2nd Phase of Vaccination Campaign, 3rd Phase of Large-Scale Testing Expected to Start Next Month

During a press conference on Monday, Luxembourg's Minister of Health Paulette Lenert reviewed the evolution of the COVID-19 pandemic since the summer and more particularly, since the upsurge in new infections at the end of October 2020.

The number of new infections started to increase shortly after the new school year began. The development of the situation from October reached its peak during the week of 26 October to 1 November 2020, with an incidence rate of 750 cases per 100,000 inhabitants. The situation then stabilised at a very high level for several consecutive weeks. A notable relaxation of the situation has only been observed since the beginning of 2021, with an incidence rate of 135 cases per 100,000 inhabitants over seven days for the period from 18 to 24 January.

However, with the recent discovery of new, more contagious variants of coronavirus, the authorities have called for increased vigilance. Depending on the degree of the spread of these variants in Luxembourg, a new wave cannot be ruled out and this could once again expose hospitals and healthcare professionals to enormous pressure.

The main strategic objectives of the fight against COVID-19 in Luxembourg are based on three pillars: the protection of public health and the maintenance of the health system, as well as socio-economic and ethical considerations.

The Health Minister stressed: “My top priority will always be the protection of vulnerable people and high-quality care for our patients. This ambition must go hand in hand with a safe working environment for health and care personnel. Our first objective is therefore to flatten the curve to preserve the capacities of our health system”.

Combined with the other elements of the global virus control policy, namely prevention, diagnosis and screening (tests), isolation of infected people, tracing and quarantine of contacts, patient care and awareness and information, vaccination is expected to play a crucial role in saving lives, stemming the pandemic, protecting health systems and helping to restore the economy. Minister Lenert added: “Access to a safe and quality vaccine against COVID-19 is a decisive part of the national system to fight the pandemic. It will complement the other tools put in place, but will not replace them!"

Vaccination campaign

The second phase of the national vaccination campaign will see the vaccination of people aged 75 and over, starting with the oldest. Highly vulnerable residents (regardless of age) will also be eligible to get vaccinated at this stage.

On 29 January 2021, Luxembourg's Government Council adopted a vaccination prioritisation strategy (based on the opinion of the country's Superior Council of Infectious Diseases) divided into several successive phases. These are based on age and varying degrees of vulnerability associated with severe forms of infection and risk of mortality. 

The Ministry of Health and representatives of the medical profession (the Association of Doctors and Dentists and the Circle of General Practitioners) discussed the criteria applicable when issuing medical certificates as proof of this state of vulnerability. It will be up to the attending physician to certify, on the basis of the recommendations of the Superior Council of Infectious Diseases, the vulnerability of patients, thus determining from what point the latter will be eligible for vaccination.

Minister Paulette Lenert was reassured by the vaccination uptake among nursing home residents (86%) who are being vaccinated on site by mobile teams. The participation rate of people invited to be vaccinated at the vaccination centre in Hall Victor Hugo (Luxembourg-Limpertsberg) remains relatively low at this stage, with 48.1% from the first batch of invitations sent out and 43.3% from the second batch.

The authorities recalled that the second phase of the vaccination campaign cannot start before the first phase is completed, in principle at the beginning of March 2021, subject to the delivery and availability of sufficient vaccine doses.

Large-scale testing

The second phase of the large-scale testing (LST) campaign will come to an end on 24 March 2021 at the latest. On 29 January, the Government Council approved a bill authorising the state to participate in the financing of the third phase of the campaign.

According to the authorities, the continuation of the large-scale testing system beyond the second phase, based on the lessons learned from the previous phases, is justified in several respects. Firstly, the campaign has made it possible to quickly interrupt chains of transmission by identifying a certain number of COVID-19-positive people who otherwise would have risked infecting others. Since the start of the second phase of LST (between 16 September 2020 and 16 January 2021), 9,211 positive cases have been detected.

Nevertheless, the third phase of LST will differ in several ways from the second phase in order to adjust the orientation of the programme in relation to the specific needs to be addressed during the months to come. Mobile testing teams will be strengthened to be able to concentrate more on accommodation facilities for the elderly and other vulnerable people, to help them overcome their significant vulnerability while waiting for enough people to have been vaccinated. The frequency of interventions by mobile teams in educational structures will also be increased.

Beyond making it possible to verify the presence or absence of antibodies, serological tests will henceforth also be used to establish the degree of antibody concentration. This quantitative result can give an indication of the level of immunity in the population. Six sampling centres are provided for blood samples in order to carry out serological tests. As of 10 January, the prevalence rate was 7%.

This new phase also aims to monitor the effectiveness of the vaccination campaign through the identification of vaccinated but infected people - a development which is not yet excluded. 

In addition, this third phase is considered justified by the arrival of new virus variants in Luxembourg and elsewhere. International health authorities have recommended an increase in testing and sequencing capacities to obtain a better view on the spread of these new variants. The results of the tests performed by the LST will contribute to this testing capacity which will be the focus of genomic sequencing efforts.

The third phase will be launched no later than 15 March 2021 and will end on 15 July 2021. It could be extended until 15 September 2021 if the epidemiological situation so warrants and / or if collective immunity has not been reached by then.

The cost estimate, based on a maximum of 53,000 tests performed per week and 1,000 serological tests per week, amounts to a total of approximately €42.83 million for the period from 15 March to 15 July.

It should be noted that the LST test centre at Luxembourg Airport has been temporarily closed since 29 January 2021. That being said, any person aged 6 or over wishing to travel by air transport to the Grand Duchy is now required to present (upon boarding) a negative PCR or rapid antigen test carried out less than 72 hours before their flight. The screening capacities of this test centre will be redirected towards accommodation facilities for the elderly. Anyone traveling by air transport from a third country will have to undergo an additional rapid test on arrival at the airport. This test offer will therefore remain in place, but will cost €10 as of today, 1 February 2021.