COVID-19 pandemic: the European panorama. Focus in Italy and Spain.

by Laura Moro, Ph.D.

Coronavirus disease 2019 (COVID-19) continues to escalate worldwide, with Europe and the USA being the current epicentres of the pandemic. As of April 22, there are around 2,471,000 declared cases and over 169,000 deaths globally, with many countries undergoing community transmission. The situation in Europe is particularly gloomy with over 1.2 million cumulative cases and around 110,000 deaths. All countries in Europe −with the exception of Sweden− are following the lockdown strategy to ‘flatten the curve’, forcing citizens to stay home (although with different restriction levels) and halting non-essential activities.

In Italy (my adoptive country) and Spain (my home country), the hardest hit European nations, the number of daily new cases is slowing down. However, COVID-19 mortality in these two countries is currently among the highest in the world. This could be probably explained by several reasons ranging from the population ageing, cultural habits such as the integration of the elderly in the society and families, slow responses, or differences in the criteria to report cases and deaths. Several economic causes can be added to the equation too (weakened health systems, limited testing capacity and availability of resources, low investment in health, etc., some of them consequences of the 2008 economic crisis). As an example, according to the most recent study providing data covering all EU27 plus UK, Germany is the country with most critical care beds per 100,000 people (29,2 in 2012) followed by Luxembourg (24,8) and Austria (21,8). Numbers that are pretty far away from the 12,5 of Italy or the 9,7 of Spain. The pandemic situation in other European countries −for example France and UK− is following a similar trend to that of Italy and Spain, while some others are doing slightly better, but still far from the more effective management of Asian countries such as Singapore, Hong Kong, Japan or Taiwan.

I am currently writing from the North of Italy, where we have been under lockdown since the 10th of March. Since then, we are living times of great uncertainty and infoxication. I considered myself lucky to be able to carry on with many of my work activities online. With a background in infectious diseases research, I have seen the amount of work increasing and I am also giving my contribution to COVID-19 ‘fight’ as a volunteer (scientists can volunteer through online hackathons and many other great initiatives). Apart from that, I try to keep myself physically and mentally healthy and stay in contact with friends and family. Since we scientists are frequently ‘expats’, we are concerned about the situation in our home-countries and wondering when we will be able to hug our people again, and I am not the exception.

COVID-19 and political decisions

I agree that European countries did ‘too little, too late’ to contain the epidemic in its initial phases, or, better, to prevent it −as this editorial in Lancet claimed on 7th March−. As health professionals know, ‘prevention is better (and cheaper) than cure’. Although we have seen a rising trend in disease outbreaks −a majority of them from zoonotic origin− in the last years, our pandemic preparedness is very limited. Scientists have warned about potential epidemics, or about the consequences of humans’ impact on the planet, or about the grim future that we will see because of climate change, but with little influence on political decisions. But even the epidemiologists could not forecast the global impact of COVID-19 when the outbreak started in China.

While national political leadership against the pandemic has been frequently poor, the lack of unity and a shared objective among countries from the European Union is surely having an impact on our response capacity. As a young scientist that benefits from initiatives such as Marie Skłodowska-Curie actions or Horizon Europe, I am a firm believer in the European project, and I am concerned about this division when we should be more united than ever.

The future post-lockdown and post-pandemic

Now, countries are thinking about the best way to restart the economic and social activities after several weeks of complete lockdown. It is probable that we will have to live in a world full of face masks, contact tracing apps, and physical distancing −I personally disagree with the use of the term ‘social distancing’− at least for several months. Until we do not have the results from mass serological testing, currently ongoing in several countries, we will be largely unaware of the real extent of the pandemic. We expect to see a high proportion of asymptomatic infections. And even if antibodies are detectable in those that have been exposed to the virus, it remains unclear whether those antibodies will be protective and, in that case, for how long the protection will last.

More than 500 clinical trials are currently ongoing searching for a treatment for COVID-19. Drug repurposing −this is, the process of redeveloping a compound for its use in a different disease− will probably win the race by obviating all the safety studies required for new drugs. Soon we will get the first results from SOLIDARITY trial, a massive clinical trial launched by the WHO to evaluate the efficacy of the four most promising drugs (remdesivir, lopinavir/ritonavir, hydroxychloroquine or chloroquine, and interferon-beta) to slow disease progression or improve survival. More time will be needed until a commercial vaccine is available since candidates are currently in phase I or pre-clinical phases.

Many questions remain open about COVID-19, but it is undeniable that the pandemic has already changed our world. I am firmly convinced that we have a great opportunity to take lessons and redirect our societies towards a more health-centered, equitable, and sustainable way of living. And scientists will play a critical role in this change.

We need more scientists as leaders, it’s now or never

Scientists −not only those behind the bench, but also those with a scientific or technical background working in different fields− are making an unprecedented effort to produce knowledge about COVID-19 and find innovative solutions to this global challenge. We have seen basic science labs reconverted to diagnostic units, technological institutes producing ventilators, start-ups 3D printing face shields, and hackathons inviting citizens and professionals to team up to find answers to the most pressing issues regarding the pandemic. We have seen researchers, epidemiologists, and medical doctors advising politicians and answering the journalists’ questions in the media.

Despite most of us are isolated at home, there is more collaboration than ever thanks to the available digital tools. Scientists, even those that are not working in fields related to COVID-19, are giving their contributions (and you can also contribute as a volunteer, for example Crowdfight COVID-19 initiative or publishing your research regarding COVID). All the science regarding COVID-19 is being published with open access and many pre-prints are shared through repositories, being accessible from anybody anywhere. Several portals, such as the European COVID-19 Data Portal or, have been created to accelerate research through data sharing. To face this global health problem, international multi-disciplinary collaboration, including public-private partnerships, is crucial. Decision-makers and the whole society waiting for scientists to provide the solutions for this crisis in the form of a drug or a vaccine. Maybe this is the right moment, in particular in countries where research does not constitute a priority in the political agenda, to strengthen social and economic support for science.

However, since the beginning of the pandemic, we have rarely seen scientists among those taking the final decisions, even if those decisions are directly dealing with human health. It is time for scientists to step up and take the leadership in a changing world. We have been saying for years, without success, that the climate is dramatically changing, that the toll of human actions is too high for the planet, that novel zoonotic diseases with unknown consequences will come. But the translation of this knowledge into political actions has been scarce.

It is too late to prevent the COVID-19 pandemic, but we can act now to avoid the next threat. We urgently need more scientists in decision-making. We urgently need more young scientists to raise their voices. It’s now or never.

Laura Moro, Ph.D., is a researcher and science & medical writer particularly interested in infectious diseases, global and planetary health, and health innovations. She conducted research for several years on the immunopathology and diagnosis of infectious diseases with a focus on women’s and maternal health in Sub-Saharan Africa.

In 2015 she received a Marie Curie postdoctoral award to work in the interface between the academia and the industry for the design of novel diagnostic devices. She is the co-founder of AI Scope, a non-profit organization using artificial intelligence to improve the diagnosis of infectious diseases in low-resource settings. She believes in the power of science (and scientists) to improve our world.