#EAPM - To ease restrictions, or not….to improve testing, the role of digital!

Mixed messages are coming out from all over the planet with some places already starting to relax movement to a degree, and others saying that, for them, it is way too early, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

The frustration as the good weather hits in Europe and near-Europe is palpable, but most people seem to understand and are generally doing as advised. Not all, but most.

What is clearly proving difficult is for citizens in one country to see restrictions lessened in other near-neighbouring countries and, with all the different information on everything from the usefulness of masks to the merits or de-merits of ‘herd immunity’ happening at the same time, it is psychologically tough for many.

Of course, the whole novel coronavirus issue and its fallout will be discussed in as many aspects as we can manage at EAPM’s next ‘virtual’ conference, coming up at the end of June.

This will be a Bridging Conference between the Croatia and German Presidencies of the EU which, due to current circumstances, we have to hold online. The title of this ‘gathering’ is “Maintaining Public Trust in the use of Big Data for health Science in a Covid and Post Covid World.”

Registration opens this week, and we hope you will join us.

The current COVID-19 crisis has thrown many European, and indeed, global health-care issues into sharp relief.

It has also raised important questions, not necessarily new ones, but ones that have shifted more into focus during the pandemic.

One such question is whether the EU should have a bigger role in public health – and particularly in the provision of health technology. This, of course, would impinge upon the closely guarded member state competence in healthcare so, if this were to happen, how would that be?

Another question is how can the now very evident gaps be bridged to in order to better protect Europe’s health ahead of another crisis? What are the priorities? The broader question, as mentioned above, is whether it’s time to give the EU a bigger role in Europe’s health protection.

As the pandemic has unravelled and lethally struck at the heart of Europe, the deficiencies in availability and supply of necessary assets for responding have become overtly clear.

There have been huge shortages of personal protective equipment (PPE), such as face masks, as well as too little basic ICU equipment, devices and infrastructure.

On top of this, there has been inadequate provision of high-tech procedures and processes, for testing (both for infection and for immunity), a shortage of medicine for symptomatic treatment, for any curative therapy, and (not surprisingly given the timescale) for preventive vaccines.

There is much to discuss. And that will also include an even more accused emphasis on access to diagnostics and treatment.  

What is clearly needed, alongside other aspects, is much more international cooperation, and the European Parliament has been supportive of this.

Above and beyond the COVID-19 issue, the EU should of course champion equal access to basic health care and the best treatments available. This would deliver European solidarity going way beyond a political soundbite, that would forge bonds beyond a perceived East- West and North-South ‘divide’.

Specifically to the current virus, in this sense when a vaccine does come online, we need to ensure that everyone has access to it. There should be no more recurrence of pan-European competition for resources (such as we have also in the US and Asia, for example).

It is certainly good to note that the G20 has committed to sharing timely and transparent information and materials for research. This as well as vowing to expand manufacturing capacity to meet the need for medical products and to make them widely available, at an affordable price, on an equitable basis, where they are most needed, as quickly as possible.

This doesn’t take away from the direct challenge, however, as there is currently adequate global manufacturing capacity for emerging diagnostics, for a start, which may push public health decisions towards compromising health outcomes. So we need a rethink.

One intriguing question that we’ve heard asked in and around the EAPM corridors is whether more authoritarian regimes have done a better job over the course of the crisis than democracies.  

That’s an uncomfortable question for voters everywhere, isn’t it? One that asks whether western societies are prepared to forgo (hopefully temporarily) their freedoms and privacies.

Although we work hard to keep a watchful eye on intrusion, there is no denying that down the decades we have given up much - lots of data, even through social media, CCTV cameras everywhere, most licences, biometric passports, running all the way back to the dawn of fingerprinting right up to DNA.

Where’s the line to be drawn in the sand? Especially in exceptional circumstances such as the ones we find ourselves in.

This will be at our end-of-June virtual conference…

As it stands

Over the weekend the total number of deaths from COVID-19 across Europe (at least, as far as we know) passed 100,000, according to the Johns Hopkins Coronavirus Resource Center. 

The unenviable league table still has Italy at the top, followed by Spain and France. Meanwhile, Belgium has the highest death rate per capita of infected citizens, depending upon who you read.

It’s not all bad news, though, as the weekend also saw what looks like a decline in Italy’s infection curve, while Sunday in Spain brought us the lowest increase in its death toll for a month.

On the topic of Belgium’s rate, the country of 11 million people has so far suffered more than 5,000 deaths, according to reported figures. Brussels says that this is because Belgium has put in place its own reporting system. 

Steven Van Gucht, who chairs the government’s scientific committee for coronavirus, went on record to say: “Whoever wants to compare our number with other countries has to divide it by two. Any other comparison isn’t relevant at all.” Interesting argument…

Making contact: The role of digital

As exit strategies are already being talked about across Europe it has become clear that tracking apps are expected to play a part by all capitals.

But we’re back to privacy versus health again, it seems. As well as effectiveness.

For example, on the latter point, Italy reckons that about 70% of the population will need to install the government’s preferred app for it to be effective. (Also in Italy, Milan is set to host the first “bio-bank” for Covid-19, which will consist of a database of related blood and tissue samples.)

On privacy, the UK’s Ada Lovelace Institute has published a review calls for the establishment of a Group of Advisors on Technology in Emergencies to oversee any process of deploying a digital contact tracing app with, perhaps, add-on “immunity certificates”.

France is also a little bit twitchy about the scope of such apps, while Germany has issued cybersecurity guidelines.

More on the exit doors

Over the weekend, Italy’s Prime Minister Giuseppe Conte announced that economic activities in the country will gradually re-open from 4 May, while French Prime Minister Edouard Philippe has begun to drop hints about his country’s upcoming strategy (due 11 May).

Prime Minister Philippe confessed to contemplating making masks mandatory in public, with Health Minister Olivier Véran saying 17 million masks could be produced every week.

Over in Spain, the country’s Ministry of Health has assembled a panel of experts to draw up a plan on lowering lock down measures in due course.

Propping up the economy

Last week, the EU’s finance ministers agreed a €540 billion package of measures geared towards struggling economies, in tandem with an EU-budget linked recovery fund. 

The word is, however, that such a sum will not be enough as Europe faces a “long and costly” economic recovery. A second phase may well need the same again from EU institutions, if not more.

This all comes against the backdrop of the fact that in excess of 25% of all jobs in Europe could suffer badly due to the economic fallout of the novel coronavirus.

The analysis comes from McKinsey, alongside a prediction that unemployment may almost double in the months ahead.

Better news next time, we hope!

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