A look into the future of the COVID-19 pandemic in Europe: an expert consultation

How will the coronavirus disease 2019 (COVID-19) pandemic develop in the coming months 49 and years? Based on an expert survey, we examine key aspects that are likely to influence 50 COVID-19 in Europe. The future challenges and developments will strongly depend on the 51 progress of national and global vaccination programs, the emergence and spread of variants 52 of concern, and public responses to nonpharmaceutical interventions (NPIs). In the short term, 53 many people are still unvaccinated, VOCs continue to emerge and spread, and mobility and 54 population mixing is expected to increase over the summer. Therefore, policies that lift 55 restrictions too much and too early risk another damaging wave. This challenge remains 56 despite the reduced opportunities for transmission due to vaccination progress and reduced 57 indoor mixing in the summer. In autumn 2021, increased indoor activity might accelerate the 58 spread again, but a necessary reintroduction of NPIs might be too slow. The incidence may 59 strongly rise again, possibly filling intensive care units, if vaccination levels are not high enough. 60 A moderate, adaptive level of NPIs will thus remain necessary. These epidemiological aspects 61 are put into perspective with the economic, social, and health-related consequences and 62 thereby provide a holistic perspective on the future of COVID-19.