All countries should pursue a Covid-19 elimination strategy: here are 16 reasons why
Thu 28 Jan 2021
I’ll post a link to the article, and to my script, in the shownotes
Many countries, for example NZ, China, Taiwan and Vietnam, have successfully pursued New Zealand and China have successfully pursued a coronavirus elimination strategy.
The past year of Covid-19 has taught us that it is the behaviour of governments, more than the behaviour of the virus or individuals, that shapes countries’ experience of the crisis.
The apparent waves of infection were driven by government action and inaction.
As governments draw up their battle plans for year two, we think they should base their strategies on evidence about what works best.
And the evidence suggests that countries pursuing elimination of Covid-19 are doing much better than countries trying to “live with the virus”.
Here are 16 reasons why we think all countries consider an elimination approach:
- It saves lives. Not surprisingly, eliminating transmission of the virus minimises Covid-19 deaths. Countries pursuing elimination have Covid-19 mortality rates mostly below 10 per million, which is 100 times less than many countries “living with” the virus.
- The elimination of community transmission prevents “long-Covid”, which causes persistent health problems, such as fatigue and headaches in survivors.
- Elimination is fair to everybody. Pandemics always affect poorer people more (because they can’t work from home, or have worse health to begin with) – eliminating Covid-19 can minimise these inequalities, particularly if a suitable social “safety-net” is also provided.
- Elimination is good for the economy – China and Taiwan are possibly the only countries with economic growth in 2020.
- Elimination works in many different countries with very different cultures, governments and economies: mainland China, Taiwan, Vietnam, Cambodia, Laos, Mongolia, Singapore, Australia and New Zealand. They are all very different in geography, population size, resources, and styles of government, but have all successfully pursued a strategy of elimination.
- The virus can be eliminated even after intense local transmission has occurred.
For example Wuhan in China, and the state of Victoria in Australia eliminated Covid-19 even after a period of intense local transmission (Victoria had higher rates than the UK in April, but now Victoria has zero whilst the UK has been up to 1,800 deaths per day).
- It’s easier if more countries adopt this approach, because then travel becomes safe – this helps the economy.( This opening-up is already happening among Australian states and between Pacific islands and New Zealand.
- Vaccines make elimination easier. Effective vaccines working in combination with other public health measures have led to successful elimination of diseases such as polio 急性灰白髄炎 and measles 麻疹 in many countries.
- Zero covid is a clear goal, whereas suppression never ends, which makes it impossible to plan (which is very stressful for schools work and cultural and social life).
- It is sustainable. Countries pursuing elimination have had setbacks but have mostly been able to contain them.
- If the virus mutates, elimination still works.
(border management, physical distancing, mask wearing, testing and contact tracing are not seriously affected by virus mutations)
- It also still works if vaccines provide only limited long-term protection.
- There will be fewer variants because less virus means fewer mutations.
- Fewer lockdowns – New Zealand have had far less time under lockdown than most countries pursuing suppression – for example here in Japan we are into our 3rd state of emergency whereas NZ has had only one.
- Elimination also reduces transmission and death rates from other diseases such as influenza.
- It provides a good short-term strategy while we identify the best approach. It buys us time while we think about whether to aim for global elimination, or management with vaccines like we manage influenza.
Of course, the benefits of pursuing a Covid-19 elimination strategy need to be balanced against the costs.
However, these same costs are also experienced by countries trying to suppress the virus, except repeatedly, after each resurgence. Elimination is only once.
On balance, elimination looks like the “least bad choice” for many countries. We hope that all governments will consider the elimination strategy as they plan year two of our global response to the pandemic.
Michael Baker is a professor of public health 公衆衛生 at the University of Otago
Martin McKee is a professor of European public health at the London School of Hygiene and Tropical Medicine ロンドン大学衛生熱帯医学大学院
Hey Saimon what do you think? 私に勝手な一コメントいわせていただければ・・・
“with corona” is an interesting idea, and I can see why Japan initially went for this, but it only works statistically – it’s of no comfort to the families of people who die.
And Living with corona is very stressful – I am very envious of countries like Taiwan and New Zealand – they have zero corona so are living normally, going to work and school, holding sports and cultural events. I’ve had a very stressful year, and I am sure many people have too – we could end this stress.
It’s difficult for anyone to change strategy because to change you have to first admit that you were wrong…but I think Japan should admit that suppression is no longer working well, and should change their plan to go for elimination.
Listeners, what do you think? 皆さん、いかがでしょうか？
Do you think Japan should continue to live “with corona”?
Or do you think we should follow New Zealand and Taiwan and aim to live “without corona”?