Europe's COVID-19 surge highlights warnings for US

Experts say a COVID-19 surge in Europe serves as a warning to the United States about the continued threat of the virus, even as many are ready to move past the pandemic era.

Despite the European Union having a higher vaccination level than the U.S., parts of Europe saw a record number of coronavirus infections on Wednesday.

The spike in cases has prompted Austria to reimpose a lockdown, while Belgium has moved to righten rules including a mask mandate amid its own surge, sparking protests.

Tough measures like a lockdown, or anything like it, are not expected in the United States, where there is no appetite among the public and the Biden administration has dismissed the idea.

But experts say Europe's crisis shows that the virus remains a major threat, particularly anywhere there are unvaccinated people.

"If you've got unvaccinated population, the virus is going to find them," said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

Austria, which is going into lockdown amid a major surge in cases and deaths, has 64.5 percent of its population fully vaccinated, close to the average for Europe, compared to 59 percent in the U.S.

"In places where you do have Austria-like vaccination rates or lower, I think the risk is definitely there for cases to surge," said Josh Michaud, associate director for global health policy at the Kaiser Family Foundation.

The risk is overwhelmingly among the unvaccinated. Updated data from the Centers for Disease Control and Prevention (CDC) show that in September, unvaccinated people were 5.8 times more likely to test positive for the virus and 14 times more likely to die from it.

Experts stress that the most important response is to get more people vaccinated. In the U.S., those efforts have hit resistance, though the Biden administration is trying to break through with an array of mandates.

Protection from the vaccines is also waning over time, leaving more people exposed to generally milder breakthrough cases. That has led to a push to get booster shots to all vaccinated U.S. adults.

"With a large number of people who are still not vaccinated, and reduced vaccine-induced protection against infection and mild disease, many people are left vulnerable to the virus," the World Health Organization (WHO) said in explaining Europe's surge while also pointing to the transmissibility of the delta variant and more people gathering inside after restrictions were eased.

The WHO warned that with current trends, Europe and Central Asia would see an additional 700,000 deaths from the virus, from 1.5 million to 2.2 million, by the spring.

Adalja said the main step to prevent hospitals from being overwhelmed is to get more people their initial vaccine doses, since the vaccines are highly effective against hospitalization. But he said as much as 80 percent of the population being fully vaccinated could be needed to provide "resiliency" against surges.

Michaud noted that within Europe, countries like Spain and Portugal with very high vaccination rates over 80 percent are faring better.

Eric Topol, professor of molecular medicine at Scripps Research, tweeted that boosters would also help, pointing to data from the U.K. showing larger declines in hospital admissions among older age groups receiving boosters.

"Boosters (3rd shots) are working, as seen by fewer hospital admissions among the age groups receiving them," he wrote.

While not currently as bad as in Europe, cases are also on the rise in the U.S., and hospitals in some states are again stressed.

But the Biden administration is clear that it does not see a return to anything close to a lockdown in the U.S.

"We are not headed in that direction," White House COVID-19 response coordinator Jeff Zients said Monday when asked about Austria. "We have the tools to accelerate the path out of this pandemic: widely available vaccinations; booster shots; kids' shots; therapeutics, including monoclonal antibodies to help those who contract the virus."

The country is in a delicate moment in the COVID-19 response. Many people are fatigued with restrictions and eager to return to a normal life. Many experts as well say that a point is approaching when the virus will be "endemic," meaning it will fade into more of a fact of life in the background rather than a crisis.

Vaccinations for children, as well as promising new antiviral treatments from Pfizer and Merck, can help bring that moment closer.

Washington, D.C., this week officially lifted its mask mandate. D.C. health department director LaQuandra Nesbitt said, "We are learning to live with COVID."

While it is dismissing lockdowns, the Biden administration is still stressing the importance of mask mandates, even if most states have already left them behind.

CDC Director Rochelle Walensky said last week that her agency still recommends that areas have low levels of transmission for several weeks "before releasing mask requirements."

The continued threat is also evident in surges within the U.S., like in Michigan, where hospitalizations are spiking.

Michigan hospital officials warned this week that the spike is "straining or exceeding the capacity of emergency departments and hospitals across the state."

The officials called on the public to get vaccinated, get a booster dose and to exercise caution with indoor events, including wearing masks.

"We cannot wait any longer for Michigan to correct course; we need your help now to end this surge and ensure our hospitals can care for everyone who needs it," they said.