(Bloomberg) --

The U.K.’s success at avoiding the latest virus emergency ripping across the European continent has come at a price.

Thanks to an aggressive booster campaign for older and vulnerable people, the country has managed to keep hospitalization and death rates relatively steady without imposing fresh restrictions. Meanwhile, lockdowns are being reimposed elsewhere in a bid to damp down another Covid wildfire.

However, more U.K. residents have died of Covid per capita than in most other western European countries, despite earlier access to vaccines than in the European Union.  

“The U.K. has been ‘running hot’,” said Devi Sridhar, a professor of global public health at the University of Edinburgh in Scotland. “We act like Europe is so much worse, but we’ve just accepted a higher death toll and higher infection rates for longer.”

The tally of deaths has risen in particular since July, when Prime Minister Boris Johnson scrapped all restrictions, even mandatory masks. Daily numbers are currently running almost five times higher than in the weeks before his much-ballyhooed “Freedom Day.” 

The varying virus trends across countries have created an intense political debate about the best way to beat back the pandemic’s latest wave. 

Austria has gone for a full lockdown and threatened to make vaccinations compulsory, while Italy and Germany are toughening measures on the unvaccinated.

The U.K. is the poster child of the opposing strategy, instead relying heavily on boosters to keep deaths and hospitalizations to a manageable level. Johnson has warned of a Covid “blizzard from the east” but indicated there’s no plan to change the rules on masks or to adopt vaccine certificates, which many EU countries have imposed. 

While Britain looks in better shape now, at least relative to some of its neighbors, it’s still unclear how the two models will play out over the Christmas holidays and beyond. 

During a previous Covid wave last winter, the U.K. initially pushed down virus numbers more quickly than EU countries, only to see cases flare anew later in the new year. That spike was subsequently contained amid a rapid vaccine rollout. 

But national immunization rates alone don’t tell the whole story. 

In Germany, only about 86% of the population age 60 and up -- a bracket that accounts for more than 90% of the country’s Covid deaths -- has been vaccinated, meaning 3.4 million highly vulnerable people have yet to receive shots. In the U.K., significantly more than 90% of that age group has been inoculated.

One thing that EU countries can learn from the U.K. is the importance of zeroing in on the people who most need shots, said Mike Ryan, head of the World Health Organization’s health emergencies program.

“Governments should know exactly who has not been vaccinated and move away from blunt percentages to missed individuals,” he said Wednesday. “The U.K. has really led the world in how to look at data.”

Given the stakes for health-care systems and economies, some European health officials say governments don’t have the luxury to pick and choose their policies. In their view, whatever can be done, must be done.

The alternative is an “overload in the health system over the next two months,” said Andrea Ammon, director of the European Centre for Disease Prevention and Control. “We do not have the choice between either vaccination or non-pharmaceutical interventions. We have to do both.”

Meanwhile, politicians are scrambling to get control of the situation in their respective countries. 

Slovakia, which has had among the world’s worst increases in cases in the past week, on Wednesday announced a new lockdown. France, on the other hand, is following the U.K. and resisting such dramatic moves. With just months to go before President Emmanuel Macron faces elections, the government says it wants to avoid “closures, curfews or lockdowns.”

Exactly why the U.K.’s high Covid case numbers have not resulted in more deaths of late is probably due to a complicated mix of factors. The country reported more than 43,000 new infections on Wednesday, among the highest levels in Europe and consistent with daily tallies since July, along with 149 deaths. 

Boosters may be helping to protect the most vulnerable. Almost 16 million people have received their third shot, versus 6.6 million in Germany.

The sluggish vaccine rollout for young people could also be a factor. The spread of infections has been particularly pronounced among school goers, and children are less likely to suffer severe illness or die from Covid.

“It’s all about population immunity,” said David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine. “Population immunity in the U.K. is likely very high because the virus has been permitted to circulate in the communities.” 

AstraZeneca Plc Chief Executive Pascal Soriot claimed this week that the U.K.’s heavy reliance on the company’s vaccine for older people, might be helping to hold down the death rate. The Astra shot, he said, may offer greater long-term effectiveness -- something U.K. scientists have shown is not the case.

“The U.K. has more immunity than many places, because of both infections and vaccination,” said Graham Medley, a member of the government’s Covid advisory panel and an LSHTM professor. “If people keep getting vaccinated and getting their boosters, and keep testing to limit transmission, then the U.K. might not have to introduce any more measures to reduce the number of patients in hospital.”

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