaker who did actually break the law was Scottish MP Margaret Ferrier, who travelled from Scotland to London after taking a Covid test, spending a few days in Parliament then getting a train home after testing positive.
Former prime minister Tony Blair has had questions raised over whether he spent two weeks in quarantine after an America trip, as has Brexit Party leader Nigel Farage.
In Ireland, the rule-breaking saw Phil Hogan resign as European trade commissioner after breaching regulations during a golfing break. Austria's President Alexander Van der Bellen had to apologise for breaking a restaurant curfew after dinner with his wife. In Germany, the liberal FDP party leader, Christian Lindner, was caught hugging a friend at a restaurant.
"What this says about people in government is that they are not abiding by the rules they are setting which really has not helped, especially when you witnessed all the contortions Dominic Cummings went through to try to claim he did nothing wrong,” Dr Ilan Kelman, Professor of disasters and health at the University of London.
Universities
Last month, education facilities in Britain accounted for 45 per cent of all new positive cases with more than 90 universities experiencing outbreaks.
With two million university students, a quarter from overseas, many British institutions would have closed if they went to online learning alone. But the virus swept through campuses as students criss-crossed the country between home and university.
The reopening of universities in Belgium was also a major driver of spreading the disease. With students travelling home at weekends they then exposed the infection to their parents, driving transmissions among the 40 to 60 plus age group. “These are the people entering the hospitals,” said Pierre Van Damme, an epidemiologist in Belgium.
In the Czech Republic it was predicted that schools opening on September 1 would help infections spread. Within two weeks, 144 out of the country's 11,000 schools had outbreaks.
Messaging
British PM warns of 'medical and moral' disaster without lockdown
A key part in the problem in Britain has been the confused communications from government which made it difficult for people to follow the rules.
A report on government communications criticised its hyperbole and over-promising. One local leader quoted in the Foresight Group report said: “One minute it will all be over by Christmas, the next minute Christmas is cancelled. We are seemingly no longer even following the science. The public is bemused and becoming very angry and public messages have lost credibility.”
Boris Johnson has been criticised for exaggeration, using words such as "world beating" for Britain's foundering testing regime and setting superfluous targets. Localised restrictions, ranging from tier 1 to tier 3 also meant people in different parts of the country fell under different rules.
"People's faith in government has been undermined by mixed messages," said Dr Kelman. "What we need is one, clear, consistent, accurate message because we have been through five or six different iterations of government advice."
Face masks
Belatedly, face masks have become mandatory across European countries in public areas with governments accepting WHO advice that they help stop the spread of the disease, especially by those infected. The Czech Republic was among the first to make face masks mandatory but the rules were only reintroduced last month after the huge rise in infections. Likewise, Belgium dropped mandatory face masks in outdoor places in late September only to reintroduce the rule last month.
“These measures should have been introduced earlier. There is now too much of the virus around to use the same methods that we used in the spring,” said Jan Pačes, a virologist from the Czech Academy of Sciences.
Testing
Prof Julian Peto has long trumpeted the view that only a thorough testing scheme – as much as every person at least once a week – will bring back normality until a vaccine is found.
"The thing for Europe to get out of the mess is to develop a test that's quick and efficient and works," said the statistician and epidemiologist at the London School of Hygiene and Tropical Medicine.
He condemned the British government for watering down its ‘Operation Moonshot’ experiment whereby it was going to test each of 250,000 people in Salford once a week with 40,000 tests a day. This has now been dropped to just 1,000 a day. However, the city of Liverpool has launched its pilot scheme. Liverpool, currently one of the hardest hit parts of the UK with 410.4 cases per 100,000 people as of late October, will become the first city in England to receive regular testing for its entire population under the plan that will begin this week.
“The most important Covid story is the government's failure to pursue the "Operation Moonshot" plans for weekly testing that were announced with such fanfare two months ago and has hardly been mentioned in the press,” said Prof Peto. “Until a vaccine is available this is the only way to stop the epidemic and restore normal life.”
Relaxation
The desire to get back to normality was huge and across the continent bars and restaurants tried to make the most of the warm weather. It couldn’t last. Curfews for hospitality venues began appearing in earnest in late summer as governments decided they were 'superspreaders'. The time limits varied from 9pm to 1am but now many bars and eateries have been forced to shut altogether, including Britain, Belgium, The Netherlands and Czech Republic and parts of France.
