Weekly surveillance summary

Overall situation

At the end of week 20 (week ending Sunday 23 May 2021), three countries in the European Union/European Economic Area (EU/EEA) had reported increasing case notification rates and/or test positivity. Case rates in older age groups had not increased in any countries; one country reported increasing hospital or intensive care unit (ICU) admissions and/or increasing occupancy due to COVID-19, and no countries reported increasing death rates. Absolute values of several indicators, including hospital and ICU occupancy, remained high, but trends for a number of indicators were stable or decreasing in several countries. Moreover, the median cumulative uptake of at least one vaccine dose among adults aged 18 years and above in the EU/EEA is 41.7% and increasing, as reported in the COVID-19 Vaccine rollout overview.

Recent changes to the report

Country-level figures showing age-specific vaccine uptake aligned with key epidemiological indicators (age-specific case and death rates, hospital/ICU occupancy and admissions due to COVID-19) in Section 5.

Trends in reported cases and testing

By the end of week 20, the 14-day case notification rate for the EU/EEA, based on data collected by ECDC from official national sources in 29 countries, was 132 (country range: 9-467) per 100 000 population. The rate has been decreasing for seven weeks.

Among the 24 countries with high case notification rates (at least 60 per 100 000 population), an increase was observed in one country (Denmark). Stable or decreasing trends in case rates of 1–12 weeks’ duration were observed in 23 countries (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czechia, Estonia, Germany, Greece, Hungary, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Slovakia, Slovenia, Spain and Sweden).
Based on data reported to The European Surveillance System (TESSy) from 23 countries for people over 65 years old, high levels (at least 60 per 100 000 population) or increases in the 14-day COVID-19 case notification rates compared with last week were observed in 13 countries (Belgium, Cyprus, Czechia, Estonia, Greece, Hungary, Latvia, Lithuania, the Netherlands, Poland, Romania, Slovenia and Sweden).
Notification rates are dependent on several factors, one of which is the testing rate. Weekly testing rates for week 20, available for 29 countries, varied from 616 to 73 134 tests per 100 000 population. Denmark had the highest testing rate, followed by Austria, Greece, Cyprus and Czechia.

Among the 13 countries in which weekly test positivity was high (at least 3%), no countries had observed an increase in test positivity compared with the previous week. Test positivity remained stable, or had decreased, in 13 countries (Belgium, Bulgaria, Croatia, Estonia, Germany, Hungary, Latvia, Lithuania, the Netherlands, Poland, Slovakia, Spain and Sweden).

Hospitalisation and ICU

Pooled data from 23 countries for week 20 show that there were 5.7 patients per 100 000 population in hospital due to COVID-19. According to weekly hospital admissions data pooled from 19 countries, new admissions were 3.6 per 100 000 population.
Pooled data from 18 countries for week 20 show that there were 1.4 patients per 100 000 population in ICU due to COVID-19. Pooled weekly ICU admissions based on data from 13 countries show that there were 1.2 new admissions per 100 000 population.
Hospital and/or ICU occupancy and/or new admissions due to COVID-19 were high (at least 25% of the peak level during the pandemic) or had increased compared with the previous week in 20 countries (Austria, Belgium, Bulgaria, Cyprus, Estonia, Finland, France, Germany, Greece, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Romania, Slovenia, Spain and Sweden). However, in 23 countries, there were decreases in these indicators compared with the previous week.

Mortality

The 14-day COVID-19 death rate for the EU/EEA, based on data collected by ECDC from official national sources for 30 countries, was 31.0 (country range: 0.0-105.0) per million population. The rate has been decreasing for four weeks.

Among the 21 countries with high 14-day COVID-19 death rates (at least 10 per million), no increases were observed. Stable or decreasing trends in death rates of 1–9 weeks’ duration were observed in 21 countries (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czechia, Estonia, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Poland, Romania, Slovakia, Slovenia and Spain).

Variants of concern (VOC) and variants of interest (VOI)

Sequencing capacity varies greatly across the EU/EEA; 12 EU/EEA countries (Belgium, Denmark, Estonia, France, Germany, Hungary, Iceland, Ireland, Luxembourg, Malta, Norway and Poland) met the recommended level of 10% or 500 sequences of SARS-CoV-2-positive cases sequenced and reported to the GISAID EpiCoV database by 25 May 2021, or to TESSy by 23 May 2021 (data referring to the period 3 May to 16 May 2021). During the same period, 11 countries sequenced and reported between 60 and 499 samples, while seven countries sequenced and reported <60 samples or did not report data.
Among the 12 countries with the recommended level of 10% or 500 sequences reported per week in the period from 3 May to 16 May 2021, 10 had a valid denominator. The median (range) of the VOC reported in all samples sequenced in the period in these 10 countries was 90.4% (69.2–95.8%) for B.1.1.7, 0.8% (0.0–8.0%) for B.1.351, 0.3% (0.0–5.1%) for B.1.617, 0.2% (0.0–7.9%) for P.1 and 0.0% (0.0–1.3%) for B.1.1.7+E484K.
The median (range) of the VOI reported in all samples sequenced in the period for these 10 countries was 0.0% (0.0–0.9%) for B.1.525, 0.0% (0.0–0.3%) for B.1.620 and 0.0% (0.0–0.0%) for B.1.621. A list of current variants of concern and variants of interest for the EU/EEA is published on ECDC’s website.

Long-term care facilities (LTCFs)

Based on data reported to TESSy from seven countries (Belgium, France, Lithuania, Luxembourg, the Netherlands, Slovenia and Sweden), in week 20, the pooled incidence of COVID-19 cases among LTCF residents was 64.2 per 100 000 LTCF beds, the pooled incidence of fatal COVID-19 cases was 6.6 per 100 000 LTCF beds, and 5.4% of participating LTCFs reported one or more new COVID-19 cases among their residents.

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