The Evening Report - Sept 1
Variant specific vaccines for Europe. Reducing CO2 emissions derailed by pandemic.
🦠Pandemic🦠
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The European Medicines Agency has recommended that both the newly formulated bivalent COVID vaccines from Moderna and Pfizer/BioNTech be approved for use in the EU. The European Union Commission will now make a final decision.
EU Health Commissioner Stella Kyriakides says an approval from the Commission will come soon.
“We will soon present further actions for COVID vaccination strategies and measures for autumn and winter.”
The bivalent vaccines recommended for approval target both the original coronavirus and the Omicron BA.1 variant. The EMA says the new vaccines would be for use as booster doses for people 12 years old and older.
“Vaccines are adapted (i.e., updated) to better match the circulating variants of SARS-CoV-2. Adapted vaccines can broaden protection against different variants and are therefore expected to help maintain optimal protection against COVID-19 as the virus evolves.”
The agency cites studies showing the bivalent vaccines elicit a strong immune response against both the original virus and the Omicron variant. It says side effects from the new vaccines are comparable with the mRNA vaccines used to date.
“National authorities in the EU Member States will determine who should receive which vaccines and when, taking into account factors such as infection and hospitalisation rates, the risk to vulnerable populations, vaccination coverage and vaccine availability.”
The EMA also adds these are not the only bivalent vaccines in the approval process pipeline.
“Other adapted vaccines matching different variants, such as the Omicron subvariants BA.4 and BA.5, are currently under review by the EMA. Adapted vaccines help maintain optimal protection as the virus evolves.”
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Denmark’s Health Minister Magnus Heunicke was quick to react to the news of the EMA recommending use of the new bivalent vaccines as an “Important step towards ensuring that we are as well prepared as possible for autumn and winter, when we expect higher infection rates.”
Heunicke adds that he will discuss the impending approval of the new vaccines with health authorities and the health rapporteurs.
Shortly after the minister responded to the news, the Danish Health Ministry called a press conference for Friday in the early afternoon to update the pandemic situation, the role of the new bivalent vaccines, and the imminent fall vaccination campaign.
Denmark is set to begin a booster dose campaign in two weeks
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“Overall, it looks really good right now”
Denmark’s Health Minister Magnus Heunicke says the coronavirus contact number, reinfection rate or R0, is 0.7 for a 2nd straight week.
Heunicke adds that COVID wastewater surveillance shows declining virus activity across all five Danish regions.
He adds that the COVID incidence rate, as measured by PCR testing, also shows decreasing rates across all five Danish regions.
“Our monitoring shows that the situation is exactly as we hoped it would be towards the end of the summer.”
The health minister also cites COVID hospital admission statistics as more proof of an epidemic that is well in hand. He says there has also been a downward trend of pandemic related hospitalizations over the last two weeks.
But as he hails the good indicators, he also cautions another infection wave will arrive in the fall and winter as the seasonal effect turns against us.
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COViD numbers continue to fall in Denmark. Infection numbers dropped by another 27% last week, according to the latest weekly pandemic assessment from the Statens Serum Institute. The positivity percentage also dropped from 19% to 15.5% from one week to the next. But PCR testing also continues to fall, down 12% last week.
Region Nordjylland has the highest COVID incidence rate of 138 per 100,000 people. Region Midtjylland is right behind with a rate of 132. That said, the SSI says the COVID incidence rate and positivity percentage all declined across all five Danish regions.
Looking at infection activity by age, the COVID incidence rate is highest among 50 to 69 years olds, with 149 per 100,000 people for those 60 to 69 years old and 146 for those 50 to 59. While the positivity percentage also fell across all age groups, it was highest (18%) among 60 to 69 year olds, with those 25 to 29, 50 to 59, and 70 to 79 years old just behind with a positivity percentage of 16%.
COVID hospitalizations fell to 383 last week, 104 fewer than the week before. Seniors 70 to 89 years old continue to make up the largest proportion of new infection admissions. ICU numbers crept upward last week, with 19 severely infected people admitted to intensive care, six more than the week previous. The proportion of admissions directly due to a coronavirus infection inched upward, going from 60% to 63% from one week to the next.
There were 44 COVID fatalities in Denmark last week, three fewer than the week before.
Among vulnerable seniors in care PCR testing rates decreased, falling two points to 7.5%. The positivity percentage also inched downward to 2.7%. Infection numbers dropped 33% with 82 coronavirus cases last week. There were 21 car home residents who had infections requiring hospitalization last week, compared to 29 the week prior.
But pandemic deaths among seniors in care rose last week, with 18 lives lost, eight more than the week before.
BA.5 is still king in Denmark, accounting for 95% of all sequenced positive test results last week. But among the BA.5 sub-variants, BA.5.1 (26.81%), BA.5.2 (23.25%), and BA.5.2.1 (17.92%) all continue to gain ground, gradually increasing their viral market share.
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Denmark is reporting 792 infections (underreported), including 224 reinfections, and 11 more coronavirus deaths in the last day.
With 7,825 PCR tests taken on Wednesday that equals a positivity percentage of 10.12%. Over the last seven days the rate is 14.48%.
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COVID hospitalizations (289) are down (-16) while the number of severe infections in an ICU (9) and of those the number on a ventilator (2) are both unchanged day to day. Infection admissions to a psychiatric facility (61) dipped slightly (-1).
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The Danish regions have contracted Carelink to enhance regional vaccination efforts when the fall and winter booster dose campaign gets underway in a few weeks. If needed, Carelink will be able to offer vaccinations to everyone over the age of five. The contract is good until March 31, 2023.
Health Minister Magnus Heunicke:
“Our strategy for handling infection activity until the spring of 2023 is to ensure that we protect seniors and those in vulnerable populations to avoid overloading hospitals. The foundation for that effort is vaccination and revaccination. We are now expanding the regional vaccination offer with an agreement with a private actor, so that we can quickly scale up the vaccination efforts if necessary.”
Chair of the Danish Regions, Anders Kühnau:
“The new preparedness agreement provides the opportunity to mass vaccinate against the coronavirus at short notice, and thus we are even better prepared should the infection increase during the winter months. It is reassuring for when colder weather arrives, when there is more infection because we are indoors more.”
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Region Midtjylland’s goal of being carbon-neutral by 2050 has taken a step backwards thanks to the COVID pandemic. In its latest climate accountability report, the Regional Council reported that the region’s carbon footprint increased by 16% last year. The reason why? The huge increase in protective equipment and testing kits due to the pandemic.
Buying and using millions of COVID testing kits alone increased CO2 emissions in the region by 100,000 tonnes.
Regional Council Chairman Anders Kühna:
“Unfortunately, the increase is not in line with our objectives. We have ambitions to break the greenhouse gas emissions curve and reduce the region's emissions significantly in the coming years. But the climate account shows how complex it really is to work with sustainability and climate in an organization like ours when a pandemic like COVID strikes. During the pandemic, we had to ensure the health of our employees and citizens with protective equipment and testing kits. But unfortunately they are buy and throw away items and in no way good for the climate. We depend on special products in the healthcare system, but they must also be developed more sustainably so that we can buy greener. Unfortunately, we don't always have that option.”
The region says it is tackling the issue by launching a project to develop reusable smocks to reduce consumption in any future pandemic.
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Sweden has added 4,729 infections (wildly underreported) and another 94 virus deaths in the last week.
To date, 87.3% of those 12 years old and older have one dose, 85.3% have two, and of those 18 years old and older, 66.8% have a booster shot.
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The Swedish Public Health Agency says the latest infection wave seems to be easing. The agency says there were 3,800 confirmed infections last week, 26% fewer than the week before. It added that declining case numbers were also seen in 17 of the country’s 21 regions, including in all three major metropolitan areas. Infections are dropping among all age groups except among those 10 to 19 years old.
The health agency says COVID numbers are dropping the fastest among elderly seniors 80 years old and older.
Among seniors in care, Sweden’s most tested population, infections fell by 43% week to week. They were also down 21% among seniors receiving home care.
As always, take these numbers with a grain of salt due to Sweden’s lackluster testing regime. It restricts PCR testing to just seniors in care and those being admitted to hospital.
As of September 1, the Swedish Public Health Agency is recommending that seniors 65 years old and older, along with anyone 18 years old and older who are in a high-risk or vulnerable population, get a 4th vaccine dose. The recommendation also applies even if a person who is eligible has had a recent infection.
Department Head Sara Byfors:
“These groups have a higher risk of serious illness and death from a COVID infection. The vaccine's effectiveness also declines faster in older people than in those who are younger. Since it has now been at least four months since the last dose for many in these groups, it is time to top up protection.”
The positivity percentage in Sweden last week was 17% a slight week-to week decrease.
There were nine new severe infection cases admitted to intensive care last week. Of the 74 ICU patients over the last month, the average age was 66. And of the 74, the majority, 60, belonged to a group dealing with medical issues putting them at risk.
The health agency says the number of pandemic deaths last week was at an “unchanged level since mid-July”. It doesn’t provide the number of coronavirus deaths last week. We know there were 106 coronavirus deaths reported two weeks ago and Sweden averaged 76 fatalities per week in each of the three weeks prior to that.
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COVID hospitalizations in Sweden’s capital region are creeping upwards again. Region Stockholm has also increased the frequency of its epidemic hospitalizations, reporting from once a week back to near daily weekday reporting.
It says there are 212 pandemic patients in hospital, two more than yesterday, and of those four are in an ICU.
As of Thursday afternoon, the region’s emergency hospitals had 226 available care beds. That is 28 fewer spaces than there were on Wednesday.
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Norway has added 561 more infections (underreported) and 27 more pandemic fatalities in the last seven days.
Over the last week there were 106 COVID hospital admissions, 30 fewer than the previous seven day period.
So far, 80.5% of Norwegians 12 years old and older have one dose, 75% have two, and 55.8% have a booster dose. These numbers haven’t changed in months.
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The Norwegian Institute of Public Health says the epidemic continues to be in a “calm phase.” In its latest bi-weekly pandemic assessment, the agency says infection numbers continue to be on a slightly decreasing trend.
However, it warns the pandemic remains “unpredictable” and also notes that as coronavirus cases ease, other respiratory virus infections are increasing.
In the last eight weeks, COVID hospitalizations have remained on a downward trend. Last week, there were 92 new infection admissions were reported, down from the 123 in the previous week and 209 the week before that.
The same can be said for intensive care admissions with six severely infected people admitted into an ICU last week. The week before that it was nine.
The NIPH says 27 pandemic-related deaths were reported last week, 22 fewer than the week previous.
The agency says COVID wastewater surveillance covering roughly 30% of the population showed a “slightly decreasing trend” in virus activity over the last two weeks.
The number of coronavirus-related visits to a family doctor or emergency room has been dropping for the last five weeks.
PCR testing numbers also continue to drop.
Over the last two weeks, the number of COVID outbreaks in hospitals and other healthcare facilities “was roughly the same level as the two previous weeks.”
The Omicron sub-variant BA.5 continues to rule the roost in Norway; it accounted for 92% of all sequenced positive test results in the last two weeks. Just a single case of the BA.2.75 variant, has been confirmed. The NIPH says it is also keeping a close eye on a BA.5 variant with the R356T mutation. The mutation allows for greater immune escape, hence the concern.
The agency says its mathematical modeling shows that the infection trend will continue to decrease over the next few weeks at least.
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Norway is launching its fall booster dose campaign. Anyone in the country 65 years old and older and anyone in a nursing home are eligible for a 4th COVID vaccine dose. The NIPH adds that “more groups may soon become relevant.”
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Finland registered 8,119 infections and 113 pandemic deaths since its last update a week ago.
COVID hospitalizations (476) have dropped (-112)
On the vaccination front, 79.9% of the total population have one dose, 76.9% have two, 53.9% have one booster dose, and 13.7% have a second booster shot.
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The Finnish Institute for Health is recommending that seniors 65 years old and older and anyone 18 years old or older in a high-risk, or vulnerable group be eligible for a 4th COVID vaccine dose this fall. The agency notes for most seniors and those considered high-risk their last vaccination was between five and seven months ago, with any associated protection long since faded.
It adds that in exceptional cases other people over the age of 18 may also receive another booster shot.
In all cases, at least three months must have passed since a previous vaccination or recent infection.
Chief Physician Hanna Nohynek:
“It's about a targeted booster vaccination that maintains protection against serious disease and death, and potentially expands the immunological basis of protection.”
The Institute says for those under 65 vaccine-induced protections against severe infection, hospitalization, and death “is maintained for a long time.”
“According to research data, inhealthy working-age adults, at least two vaccine doses and an infection or three vaccine doses provide protection against severe infection for at least nine months. During this time, protection remains at almost the same level as after vaccination. Even after nine months, there is still significant protection.”
In an effort to prevent straining healthcare resources and staff, the health agency says whenever possible a booster dose will be given at the same time as a flu shot.
The institute is also working to determine if eligibility for another booster shot will be extended to include hospital staff and workers in places like senior care homes.
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The Finnish Institute for Health is taking a more cautious approach to bivalent vaccines saying there is “very limited clinical information about them.” The agency says the effectiveness of variant specific vaccines is “not yet known.” Now that the EMA has recommended bivalent vaccines be approved for use in the EU, the agency says it will assess which vaccines will be used in the fall and winter booster dose campaign.
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Germany reported 39,396 infections and 90 more pandemic deaths in its Thursday update.
It added 900 new COVID hospitalizations, while ICU numbers (796) dropped (-32). As a percentage of all intensive care beds in the country, coronavirus patients are using 3.7%.
So far, 77.9% of the total population have one dose, 76.3% have two, and 62% have a booster shot.
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Germany’s Health Minister Karl Lauterbach is calling it a very good day in the fight against the pandemic as the European Medicines Agency recommends bivalent vaccines be approved for use in the EU.
“A quantum leap in the fight against the pandemic. Finally, there are vaccines against Omicron variants. This means that significantly better protection can be expected for the autumn. Everyone should now close existing vaccination gaps.”
WHO🦠🌍
The World Health Organization says after weeks of increasing global pandemic deaths, things may be, finally, turning around, but for how long?
Director General Dr. Tedros Adhanom Ghebreyesus:
“We are now seeing a welcome decline in reported deaths globally. However, with colder weather approaching in the northern hemisphere, it’s reasonable to expect an increase in hospitalizations and deaths in the coming months.”
Dr. Tedros is again urging people to get vaccinated and get boosted as Omicron sub-variants are much more infectious than any previous coronavirus strain.
“The risk of even more transmissible and even more dangerous variants remains. Meanwhile, vaccination coverage among the most at-risk people remains too low, especially in low-income countries. But even in high-income countries, 30% of healthcare workers and 20% of seniors remain unvaccinated. These vaccination gaps pose a risk to all of us. So, please get vaccinated if you are not, and get a booster if it’s recommended that you have one.”
He said it is unwise to pretend the pandemic is over when it is clearly not.
“Living with COVID doesn’t mean pretending the pandemic is over. If you go walking in the rain without an umbrella, pretending it’s not raining won’t help you. You’ll still get wet. Likewise, pretending a deadly virus is not circulating is a huge risk.”
🇨🇳
Chinese authorities are locking down the city of Chengdu, home to more than 20 million people, after confirming about 150 coronavirus infections. Everyone in the city is to stay home, unless their job absolutely requires them to be there in person. The entire city population is to be COVID tested. Chengdu is the largest city in China to be locked down since Shanghai, earlier this year. In Shanghai the lockdown was initially supposed to be just a few days but ended up lasting for two months.
🇨🇦
The Public Health Agency of Canada only updates national COVID statistics once a week every Thursday.
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The Public Health Agency of Canada has approved the use of Moderna’s new bivalent COVID vaccine. The new vaccine can be used as a booster dose for those 18 years old and older. It is to be given at least four months after a previous vaccination.
“After a thorough and independent scientific review of the evidence, Health Canada has determined that the bivalent Moderna Spikevax booster is safe and effective. It was also found to generate a good immune response against the Omicron BA.4 and BA.5 subvariants."
Chief Medical Adviser Dr. Supriya Sharma
"It's essentially two vaccines in one. This booster is also intended to extend the durability of protection. This will help us face the next wave."
An initial 780,000 doses of Moderna’s bivalent vaccine will arrive on Friday as the first shipment of the new vaccine. 10 million more doses are under contract to arrive by the end of the month.
Canadian health authorities continue to assess the bivalent vaccine candidate from Pfizer/BioNTech. The pharmaceutical company submitted its vaccine for review on July 25.
🦠Monkeypox🦠
The World Health Organization has some positive news on the monkeypox front as case numbers appear to be falling in one of the hardest-hit areas on the plant.
WHO Director General Dr. Tedros:
“In the Americas, which accounts for more than half of reported cases, several countries continue to see increasing numbers of infections, although it is encouraging to see a sustained downward trend in Canada. Some European countries, including Germany and the Netherlands, are also seeing a clear slowing of the [monkeypox] outbreak, demonstrating the effectiveness of public health interventions and community engagement to track infections and prevent transmission.”
Dr. Tedros says the decreasing monkeypox infection numbers confirm what he WHO has said from the beginning, that this is an outbreak that can be stopped.
“But it won’t just happen. Eliminating monkeypox needs three things: the evidence that it’s possible, which we are now beginning to see; political will and commitment; and the implementation of the public health measures in the communities that need them most.”
⚡️Energy Crisis⚡️
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European Union politicians are beginning discussions about how to tackle the energy crisis. Options on the table include intervening in the electricity market. An initial proposal is expected to be tabled on September 14.
Early word is that demand reductions as have been currently made to member nations to reduce natural gas use by 15% could also be broadened to include electricity usage. Another avenue would be to cap or regulate electricity prices to try and keep energy costs down.
🇷🇺/ 🇪🇺
As of Wednesday, Russia’s nationalized energy giant Gazprom has again stopped all shipments of gas through the Nord Stream 1 pipeline. It is again using the pretext of “maintenance” in the unscheduled stoppage as it weaponizes its energy exports to try and force Europe to its knees.
The question now is will gas supplies, already running at just 20% of capacity, resume through the pipeline this weekend or will Russia keep the taps off.
🇩🇪/ 🇷🇺
Germany’s Economy Minister is calling it an “alarming” trend as some manufacturers in the country halt production due to soaring energy prices.
Economy Minister Robert Habeck spoke to the Financial Times:
“It’s not good news because it can mean that the industries in question aren’t just being restructured but are experiencing a rupture, a structural rupture, one that is happening under enormous pressure. Wherever energy is an important part of the business model, companies are experiencing sheer angst.”
Habeck said that the energy crisis is putting a squeeze on everyone from major industrial companies down to medium and small-sized businesses. He says the business model in Germany has been built on an abundance of cheap natural gas from Russia. He added that competitive advantage “won’t come back any time soon, if it ever comes back at all.”
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As energy prices and inflation continue to rocket upward in Germany, energy saving rules have come into force to try to encourage businesses and homeowners to cut power use and reduce energy costs.
For the next six months:
Businesses must keep doors closed to reduce electricity use for cooling or heating.
All illuminated advertising must be turned off from 10:00pm and on through the night. There are some exceptions.
Public monuments and buildings are no longer to be lit up at night.
Public buildings must limit thermostat settings to a maximum of 19 degrees. Hallways and corridors are not to be heated at all. This does not apply to hospitals, schools, or daycares.
Public facilities are also required to turn off water heaters and hot water tanks if they are mainly used to heat water for things like washing hands. In some German cities showers in sports facilities and swimming pools will no longer be heated.
Privately run pools cannot use gas or electricity for heating.
A second set of energy saving rules are waiting in the wings and could come into force in October if need be.
The European Commission has mandated that all EU countries reduce their energy use by 15% to try and mitigate the impacts of the ongoing energy crisis. Germany is seeking to exceed that target and reach a reduction of 20%.
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Finland is taking steps to tackle the energy crisis and in particular the soaring cost of electricity. Treasury Minister Annika Saarikko announced on Thursday that the government is lowering the tax on electricity, launching power use reductions, and providing subsidies for the country’s lowest income earners.
“The price tag of the coming winter is too heavy for many homes. It is currently impossible to predict the price of electricity, but efforts are being made to contain the increase in costs for consumers.”
🇭🇺/ 🇷🇺
Hungary continues to be a thorn in the EU’s side and a blessing for Russia. The Hungarian government has signed a contract with Russia”s Gazprom for an extra 5.8 million m3 of natural gas on a daily basis. This is on top of the gas supplies it already has under contract. Hungary has also agreed to pay for its gas supplies from Russia in rubles, providing Russia with an end-run around European Union sanctions.
The Orban government will hail this as a mission accomplished in ensuring gas supplies for its citizens. Russia is also hoping that this will help cause fissures in European unity, especially if it is a cold winter and the energy crisis in Europe becomes an all-out calamity.
🇺🇦/ 🇷🇺 War
A team from the International Atomic Energy Agency has pushed through to the Zaporizhzhia Nuclear Power Plant in Southeastern Ukraine despite heavy fighting and efforts by Russian forces to hinder their travel.
The Director General of the agency, Rafael Mariano Grossi, tweeted from the plant on Thursday to say his team has arrived, set-up, and have completed their "first tour of the key areas that we wanted to see”. He says there is lots more work to be done at the Russian occupied nuclear facility adding the agency is working to establish a continued presence at the plant.
🇫🇮/ 🇺🇦
Finland’s Defense Minister says an 8th package of weapons and other military supplies for Ukraine is being worked on and details will be sorted out soon. Finland traditionally does not reveal details around what weapons it supplies Ukraine or when they will arrive.
🇸🇪/ 🇺🇦
Sweden has authorized a 7th weapons package to Ukraine.
According to Ukraine’s Minister of Defense this latest weapons package will be built primarily around artillery ammunition.
🇫🇮/ 🇸🇪 NATO
The Czech Republic has become the 24th NATO member country to ratify Sweden and Finland’s membership applications. The two Nordic countries need all 30 member nations to approve their membership in order to become full time member nations of the alliance.
As I have stated before, you can expect Turkey to drag its feet on any decision as it seeks to crowbar every advantage out of the situation.
🇪🇺/ 🇺🇦
The European Union has set up a new medical evacuation hub for wounded Ukrainians and others in need of medical care. The hub is near the Polish city of Rzeszów. Patients from Ukraine will be medically evacuated there, assessed, and then airlifted to healthcare facilities in another European country for treatment. Norway is facilitating twice weekly airlifts from the facility near Rzeszów to other EU destinations.
The EU Commission says since March more than 1,100 Ukrainians have undergone medical evacuations for treatment across 18 countries.
🇪🇺/ 🇷🇺
While not quite a full ban, the European Union has placed a lot of bureaucratic roadblocks in front of Russian tourists looking to enter the EU. This week, at a meeting of European Foreign Affairs Ministers, a decision was reached to immediately suspend the visa facilitation agreement with Russia. This makes it much more expensive and complicated for Russians to get a visa to enter Europe.
Several EU states like Finland and the Baltic countries had been pushing for a total ban on Russian tourists.