New Covid cases in the World Health Organization’s 53-country European region rose 10% last week after falling for 10 straight weeks, the body has said, warning of a possible new surge before autumn and calling for more monitoring of Euro 2020 matches. Infection numbers continue to fall in many parts of the region, including the EU, but Katy Smallwood, WHO Europe’s senior emergencies manager, said some – such as Russia – were recording their highest daily death tolls of the pandemic. Driven by the more contagious Delta variant, combined with “increased mixing, travel, gatherings, and easing of social restrictions”, infections were rising while vaccination levels in the region were not high enough, the regional director, Hans Kluge, said. Israel, a world leader in vaccinations, on Thursday reported its highest daily infection rate in three months. Authorities raced to vaccinate children and considered tighter travel restrictions at its main airport, while its health ministry warned numbers could climb further in coming days. The country, part of the WHO’s Europe region, is seen as a test case for others after vaccinating 85% of its population. It has reopened businesses, schools and venues and lifted nearly all restrictions, but increased cases have not so far led to more deaths. Kluge, asked whether the Euro championship was acting as a “super-spreader” event, said: “I hope not … but this can’t be excluded.” Hundreds of cases have been detected among spectators, including Scots coming back from London, Finns returning from St Petersburg and Delta variant infections in Copenhagen. Smallwood said that in the context of increasing infections, large mass gatherings, in particular, “can act as amplifiers in terms of transmission. It’s really important that local authorities implement a continuous public health risk assessment.” Concerns were not limited to the matches and stadiums, she said, calling for increased monitoring of the mixing that happened around them: “How are people getting there? Are they traveling in large crowded buses? Are they taking individual measures when they are doing that? What’s happening after the games? Are they going into crowded bars and pubs?” Kluge said the WHO was “definitely concerned” by the possibility that the tournament would help spread the Delta variant. “We know it is reported by a total of 33 countries out of the 53, including host countries and some host cities”, he said. Individuals and governments had to assess risks and act accordingly, he said: “People have to do it by safely taking care of individual behaviour, but also governments, by strengthening health systems, increasing testing, contact tracing and sequencing.” Smallwood emphasised that the region now had a “window of opportunity” while infections were still falling in many countries. Governments should not lift social measures where infections were increasing, she said, or if they did, public health measures such as sequencing should be reinforced. “Continue to invest in testing, in contact tracing, in case investigation like Scotland, which has just announced really rapid analyses of where people are getting infected. Take strategic, targeted, swift action. And vaccinate, vaccinate, vaccinate.” Kluge said the Delta variant was “already translating into increased hospitalisations and deaths. By August, the WHO’s European region will be ‘Delta dominant’ – but it will also not be fully vaccinated, and it will be mostly restriction-free.” That meant the three conditions for “a new wave of excess hospitalisations and deaths” were all in place, he said: “New variants, deficit in vaccine uptake, increased social mixing. There will be a new wave unless we remain disciplined.” Kluge said that despite huge efforts by many countries, it was “unacceptable” that across the region 63% of people were still waiting for their first vaccine dose, while half of older people and 40% of health care workers were still not protected. Smallwood said people who decided to travel abroad should ask: “What’s the risk to myself? Am I fully vaccinated? Where am I going, what’s the epidemiology? Am I going to be in crowded areas or hiking up a mountain, where the risk is much lower?”