SSince the outbreak of the pandemic, the countries in Europe have reacted very differently to the challenges. The relatively loose strategy of the Swedes compared to the hard lockdown in many other countries is just one example.
But who has actually done best on balance so far? And what lessons can be learned from this for the future? The OECD examines these questions in detail in a health report submitted jointly with the EU.
The Paris think tank could hardly have found a more dramatic environment for the publication of the 277-page bundle. Originally, “Health at glance” was supposed to compare the health structures in Europe every two years. In the midst of the pandemic, this has turned into an analysis of the shortcomings.
If you only look at the absolute numbers up to October when it comes to the disease, Great Britain is still the country that has been hit hardest in Europe so far, with over one million confirmed Covid 19 cases and over 46,000 people who have died from it.
It is followed by France, Spain and Italy with 35,000 deaths each. If you put this number in relation to the size of the population, Belgium is even worse off with a rate of more than 500 Covid 19 deaths per 100,000 inhabitants.
With extensive measures and a lot of money, the governments have tried since then to counter the global epidemic and to save their health systems from collapse.
The example of Great Britain shows above all that such short-term means are not necessarily the solution in the fight against a pandemic, because in case of doubt they come too late to turn a dangerous trend in time.
There Prime Minister Boris Johnson initially ignored the epidemic from far-away China for a long time and then turned it around relatively late. In the meantime, according to the OECD, the British government has announced additional health expenditure of EUR 446 per capita, adjusted for purchasing power, significantly more than all other European neighbors.
Germany, for example, which has so far also pummeled and not messed up in the fight against the pandemic, comes to 302 euros per capita and is second in this category in the OECD ranking.
The European average is around 112 euros. In most cases, governments have pledged the additional funds for the health sector to purchase protective equipment and create additional hospital capacity.
In Germany, Finland, the Netherlands and Norway, the total also includes planned expenditure on vaccine programs. However, the OECD’s list is based on government announcements, not actual expenditure, and does not claim to be exhaustive.
The economic effects are also dramatic. The OECD comparison shows that the gross domestic product (GDP) of some countries has plummeted in the course of the crisis.
This is particularly true of the two countries particularly affected by the pandemic, Great Britain and Spain, where growth in the spring declined by 19.8 percent and 17.8 percent compared to the previous quarter. In this comparison, Germany is in a slightly better position with a minus of 9.7 than the EU average of 11.4 percent.
The fact that the largest euro nation has come through the crisis relatively well in comparison is also due to the high capacity of the available intensive care beds. Even before the outbreak of the pandemic, Germany was in the best position in Europe with 34 beds per 100,000 inhabitants, followed by Bulgaria and Austria.
According to the OECD list, Sweden ranks at the lower end with 2.1 and Denmark with 2.4 beds per 100,000 inhabitants. The European average is five beds per 100,000 inhabitants.
At the height of the first wave in spring, 80 percent of the intensive care beds in Italy were occupied by Covid 19 patients, in France it was 65 percent, with the differences between the individual regions within these countries being extremely high. While in the greater Paris area, for example, capacities were almost completely exhausted at times, there were always enough beds in other regions of France.
When asked how flexibly the individual countries reacted to impending capacity bottlenecks, France and Italy did accordingly well in retrospect: in both countries all the stops were pulled to create new intensive care beds, from the conversion of departments to field hospitals up to the relocation of patients to independent hospitals and cooperation with privately run clinics. However, the limiting factor in all 36 countries in comparison is and remains the availability of medical staff.
In order to keep capacities free, so-called elective, i.e. not acute, operations have been postponed in many countries. The emergency rooms were also used significantly less frequently than is normally the case.
Significant effect on cancer treatments across Europe
In Germany, for example, the number of hospital admissions in hospitals fell by 30 percent, and in Italy the emergency rooms of children’s clinics were even 88 percent less frequented than usual. However, due to the very different structures of health systems, such figures are difficult to compare.
The Covid-19 measures in clinics had a significant effect on the treatment of cancer patients, across Europe. In the Netherlands, for example, cancer diagnoses fell significantly according to data from the national cancer registry, which was not due to the fact that the disease was less common, but simply to the fact that significantly fewer preventive examinations and screenings were carried out, especially in spring.
In France, too, the rate of cancer diagnoses fell by up to 50 percent. In the UK, chemotherapy treatments were reduced by 60 percent compared to the period before the pandemic broke out. According to initial studies, the long-term effect should be considerable.
Experts in Great Britain expect the number of cancer deaths in certain indications to rise between five and 16 percent because of the delayed diagnosis. The result is likely to be similar in other countries.
Across Europe, the OECD study also shows that the infection rate and the risk of death with Covid-19 are significantly higher for socially disadvantaged groups. The risk of death in Great Britain for people from particularly socially disadvantaged classes is more than twice as high, in Sweden even 80 percent higher.
In the course of the pandemic, telemedicine care has made significant progress. In Germany, for example, the number of virtual consultations rose from 1700 to 19,500 at the height of the first wave. This effect was similar in France. It remains to be seen whether this will continue after the epidemic subsides.
Surprising winner: Malta
But which countries have succeeded particularly well in reducing the reproductive rate through appropriate measures? The OECD also looked into this question in its report.
The surprising winner in this comparison is Malta: According to the study, the country managed to reduce the reproductive rate to the crucial value of below one in just eleven days. The rate indicates how many other people an infected person infects on average.
In order to contain a pandemic, a value below one is aimed for. In this comparison, Germany‘s 37 days are slightly worse than the European average, which is 34 days. The clear negative leader is Sweden with its long-term, very relaxed strategy. According to the study, the reproduction rate there was 58 days, in Great Britain it was 54 days.
However, it remains difficult to find out which measures exactly help to contain the infection rate quickly, write the OECD authors. “It seems that early interventions pay off particularly well,” the experts concluded.
What this means in concrete terms for the second wave of infections currently underway in Europe remains open in the extensive work. What is certain is that Europe must be better equipped for the next pandemic. Covid-19 is neither the first nor the last global epidemic that the continent has to deal with.