PLAYING OUT OF TUNE Europe’s discordant reaction to a pandemic

Speech by President von der Leyen in a virtually empty hemicycle at the European Parliament Plenary on the EU coordinated action to combat the coronavirus pandemic and its consequences.

 

Many years ago, I went with two school friends to Newcastle’s Theatre Royal to see the cellist Paul Tortelier perform Dvorac’s Cello Concerto in B minor. He was, as always, brilliant. I’m afraid time has erased the name of the orchestra, excellent though it was, but the programme was odd, with the Dvorac concerto forming the second part of the evening’s entertainment, after the interval, and the only symphony – Michael Tippett’s Third – rounding off part one. Rumour has it that the management feared that too many patrons might otherwise have decided to leave in the interval after hearing Tortelier; Tippett’s music is more of a specialist taste. I have to be in the right mood for it myself, which probably means I’m a Philistine. When it was over, my two pals and I, finding the theatre bar still full, crossed Grey Street to the Turk’s Head Hotel (where tradition claims that Paul McCartney and John Lennon wrote ‘She Loves You’ after the Beatles appeared at the Majestic Ballroom). There, in the beautiful Victorian bar, we met and had a drink or two with a few members of the orchestra. “Which do you prefer to play?” we asked a rather well-lubricated violinist, “the Dvorac or the Tippett?” The man smiled, sipped his whisky, and replied something along the lines of “Well, you can’t beat the soaring harmonies of Dvorac. But there again, if you hit a wrong note when you’re playing Tippett, nobody will notice.”

Staff of Elmhurst Hospital in Queens, bring in a new patient during the COVID-19 outbreak in New York UN Photo/Evan Schneider

In Europe’s response to the Covid-19 outbreak, there have been a lot of wrong notes played. The European Union was supposed to act as conductor but it dropped its baton early in the proceedings and there have been more squeaks, snapped strings and dropped clangers since then than anyone might have expected. In short, the whole affair has been completely discordant, as if the orchestra is responding not to someone on the conductor’s podium but instead to a dozen or more amateur conductors somewhere in the upper circle waving a variety of batons in an inexpert way. We have to remember, of course, that health is not one of the EU’s competences; it’s a matter for individual governments. Even so, EU leaders seem to have turned a blind eye to what was clearly a looming catastrophe for far too long, as if they were afraid to face up to the obvious. Now the European institutions find themselves scrabbling on the edges in a bid to preserve some of the values upon which the European Union was built, while governments seek solutions in a wide variety of uncoordinated and increasingly desperate responses. “It is of the utmost importance,” said Commission President Ursula von der Leyen, “that emergency measures are not at the expense of our fundamental principles and values as set out in the Treaties.” True, but I’m not sure that anyone is listening. They certainly weren’t when it all began.

Let us get a few facts straight. Covid-19 is not just a very bad cold, nor is it ordinary influenza. It is a serious and sometimes deadly disease caused by a novel virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to which we have no immunity.

It affects different people in different ways. Some exhibit mild symptoms, not unlike those of a cold. The virus attacks the respiratory system because the protein spikes on its surface can latch onto a cell surface protein called ACE2, especially found in the respiratory tract. It’s believed that ACE2 has a rôle in controlling blood pressure and some evidence suggests that Covid-19 is especially deadly for people who have high blood pressure. But the disease is new and not all the indications point the same way. In the United States some doctors are questioning whether ventilators are the appropriate treatment, for instance. A worryingly high proportion of patients put on ventilators die, but whether that is simply because they are the most serious cases or that – as some doctors suggest – it’s the wrong treatment is unknown as yet. According to MedicineNet, Dr. Cameron Kyle-Sidell, a Brooklyn emergency room physician, said that around 70% of Covid-19 patients put on ventilators do not recover. He reported that many of them showed very low blood-oxygen levels, more akin to altitude sickness than to normal lung infections.

New York hospitals have reported a death rate for patients on ventilators as high as 80%. Perhaps the virus prefers an anaerobic existence, like the organisms that died out when oxygen first spread over the earth, 2.5 billion or so years ago?

A NASTY SURPRISE

So it’s not really surprising, if doctors are unsure what to do, that politicians are all at sea. That’s why Europe remains the epicentre of the pandemic, with more than 600,000 infected and almost 50,000 dead. The EU economy looks to be holed below the waterline and even after this health crisis is consigned to history, the long term damage it’s done will still be with us. There’s not much point in attributing blame now, although the disorderly ‘me-first’ response drew savage criticism from Commission President Ursula von der Leyen at an almost-empty European Parliament. “When Europe really needed to be there for each other, too many initially looked out for themselves,” she said. “When Europe really needed an ‘all for one’ spirit, too many initially gave an ‘only for me’ response. And when Europe really needed to prove that this is not only a ‘fair weather Union’, too many initially refused to share their umbrella.”

Dr. Richard J. Hatchett, Chief Executive Officer of the Coalition for Epidemic Preparedness Innovations (CEPI) © Wikicommons

But from the outset, most leaders had failed to grasp the seriousness of what was happening. They saw the spread of the corona virus as a Chinese problem, despite a warning at the Davos conference from Richard Hatchett, who is in charge of the Coalition for Epidemic Preparedness Innovations (CEPI). He warned delegates “China was unfortunate in that that’s where the epidemic started, but it is now a global problem.” That was on 22 January this year and it seems few if any were really listening. By the time the world was paying attention, the virus was spreading more quickly than most people had expected and more widely than health facilities could cope with. Certainly, in the last week of January, corona virus was not being talked about.

Stella Kyriakides, European Commissioner for health and food safety © EP

During that week, the European Commissioner for Health and Food Safety, Stella Kyriakides, attended the Parliamentary Assembly of the Council of Europe in Strasbourg. I interviewed her there. The topic we discussed was not the all-consuming pandemic of today but the longer-term plan by the von der Leyen Commission to address the spread of cancer. “On February 4, on Tuesday,” she told me, “we’re launching the consultation phase of the ‘Europe Beating Cancer’ plan, which we hope we’ll be able to roll out by the end of 2020.” I’m not sure that target will prove achievable under the changed circumstances. The prospect of Covid-19 was simply not in her mind, nor mine, just that short time ago.

It was not until late in February that alarm bells started to ring. It was then that Italy activated the EU’s ‘civil protection mechanism’, requesting face masks and other items of protective equipment and expecting (even demanding) that other member states respond. None did. Suddenly, the countries of the EU had become aware that if the virus could cause such problems in a country like Italy, with its excellent health service, then its neighbours could be vulnerable, too. Furthermore, despite their boast of preparedness, politicians suddenly realised that personal protection equipment (PPE) may well be in shorter supply than they expected. Then came Carnival week, a traditional Christian festival in many parts of Europe, held during the last week before the start of Lent, the season of fasting in the Christian calendar.

Jakub Jaraczewski of Democracy Reporting International (DRI)

Once upon a time, it was a way of using up produce that the faithful may well be giving up for religious reasons, back in the days before refrigeration. Lent begins 46 days before the Saturday of Easter weekend, which in 2020 Lent fell on the 25 February. Traditionally, there are a great many festivals and carnivals held in that time, not only in Rio and other exotic places but also in Europe. Many find it a good time to go skiing, as a lot of Europeans did in late February and early March. It’s thought that it was in those ski resorts, with so many people from different countries partying together, that much of the damage was done, leaving the merry-makers to carry back the corona virus to their home countries.

IS ANYBODY LISTENING?

The European Commission created a corona virus emergency response group at the beginning of March, but behind the scenes, many leaders were growing increasingly alarmed. The EU’s main attention at that time, though, was focused on the Turkey-Greece border, after the Turkish president, Recep Tayyip Erdoğan, opened his country’s frontier to allow migrants and asylum-seekers to rush towards Greece. It remains an ongoing issue for Europe which successive leaders have so far failed to resolve.

When, on 3 March, France announced measures to take control of the production of personal protection equipment, Germany decided unilaterally to ban exports of the equipment, even to other EU states. These were signs that the EU’s two biggest and most powerful countries were turning their back on working together for the common good. Other member states started taking similarly selfish measures. It’s not just that countries were making moves without consulting the others, they weren’t even telling them what they were up to. Some government ministers complained they were only finding out what was going on by reading the newspapers. Meanwhile, the citizens of Europe remained, in the main, blissfully ignorant of the dangers. In Belgium, the Flemish and French parliaments couldn’t agree on whether or not to close schools. The Francophone side won in the end and schools were eventually closed. Public events continued, though, such as the marches to mark International Women’s Day in Spain, although anyone exhibiting symptoms was advised not to attend.

Health workers in Wuhan carry out physical examinations on employees returning to work at a company on April 9, 2020. Photo by Zhou Guoqiang for Chinadaily.com.cn

When some of leaders of EU countries reassured people that the wearing of masks was not necessary, despite the evidence from China, rumours said it was because they knew their country didn’t have enough to go around. However, the European Centre for Disease Control (ECDC) was (and remains) unsure that face masks would help in Europe, because most people are too inexpert to know how to wear them correctly or even to recognise if the mask in question could stop the virus; there are many out there designed to hold back dust or pollen which wouldn’t work against the virus, but which various unscrupulous merchants are keen to offload to a gullible and fearful public. There is also the fear that if everyone tried to obtain one, the supply for medical professionals could run out while too many members of the public could abandon ‘social distancing’ in the false belief that they were safe. Face masks worked in Wuhan because they were all officially sanctioned and wearing one was a legal requirement, which the Chinese were able to enforce, partly by tracking mobile phones so that they could control people’s movement. The same approach wouldn’t be legal in Europe. But rumour has had a field day during this crisis.

RUMOURS ABOUND, TESTS FAIL

In the United States, it was claimed that the Trump administration had declined an offer from the World Health Organisation (WHO) of testing kits for the virus in order to let American firms make them, prioritising profit over public health. It was even claimed by Presidential candidate Joe Biden at a Democrat rally.

UK Premier Boris Johnson during his speech on corona virus while in isolation

But it was never true; the WHO made no such offer. It’s probably as well: so far, testing kits have proved a disappointment. The British government bought 17.5 million of them, which Prime Minister Boris Johnson, now recovering from Covid-19 himself, said would be a “game changer”. They were supposed to work with just a pin prick of blood and would take up to 20 minutes to detect antibodies. A person showing the presence of antibodies would test positive for the infection. The idea was to sell them openly at pharmacies and on-line, and they were central to UK plans to ease the lockdown. Like many other such tests, however, the kits simply don’t work, and Britain is trying to get its money back. “There are many challenges to creating accurate tests” explained Professor Sir John Bell, Regius Professor of Medicine at Oxford University and Government Advisor on Life Sciences, “hence these tests need to be validated carefully. Other countries such as Spain have already sent test kits back because they don’t work. There are 100 or more such kits from different suppliers available for identifying Covid-19 antibodies, and it is important that each of these is checked for accuracy before making them available to the public.”

Professor Sir John Bell, Regius Professor of Medicine, University of Oxford, received the degree Doctor of Science, honoris causa, for his advancement of our understanding of immune activation in a range of autoimmune diseases © University of Toronto

In fact, Professor Bell says, no test currently available seems to be fool-proof, requiring examples of blood donated by the person being tested before the pandemic started. “Multiple tests have been provided for evaluation, and a range of convalescent sera has been used to determine whether the tests can identify both low and high levels of antibodies. We have been very careful to test using gold standards checked against a sensitive enzyme-linked immunosorbent assay (Elisa) of the spike protein and other viral proteins. Sadly, the tests we have looked at to date have not performed well. We see many false negatives (tests where no antibody is detected despite the fact we know it is there) and we also see false positives.” The problem seems to be that the corona virus family is very large with many closely-related cousins, and the tests cannot always or reliably tell the difference between people who’ve had infections of SARS-Cov-2 and those from other, similar viruses. Both Germany and China believe that really effective tests may still be some way off. In any case, they take time to show a result. The problem with the Spanish testing kits was, according to the Chinese embassy in Madrid, because they had been bought from an ‘unauthorised’ manufacturer in China, as well as from South Korea. In this case, the 640,000 ‘rapid testing’ kits were sent back because 9,000 of them failed to meet specifications. However, they were not part of a €432-million contract with China announced by the Spanish government, which will include 5.5-million testing kits. The faulty kits are reported to have had an accuracy rate lower than 30%.

A patient is taken to Mount Sinai hospital in Astoria, Queens, during the COVID 19 outbreak in New York

According to the European Centre for Disease Control and Prevention (ECDC), “Statistics suggest the United States may ultimately be hit hardest, having reacted even more slowly than Europe, and with deep societal divisions that created obstacles to the unity of purpose in countries like Germany that have fared relatively better.” Complacency would be unwise, however, says the Centre: “it is also clear that untold lives were lost because Europe did not react as fast and forcefully with lockdown measures as China, or as aggressively with testing as South Korea, which they had learned from the traumatic experience of the 2015 MERS (Middle East respiratory syndrome) outbreak.”

Meanwhile, the disease, still rampant despite the lockdown currently in force in many countries, marches on, with no sign of an anti-viral treatment, still less a vaccine, with which to address it. “Based on data from EU/EEA countries,” the ECDC reports, “32% of the diagnosed cases have required hospitalisation and 2.4% have had severe illness requiring respiratory support and/or ventilation. The crude fatality rate was 1.5% among diagnosed cases and 11% among hospitalised cases.” Meanwhile, Covid-19 is starting to spread across Africa, with over 14,000 cases and nearly 800 deaths at the time of writing, and relatively scant medical facilities. The Central African Republic, for instance, has just three ventilators for a population of 5-million.

Things seem to be getting critical in the United States, meanwhile, where the seriousness of the disease was recognised even later than it was in Europe. The Verge website reports that “In New York City, for example, there’s hardly a bottle of hand sanitizer to be found, and pasta and beans are in short supply. It’s good to prepare for disruption to everyday life, but there’s a difference between preparedness and panic buying — and the latter can cause shortages.” It has in parts of Europe, sometimes exacerbated by supermarkets trying to prove they’re enforcing the rules more vigorously than their rivals or by over-eager police forces trying to vie with each other in displays of keenness by going further than the law insists, or even allows. In Britain, one police force was threatening to put police officers on every aisle in a supermarket to ensure that people were not trying to buy “non-urgent items”. It took a letter to Chief Constables from Home Secretary Priti Patel to urge common sense.

Home Secretary Priti Patel © Wikipedia

DASHING TO THE RESCUE, RATHER LATE

Back when the seriousness of the situation was first beginning to become clear, EU health ministers initially squabbled over what to do. Charles Michel, President of the European Council, managed, despite these disagreements, to get them to agree to four primary goals: containing the spread of the virus, ensuring an adequate supply of essential medical equipment, addressing the socio-economic fall-out of the pandemic and supporting medical research into treatment and – with luck – a vaccine. At the suggestion of von der Leyen, they agreed to commit €7.5-billion in unspent structural funds to help countries deal with the problem. Additionally, the European Commission has announced that it will directly support EU healthcare systems with €3-billion from the EU budget, to be matched with a further €3-billion from each member state, to fund the Emergency Support Instrument as well as a new initiative, called RescUE, which gathers together essential equipment.

Belgian statue near the European Parliement in Brussels, Belgium © European Union Eve Van Soens

That includes things like ventilators and personal protective equipment, as well as helping to mobilise medical teams to work with the most vulnerable, such as in refugee camps. This will allow the Commission to procure directly on behalf of Member States. It will also finance and coordinate the transportation of medical equipment and of patients in cross-border regions, as well as trying to scale up testing.

Another Commission initiative has been the creation of an advisory group, made up of seven epidemiologists and virologists, chaired by President von der Leyen with Commissioner Kyriakides as Vice-Chair. The idea is to give guidelines on science-based and coordinated risk management, advising on response measures, gaps in clinical management, the prioritisation of health care, civil protection and other resources, as well as policy measures for the long-term consequences of the pandemic. More recently, the Commission adopted guidelines to optimise the supply and availability of medicines that included guidance on the application of anti-trust measures to allow limited cooperation among businesses. Von der Leyen announced other measures to bring down the cost of medicines and other essentials, too, by suspending customs duty and VAT. “In Italy, customs duty of 12% and a Value Added Tax of 22% is levied on some face masks or protective garments that we import from countries like China,” she explained. “Our decision will make them one third cheaper.” And it’s not only the EU that has been trying to sort out the mess. NATO has been active in ferrying supplies of essential medical goods to wherever they are needed, as Jens Stoltenberg, the Alliance’s Secretary General announced at the beginning of April. “Our airlift capabilities have delivered significant amounts of crucial medical equipment and field hospital tents,” he said. “Just this morning, a military cargo plane with masks, protective equipment and other medical supplies has taken off from Turkey, heading to Italy and Spain, in response to requests made through NATO’s disaster relief coordination centres.” Just how much of this essential PPE is needed, and how much each member state already has, is something the Commission is working hard to discover. It has also adopted a Recommendation on conformity assessment and market surveillance, which it says will increase the supply to civil protection authorities, of ‘certain types of PPE’, such as disposable face masks, without, they say, compromising health and safety standards. In addition, it’s in discussion with industry about converting production lines, so that, for instance, textile manufacturers can produce face masks and even distillers of vodka and gin can switch to providing hand sanitizers and disinfectants. Incidentally, the export of PPE outside the EU now requires special authorisation at national level. The biggest threat could be in Europe’s prisons. Across Europe, there were over 1.5 million prisoners in 2019, according to the Council of Europe. On average, 2.4% of inmates were aged 65 or over. The highest number of elderly inmates was in Turkey, the second highest in the UK and the third highest in Russia. The Czech Republic and Greece have hardly any.

Allied plane brings 45 tons of supplies to Bucharest © Nato photo Laurentiu Turoi

CURING A SICK ECONOMY

If the people survive, and it’s highly probable that most of us will, will the economy recover? A lot of businesses have been hit hard, not least in the hospitality and entertainment industries. Furthermore, a number of employees and self-employed people whose jobs cannot be done from home have been unable to get to work because of the lockdown. There is financial support for farmers and fishermen, and the European Investment Bank, based in Luxembourg, is aiming to invest an additional €20-billion in small and medium-sized businesses, partly from its own capital and partly backed by the EU budget. The Commission has unlocked another €1-billion in EU budget guarantee to the European Investment Fund, so it can provide liquidity to businesses. This, they say, will mobilise €8-billion in total that will help at least 100,000 companies. The European Central Bank is also taking steps to relieve the crisis: a €750-billion Pandemic Emergency Purchase Programme of private and public securities, which is in addition to the €120-billion already announced. As for the pandemic itself, the European Commission has mobilised €140-million to help develop vaccines, new treatments, diagnostic tests and medical systems to prevent the spread of the virus, as well as €48.5-million for eighteen projects and 140 research teams from the Horizon 2020 research and innovation programme. The hunt for cures goes on, and the Commission has offered up to €80-million to the European vaccine developer, CureVac, in the form of a European Investment Bank loan. The company says it hopes to begin the clinical testing of a vaccine by June. Everyone is doing something but it might have been helpful if they’d started doing it earlier and in closer harmony.

European Parliament © europa.eu

The piecemeal response of member states shows that, yet again, they’re prepared to blame the EU for everything and without ever acknowledging its advantages. Hungary’s Victor Orbán and Polish president Mateusz Morawiecki blamed the EU for not doing enough, even though the EU had ensured that the two countries could use funds of around €1-billion each from unused cohesion funds, which would normally have to be returned to the EU. The problem, especially in the case of Orbán, is that he only sees the value of the EU in terms of the cash his country can get out of it. He does not seem to accept that this requires anything in return, such as the correct application of EU laws and respect for the EU standards Hungary signed up to. “Most governments’ response to the Coronavirus crisis has included a strict curtailment of the right to freedom of movement,” writes Jakub Jaraczewski of Democracy Reporting International (DRI).

 

“Some EU Member States have imposed these, and further limitations, as part of an officially declared ‘state of emergency’. This special measure provides governments with the constitutional or legal means to impose extraordinary legal measures.” Jaraczewski warns that some countries are coming dangerously close to breaching their international obligations under not only the EU Treaties but also the European Convention of Human Rights (ECHR) and the Organisation for European Cooperation and Development (OECD). “While one can expect limits in the ability to administer justice and see non-essential court cases delayed due to shutdowns,” he writes on DRI’s website, “elements of the right to a fair trial, such as the right to challenge an arrest before an independent court, must be preserved. Moreover, some regional and international instruments, such as the ECHR, feature a mechanism for countries to notify the relevant organisation that they are suspending some elements of the legal instrument when facing an exceptional, clearly identifiable threat by enacting temporary, extraordinary measures.” Very few countries have done so. Jaraczewski points out the problems involved in getting a united response from such a disparate set of countries: Poland has laws that apply in a national emergency, Germany does not and its response is further complicated by its federal structure. Other countries have assumed almost dictatorial powers to get around sclerotic law-making systems while parliaments are not sitting. But it’s not without risks, says Jaraczewski: “While fighting existential threats can require limits to fundamental rights and freedoms, there is a high risk that governments will overstep and excessively impede rights and freedoms in response to covid-19. In extreme cases, a permanent, unlimited state of emergency, could lead to the removal of checks and balances and undermining the rule of law to the point where a country ceases to be democratic. Indeed, the Hungarian bill appears to be just that, a push towards autocracy masqueraded as a measure that ensures the safety of citizens.” It could also be argued that Ursula von der Leyen’s suggestion that all elderly people should remain in lockdown until the end of the year is excessive and would cause more problems than it might solve. Impose sensible, understandable rules and people will abide by them. Exceed those, and you tempt provoking rebellion and chaos. The United States is already seeing widespread opposition to a lockdown, with one protester carrying a placard bearing the famous words of the 18th century American statesman, Patrick Henry: “Give me liberty, or give me death.” The protester was part of a large crowd, opposed to social distancing, so she may get both.

 
ARE WE THERE YET?

Few people are suggesting that the EU should have increased responsibility in the field of health but this crisis has shown how very far from unity the European Union has fallen. There is no magical cure, but some countries have shown wisdom in dealing with the crisis. “If necessary, health insurance can be supported by public budgets,” argues the Brussels-based Breughel think tank. “Second, a support fund could be established to assist those sectors that are most affected. The German Kurzarbeitergeld (short term compensation) and the Italian Cassa Integrazione Guadagni are good possible examples of ways to support companies and workers that have to reduce their output. Third, we consider the provision of monthly lump-sum transfers to the self-employed that are immediately vulnerable to a collapse in demand as key to safeguard this vulnerable group of workers until the end of the emergency period.” The Authors of the report, Maria Demertzis, André Sapir, Simone Tagliapietra and Guntram B. Wolff, are concerned about the long-term affect on the economy, which may require drastic action. “Uncertainty has led to major volatility in financial assets and broad-based stress in the financial system,” they write on Breughel’s website. “Some companies and households will be late in meeting their financial obligations, for example mortgage payments. Central banks need to provide abundant liquidity to support the financial system and prevent short-term liquidity needs from jeopardising productive economic activity. Stress in interbank markets and money markets needs to be addressed. Swap lines need to be robust and substantial so that the European central banks can provide dollar liquidity if needed.”

But at the moment it’s all up in the air. Most of us sit at home, in self-isolation, unsure what’s going on and what we should do about it, like a flock of sheep (maintaining our woolly social distancing, of course) whose sheepdog has wandered off to sniff a distant tree. We could all try shouting “Baaaa!” at the same time in the hopes that he’ll wander back, but even if he does he’s unlikely to have many answers. Until this disease starts to diminish, we’re in unknown territory. We’re witnessing a change in the world. It’s a change, though, that demonstrates the need for cooperation, for working together, not for division and disunity. Otherwise we’re on the road to chaos, anarchy and war. In many towns and cities, the lack of people in the street is leading groups of wild animals to explore empty suburban gardens and eat the plants. They sense the end of humankind. We have to hope they’re wrong.

Jim Gibbons

Click here to read the 2020 May edition of Europe Diplomatic Magazine

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