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Covid-19 Battle to Intensify as winter sets in

Health authorities in North America and Europe are stepping up another intensive phase in the fight against Covid-19 as winter begins.

Respiratory viruses tend to spread more easily during the cold winter months, which in a typical year cause coughing and sneezing in the schoolyard and pneumonia and death for the most vulnerable elderly. The risk for the US and Europe this year is that Covid-19 cases multiply at the same time as other winter illnesses, which are overwhelming hospitals with sick patients.

Experts in public health and communicable diseases say the risk of such a storm means governments need to prepare for a difficult winter. That means working hard to reverse a resurgent pandemic before the colder months arrive.

The United States registered an average of 50,700 new cases a day over the past seven days, equivalent to 1

54 cases per million inhabitants, while the 27 countries in the European Union and the United Kingdom together registered an average of 81,600 a day, approx. 159 for every million people. The number of people hospitalized with severe cases of Covid-19 has increased, although it is still a fraction of what was recorded during the pandemic’s spring break.

Authorities in the UK are issuing public warnings about the risk of Covid-19 on city streets.


oli scarff / Agence France-Presse / Getty Images

“It would be really good to go into the winter by keeping the number of cases of coronavirus as low as possible so that we have room for maneuver and breathing,” said Jimmy Whitworth, professor of international public health at the London School of Hygiene. and tropical medicine.

With governments eager to avoid a return to the economically damaging lockdowns imposed earlier this year, getting ready for winter requires aggressive efforts to find and isolate coronavirus carriers and targeted measures to counter the spread of the pathogen, experts say. in public health.

Already in Europe, governments have introduced new restrictions in an attempt to stop the flare-up of the pandemic with a curfew imposed on Paris and eight other French cities, bars ordered to close in Scotland and parts of England, and face masks became mandatory outdoors in Italy.

A major reason why viruses tend to spread more easily in winter is that people spend more time indoors, often with others, increasing the chances of transmission. Windows normally close, reducing ventilation that spreads airborne bugs. Viruses also tend to survive longer at cold temperatures and at low humidity.

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A wide range of common viruses show seasonal infection patterns that infect children and adults during the winter months. Worldwide, influenza typically causes serious illness in between three million and five million people a year and kills between 290,000 and 650,000, according to the World Health Organization.

Other viruses that overwhelm hospitals with sick patients in colder months include norovirus, a highly contagious pathogen that causes vomiting, and respiratory syncytial virus, a defect that can cause breathing problems in children. Cases among the elderly of pneumonia, an inflammation of the lungs that are usually caused by infection, also tend to be higher in winter.

Coronavirus infections in the United States and Europe have increased in recent months as economies eased restrictions and people returned to workplaces, schools, bars, restaurants and other indoor spaces.

“It’s pretty clear that it transmits exquisitely well in indoor environments when people are close to each other,” said Isaac Bogoch, associate professor of infectious diseases at the University of Toronto.

In Newcastle, the north-east of England, restrictions have been tightened since the summer.


Owen Humphreys / Zuma Press

Cooler temperatures will push people indoors even more, giving the virus more opportunities to move from host to host. Winter also brings several holidays when people share meals with families and make friends, increasing the daily connections that help the virus spread.

Thomas Russo, head of the Department of Infectious Diseases at the University of Buffalo’s Jacobs School of Medicine and Biomedical Sciences, said a degree of “Covid fatigue” after months of restrictions could intensify people’s desire to mix this winter.

“There will be so many occasions with mixing of social bubbles mixed with eating and drinking indoors without masks that I am quite worried that it will cause a big bump in infections,” said Prof. Russo.


What makes you most nervous about the turn of the season as it pertains to Covid-19? Join the conversation below.

In a July report, the UK Academy of Medical Sciences modeled a worst-case scenario in which the country’s coronavirus epidemic rose again in the winter as transmission increased during the colder months. The model showed admissions and deaths, which peaked in January and February, at the same time as hospitals typically experience maximum demand due to other winter illnesses.

Modeling from the University of Washington’s Institute for Health Metrics and Evaluation suggests that the number of hospital beds needed in the United States for Covid-19 patients could more than double by December 1 on current infection trends to about 70,000.

Anne Johnson, professor of infectious disease epidemiology at University College London and vice-president of the academy, said the scope of health care is even slimmer this winter than in a normal year. This is because, in addition to seasonal ailments, there is a backlog of patients not seen in the spring when appointments and surgeries were canceled to free up capacity to manage Covid-19.

In addition to beating Covid-19 back, public health authorities should also fight the flu, she said. Since Covid-19 symptoms can resemble flu, doctors need quick and effective tests to distinguish between the two. Mass vaccination should cover not only those who are vulnerable to serious illness, but those who play a role in transmission, such as children, Prof. Johnson said.

Cold comfort

Rising Covid-19 case burdens have public health authorities on high alert as the northern hemisphere enters winter. A hopeful sign: the southern hemisphere experienced a mild flu season, easing seasonal pressure on hospitals.

Percentage of flu tests that are positive

Note: The regions shown are WHO ‘influenza transmission zones’ geographical groups of countries, territories or territories with similar influenza transmission patterns.

Source: World Health Organization

A hopeful sign: In the southern hemisphere, where winter has already been and is gone, the flu season was mild. It probably reflects improved hygiene and social distancing, designed primarily to combat Covid-19, but there is no guarantee of recurrence, doctors say.

If winter leads to more Covid-19 cases, doctors say they at least now have more tools available to treat the sick, even though the long-term effects of the disease are little understood.

Some disease experts say that it is possible that Covid-19 may develop into a seasonal disease over time, if the population, as with other diseases, gets some protection against ongoing transmission, as more people are exposed to it.

“We may well have seasonal Covid on top of the flu every year,” said Julian Tang, professor of respiratory medicine at the University of Leicester in the UK.

Write to Jason Douglas at jason.douglas@wsj.com

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