EU leaders
try to retake control of coronavirus response
After an
extraordinary videoconference, top leaders promise coordinated action to
contain virus and stabilize economies.
By DAVID M.
HERSZENHORN, SARAH WHEATON AND JACOPO BARIGAZZI 3/11/20, 12:17 AM CET Updated
3/11/20, 12:20 AM CET
Europe's
leaders on Tuesday moved to assert control over their initially haphazard
response to the fast-spreading coronavirus epidemic, announcing an array of
measures aimed at containing the disease, blunting an unfolding economic shock,
and reassuring an increasingly panicked public.
But it was
far from clear that any of it would work.
The new
measures, including plans for a fast injection of €7.5 billion in assistance to
health care systems, small businesses and other hard-hit sectors of the
economy, were announced by Council President Charles Michel and Commission
President Ursula von der Leyen, following an extraordinary videoconference between
the EU's 27 heads of state and government, European Central Bank President
Christine Lagarde, and the Eurogroup president, Mário Centeno.
In
statements to the press following the nearly three-hour-long videoconference,
Michel and von der Leyen aimed to project a new posture of confidence and close
coordination between all of the EU's main power players.
Among the
steps they announced were new daily conference calls between EU health
ministers or EU ministers of the interior to coordinate national responses. Von
der Leyen also said the Commission was now taking stock of available protective
equipment and respiratory devices, as well as production and distribution
capacity, to get emergency materials where they are most needed.
"We emphasized the need to work together and to
do everything necessary and to act swiftly." — Charles Michel
And they
said that in the days ahead, the EU would waive fiscal rules and other
regulations, including on state aid to businesses, so that capitals could take
the necessary action to prop up their battered economies, which will only
contract further in the weeks to come.
But many of
the measures lacked detail, and the fact that such statements were necessary at
all only highlighted how uneven the responses across Europe have been so far,
and the EU's failure to provide the initial steadying hand that capitals and
citizens now expect from Brussels.
It was this
unevenness — and complaints from some national leaders — that prompted Michel
to organize the videoconference, in an effort to restore the EU's own image of
itself as a pre-eminent crisis manager, even though most authority for health
policy lies with the member states, and Brussels mainly has a coordinating
role.
"We
emphasized the need to work together and to do everything necessary and to act
swiftly," Michel told reporters after the meeting. Michel said leaders
"stressed the need for a joint European approach and a close coordination
with the European Commission" and he issued a written statement laying out
four top goals: limiting the spread of the virus; providing medical equipment;
promoting research including for a vaccine; and addressing the socioeconomic
fallout.
The few
concrete measures put forward were announced by von der Leyen who said the
Commission, in addition to its existing internal emergency response group,
would assemble a team of epidemiologists and virologists to provide expert
advice. She said the health ministers and interior ministers would consult daily
and would offer to provide €7.5 billion in unspent funds to help speed up
access to another €17.5 billion.
She also
noted the Commission’s plans to take stock of protective gear and necessary
medical equipment to improve distribution around the EU. However, there was no
sign that Germany was backing away from its moves to restrict exports of
protective equipment, nor France’s requisitioning of face masks. On Tuesday
night, the industry association MedTech Europe said such unilateral moves could
“create acute shortages in other parts of Europe.”
"The
crisis we face because of coronavirus has both a very significant human
dimension and a potentially major economic impact, and it is therefore
essential that we act very decisively and collectively — first of all to
contain the spread of the virus and help patients, and to counter the economic
fallout," von der Leyen said, adding: "Let me be very clear: the
Commission is working flat out on both fronts."
Von der
Leyen said that by the end of the week, the Commission would develop concrete
proposals regarding new flexibility in the bloc's fiscal rules, and would put
them before a meeting of the Eurogroup on Monday. "We will use all the
tools at our disposal to make sure that the European economy weathers this storm,"
von der Leyen said.
And in a
bid to emphasize the message to citizens of the EU's largest and richest
country, von der Leyen repeated her lines about the economic measures in her
native Germany.
But even as
the leaders worked to emphasize the new choreography between the EU and its
member countries, developments continued to swirl in ways that suggested no one
was fully in control.
Several EU
countries said they had closed their representations in Brussels and that
diplomats would work from home. And the European Parliament announced its next
plenary session would be held in Brussels not Strasbourg, as was the case with
an abbreviated plenary session this week.
While some
in Italy had complained about a lack of solidarity from other EU countries,
Beijing has stepped up with a robust aid package for Rome.
Germany's
crisis management committee announced several new steps including intensified
checks by the federal police along the country's southern borders. And across
the Continent, an array of steps were taken by governments to limit large
public gatherings, close schools and cancel major cultural events.
While some
in Italy had complained about a lack of solidarity from other EU countries,
Beijing has stepped up with a robust aid package for Rome. Following a phone
call between Italian Foreign Minister Luigi Di Maio and his Chinese counterpart
Wang Yi on Tuesday, Beijing agreed to send Italy some faces masks. According to
a statement from the Chinese government, the country is also willing to send
medical staff to help fight the outbreak, “if the Italian side needs it.”
Italian
Prime Minister Giuseppe Conte tweeted that EU leaders had voiced "broad
support" for Italy's quarantine measures.
"We
must proceed with maximum coordination," he wrote. "Europe should
adopt all the necessary tools to protect the health of its citizens and restore
breath to the economy."
Officials
said that during the videoconference, Lagarde had spoken three times to address
concerns and convey the European Central Bank's willingness to take action,
particularly to protect liquidity at a time when banks and other financial
institutions are expected to become highly risk averse and capital could easily
dry up.
German
Chancellor Angela Merkel once again displayed her instincts as a trained
scientist, speaking about the importance of containing the spread of the virus
and especially protecting vulnerable populations, particularly the elderly.
Merkel also noted that all EU economies will be hard hit by the epidemic and
the EU must provide stability.
French
President Emmanuel Macron, briefing journalists in Paris on Tuesday night, said
the EU was prepared to act in unison.
"Every
day there will be a call between health ministers and the Commission to compare
notes on the evolution of the epidemic, coordinate measures in terms of
confinement, freedom of movement, organizing our school systems," Macron
said. "And we decided to have common organization and coordination in
terms of gear. We decided to exchange information, set up common markets, to
limit needs and have a collective response."
Macron
added: "What we are going through is a real global crisis that needs a
European and global coordination."
Lili Bayer,
Maïa de La Baume, Jillian Deutsch, Judith Mischke, Rym Momtaz, Carmen Paun,
Hans von der Burchard and Zosia Wanat contributed reporting.
Authors:
David M.
Herszenhorn , Sarah Wheaton and Jacopo
Barigazz
Italian doctors on coronavirus frontline face
tough calls on whom to save
With demand outpacing supply of beds and respirators,
medical workers are told to prioritize younger patients.
By GRETA
PRIVITERA 3/9/20, 10:38 PM CET Updated 3/11/20, 4:54 AM CET
Italian doctors are being told to conserve resources
for patients who have the greatest chance of survival
MILAN — In
Lombardy, the wealthy region at the heart of Italy's coronavirus outbreak, a
shortage of beds and medical supplies is forcing doctors to make increasingly
difficult choices.
As the
number of infected keeps rising — the number of reported cases in Italy topped
7,900 Monday, more than 70 percent of them in Lombardy — hospitals are
scrambling to increase the number of beds available in intensive care units.
Some have closed entire wards to dedicate them to severe coronavirus cases.
Others have transformed operating rooms into intensive care units. Doctors are
working grueling shifts to cover for colleagues who fall ill.
With no
clear sign of when the epidemic will spike, anesthesiologists and doctors are
being called on to make increasingly tough calls on who gets access to beds and
respirators when there are not enough to go around.
"It is
a fact that we will have to choose [whom to treat] and this choice will be
entrusted to individual operators on the ground who may find themselves having
ethical problems," said a doctor working in one of Milan's largest
hospitals.
Lombardy
has some 900 beds available for patients needing intensive care, but in some
provinces, particularly in Bergamo, Lodi and Pavia, hospitals are "near
saturation," the doctor said.
"We are aware that the body of an extremely
fragile patient is unable to tolerate certain treatments compared to that of a
healthy person" — Luigi Riccioni, anesthesiologist
For now,
the marching orders are: Save scarce resources for those patients who have the
greatest chance of survival. That means prioritizing younger, otherwise healthy
patients over older patients or those with pre-existing conditions.
"We do
not want to discriminate," said Luigi Riccioni, an anesthesiologist and
head of the ethical committee of Siiarti, the Italian Society of Anesthesia,
Analgesia, Resuscitation and Intensive Care, who co-authored new guidelines on
how to prioritize treatment of coronavirus cases in hospitals. "We are
aware that the body of an extremely fragile patient is unable to tolerate
certain treatments compared to that of a healthy person."
By issuing
recommendations, Riccioni said he wants to ensure doctors and medical staff are
not left alone "in front of such a difficult ethical choice."
"Many
colleagues are afraid of the dizzying increase of the epidemic," he added.
The pressure
on doctors is extremely high, with many feeling increasingly stressed, said
Giulio Gallera, welfare councilor for Lombardy, who said he saw some
practitioners cry over the dire situation in their hospitals. They are afraid
they can't give everyone the care they need as demand outpaces resources, he
said.
In an
interview that went viral after it was published in the Italian daily Corriere
della Sera Monday, Christian Salaroli, an anesthesiologist from a hospital in
Bergamo, recounted scenes of wartime triage, where old patients have to be left
by the wayside. “The choice is made inside of an emergency room used for mass
events, where only COVID-19 patients enter. If a person is between 80 and 95
and has severe respiratory failure, he probably won’t make it."
The
principle of "first come, first served" has been abandoned, said
Mario Riccio, an anesthesiologist who works at a hospital in Cremona.
The
government's decision on Sunday to place a number of regions in northern Italy,
including Lombardy, under quarantine was a welcome move for health
practitioners trying to keep up with the rapidly growing number of cases. On
Monday night, Prime Minister Giuseppe Conte announced the extension of the
total lockdown to the rest of the country.
But in a
country where health policy is in the hands of regional authorities, some say
Rome should have acted quicker and more decisively to make sure all regions
were on the same page.
"We
needed clearer messages and a less ambiguous text," Gallero said in an
interview with Italian TV network La7, referring to the decree signed by the
government on Sunday.
A leak of
the draft document published in major newspapers a day earlier sparked panic in
the region, as tens of thousands of people reportedly headed south to escape
the quarantine measures.
Health
experts are now bracing for the arrival of the virus in southern Italy, which
has so far only registered fewer than 300 cases, said Giuseppe Sofi, an
anesthesiologist at the Policlinico hospital in Milan.
Italy's
northern and central regions are not only the richest of the country — they
produce 40 percent of national GDP — they also have the best health care
systems.
"In
the south, we would risk a catastrophe," said Sofi.
Paola Tamma
contributed reporting.
This
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drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep
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