At a time when helicopters, military aircraft and medical TGVs are being mobilised to deal with the saturation of health systems, European coordination seems no less difficult to achieve. A continental reading of the responses to the Covid-19 crisis provides little comfort in the face of the magnitude of the stakes. Lack of a common screening strategy, unilateral and uncoordinated border closures, heterogeneous containment measures, resurgence of fiscal divisions inherited from the eurozone crisis, Europe seems to be having a hard time putting itself in order of battle, to stand together to face the multidimensionality of this ordeal. We are trying to study the multiple modalities of this obvious territorial fragmentation within theCovid-19 Geopolitical Observatory.

This new map, however, reveals that, in the face of loss of life, cross-border cooperation is taking place, and European territorial dynamics are emerging.

First of all, it is the heterogeneity of the weight of the regions in Europe that is evident in this map. A comparative analysis of the political link between national and regional levels of pandemic management in countries such as Spain1, Germany or France would be particularly instructive in understanding the complexity and diversity of the modalities of territorial administration in Europe.

In particular here, it is the strength of the federal states in the German political landscape that stands out. The Ministers-Presidents of Baden-Wuerttemberg, Bavaria and Rhineland-Palatinate were thus at the forefront of the decision to welcome border patients. With a population of 17 million, North Rhine-Westphalia is a major political and health player in this crisis. In particular, the region has taken the initiative to set up a cross-border task force with the Netherlands and Belgium to coordinate their actions against coronavirus. Armin Laschet, the Minister-President of the Land, has been a serious contender for the presidency of the CDU since the withdrawal of Annegret Kramp-Karrenbauer. Its national scope will emerge strengthened by the political activism of its region, from which its main competitors at the head of the Christian Democratic Party are also all drawn.

The overlapping of population-related deaths from Covid-19 and patient transfers between neighbouring countries highlights above all the relevance of the regional scale in the analysis of the effects of this crisis. As has been studied as part of our observatory2, this scale reveals the heterogeneity of the spread of the virus in national territories, beyond the time lag of epidemiological situations. It now highlights a new aspect: the concentration of cross-border cooperation around some of the most affected areas on European territory.

In both cases, the regional analysis highlights the centrality of the European ridge, as densely populated as it is urbanised. Crossed by seven countries, accounting for more than 20% of the population of the European Union, it is its industrial and economic heartland. Within this area, cross-border cooperation provides relief to regions and cities where the influx of patients threatens to exceed reception capacity, particularly in intensive care and resuscitation. If the first measures of cooperation strike by their geographical concentration, the loneliness of Spain, however hard hit, emerges all the more as an enigma. Thus, while welcome where it is operating, this cooperation appears to be an urgent response rather than as the result of an anticipatory crisis management strategy at European level. Above all, it seems to be a measure of last resort before the collapse of hospital care capacity.

However, cross-border regions occupy 40% of the EU's territory, which has 27 cross-border urban areas, where more than 1 in 3 Europeans live. Beyond the cross-border, the example of the transfer of Lombard patients to Saxony or Alsatian patients to Berlin highlights the relevance of the regional mesh for European action. These are complex operations with heavy logistics but whose potential for the burden management of European health systems and the offloading of hospitals close to the rupture is now proven by the example of the French Greater East.

This regional reading is full of contradictions, crossed by dynamics that seem more hesitant than those observed at the national level. It shows a fragmentary but effective European coordination, effective but late, pragmatic but disorganised. It also shows that national borders are not only inoperative to contain the spread of the virus, but are a hindrance to crisis management to deal with them. Finally, she asks about the finitude of pooling within the Union: in order to prepare the world that will come after the crisis, should this reading stop at intensive care beds in times of health catastrophe or open new horizons? Who would have had the reflex to spontaneously turn to the field of public health to apprehend the strengthening of European cooperation before this crisis?

The protection of health and the organisation of health systems are not within the competence of the Union, they are prerogatives specific to the Member States. The Community response, in its coordinating dimension, is, however, an indispensable condition for their guarantee in such circumstances. The legal basis on which it is based is explicitly defined in this sense by Article 168 of the Treaty on the Functioning of the EU. The study of the European legislative framework on serious cross-border health threats3 is particularly instructive here, including point (8) of Decision No. 1082/2013/EU4 which reminds us that "the protection of human health is a cross-cutting subject and relevant to many EU policies and actions." The reference at the regional level is conspicuous by its absence, reduced to the sum of the constituent parts of the Member States. This map shows us that this transversality is nevertheless eminently multidimensional and multi-national.

This crisis therefore raises the question of strengthening the mechanisms established by this legislation, which include the European Centre for Disease Prevention and Control and the Early Warning and Response System, in particular in their direct consideration of regional dynamics and structures. It also raises more broadly the question of territorial organisation on a continental scale, and therefore of our view of ourselves as Europeans.

Original article in French courtesy of 'Le Grand Continent'