London(CNN) Lockdowns, spiraling cases and a vaccine divide is framing the start of Europe's second pandemic winter, bringing chaos to eastern European countries and uncertainty to those in the West.
Despite the widescale availability of vaccines this winter compared to the last, Europe is the only part of the world reporting an increase in new Covid-19 cases globally, the World Health Organization (WHO) said Wednesday. This is the third consecutive week the region has recorded a rise in cases, it added.
The suffering has been acute in Eastern Europe and Russia, battling mounting deaths and cases fueled by vaccine hesitancy that has seen coverage rates dip as low as 24%, according to data from the European Centre for Disease Prevention and Control (ECDC).
Last Thursday, Latvia became the first country in the European Union to impose a lockdown as the country struggles with a spike in cases amid low vaccination uptake. Only 56% of all adults have had both doses of the jab compared to the EU average of 74.6%.
Western Europe is also driving the rise in Covid-19 cases despite some countries enjoying near universal vaccine coverage. Germany's Covid incidence rate rose to 100 new infections per 100,000 inhabitants on Saturday for the first time since May. Belgium, alongside Ireland, is seeing one of the highest case rates in Western Europe, according to the ECDC, of 325.76 and 432.84 per 100,00 people respectively.
Belgium's Health Minister Frank Vandenbrouck told broadcaster VRT Wednesday that the country was in a fourth wave. More than 85% of the adult population is fully vaccinated, and officials say the vast majority of hospitalized Covid-19 patients were unjabbed, Reuters reported.
The differing vaccination rates have put Europe's East and West on two separate tracks, but what they share is case rates driven higher by the relaxation of pandemic restrictions as economies open, cold weather driving people indoors, and the highly transmissible Delta variant, now the dominant strain in the region, Dr. Peter Drobac, a global health expert at the University of Oxford's Saïd Business School in England, told CNN.
Caseloads may be high in some Western Europe countries, but thanks to vaccines, Covid-19 deaths and hospitalizations have remained largely flat compared to their Eastern counterparts.
From Monday, Romania will reintroduce night curfews and make health passes mandatory for most venues, days after it recorded 19.25 deaths per million people -- one of the world's highest Covid-19 death rates per capita.
Romania's woes are not down to vaccine shortages. EU countries have access to all of the shots approved by the EU, but like many countries from the Baltic to the Balkans, Romania's vaccine rollout has been hampered by vaccine hesitancy, poor government messaging and suspicion of the authorities. Only 35.6% of its adult population is fully vaccination, according to the ECDC.
Neighboring Ukraine reported its highest daily number of Covid-19 cases since the beginning of the pandemic on Thursday, of 22,415 cases, days after President Volodymyr Zelensky implored nationals to get vaccinated, saying it was the only way to prevent a lockdown.
"There are two ways at this crossroads: vaccination or lockdown," Zelensky said in a televised interview with Ukrainian broadcast channel ICTV on Monday. "Every day we face this challenge and this choice. I am totally against lockdown... because of the economy."
But by Friday, schools in Ukrainian Covid hotspots were shut down and the government announced vaccine certificates or a negative test to access public transport in the capital after daily deaths hit a record 614, according to Reuters.
Russia is enduring its worst-ever phase of the pandemic. Moscow began a 10-day lockdown on Monday as its officials openly admitted that the country is facing a dire winter. It reported its highest numbers of daily cases and deaths multiple times in recent days, and registered a record 1,028 official fatalities on Wednesday.
"Of course, not all that needed to be done was done for informing and explaining the inevitability and importance of vaccination," President Vladimir Putin's spokesperson, Dmitry Peskov, told journalists as the Kremlin admitted partial responsibility for the low vaccination rates. "But at the same time, citizens of our country need to take a more responsible position and get vaccinated," he said.
Western Europe won't "reach the crisis levels that we saw in the past -- with field hospitals being set up -- [because] vaccines have definitely changed the game and in that sense there should be a lot of reason for optimism," health expert Drobac said.
The United Kingdom, however, shows that vaccines are not a silver bullet, he added.
Britain is registering the most daily cases in Western Europe after dropping almost all its pandemic restrictions in the summer. Health experts and medical unions have implored the British government to reimpose measures like mask mandates or vaccine passes, in line with other European countries, so as to prevent the imposition of restrictive measures like lockdowns.
But its government has rejected such a move even as hospitalizations and deaths rise. Katherine Henderson, the President of the Royal College of Emergency Care, told Sky News on Sunday that the country's health service was already in "a terrible place" due to Covid-19. Emergency departments across the UK are "already struggling to cope" with "large queues" of ambulances piling up outside, she said.
British Prime Minister Boris Johnson has instead urged people over the age of 50, and those at high risk of Covid-19, to get a booster vaccine in a bid to overcome waning protection from vaccines after six months.
This won't be enough amid skyrocketing cases that can be fertile ground for the creation of new variants. On Friday, the UK Health Security Agency designated a descendent of the Delta variant, AY.4.2, a "varient under investigation" due to "some early evidence that it may have an increased growth rate in the UK compared to Delta," the government agency wrote.
"The UK the strategy has been very much focused on letting vaccinations do all the work. And I don't think that's going to be enough," Drobac said.
It's a dangerous strategy that relies on the unvaccinated, like children, getting infected to create a "level of overall population immunity from natural infection and vaccination," he said. "The problem with that, of course, is that it not only allows for some unacceptably high level of hospitalization and death, but also that it may not work," he added.
As the UK drags its feet on new measures, Ireland is holding off on dropping pandemic restrictions amid a resurgence of cases despite having one of Europe's highest vaccination rates -- of 92% of the population fully vaccinated, according to the ECDC.
During a press conference last Tuesday, Irish Prime Minister Micheál Martin said Covid-19 vaccine passes will remain in place for indoor hospitality and events, masks will continue to be mandatory in indoor public spaces, and indoor hospitality will be confined to table service only.
Europe needs to not "sleepwalk" its way to lockdowns and deaths of last winter, Mike Ryan, executive director of the WHO's health emergencies programme, said Wednesday. We don't know what the epidemic period will be in two months, three months' time...we are going to have to be a little cautious ... a little careful."