The coronavirus pandemic recorded several grim milestones in Europe this week, but there are signs of hope on the horizon.
Italy became the latest European country to record 1m cases this week, while in France there are now more people hospitalised with the virus than at the height of the first wave.
But the news the first vaccine is effective and will be ready for distribution soon was not the only cause for cautious optimism. Across much of the Continent there are signs the second wave is slowing and may have passed its peak.
In Germany, France and Spain the rate of infection has begun to slow, while hard-hit countries such as Belgium, the Netherlands and the Czech Republic have seen a dramatic fall in new cases.
France recorded 33,172 new cases on Thursday, down from 86,852 the previous Saturday, while Belgium recorded 7.916 on Thursday, compared to 23,291 two weeks ago.
In both Germany and France, the R number — indicating how many people each person with the virus infects — has dropped below 1, while in Italy the proportion of people testing positive has begun to fall.
But leaders and health experts across Europe warned that it was too soon to talk of relaxing restrictions.
“France is facing an extremely strong second wave,” Jean Castex, the French prime minister, said. “Today in France one in 4 deaths is due to the coronavirus. Forty per cent of those admitted to intensive care are under 65.
“According to our projections the peak in the hospitals should come next week. If all goes to plan, there could be a relaxation of restrictions from December 1.”
Coronavirus France Spotlight Chart – Cases default
“We really have to grit our teeth for another couple of months,” said Lothar Wieler, the head of Germany’s disease centre, the Robert Koch Institute.
“What makes me cautiously optimistic is the fact that the number of cases is currently not rising that steeply. We don’t know yet whether this is a stable development, but it shows we are not at the mercy of the virus.”
Yet in many ways it was a week of grim developments. In Italy a patient was found dead while waiting for a test at a hospital in Naples. Disturbing footage shared on social media showed the lifeless body sprawled across the floor of a bathroom, while patients looked on from a packed coronavirus ward.
Other footage recorded outside the hospital showed people being administered oxygen as they waited in their cars for admittance.
People were given oxygen as they waited in their cars outside a Naples hospital
Credit: IPA / SplashNews.com
In France, the number of people hospitalised with the virus reached 32,638 and wards were said to be at 94 per cent capacity. According to Mr Castex, a new patient was being admitted with the virus every 30 seconds.
In Germany, Jens Spahn, the health minister, warned that medical staff who tested positive might have to keep working and wear PPE rather than self-isolate. "When staff shortages become acute, we have to consider the second best option,” he said.
German officials said it was too early to say if the signs the virus was slowing meant new “lockdown lite” restrictions introduced at the start of November are working, and warned there would be a two-week lag before any effects were seen.
There has been organised opposition to Germany's most recent lockdown. Here, riot police officers arrest an elderly left-wing protester in Frankfurt am Main
But in neighbouring Austria the government abruptly abandoned limited restrictions imposed last week and ordered a tough new lockdown – including the closure of schools.
There were grim reminders of the collateral costs of lockdown in the results of two German studies. A study in the region of Hesse found the number of deaths from heart attacks rose 12 per cent during the first lockdown, and doctors warned serious heart conditions may have been undiagnosed because patients followed advice to stay at home and did not seek medical help.
A smaller scale study in the Waldshut area found that while local deaths were 37 per cent higher than usual in April, only 55 per cent of those excess deaths were linked to the coronavirus, while the rest appear to have been caused by other conditions that went untreated.
Germany has not seen any excess mortality so far as a result of the second wave, while across Europe it remains much lower than during the first wave.
There were hopeful signs in those countries hit worst at the start of the second wave. In the Czech Republic, which had the most cases per capita anywhere in the world a month ago, infection rates have fallen sharply.
The same is true in the Netherlands and Belgium, two other countries badly affected last month. But Alexander De Croo, the Belgian prime minister, warned his country is not out of the woods yet.
“This is a marathon and we’re close to the start, not close to the finish,” he said. “We have to prepare ourselves for longer-term measures.”
The World Health Organisation (WHO) warned that even after the successful tests, it will take months to roll out a vaccine successfully.
“We may be tired of Covid-19 but it is not tired of us,” Tedros Adhanom Ghebreyesus, the head of the WHO, told the Paris Peace Forum.
“European countries are struggling, but the virus has not changed significantly, nor the measures to stop it.”