Parts of Europe are seeing renewed COVID-19 outbreaks, illustrating that the continent as a whole has struggled to contain the virus as much or more than the United States has.
The number of cases across the EU jumped nearly 60% from the week ending June 28 through the week ending Aug. 30, according to data compiled by the World Health Organization.
Spain and France, in particular, have seen major outbreaks in recent weeks.
Spain has seen 125 cases per 100,000 people in the past week, more than the 90 per 100,000 in the U.S., according to data aggregated by the New York Times.
“It’s almost like a mountain system, and you go up a hill, and then you have that flat area, and you rise again and fall down again … It’s part of one big wave that has peaks on it,” said Dr. Wafaa El Sadr, director of the Global Health Initiative at the Mailman School of Public Health at Columbia University.
France is near its worst outbreak yet, registering more than 7,000 new cases Wednesday. Already, it was near 60 cases per 100,000 people.
Italy, Germany, and other countries have also seen rising cases. Overall, the ratio of total reported cases in the U.S. versus the EU has fallen from 20 to 1 less than two months ago to roughly 3 to 1.
The rise in cases in countries that pursued strict measures to control transmission of the virus earlier in the year shows the risks that apply everywhere.
“No country can just pretend the pandemic is over,” WHO Director-General Tedros Adhanom Ghebreyesus said this week. “The reality is that this coronavirus spreads easily, it can be fatal to people of all ages, and most people remain susceptible.”
Of course, reported cases are just one measure of the seriousness of an outbreak and the gauge most susceptible to problems with testing and reporting.
Deaths, the clearest indication, have yet to rise significantly in Spain and France. Yet, they are expected to increase because it takes weeks or months for COVID-19 patients to get sick, die, and be recorded as dying from the disease.
“[Mortality is] the last thing that goes up, but then later, it’s very difficult to bring it down because groups of patients in a very serious condition start to accumulate in hospitals and often they do not progress well,” said Francisco Javier Falo, the general director of public health in Aragon, Spain.
Even then, deaths might not be recorded properly or missed altogether. For that reason, the clearest indication of the pandemic’s toll is excess deaths, that is, the excess of total deaths in a region over a historical average.
By that standard, Europe has not fared better than the U.S. since the start of the pandemic.
For instance, even before the latest surge in cases, Spain had suffered an excess death rate of 95 per 100,000 since the start of the pandemic. The corresponding figure for the U.S. is 66.
In fact, the U.S. is about in the middle of the pack of European countries. The United Kingdom, Italy, and Belgium have slightly higher excess death rates, while the Netherlands, Portugal, and France have slightly lower ones.
It’s worth noting, though, that Germany, a country of more than 80 million, has kept its excess death rate below 11 per 100,000. Several smaller countries, too, especially in Scandinavia, have avoided huge death tolls.
It is likely that the current outbreaks in Spain and elsewhere will be less deadly than the initial waves of the pandemic in the spring, just as the summer surge in Sun Belt states proved less deadly. People under 60, who are less at risk of death from COVID-19, make up a large portion of new cases in Spain, which has resulted in a mortality rate of about 6.6%, slightly over half the mortality rate during the height of the pandemic.
