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EAPM: The blood is the life – key work on blood cancers needed with respect to the upcoming European Beating Cancer Plan

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Good afternoon, and welcome to the second update of the week from the European Alliance for Personalised Medicine (EAPM). With the upcoming Europe’s Beating Cancer Plan (scheduled for its formal launch on 3 or 4 February, depending on whether DG SANTE or the Commission are correct in their predictions), health discussions will inevitably turn to how the noble aim of the campaign is likely to be achieved, and EAPM Executive Director Dr. Denis Horgan turns his particular attention to cancers of the blood. 

Beating blood cancers

Over the years, the EAPM has worked extensively with its members, particularly the European Haematology Association as well as the relevant patient organizations focus on the need for continual work towards reducing and combating the prevalence of blood cancer Such cancers (hematological malignancies (HMs) to give them their correct moniker) are frequently overlooked and, following recent discussions, it is understood that that may not be as prominently covered as they should be.  

HMs are a heterogeneous group of diseases of diverse incidence, and prognosis, and comparison of HM incidence across regions and over time is complicated by the existence of different disease classification systems. Obviously, incidence is one of the biggest and best measures of burden in a population, serving as a vital guide to the allocation of resources.

Statistics suggest that health-care costs for each patient with blood cancer reach twice the figure compared to average cancer costs. The total cost of blood disorders to the European economy was in the region of €23 billion in 2012 and is only increasing.

Blood cancers are in the top ten of the most common forms of cancer and are responsible for approximately 100,000 deaths in Europe every year. Some of the most critical cancers are Multiple Myeloma, Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Chronic Lymphocytic Leukemia, Non-Hodgkin’s Lymphoma, Myelodysplastic Syndrome, and Pediatric Hematological Malignancies.

These cancers present a serious medical and financial challenge and account for abround 40% of cancer cases in children and one third of overall cancer deaths. However, it has been suggested that the upcoming Europe’s Beating Cancer Plan is not as yet paying as much attention to blood cancers as it should.

EAPM and its key stakeholders believe that this is a gap that should be urgently addressed in the upcoming EU Beating Cancer Plan, as blood disorders are not only a burden for patients, but also for society as a whole, with around 80 million people having either malignant or non-malignant haematological disorders. We need to urgently step up how Europe tackles this and the European Beating Cancer Plan can support this common EU effort.

Transforming lung cancer care

Europe's approach to lung cancer (LC) needs a transformation in national care pathways as well as local and country policies. LC care receives high priority within only a few national health strategies. But it is largely up to the member states – incentivized by the European Union – to recognize that reorganization and reallocation of health-care resources are justified by the current massive costs to individuals and to society of the growing incidence of this type of cancer.

Improvements in outcomes are within reach but depend heavily on: 

  • A more uniform approach to national risk-based screening programmes to identify patients early and decrease the rate of patients diagnosed in advanced/metastatic stages;

  • early access to comprehensive genomic profiling;

  • the identification of most appropriate treatment pathways based on the patient’s tumour genetics through multi-disciplinary molecular tumour boards;

  • fast and broad access to most beneficial treatment options;

  • adequate monitoring of patients including patient reported outcomes that will allow for targeted interventions, and;

  • the integration of patient data to gain further insights for research, validity of clinical treatment pathways and cost-efficiency of comprehensive diagnostics and targeted medicines.

These are key issues that should be taken into account as highlighted by the multistakeholder engagement that EAPM has undertaken. 

Stop finger-pointing over vaccination and get to work, says Commission

We are racing against time, not against each other,” Health Commissioner Stella Kyriakides said on Tuesday (19 January). “On the contrary, it is a race that we in the EU are running together, as a team and in unity. As a team, it is important to set clear and ambitious targets.”

And the Commission has set vaccination goals for March and the summer, and backed a bare-bones vaccine certificate. Vice President Margaritis Schinas left the door open to using them later for travel.

Leaders consider travel bans and faster vaccine rollout 

Ursula von der Leyen and European Council President Charles Michel concluded a virtual meeting of EU leaders on Thursday (21 January). European leaders, struggling with a slow vaccination effort and fearful that highly contagious coronavirus variants could rapidly overwhelm their medical systems, moved to begin reimposing border restrictions and to speed the distribution of vaccines — even those not yet approved for use.

We are increasingly concerned about different variants of the virus,” von der Leyen told reporters after a virtual summit of European Union leaders, saying that although the bloc intends to keep borders open for trade, it may restrict nonessential travel. The leaders held back from endorsing a specific plan for borders.

But Germany — which as the richest and most populous EU member often drives its discussions — proposed strict, temporary bans on travel to the EU from countries where mutated forms of the coronavirus are already prevalent, including Britain. The proposal would restrict EU citizens from returning to their home countries if they are currently in an affected country, and would therefore be more stringent than previous border measures. 

The coronavirus situation is deteriorating so badly in some member states that EU leaders have agreed to create a new “dark red” zone indicating the virus is spreading at a “very high level”, Commission President Ursula von der Leyen announced Thursday night (21 January). People traveling from a dark red to another zone could be required to get a test before leaving and might need to quarantine upon arrival. 

France to impose COVID testing on EU travellers

France’s President Emmanuel Macron has announced new coronavirus rules for travellers from the EU, with the country requiring European visitors as well as those from outside the bloc to have a negative Covid-19 test performed less than three days before they enter the country. 

The new restrictive measures, to come into effect from Sunday morning (24 January), were announced by the Elysée Palace late on Thursday and follow an EU summit by videoconference at which leaders discussed measures to control the pandemic with continuing vaccination programmes and controls on free movement. Until now, Macron had sought to maintain freedom of movement within Europe, but pressure on hospitals and the spread of new, more infectious variants of the virus have convinced him of the need to extend testing to almost all those crossing national borders. 

Hungary first in EU to approve Russian vaccine

Hungary has become the first country in the European Union to give preliminary approval to the Russian coronavirus vaccine, Sputnik V. On Thursday, Prime Minister Viktor Orban's chief of staff confirmed both the Russian jab and the Oxford-AstraZeneca vaccine had been given the green light by the health authorities. Foreign Minister Peter Szijjarto is travelling to Moscow for further talks, where he is expected to discuss a shipment and distribution deal.  

And that is all from EAPM for this week – have an excellent, safe weekend, stay well, and see you next week.

Cancer

EAPM: Stronger together against cancer and with good data sharing

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Good morning, one and all, and welcome to the European Alliance for Personalised Medicine (EAPM) update – there is much positivity concerning the battle against cancer and the consultation on the health data sharing plan, so some refreshing good news after all the recent COVID-related despondency, writes EAPM Executive Director Dr. Denis Horgan.

Porto Declaration on Cancer Research

The Porto Declaration on Cancer Research was launched during the European Cancer Research Summit 2021, held on 3 May at the Portuguese Institute of Oncology (IPO) in Porto under the Portuguese Presidency of the Council of the European Union.

The declaration presented by Portuguese Minister Manuel Heitor is the result of the work done by several researchers, scientific and clinical leaders and political decision-makers, who have reinforced the need to broaden Europe's Beating Cancer Plan over recent months, particularly through extending and reinforcing the European network of Comprehensive Cancer Centres (CCCs), based on the reinforcement of three types of research infrastructure:

Translational research infrastructure
Clinical and prevention trial infrastructure
Outcomes research infrastructure

These infrastructure components are increasingly being deemed critical to prevention, early detection, diagnosis, treatment, monitoring disease treatment and patient support and assistance. National participation in the European network of Comprehensive Cancer Centres is led in Portugal by the “Porto Comprehensive Cancer Centre”, based in the Porto IPO, in partnership with its associated laboratory, i3S, which recently received funding of around EUR 15 million for new equipment under the North Regional Operational Programme.

The Porto Declaration on Cancer Research strengthens the commitment of the Trio Presidency of the Council of the European Union (Germany, Portugal and Slovenia) to significantly reduce cancer mortality by 2030, with a goal of 75% of cancer patients in Europe surviving for at least 10 years. Ensuring this goal across Europe means reinforcing the development of a continuum of research activities, from basic to clinical research, including the reinforcement of the European network of Comprehensive Cancer Centres and the three research infrastructure components mentioned above, as well as active participation by the patients and their associations in order to mitigate social and economic inequalities.

The Porto Declaration on Cancer Research thus calls on all European citizens and their Member States to stimulate the synergies in the areas of regional, national and European funding so that cancer research infrastructure access will be easier and fairer.

Speaking at the Cancer Research Summit on 3 May, Health Commissioner Stella Kyriakides said that it’s key the Commission’s Cancer Plan “works hand in hand” with the Horizon Europe Mission on Cancer in order to “ensure coherence between research goals and policy objectives.”  screening program was suspended five years ago due to low turnout and needs to be upgraded, she explained. 

Consultation on health data sharing plan opened by Commission

On 3 May, the Commission published an open public consultation on the European Health Data Space (EHDS) - an important building block of the European Health Union. The EHDS aims to make full use of digital health to provide high-quality healthcare and reduce inequalities. It will promote access to health data for prevention, diagnosis and treatment, research and innovation, as well as for policy-making and legislation. The EHDS will place individuals' rights to control their own personal health data at its core. The consultation will remain open for responses until 26 July 2021. Health and Food Safety Commissioner Stella Kyriakides said: ″The European Health Data Space will be a crucial component of a strong European Health Union. It will enable EU-wide collaboration for better healthcare, better research and better health policy making. I invite all interested citizens and stakeholders to take part in the consultation and help us leverage the power of data for our health. This will have to rest on a strong foundation of non-negotiable citizens' rights, including privacy and data protection.″

Innovative solutions and digital technologies including artificial intelligence (AI), can transform healthcare systems. They make them more sustainable and improve people's health. The development of these technologies requires secure access by researchers and innovators to substantial amounts of health data.

This public consultation focuses on:

the access to and use of health data for healthcare provision, research and innovation, policy-making and regulatory decision;

fostering a genuine single market for digital health services and products, including innovative ones.

The creation of a European Health Data Space is one the key priorities of this Commission in the area of health. The purpose of the EHDS is to promote health-data exchange and support research on new preventive strategies, as well as on treatments, medicines, medical devices and outcomes. In the Communication on the European Strategy for Data, the Commission announced its objective to deliver concrete results in the area of health data and to understand the potential generated by developments in digital technologies. The collection, access, storage, use and re-use of data in healthcare present specific challenges that need to be addressed.

This requires a regulatory framework that best serves individuals' interests and rights, especially as regards the processing of sensitive personal health data. In this context, the Commission adopted its Data Governance Act proposal (2020) with conditions regarding access to data, and provisions to foster trust in voluntary data sharing. Facilitating better access to, and exchange of, health data is essential to ensure increased accessibility, availability and affordability of healthcare. It will stimulate innovation in health and care for better treatment and outcomes, and encourage innovative solutions that make use of digital technologies, including AI.

Health commissioner offers sweeping ambitions for pharma reform and health committee publishes draft response to pharma strategy

No patient in Europe should have to go without medicines that he or she needs due to money or other obstacles, Health Commissioner Stella Kyriakides has said. 

Speaking at an event organized by the European Commission and the Portuguese EU presidency, Kyriakides pledged that EU’s pharmaceutical strategy will tackle the core issues that make medicines unavailable to those who need them. 

The strategy will culminate with a legislative proposal, planned for 2022, revising the EU’s basic pharma rules, which will open the door to the overhaul. 

Kyriakides’ willingness to tear up the current rules may make drugmakers nervous, since they rely on perks like market exclusivity to protect their bottom line. The 2022 reform will take into account “the relationship with intellectual property rights to address aspects that impede the competitive functioning of markets,” she noted. “The failures of markets should not be the failures of our health systems.”

The European Parliament’s Committee on the Environment, Public Health and Food Safety has published a draft response to the Commission’s Pharmaceutical Strategy. The draft report is authored by Spanish MEP Dolors Montserrat from the European People’s Party who is rapporteur for the pharmaceutical strategy. The document calls on the Commission to push ahead with a number of priorities that it identified in the pharmaceutical strategy, which it published in November. Among the demands made in the draft is a call on the Commission “to incorporate new criteria into the system of incentives for research into and the development of new medicines for unmet therapeutic needs.” It also asks the Commission to review incentives and improve price transparency.

EU pharma vulnerabilities

The executive arm of the European Union on Wednesday (5 May) moved to reduce the bloc's dependence on foreign supplies of products in key fields such as pharmaceuticals and digital technology. The initiative forms part of an updated industrial strategy aimed at strengthening the EU's single market, and was presented alongside a proposal for new regulations to tackle distortions caused by foreign subsidies in the bloc.

The European Commission's new industrial strategy is an update from one made in March 2020, before the World Health Organization declared COVID-19 a pandemic. Coronavirus has wreaked havoc in the 27-member EU, making itaware that over-reliance on imports for key components such as those required in drug production and semiconductors could disrupt entire sectors.

"We are updating our industrial strategy, applying the knowledge we have accumulated during the pandemic, drawing on lessons learned and the available evidence," European Commission Executive Vice President Valdis Dombrovskis told a news conference on Wednesday. He said that three key factors have influenced the thinking on the new strategy. The pandemic has highlighted some fragilities in the single market when exposed to particular types of disruption. There has been a growing trend in many jurisdictions to analyze vulnerabilities in key strategic value chains. And the business case for the EU's green and digital transition has become even stronger, Dombrovskis said.

Europe depends on third countries, primarily China and India, in its pharmaceutical supply chains, according to a Commission staff working document.

WHO’s emergencies programme ‘can't deal with multiple crises’

The coronavirus pandemic has revealed that the World Health Organization’s health emergencies programme is “inadequately equipped to deal with a global pandemic while simultaneously responding to other emergencies”, with chronic under-funding and under-staffing leaving it overstretched in some areas, a new report has found.

The report, penned by the Independent Oversight and Advisory Committee for the WHO’s health emergencies programme, covers May 2020 to April 2021 and will be presented at the World Health Assembly later this month. The committee is chaired by Felicity Harvey, a visiting professor at Imperial College London’s Institute of Global Health Innovation.

The programme had to leverage the entire organization during the pandemic and strengthen partnerships with member countries and expert groups to overcome those challenges, the panel found.

The report made specific mention of the Access to COVID-19 Tools Accelerator, of which COVAX is part of, noting that it has “struggled with shortfalls of political will and global solidarity, limited production capacity of vaccines and insufficient financial investment.”

Digital Green Certificate

The EU’s so-called COVID passport – the Digital Green Certificate – to travel freely during the pandemic should be ready for use from the end of June, according to Justice Commissioner Didier Reynders. At the Committee on Civil Liberties, Justice and Home Affairs (LIBE) of the European Parliament on Tuesday (4 May), Reynders said that the certificate will be in use before the summer. “We want to ensure that all EU citizens receive the same treatment when member states lift restrictions on free movement for holders of vaccines, recovery or test certificates,” he said. Last month, the European Commission presented its proposal for the certificate, which will provide proof that a person has been vaccinated against COVID-19, has natural immunity from it, or has a recent negative test result.

On 26 March, the European Parliament launched an accelerated procedure to fast-track the certificate’s approval, and the Parliament and the Member States are currently negotiating the practical details. In principle, however, the individual member states decide which consequences are attached to the document. These could include, for example, free access to the territory without mandatory quarantine.

And that is all from EAPM for this week – stay safe, stay well, have an excellent weekend, and see you next week.

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European Alliance for Personalised Medicine

EAPM: Leviathan, or the rudder of public health

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Welcome, health colleagues, welcome to the European Alliance for Personalised Medicine (EAPM) update. In this edition, we take a good, close look at public health provision in the EU, assessing the ramifications of the problems that the size of public health policy has manifested, as well as our usual look at the health news, writes EAPM Executive Director Dr. Denis Horgan.

The great Leviathan

Is public health provision in Europe not big enough, or is it just too big? Certainly its huge size has enabled it to do great things for European citizens for many years. Three generations of western Europeans have enjoyed an increasingly comprehensive range of services that have improved the length and quality of life for many, to the extent that such provision has come to be taken very much for granted. And even in the EU's newer member states and its candidate countries, expectations have risen in line with – and often ahead of – growing prosperity and access to more extensive services.

But the size that public health policy has attained, together with the consequent complexity, also makes it very difficult to manage, to modify, and above all to rethink. The health system in Europe is indeed a leviathan – and as with supertankers, there are no possibilities of a light touch on the rudder to make quick changes to its course.

The time is coming when some agile navigation may be necessary. There are risks in policy complacency when public health provision is confronted with the massive changes in its context, ranging from demography and scientific advance to new technological possibilities and economic constraints unparalleled since the rise of post-World War II public health thinking. The depiction of public health provision as the great leveller, the guarantor of a minimum of care for everyone, is a compelling argument for the retention of a standardized, one-size-fits-all approach. Negligent watch-keeping on the supertanker's bridge, clumsy hands on the tiller, or indeed reliance on an inadequate or unresponsive tiller, could endanger rather than enhance the general good that public health policy is deemed to protect.

Striking the right balance for the common good necessitates taking full account of competing and even conflicting dynamics. An unthinking acceptance that everything is right as it is at present can lead to blindness over emerging risks. Depending on nursery-rhyme reflexes that if ‘the bough breaks, The cradle will fall’ may cause undue attention to be given to just one bough, overlooking both the possibility that cracks may appear over time and the chance that other and younger boughs – or different and more modern technology - may offer equivalent or better support. Unquestioning attachment to the concept of a homogeneous health system could hinder exploitation of opportunities that may arise for local or spontaneous improvements.

The European Union, as the overarching framework for policy formation in most of Europe, brings an additional complexity to discussions about public health. It is a powerful potential channel for informed reflection, and at its best, the EU could serve as a compass, a lodestone in plotting the voyage. But the search for consensus as the EU's constant operating principle can also stifle original thinking, so that at its worst the EU can obscure the horizon with a self-generated fog, or have the effect of barnacles encrusting the hull below the waterline. Specifically in the health field, the strict limitations on EU competence act as a further confounding factor, with responsibility for public health uncomfortably half in and half out of the realm of coherent planning.

The EU attachment to equality – as most recently enshrined in its approach to social affairs and its bill of rights – is laudable as a philosophy, but can run into problems in such a diverse organization, where national conditions vary so widely across the bloc. This raises the question as to what is the appropriate role for the EU, and whether its espousal of a generalization so simplistic as the common good of EU citizens constitutes a route-map for the best service in public health. There is a risk in ready-made slogans, particularly in areas of great complexity, significance and sensitivity.

So the undeniably admirable concern for public health needs some nuance to translate the ideal into practice, both to avoid it being used too bluntly and to prevent it being overshadowed by other policies. A balance difficult enough at national level. In the European context, a more selective approach to policy design may be even more necessary to keep public health policy finely attuned to real public good.

It is not certain that the EU has practiced that selectivity optimally. It has exercised some choices, and some of those choices have worked out better than others. The ban on smoking in public places resulted more from the issue of protection of workers than directly from public health policy. The effect has been beneficial, but it is striking that an obviously valuable public health policy came about uniquely through the exercise of a completely different policy competence.

Diversity of approach

The sheer diversity of approach confirms that there is no underlying logic or overarching perspective for making EU policy decisions on public health. Policy is often the result of random factors, a consequence sometimes of caprice more than of coherence. There is, for instance, a manifest reluctance by some in the healthcare community to make use of emerging technologies, to harvest the fruits of scientific research in new health applications that can treat the patients or the broader public. Just take the example of patients contributing to earlier diagnosis of melanoma by using their own smartphones, making the condition easier to treat – and then just look at how widely that is endorsed and supported across the member states.

As the stakes rise in ensuring sustainable health systems, the time is coming when a more sophisticated rationale will be needed to guide public health policy effectively – a more soundly based social contract to move forward, above all at EU level. Retaining public health as a sovereign member-state competence demonstrably has had adverse unintended consequences, and continues to do so. Most obviously, it has handed each member state an effective veto on any EU-wide joint approaches, because any country can simply invoke the sovereignty clause to bring any common action to a juddering halt.

COVID-19

Since the beginning of the pandemic, the EU has been working with member states to reinforce national healthcare systems and limit the spread of the virus. It has been coordinating action at EU level based on the best available science and giving recommendations to EU countries on public health measures. The EU's response in the field of public health includes increasing capacity for production of a safe and effective vaccine and through the EU vaccine strategy ensuring the provision of medical supplies and personal protective equipment.

There are the seeds of injustice in standing in the way of progress in something so fundamental to each person's rights as health care, and there are the seeds of something approaching an undemocratic élitism in brandishing 'public health' as a pretext for opposing change. And when the current uneasy status of health policy in the EU leaves action within it vulnerable to veto, then the rights are compromised of many who might wish to embrace change – such as those sharing a genetic characteristic or a rare disease.

The rudder that once acted to steer public health is no longer adequate to the job, and new thinking is needed to take advantage of opportunities that did not before exist.

Outgoing German Chancellor Angela Merkel said on 21 April that the European Union needs more power to coordinate the bloc’s response to health crises like the coronavirus pandemic, and did not rule out a treaty change to secure them. Her comments to an online meeting on the Future of Europe of fellow European conservatives raised eyebrows in Brussels, where the start of a large-scale public debate on the future of the EU has revived talk of reopening the bloc’s governing structure.

In other news…

Draft report on pharma strategy will be presented in ENVI committee in late May

MEP Dolors Montserrat will present a draft of the own-initiative report on the Commission’s pharmaceutical strategy to the the European Parliament’s health committee at the end of May, she said today (29 April).

“This requires an ambitious, clear and up-to-date regulatory framework as well as dedicated resource for science and health research,” said Montserrat, speaking at an event organized by the Portuguese EU Presidency and the European Commission. 

Health commissioner offers sweeping ambitions for pharma reform

No patient in Europe should have to go without medicines that he or she needs due to money or other obstacles, said Health Commissioner Stella Kyriakides today (29 April). 

Speaking at an event organized by the European Commission and the Portuguese EU presidency, Kyriakides pledged that EU’s pharmaceutical strategy will tackle the core issues that make medicines unavailable to those who need them. 

Kyriakides’ willingness to tear up the current rules may make drugmakers nervous, since they rely on perks like market exclusivity to protect their bottom line. The 2022 reform will take into account “the relationship with intellectual property rights to address aspects that impede the competitive functioning of markets,” she noted. “The failures of markets should not be the failures of our health systems.”

Parliament approves COVID-19 certificate position

The European Parliament adopted its position on the digital green certificates Brussels wants to use to reboot travel by proving holders got a jab, a test, or have antibodies following a coronavirus infection with a broad majority. In Wednesday’s (28 April) plenary vote, 540 lawmakers voted in favor of the position; 119 opposed and 31 abstained. Parliament’s position on certificates for third-country nationals got the backing of 540 MEPs, while 80 opposed and 70 abstained.

And that is everything from EAPM for now – have a safe, enjoyable weekend, stay well, see you next week.

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European Alliance for Personalised Medicine

EAPM: Lockdown loosening, third wave warnings

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Welcome, dear health colleagues, to the first post-Easter update from the European Alliance for Personalised Medicine (EAPM). We hope you all had an excellent break and, if you are based in one of the more fortunate countries such as the UK, that you are beginning to enjoy the release from coronavirus lockdown restrictions. EAPM certainly has some busy months ahead, looking forward to work on Next Generation Sequencing (NGS) and Real World Evidence (RWE). That is for the future – for now, here are the updates on the leading health stories of recent days, writes EAPM Executive Director Dr. Denis Horgan.

Not-quite Single Market for medicines

It’s not just inequalities in the distribution of vaccines that is causing worries. A group of MEPs have written to the Commission to push for more equitable access to medicines in the EU, maintaining that currently there’s no “no genuine Single Market for pharmaceuticals”. The current EU rules create unfair discrimination against member states with smaller health systems and pharmaceutical markets. The decision to effectively place a product on the member states’ markets is solely based on the pharmaceutical companies’ commercial and economic interests. While the current legislation provides the industry with the right to place their products on the markets of all member states, there is no mirroring right entitling the member states to get access to those products that have been authorised and placed on the EU Single Market.

It is a known fact that unfortunately private companies often have no interest or incentive to place a medicinal product in the small member states. This situation creates difficulty in accessing affordable medicines for certain patients, higher prices, and often even the withdrawal of particular products. This scenario which is faced by multiple states has resulted in a long-standing structural problem and most member states have joined regional groupings like the Valletta Declaration to try and combat this issue.

Long-term effects of COVID-19

What are the long-term side effects of COVID-19?

Most people who have had COVID-19 expect their symptoms to disappear after a few weeks, but some continue to experience effects months after recovery. People who suffer from persistent symptoms after recovering from the acute illness, also known as “long-haulers,” are often healthy prior to getting infected with COVID-19. This can occur in up to 10% of those infected with the virus.

Common long-term COVID-19 symptoms include:

  • Shortness of breath
  • A lingering cough
  • Chest pain and heart palpitations
  • Dizziness and lightheadedness
  • Fatigue with limited ability to exercise or even perform activities of daily living
  • Joint and muscle pain
  • Loss of taste and smell
  • Sleep disturbances with insomnia and sleepiness during the daytime
  • Gastrointestinal symptoms, such as difficulty swallowing, irritable bowel syndrome (IBS) and indigestion.
  • Depressed mood and anxiety

Because long-term effects of COVID-19 vary from person to person, it is difficult to determine when they will end. The best approach is to be evaluated by your physician or a specialized post-COVID clinic – especially if you have persistent symptoms that are affecting your quality of life. It is also important to seek help if symptoms of anxiety, fear and depressed mood develop.

Digital Green Certificates

The Digital Green Certificate will be a proof that a person has been vaccinated against COVID-19, received a negative test result or recovered from COVID-19. It will be available, free of charge, in digital or paper format. It will include a QR code to ensure security and authenticity of the certificate. The Commission will build a gateway to ensure all certificates can be verified across the EU, and support Member States in the technical implementation of certificates. Member States remain responsible to decide which public health restrictions can be waived for travellers but will have to apply such waivers in the same way to travellers holding a Digital Green Certificate.

Values and Transparency Vice President Věra Jourová said: “The Digital Green Certificate offers an EU-wide solution to ensure that EU citizens benefit from a harmonized digital tool to support free movement in the EU. This is a good message in support of recovery. Our key objectives are to offer an easy to use, non-discriminatory and secure tool that fully respects data protection. And we continue working towards international convergence with other partners.”

Germany’s ICU beds filling up

It has been noted that Germany's seven-day incidence rate had dropped, possibly because of the Easter holidays, but that the number of occupied ICU beds across Germany was increasing "much too quickly".

During the first wave of the pandemic, the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) set up a central registry that records and publicizes the situation in hospitals, or rather in intensive care units, on a daily basis.

A glance at the current map shows that the situation is critical again in some towns and municipalities, meaning that less than 10% of intensive care beds are free — and in some cases none at all. DIVI President Gernot Marx gave a clear statement during a press conference: "Every single day counts; we quickly need a hard lockdown of two or three weeks to lower the number of cases and give us more time for vaccinations."

UK risks third wave

Experts are warning that the UK is risking a third wave as it reopens pubs, hairdressers, outdoor attractions and shops as of 12 April. While prevalence of COVID-19 has fallen to an average of 30.7 per 100,000 across the country, there are hotspots where that rate is double. “However, many people [in those areas] cannot afford to self-isolate,” said Stephen Griffin, of Leeds University medical school. “We need to tackle that issue urgently or the virus will come back again.”

Euthanasia bill fails in France

A bill that would have allowed euthanasia for people with incurable diseases failed last week in France’s National Assembly, despite clear majority support. Because the bill was put on the agenda on a day reserved for a minority group, the chamber had until midnight to pass it. To nip the bill in the bud, a handful of MPs wrote up thousands of amendments to it, making it impossible to debate in a single day.

Romanian hospitals under pressure

According to Romania Insider, Romanian hospitals are overwhelmed. Speaking on Sunday (11 April), Health Minister Vlad Voiculescu said that there were 167 children in hospital — 16 in intensive care — with the minister explaining that they were implementing several measures to manage the cases. According to local media, these include using beds in hospitals that the government had tried to keep for other conditions, such as a cancer institute and another facility for chronic conditions. Voiculescu urged people to wear masks, avoid crowds and stay at home to try and reduce pressure on the health care system. 

Best-case expectations for Q2

In a perfect world, the EU should receive around 470 million doses of approved vaccines by the end of the second quarter. Still, few EU officials believe everything will go according to plan. “We have seen from past experience all sorts of things can go wrong,” said one diplomat this week. One ongoing source of tension is that these second-quarter doses won’t be distributed equally across the EU, because some countries purchased fewer doses than they could have based on their pro-rata allocation. Many smaller and poorer countries, for example, banked heavily on the cheaper Oxford/AstraZeneca jab and purchased fewer mRNA vaccines. Richer countries, like Germany, Denmark and Malta, bought the surplus instead.

And that is everything for now from EAPM – stay safe, stay well, enjo lockdown easing if you can, see you later in the week.

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