BARCELONA, Spain — A resurgence of coronavirus cases in Spain and beyond have people questioning if Europe, which has already been traumatized by more than 181,000 deaths in the ongoing COVID-19 pandemic, can reduce the impact of a second wave.
Clusters of cases have appeared in various parts of Europe. In Spain, some have required drastic measures. Now, epidemiologists throughout the continent agree that a second series of outbreaks is inevitable. The big question however, is whether the second wave arrives as a series of manageable ripples, often at the local and regional levels, or an all-out tsunami.
“As we move forward through time, the number of waves we will observe will be a function of how much of the economy we open up, said Gerardo Chowell, a professor of mathematical epidemiology and chair of the Department of Population Health Sciences at the Georgia State University School of Public Health. “You should be expecting these waves. But you can also be ready to control them. It’s not easy to do but it is possible.”
It is a project that can easily go wrong as was witnessed in Spain, which has had 6,361 new cases since Friday — 855 in the past 24 hours, according to the Spanish Health Ministry.
(The U.S. has recorded 146,546 deaths from the coronavirus during the pandemic, according to the U.S. Centers for Disease Control and Prevention. Overnight Sunday to Monday, the CDC reported 61,795 new cases for a total of 4.23 million.)
The cases in Spain were driven for the most part by a combination of factors: young people gathering at parties, on the beaches and in nightclubs, often spreading the disease among themselves.
At the same time, in the city of Lleida some 156 kilometers (96 miles) from Barcelona, migrants who had arrived to pick fruits and vegetables were often housed in extremely close quarters. Many even slept on the street.
“This may already be a second wave,” María José Sierra of the Spanish Health Ministry’s Coordination Center for Health Alerts said last week.
The consequences of losing control — or even being perceived as such — can be profound.
Over the weekend, the British Transportation Ministry announced that all travelers coming from Spain to the United Kingdom must self-quarantine for two weeks or face stiff penalties or jail time.
French Prime Minister Jean Castex said Friday that French citizens have been advised not to travel to the Spanish region of Catalonia “until the health situation there improves.”
Spanish government officials insist that despite the recent outbreaks, quarantine measures are unwarranted.
"Spain is a safe country," Spanish Foreign Minister Arancha Gonzalez Laya said Sunday. "Like other European countries, Spain has new outbreaks. It's not unusual."
Nevertheless, some of Spain’s regional governments, which are normally charged with implementing health measures, have come under withering criticism.
“We were advising the government that we needed 2,000 contact tracers in Catalonia,” said Alex Arenas, a researcher and epidemiological modeler at the University of Rovira i Virgili in Tarragona, Spain.
Arenas said that the Catalan regional government’s projections, which assumed that the number of cases would remain stable during the tourist season, were not realistic.
“I don’t know what they were thinking,” he said.
Part of the problem is technical. While virtually every government in Europe has a legion of experts to address the spread of the disease, this is less true at the regional and the local levels.
“Public health departments are used to managing noncommunicable diseases but they have never managed infectious disease epidemics,” said Oriol Mitjà, an associate professor of infectious diseases and global health at the Germans Trias i Pujol hospital in Spain.
If Spain represents a place where the spread of COVID-19 threatens to get out of hand, much of the rest of Europe cannot be said to be better off.
Rates of transmission are roughly stable across Europe with countries like the U.K., Spain and Albania reporting more cases than others.
“No country is in red zone,” EnricAlvarez, abiophysicist at the biocomsc group of Polytechnic University of Catalonia, said. “But lots are in the yellow zone.”
The continent is in a transition period, Flavia Riccardo, an epidemiologist at the Italian Ministry of Health, said. In Italy and elsewhere in Europe,, public health officials are racing against time to bolster their monitoring systems, including contact tracing, intensive care unit capacity, as well as messaging so as to keep the disease at a manageable level.
“This outbreak is not over,” she said. “There are a lot of things that we might have right now that we may eventually get wrong. We still haven’t seen the end of the story.”