COVID-19 Pandemic in the EU: A Critical Look at Crisis Response

Introduction

COVID-19 is disease caused by a new coronavirus, originating as an outbreak in December 2019 from the Wuhan Municipality of China. The virus swiftly spread beyond China to other parts of the world, leading to the WHO declaring it a pandemic on 11 March 2020 for the first time in 21st century. Italy was initially the major European country to be affected in February 2020, with all other EU countries subsequently reporting expanding outbreaks. By April 2020, Europe had become the global epicenter of the pandemic and engulfed in an unprecedented crisis. Europe with the rest of the world has gone through multiple lockdowns coinciding with different waves of the pandemic, until gradual resolution of the emergency situation. While the WHO declared an end to COVID-19 as a public health emergency on 5 May 2023, its far-reaching lingering effects continue to be felt in Europe. ??????????

COVID-19 pandemic was perhaps the best case study to demonstrate true EU integration, given its uniquely cross-sectoral reach. These could be considered under the umbrella of ‘three Ps’: public health, policy and politics. EU actions during this crisis have been recognized under six broad subcategories (European Council 2023): emergency response & COVID-19 vaccination under public health, recovery plan & travel measures under policy, global solidarity & crisis coordination under politics (1). This offers a useful framework to conduct an after-action review into the EU response and its overall impact on integration.

Public Health: Emergency Response & COVID-19 Vaccination

Traditionally, member states preferred to be autonomous actors in the realm of public health, partly due to the influence of industry groups such as fast food, chemical and tobacco (Greer & Kurzer 2013; Passarani 2019; Guigner 2018 (2,3,4). It often took a drastic and focusing crisis to elevate public health as a priority on the EU agenda, exemplified by the mad cow disease in the 1980-1990s (Kingdon 2003; Ansell & Vogel 2006; Ansell and Gingrich 2007; Farrell 2005) (5,6,7,8). ?Predictably therefore, the immediate response to outbreaks in EU member states were haphazard, uncoordinated and sometimes competing national action plans (Alemanno 2020) (9). The period of March to April 2020 will forever be marred by export bans on personal protective equipment (PPE) and unsubstantiated border closures.

Such actions were despite the existence of scientific evidence of a shared risk and pre-existing public health policy to manage exactly such an event. Perhaps this highlights a key deficit in governance of the ‘primacy’ of EU law over national law as set out in Article 2 of TEU. Supremacy of the EU it seems has frequently been undermined on justification of national interest, at least in the realm of public health. Underpinning this confusion is the perceived legality of invoking public health as an exception to Article 36 of TFEU at state level, which prohibits infringement on the “four freedoms” of movement. ?(Weatherill & Beaumont 2014) (10). Evidently, the legal framework was inadequate to justify necessary EU-wide response to a pandemic. European integration clearly receded at the outset of the pandemic due to ‘member state egotism’ (Greer et al. 2020) (11). ?

This stage however quickly passed when the shared responsibility of managing a pandemic became apparent to member states by Summer 2020, that a coordinated and cross-national response was in their best interest. As stated by the? European Council (2023), EU leadership agreed and committed to below priorities during ensuing months of 2020, 2021 and 20221:

·???????? Evidence-based measures to limit viral spread

·???????? Procurement of medical equipment and supplies

·???????? Research and development on treatments and vaccines

·???????? Manufacturing and deployment of COVID-19 vaccines

·???????? Mutually recognized testing strategies

·???????? Cross-border contact tracing and quarantine regulations

·???????? Provision of digital vaccination certificates

As Greer et al. (2020) note, the EU’s initial organized response relied on the health emergencies system of European Centre for Disease Control (ECDC) and civil protection mechanism of RescEU that were already at its disposal (11). The ECDC’s remit was primarily risk assessment and information sharing, which it performed as well as expected. Risk management was conducted through the Health Security Committee, but member states still had freedom of policy implementation.

Until then the EU Health Programme had a limited influence with an operating budget of €446 million ?for 2014–2020; the new ‘EU4Health’ plan for 2021–2027 was expanded to €1.7 billion with a broader mandate to strengthen health care system capacity Europe-wide (European Parliament 2020) (12). Finally, neo-functionalists and public health advocates were on the same page, and process of European integration advanced.

Perhaps the brightest moment for European integration was contribution to development and subsequent distribution of safe and effective COVID-19 vaccines. The EU redirected substantial research funding to this end and pooled resources to procure sufficient quantities of leading vaccines through joint purchase agreement with manufacturers (European Council 2023) (1). Having started in late December 2020, the landmark achievement of the COVID-19 vaccination campaigns has meant that nine out of ten adults in the EU population (86%) are fully vaccinated by June 2022. Over 1.7 billion vaccine doses have been administered in the EU including 50% of the population having received a booster dose. Its diversified vaccine portfolio consists of up to 4.6 billion secured doses from different manufacturers. In public health terms, this is a remarkable achievement on par with efforts leading to eradication of smallpox by the 1980s (Meyer et al. 2020) (13). The role played by European Medicines Agency (EMA) cannot be overstated throughout this process. As a regulatory agency, it conducted independent risk benefit assessment of available vaccines in real-time (‘rolling reviews’) ?before authorization for use. Decisions of the EMA were wholly adopted by essentially all member stated and their national agencies in support of their ongoing vaccination campaigns. As such, the ECDC and EMA have probably contributed more to European integration in public health policy than any other regulatory body in recent years.?? ?????????

Policy: Recovery Plan & Travel Measures

Neo-functionalism made further inroads on the back of COVID-19 vaccination campaigns with the advent of digital COVID certificates. The EU agreed and issued these (via national authorities) free of charge as proof of vaccination, negative testing or recovery from the disease (European Council 2023) (1). Temporary EU regulation governing the EU digital COVID certificate was in force from July 2021 to July 2023. This was a far cry from the uncoordinated and largely unsuccessful border policies earlier.

Schengen states established integrated common border regulations for entrants, including stringent requirements for travelers from pandemic hotspots outside the EU. The Home Affairs Council provided leadership, and indeed was challenged in its endeavor given the impact of closed borders to some of Europe’s biggest trading partners. Nonetheless, it persisted and sustained cohesive decision-making for a substantial period. The Commission now plans to introduce recommendations and transition to a global digital health certification network being established by WHO. This was, albeit transient, an example of an advancing European integration agenda. ???

The ensuing economic crisis was daunting, with contraction of Eurozone economy by nearly 4% in the first quarter of 2020 (Greer et al. 2020) (11). In a measure generally viewed as remarkable in European terms, member states managed to transcend pre-existing recessionary narratives of northern creditor countries bailing out southern debtor countries. After first invoking the ‘general escape clause’ from the fiscal governance of Stability and Growth Pact, the EU proceeded to implement a shared and unconditional debt instrument through Recovery and Resilience Facility. ?This was a historic first for Europe, and indeed, it’s been contemplated by Greer et al. (2020) as a potential ‘Hamiltonian moment’ for the EU (11).

In April 2020, ?the Eurogroup established a €540 billion emergency support package for workers and businesses in member states. Subsequently, Recovery Plan for Europe was proposed with EU leaders agreeing on a comprehensive package of €1824.3 billion: a combination of ?€1074.3 billion multiannual financial framework (MFF) for 2021-2027 and €750 billion Next Generation EU (NGEU) fund. The European Council (2023) showcases this recovery effort as their strategy to manage and rebuild from the socio-economic impacts of the pandemic. Further, the Recovery Plan for Europe also reached for wider ambitions by requiring over 50% of fund allocations to reflect green and digital transitions in national plans. Greer at al. (2020) believe this common European debt mechanism sets an unforgettable precedent and constitutes evidence of ‘heading forward’ towards integration (11). The previous German Chancellor Angela Merkel agreed: “extraordinary times call for extraordinary measures”. ?

Abandonment of the EU fiscal governance structure dating back to the 2008 financial crisis and issuance of common European debt mark a more federalist turn in EU integration. While the EU always demonstrated quasi-federal qualities, it had never developed the capacity to absorb debt on an EU-wide scale. Clearly it’s far from being the European Federation of Altiero Spinelli’s aspiration in his Ventotene Manifesto of 1941. Rather, it assumed for the first time fiscal capability for central governance of debt that is characteristic of federated states like the USA. Dian (2010) may have stated that “the idea of a federal Europe is uncongenial to most Europeans” (14). Yet real actions surely speak louder than inklings, at least for once on the fiscal front. However, it’s arguable that Recovery Plan for Europe is more neo-functional in nature, with clear evidence of ‘functional spillover’. Specifically, integrated economic policy is facilitating and leading to integration of green and digital transformations EU-wide. ??

Politics: Global Solidarity & Crisis Coordination

Current President of the European Council, Charles Michael, has stated that: “only a shared spirit of global solidarity and responsibility will defeat the COVID-19 crisis”. The European Council (2023) points out that ‘Team Europe’ is one of the leading donors to COVAX, the global platform set up to collaborate on equitable access to COVID-19 vaccines (1). Yet closer scrutiny of COVAX figures from early 2022 reveals that the proportion of monetary donations (contributions of €2.5 billion vs. €1 billion) by member states outstrip that of the EU. It’s also interesting to observe ‘Team Europe’ being superficially defined as EU, EU member states and EU financial institutions. It seems while the EU agreed in principle on global solidarity, its implementation capacity in reality has been rather limited. Member states have predominantly used multilateralism at their own initiative to promote the concept. Such a state of play would be recognized by intergovernmentalists, who accurately predicted integration would be driven by state-centric and not supranational activities. ????

In March 2020, then Croatian presidency of the European Council escalated EU's integrated political crisis response mechanism (IPCR) to ‘full mode’ (Council of the EU 2020) (15). IPCR mechanism had been approved in 2013 and codified into a legal act in 2018. When the pandemic broke, it provided a testing ground to see? IPCR in action.

Full activation mode allowed and required production and sharing of analytical reports by the Commission, creation of an integrated web platform and facilitation of crisis meetings for proposal of EU action. It must be noted however, IPCR was underpinned by the ‘subsidiarity principle’, still recognizing member states' responsibilities as foremost in the face of a crisis. IPCR performed well during the height of COVID-19, until deactivation to ‘monitoring mode’ by the Swedish presidency in May 2023. Liberal intergovernmentalism, while effectively explaining the ordinary slow legislative process, poorly captures extraordinary and decisive decision making observed during COVID-19. Crucially, the EU’s response was neither ‘institution-free’ nor ‘asymmetrically-interdependent’ as per ?liberal intergovernmentalism. On the contrary, institutions like the ECDC and EMA led key aspects and nation states were indeed ‘symmetrically dependent’ on each other to control a borderless virus.

New-institutionalism better explains how institutions were heavily leaned upon to formulate European pandemic policy. Nonetheless, as the EU relied on the cooperation of national governments to implement its advisory policy output on pandemic control, elements of liberal intergovernmentalism still loomed in the background. Further, COVID-19 for once represented a shared fate, thus lacked the fertile ground for postfunctionalist narratives early on. The end result was institution-led European integration, albeit up to a point deemed necessary. It soon became clear that that COVID-19 was turning into an endemic disease here to stay for the medium to long-term. This has given rise to limited ‘constraining dissensus’ that postfunctionalists argued would be inevitable. For example, certain sections of the European public fed by misinformation grew pessimistic on vaccination mandates, quarantine requirements and persistent lockdown advisories, a phenomenon now recognized by the WHO as an ‘infodemic’. These sentiments have abated somewhat since the WHO in May 2023 declared COVID-19 as a public health emergency was over. It seems even a pandemic was not immune to unwarranted politicization, at least transiently threatening European integration. ??????????

In fact, IPCR arrangements are largely consistent with the EU’s growth as a ‘polity’, a law state seeking deep regulatory reach into member states yet lacking implementation capabilities (Kelemen 2019; Majone 1994; Page 2001) (16,17,18). The EU’s fallback mode of operation in public health has been to arrive at the least-common-denominator policy response to a crisis (Kleine 2013) (19).

This is usually after member states ‘muddling through’ initial attempts to confront a shared problem. Greer et al. (2020) contend that amounts to ‘another European rescue of the nation state’ (11). As experience has proven, such rescues are often reactive to contain crisis, seldom to the satisfaction of EU integrationists or level of comprehensive policy. It remains to be seen if the EU’s political approach to public health matters departs from a strategy of muddling through to consensus when it’s become unmanageable at individual national level. ?????????

Discussion

As above considerations indicate, the EU’s response to COVID-19 can only be viewed as a mixed bag at best, with elements promoting both European integration and disintegration. As Anderson et al. (2020) stipulated early at the outset , EU was unlikely to ‘set the tone’ for the pandemic response, rather be guided by and restricted to demands of member states (20). ??????

The pan-European response to the still ongoing endemic however has not always yielded the intended outcome, nor contributed to European integration in any effective sense. For example, as reported by Kuchler (2024), over 2.2bn worth of the antiviral drug Paxlovid are expected to have been wasted by February 2024 (21). Analytics group Airfinity (2024) estimates this figure still only accounts for those procured in advance by individual European countries and not EU-wide purchases (22). Paxlovid became available ?from early 2022, with many countries competing to procure stockpiles from drugmaker Pfizer, driven by surging infections globally due to the 2021 Omicron variant. This was justifiable as clinical trial evidence of the antiviral had shown nearly 90% reduction of severe illness if given early on after contracting the virus. Many EU countries restricted its prescription eligibility to only those at very high risk from COVID-19 complications. Subsequently, a much lower infection burden coupled with steep reduction in testing has plummeted demand resulting in expected wastage of over 3 million treatment courses in Europe. A similar trend was seen in the United States; yet in contrast to the EU, the latter managed to exercise better governance of public procurement by renegotiating to return its unused stockpile to Pfizer.

Given ?earlier experience with procuring COVID-19 vaccines, it should have been evident to EU policy makers that universal adoption of a centrally-coordinated purchasing programme (e.g. Joint Procurement Agreement) would have performed better by eliminating inefficiency and enhancing bargaining power. Clearly, even at a late juncture of the pandemic, this is an example of a disintegrated EU response which coincided with member states muddling through an ultimately ineffective strategy. It’s reminiscent of the policy failure of 2009 H1N1 influenza epidemic, characterized by hoarding and wasting of vaccines and antivirals (de Ruijter et al. 2019) (23).

As Greer et al. (2020) predicted, this is a disappointment to neo-functionalist integrative ideals (11). On a separate note, it highlights the detachment of many EU scholars from on-the-ground reality of the average EU citizen, the latter often expressed through reactionary Euroscepticism. Their ‘stylized debates between neo-functionalism and intergovernmentalism often distract us’ from solving the problems at hand (Greer et al. 2020) (11). If integration is the ultimate goal in public health matters, EU scholarship is best advised to heed empirical reality.

Conclusions

Jean Monnet (1976) proclaimed that: “Europe will be forged in crises and would be the sum of the solutions adopted for those crises” (24). In summary to use a visual analogy, the EU seems to consistently act like the vent of a kitchen sink, seeking only to relieve overflow and leaving the sink half full when crisis pours in continuously. In Greer et al.’s (2020) terms, Europe ‘fails forward in public health’ (11). The next inevitable health crisis will test if the EU continues this half-hearted, status quo approach or radically departs towards genuine integration. Going by the European Commission’s swift abandonment of plans to halve pesticide use by 2030 in response ?to farmers’ protests in major EU states, the prognosis for initiatives with public health relevance looks poor if opposing political pressure exists (Henley, Jones & Tondo 2024) (25). As Deruelle (2020) has argued, COVID-19 pandemic has given ample learning opportunity to recognize it will take more than just solidarity towards that objective (26). If integration is indeed what member states prefer, they need to address historical insufficiencies of the EU governance system. ??

References

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