Introduction

Like every region in the world, the EU struggled in its response to COVID-19 – particularly in 2020 when much was still unknown about the disease. The Global Health Security Index ranked several European Union (EU) countries – the Netherlands, Sweden, Denmark, Finland, France, Germany and Spain – among the 15 countries with the highest health security capabilities to respond to infectious disease outbreaks (Nuclear Threat Initiative and Johns Hopkins Bloomberg School of Public Health, 2019). Similarly, much of Western Europe received the best scores on the Epidemic Preparedness Index published early in 2019 (Oppenheim et al., 2019). But just a few months into 2020 it was clear these index predictions were wrong.

COVID-19 policy making has involved significant uncertainties – about the nature of the disease, its transmission, and behavioural responses – and our understanding of the current and past trajectory of the pandemic has been limited by this (Manski, 2020). Thus, the EU was not alone in facing challenging choices.

Even before COVID-19 hit, it was widely acknowledged that the world was underprepared. But many assumed that given the resources at its disposal, the EU would be better equipped to fight infectious outbreaks. After all, it is home to some of the highest performing health systems and scientific institutions in the world. Additionally, several institutions designed to support collective European response to communicable diseases were well established before COVID-19.

However, there was limited consideration of globalization, geography and governance in the abovementioned measures – including gaps in analysis of regional and international organizations and the need to coordinate efforts between sub-national, national and global entities (Baum et al., 2021). Additionally, predictions about Europe's health security capabilities made the flawed assumption that just because European intergovernmental institutions were established, they had decision-making power, authority and adequate financing, they served the entire European region, and they had strong coordination with national and local-level efforts within countries.

This was a significant oversight for the EU, where countries are highly interdependent and where healthcare systems and associated decision-making power lies with national governments rather than international policy bodies. As of 2017, 19 of the 25 most connected countries in the world and five of the world's 20 busiest airports were in Europe (Pan-European Commission on Health and Sustainable Development, 2021). Thus, an infectious agent emerging anywhere in the world can quickly pass into Europe and become a threat, and vice versa. Additionally, while Europe's global connectivity is a strength in many ways, disruptions in global trade and supply chains can prove catastrophic because of its interdependent nature.

In this paper, instead of focusing on the individual national strategies that were so often split across Europe (Dergiades et al., 2020), we examine how the EU responded to the COVID-19 crisis and the interplay between the EU and its member states. Throughout, we consider the legal, institutional and political restrictions that may have influenced the boundaries of EU policy decisions.

We begin with a background on the constraints on EU health (care) policy and then describe how these led to a series of knee-jerk reactions in initial COVID-19 management efforts which were exacerbated by the rise of nationalism among and lack of coordination between Member States. We then discuss how this was followed by elements of more strategic decision-making with the refinement of vaccination policies, the announcement of a new European health emergencies response agency and considerations on how to expand and strengthen infectious disease control at the European level. Finally, we conclude with suggestions on how the EU can continue taking strategic approaches towards pandemic planning and response, including through globally collaborative mechanisms and efforts.

中文翻译：

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欧盟对 COVID-19 的回应：从被动政策到战略决策

介绍

与世界上每个地区一样，欧盟在应对 COVID-19 方面举步维艰——尤其是在 2020 年，当时对该病还有很多未知数。全球卫生安全指数将几个欧盟 (EU) 国家——荷兰、瑞典、丹麦、芬兰、法国、德国和西班牙——列为应对传染病爆发卫生安全能力最高的 15 个国家（核威胁倡议和约翰霍普金斯大学彭博公共卫生学院，  2019 年）。同样，西欧大部分地区在 2019 年初发布的流行病防范指数中得分最高（Oppenheim等人，  2019 年）。但进入 2020 年才几个月，这些指数预测显然是错误的。

COVID-19 政策制定涉及重大的不确定性——关于疾病的性质、传播和行为反应——我们对大流行当前和过去轨迹的理解受到了限制（Manski，2020 年 ）。因此，欧盟并不是唯一面临具有挑战性选择的国家。

甚至在 COVID-19 爆发之前，人们就普遍认为世界准备不足。但许多人认为，鉴于其可支配的资源，欧盟将能够更好地应对传染病爆发。毕竟，它是世界上一些表现最好的卫生系统和科学机构的所在地。此外，在 COVID-19 之前，一些旨在支持欧洲集体应对传染病的机构已经建立。

然而，上述措施对全球化、地理和治理的考虑有限——包括对区域和国际组织的分析存在差距，以及协调地方、国家和全球实体之间努力的必要性（Baum 等人，2021年 ）。此外，对欧洲卫生安全能力的预测做出了错误的假设，即仅仅因为欧洲政府间机构的建立，它们就具有决策权、权威和充足的资金，它们服务于整个欧洲地区，并且与国家和地方有很强的协调——国家内部的水平努力。

这是对欧盟的重大监督，欧盟各国高度相互依存，医疗保健系统和相关决策权属于各国政府而非国际政策机构。截至 2017 年，世界上连接最紧密的 25 个国家中有 19 个在欧洲，世界上最繁忙的 20 个机场中有五个在欧洲（泛欧健康与可持续发展委员会，2021 年 ）。因此，世界任何地方出现的传染性病原体都可以迅速传播到欧洲并成为威胁，反之亦然。此外，虽然欧洲的全球连通性在许多方面都是一种优势，但由于其相互依存的性质，全球贸易和供应链的中断可能会造成灾难性后果。

在本文中，我们没有关注经常在欧洲分裂的个别国家战略（Dergiades等人，  2020 年），而是研究了欧盟如何应对 COVID-19 危机以及欧盟与其成员国之间的相互作用. 在整个过程中，我们考虑了可能影响欧盟政策决定边界的法律、制度和政治限制。

我们从欧盟卫生（保健）政策的限制背景开始，然后描述这些限制如何导致最初 COVID-19 管理工作中的一系列下意识反应，这些反应因民族主义的抬头和缺乏协调而加剧成员国。然后，我们将讨论如何通过完善疫苗接种政策、宣布新的欧洲突发卫生事件响应机构以及如何在欧洲层面扩大和加强传染病控制来制定更具战略性的决策要素。最后，我们就欧盟如何继续采取战略方法来规划和应对大流行病提出建议，包括通过全球合作机制和努力。