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European Commission President Ursula von der Leyen removes her mask during a COVID-19 vaccination target news conference in Brussels. Image credit: Valeria Mongelli/Hans Lucas/Bloomberg via Getty Images
  • Public health experts and European Commission officials have discussed the response of the European Union (EU) to the first wave of the pandemic in interviews with researchers.
  • They said that member states adopted different approaches due to the EU’s limited powers to enforce a common strategy to contain the spread of COVID-19.
  • The researchers found that while EU mechanisms were in place to deal with infectious disease outbreaks, the implementation was slow, inefficient, and hampered by bureaucracy.
  • The study authors conclude that the pandemic has shed light on the fragility of the political and structural systems in Europe for dealing with public health emergencies.

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In early March 2020, as the threat posed by COVID-19 became clear, the EU declared a state of emergency.

On March 10, a meeting of the European Council, which comprises the political leaders of the EU’s 27 member states, highlighted the following priorities:

  • limiting the spread of the virus
  • providing medical equipment, in particular masks and respirators
  • promoting research, including research into a vaccine
  • tackling the socioeconomic consequences of the disease

The meeting also emphasized the need for solidarity, cooperation, and exchange of information among member states.

However, according to the authors of a new report, the EU response early in the pandemic was hamstrung by its limited powers to enforce public health interventions in member states.

Instead, various countries adopted their own strategies to monitor and contain outbreaks.

For example, whereas Italy, Spain, and Belgium introduced strict quarantines and restricted movement early in the pandemic, Sweden and the Netherlands opted for voluntary measures. Germany, meanwhile, focused on regular testing.

The study found that while the EU had long-established mechanisms to tackle outbreaks of infectious disease, the implementation at the start of the pandemic was slow, inefficient, and hampered by bureaucracy.

Researchers at Maastricht University, in the Netherlands, and the University of Hasselt, in Belgium, interviewed 18 European Commission officials and public health experts from member states between May and August 2020.

They report their findings in the journal Frontiers in Public Health.

While the interviewees remain anonymous, the report reveals their roles and quotes them extensively.

The researchers conclude:

“The complex politics of public health at the EU level have led to the fragmentation of its governance for effective pandemic responses. This ongoing pandemic has shed light on the fragility of the political and structural systems in Europe in public health emergencies.”

Interviewees noted that legal limits on the EU’s mandate to tackle infectious disease outbreaks had a particularly significant impact on the European Centre for Disease Control and Prevention (ECDC).

The EU created the ECDC in 2004 to coordinate disease surveillance and guidelines across member states. However, the experts mostly agreed that individual nations’ interests often trumped these efforts during the pandemic.

“The preoccupation with short-term national political interests and the fragmentation and missing leadership of EU institutions hindered a coordinated and effective pandemic response,” said co-author Prof. Thomas Krafft, of Maastricht University.

But study participants also criticized the ECDC’s leadership role during the pandemic.

While it had performed risk assessments and shared information, the ECDC’s actions were not sufficiently visible to the public and national authorities, interviewees said.

In addition, they said that its recommendations were too vague.

An advisor in health and international relations at FPS Public Health, Belgium’s federal food, health, and environment service, told the researchers that the EU was ill-prepared for the emergency.

“There was a very big panic reaction among many member states, and that was also driven by insufficient preparedness at the level of the EU for health crises,” the advisor said.

They added that people assume that the COVID-19 crisis in Europe was unavoidable. “But I think that a lot would have been avoidable with better preparedness and coordination,” the interviewee said.

Dr. Agoritsa Baka, an emergency response expert at the ECDC, believes that the EU as a whole needs to take public health much more seriously.

“We need a lot more tools to be adopted and ready to be run immediately at short notice,” she said on the ECDC’s podcast on August 4, 2021.

“As far as the EU is concerned, we really need to do a lot better in coordination. I don’t know how we could do that, but I think this is something that we need to seriously discuss with member states,” she added.

Several interviewees for the new research said the EU’s poor leadership in the crisis stemmed from its institutional complexity.

“The EU has multiple political levels of decision making and a lot of bureaucracy, impacting the speed of its responses and actions,” the researchers explain.

A health security specialist at the Finnish Institute for Health and Welfare highlighted poor funding of pandemic preparedness.

“I think there’s been a lot of work done by the ECDC and the [member states]. But, it’s all about resources,” the specialist said.

“There’s a lot of money and resources we use for military threats, but there’s not much we use actually for biological threats.”

The experts also advocated for the establishment of stockpiles of protective equipment, essential medicines, and medical devices such as ventilators for deployment in future public health emergencies.

But interviewees also applauded the European Commission’s Joint Procurement Agreement, which coordinates the acquisition of medicines and vaccines for the EU as a whole.

“The overall view on the joint procurement was positive, as one, or even the one example of a coordinated and relevant action by the commission in response to the pandemic,” said Prof. Krafft.

“Interviewees’ assessments differed regarding the timeliness and whether it could have been even more efficient, but overall the view was positive,” he told Medical News Today.

Looking to the future, most of the experts predicted a strengthened EU role in crisis management and a more robust public health community.

However, some were sceptical about whether the EU would learn lessons from the pandemic, judging by past performance after outbreaks of other infectious diseases.

“I would like to think that, given what happened, there will be more resources, more funding toward public health, but unfortunately, I don’t believe it will actually happen,” said a public health and epidemiology specialist at Instituto Nacional de Saúde, in Portugal.

“I think that once this sort of gets sorted out, we’ll just go back to business as usual, in the usual priorities,” the specialist said.

Despite repeated warnings about future pandemics from the World Health Organization (WHO), there has been little interest and investment in health emergency preparedness at the national level, the report concludes.

The authors write:

“One reason that frequently appeared in the results was the belief that infectious diseases would break out mainly in developing countries and that the EU region was invulnerable, due to its economic position in the world.”

They note that their findings are limited to the first wave of the pandemic. Future interviews will provide a more complete picture of the EU’s response, including its attempts to coordinate vaccine procurement and distribution.

In addition, the researchers acknowledge that the number of interviewees in this first report was relatively small and that their expertise does not represent the EU’s political organization.

“Expert opinions and views are not free from subjectivity and distortion,” they add.

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