Across the European Union, COVID-19 cases have started to increase steadily, from 200 per million in mid-February to 270 per million last weekend.
This level is still far from the EU record of 490 per million in November, but a worrying trend nonetheless.
“We are tired of it all, but we are determined too,” a doctor at an Italian hospital told Al Jazeera, speaking on condition of anonymity.
Most parts of Italy, including Rome and Milan, are now classified as high risk and there will be a three-day nationwide lockdown over Easter.
“We were in a period of relative stability around December and January, but now the numbers are deteriorating again very quickly,” said the doctor.
At his large hospital in central Italy, there are concerns about the average age and state of health of recent COVID-19 patients – many have observed a change. These are no longer mainly elderly people with underlying diseases in the wards, but also people 50 years old who were previously in good health.
“It’s a dramatic situation,” she said.
In much of Eastern Europe, too, in countries such as Hungary, Slovakia, Poland and the Czech Republic, COVID-19 infection numbers are skyrocketing.
More infectious strains, slow vaccine deployments
Last year, Italy became the western epicenter of the pandemic when the virus first exploded in Europe, and images of military trucks in Bergamo carrying bodies are still fresh in the memory. Soon after, many European countries were overwhelmed.
But academics have cautioned against viewing the recent surge as a third wave on a European scale.
“You have to take it nation by nation for now,” Guillermo Martínez de Tejada, professor of microbiology and parasitology at the Universidad de Navarra in northern Spain, told Al Jazeera.
Like Italy, Spain was particularly affected by the first wave in 2020.
“Some countries are clearly struggling, but in others, like Portugal and Spain, the numbers are not as high,” said Martínez de Tejada.
“There has been a big increase in testing everywhere too. The more you search for COVID-19, the more you will find.
“Then there is the question of these new strains, in particular the British”, which would be 70% more infectious. “These are undoubtedly amplified cases too.”
Martínez de Tejada is also convinced that the slow vaccination rates in Europe are also behind the outbreak.
Last week, according to Bloomberg’s Coronavirus Vaccine Tracker, the EU administered eight first doses per 100 people, compared to 33 for the UK and 25 for the US.
The slow rollout has been attributed to seemingly chronic delays in supplies dating back to January, when reduced shipments of the Pfizer vaccine sparked feuds with Italy.
Since then, there have been problems in France and Italy with the Moderna vaccine, a reduction of two-thirds of the total promised by AstraZeneca of 90 million doses at the end of March, and last week it was reported that one-shot supplies Johnson & Johnson vaccine, recently approved by the European Medicines Agency, may also be delayed.
Factor in recent tour suspensions of the AstraZeneca vaccine in several countries following reports that a small number of people developed blood clots after receiving the vaccine, and it is easy to see why the vaccination campaign in Europe was so hampered, and how that might affect the rise in cases.
“If we had vaccinated more ambitiously, earlier, I think we could have put a stop to these situations,” said Martínez de Tejada.
“Cyprus has the highest level of people vaccinated in Europe right now, and even there it is nowhere near enough to create herd immunity, at a minimum of 60 percent of people.
“While each country will progress differently, I don’t think we’ll get to this point until the end of the summer. Certainly not in Spain.
Conflict between economic concerns, foreclosure measures
Beyond short-term factors, other academics say the way some European governments have handled the health crisis meant cases would inevitably rise again.
“Generally speaking, around the world there are three different ways of responding to the virus,” Joan Benach, professor of public and occupational health at Pompeu Fabra University in Barcelona, told Al Jazeera.
He said that at one end of the spectrum there was a “laissez-faire” strategy like in the United States and Brazil. On the other hand, in some East Asian countries, a strict policy of “COVID-zero” “which attempted to eliminate it completely by strict collective measures”.
The third way, according to Benach, dominates in Europe – “much more reactive than proactive and strongly influenced by the demands of the business sector”.
“Rather than trying to wipe the virus out entirely, it’s more about learning from it – strengthening the restrictions when the contagion count was high, reducing them as they improved.
“It’s a lifelong game that won’t end until there is a mass vaccination, and it will take months, probably all year round, to happen.
The underlying conflict between economic interest and social restrictions reappeared recently when German company Eurowings announced 300 more flights to Mallorca at Easter after Germany eased travel warnings for parts of Spain .
Hotels in Germany are currently closed, the German Foreign Ministry advises against non-essential tourist travel, and Spaniards are prohibited from all non-essential travel outside their region.
But tourists from Germany to Mallorca will only need a negative PCR test to enter the country, and no quarantine will be required upon their return.
At the same time, in Germany on March 14, the 14-day average number of COVID-19 positive cases increased by 26%, to more than 17,000.
Last week Lothar Wieler, president of the Robert Koch Institute which manages pandemic data in the country, warned of “the start of a third wave”.
Benach said: “Another European-wide wave is not happening yet … [But] given how many waves we have had so far another one wouldn’t be a surprise. The key question is how to prevent it. “
Given vaccination delays, the tension between trade needs and lockdown measures, and the new, more infectious strains of the COVID-19 virus, this looks like an uphill struggle.
Returning to Italy, the anonymous hospital doctor argued that failure to comply with physical distancing measures could undo any positive measures taken during the deployment of vaccines.
“While maybe 80 percent of people obey the restrictions, there is another part, especially young adults, who still feel invulnerable and willingly flout social distancing rules and so on.
“It’s infuriating and threatens to make the sacrifices made by those fighting the pandemic almost unnecessary. But we don’t give up.