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Same picture across Europe: confirmed COVID-19 cases are on the rise, healthcare systems are showing the first signs of pressure, and governments are resorting to a new round of restrictive measures, which may not be in the form of a lockdown. standard, but they are close enough.
The concern is growing because although various measures, such as the mandatory use of a mask, have been in place for a long time, the cases continue to increase and the focus is on what is happening in restaurants and entertainment venues. It is no coincidence that in other countries Christmas is now entering as a milestone to overcome restrictions, while in other countries a climate of communication is already forming that this time we must forget about Christmas.
And concern is mounting, as anxiety about whether a wave of high mortality, like the one in the spring, will occur again, is compounded by growing concern about an even bigger recession, with all the social consequences it could have. .
The announcement of the closure yesterday in France by E. Macron shows what is going to happen in the coming weeks in Europe.
The dynamics of the pandemic
In fact, the pandemic in Europe follows a pattern that many have referred to from the beginning. It started with a large first wave, which was based on dispersal in the community that preceded the spring closures, the large dispersal in hospitals, the nursing home tragedy and the constant exposure of “essential workers.” This first wave diminished under the weight of severely restricted sexual intercourse and mobility, and then gradually began a new cycle of dispersal. It wasn’t very big at first – it was summer after all – but gradually it started to expand, especially as most countries returned to a more normal pace and “opened up”, albeit with a greater emphasis on restrictive measures such as the Mandatory use of a mask indoors, at MMM and in crowded places. The return of most European countries to a “wintery” lifestyle in recent weeks, that is, more shelter indoors, has strengthened this momentum.
At the same time, the much greater availability of tests and the large waves of ongoing tests have resulted in a much higher number of positive cases, including many asymptomatic people.
Mortality from COVID-19 itself does not appear to be at the same level as in the spring. In any case, the statistical dynamics converge in an estimate that the final death rate in all cases will be relatively low, possibly below 0.3%, but even so at very high rates of population infection this means a significant number of victims.
The relative decrease in mortality is due to several parameters. One is that in some countries better measures have been taken with regard to nursing homes and other similar structures for the elderly. Another is that the protocols for treating severe cases have been significantly improved and this saves many lives, from more careful evaluation of the need for intubation (in many cases simple oxygen therapy is preferred), to knowing which drugs are most effective. .
However, this does not mean that the pressure on health systems has decreased. This concerns both the gradual increase in ICU patients, even if they have not reached spring levels, and the total number of COVID-19 patients, given that the spring situation in which people only arrived at hospitals when the intubation was the only solution. 
The time that was not used
Last spring, the rhetoric about the need to save time prevailed in all European countries. It is time to strengthen health systems, but also to seek treatments and continue research and testing of the vaccine.
However, it actually appears that small steps have been taken. The relative decline in the dynamics of the pandemic in the summer, despite the resumption of tourism, was considered by most countries to mean that any next “wave” could be addressed with the existing infrastructure of health systems.
In France, for example, the promises of 12,000 ICU beds were gradually forgotten in September, as this would require thousands of nurse and doctor appointments to staff.
Primary care structures were also not climate-driven, although they are particularly important in coping with the pandemic.
Similarly, although measures have been taken to improve the situation in nursing homes and other nursing homes, there are obvious gaps in the measures, judging by the fact that in countries like France there are already a growing number of deaths.
Nor were additional plans drawn up for specific measures, for the protection of the vulnerable, for safer practices. Apart from the shift towards universal use of masks, the repertoire of public health measures remained that of the spring. 
The absence of specific measures
European countries, as in spring, have focused on “horizontal” measures, from the mandatory use of a mask, to the different variants of the prohibition of night traffic and the reduction of restaurant hours.
The hope is that all of this can reduce the overall spread, reduce daily cases, and translate this into a proportional reduction in severe cases and infections in the elderly. It is no coincidence that across Europe there is talk of restricting trafficking to limit the spread to young people and prevent them from transmitting the virus to older people.
At the same time, governments have avoided going to a standard lockdown, that is, mandatory stay at home and universal closure of restaurants (excluding home delivery) and retailers (excluding supermarkets, pharmacies and other essential items), to avoid recession yet greater and its social impact.
However, what is lacking are specific measures. That is, those measures that would focus mainly on the most effective protection of the elderly and other vulnerable people. That is, it is not clear that very strict protocols have been applied everywhere in nursing homes, while there is a lack of systematic effort to give instructions on how life can be organized to protect the vulnerable more effectively.
The lack of measures to strengthen health systems in combination with gaps in targeted measures for the vulnerable, configures the field of risk that not only the expected increase in cases, but that this will lead to great pressure on the systems health but prospects. the increase in casualties.
In other words, most European countries today cannot guarantee that they will be able to have an epidemiological picture in which the increase in cases is not accompanied by a corresponding increase in severe cases and deaths (a picture that some countries are showing currently to achieve, like Sweden, that after the tragedy of the nursing homes, although it has many cases, it has a low mortality).
Fear, fatigue and reactions
The new wave of pandemics is causing mixed reactions in societies. Governments are escalating measures and restrictions, but we no longer have the unanimous reaction of societies and their compliance with the measures we saw in the spring. There is fear, but there is also fatigue, a phenomenon that occurs when a risky situation “normalizes”, since there is a reaction to social costs, something that appears in the mobilizations that erupt (and not all are led by extreme right).
How the reactions of societies will evolve is something that will be seen in the near future. Fear and anxiety can lead to acceptance of the measures, but it is also possible that we have a growing distrust fueled by the widespread feeling that governments do not have a plan or an effective way to win spring.
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