Yesterday, a short paper titled “SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties” was published in The Lancet. The authors claim, “Countries that consistently aim for elimination – i.e., maximum action to control SARS-CoV-2 and stop community transmission as quickly as possible – have generally fared better than countries that opt for mitigation – i.e., action increased in a stepwise, targeted way to reduce cases so as not to overwhelm health-care systems.”
This claim is supported by three charts, each comparing “OECD countries opting for elimination” with “OECD countries opting for mitigation” (see below). The first chart shows that “OECD countries opting for elimination” had fewer deaths per million; the second shows that they had smaller declines in GDP; and the third shows that they had less restrictive lockdowns.
The authors note, “With the proliferation of new SARS-CoV-2 variants of concern, many scientists are calling for a coordinated international strategy to eliminate SARS-CoV-2.” They also note, “Countries that opt to live with the virus will likely pose a threat to other countries” whereas those “opting for elimination are likely to return to near normal”.
One might be tempted to conclude that “elimination” (or “Zero Covid” as it’s sometimes termed) is a sensible strategy going forward. However, I don’t find the authors’ analysis very convincing.
First, they don’t explain how they classified countries as either “opting for elimination” or “opting for mitigation”. For example, did they simply look at outcomes (which would be circular), or did they examine statements by politicians from the spring of last year? (E.g., “This Government will pursue an elimination strategy.”) It’s not clear.
Only five countries were classified as “opting for elimination”: Australia, Iceland, Japan, New Zealand, and South Korea. All other OECD countries were classified as “opting for mitigation”. It may have occurred to you that the five “eliminationist” countries are not exactly representative. Four are islands and one is a peninsula (with a fairly impenetrable border to the north). Two are East Asian. And in fact, these two – Japan and South Korea – are the only East Asian countries in the OECD.
As I argued in a piece for Quillette, all the Western countries that have kept their death rates low are geographically peripheral countries that imposed strict border controls at the start (Norway and Finland, plus a few islands). Their geographic circumstances not only made border controls practical, but also gave them a head start in responding to the pandemic.
It’s very unlikely that large, highly connected countries like France, Italy or the US would have been able to contain the virus during the deadly first wave. And although Britain is an island, we probably wouldn’t have been able to either. The epidemic was already more advanced in London and other international hubs by the time most Western countries introduced lockdowns and social distancing.
In other words, “elimination” was probably never a realistic option for Britain and other large Western countries – even if it could have a passed a cost-benefit test. But what about Japan and South Korea?
Although South Korea did use a combination of early lockdowns and strict border controls to contain the virus, the same cannot be said for Japan. According to the Oxford Blavatnik School’s COVID-19 Government Response Tracker, Japan has had only two days of mandatory business closures and zero days of mandatory stay-at-home orders since the pandemic began. (And the two days of mandatory business closures were the 25th and 26th of April this year.)
Japan did introduce border controls quite early, which may have protected it during the first wave. However, these were not sufficient to prevent an epidemic from burgeoning in the winter of 2020–21. (By early February, the number of daily deaths was in the 90s.) Yet this epidemic retreated without any real lockdown measures being imposed, which suggests that some other cultural or biological factor accounts for Japan’s success.
Second, even if you believe an “elimination” strategy was feasible for Britain and other large Western countries in the early weeks of the pandemic, that ship has arguably sailed. This is particularly true for Britain, where almost 70% of adults now have COVID antibodies. In other words: while it might have been sensible to “eliminate” the virus last spring (assuming that was possible), the costs of doing so now would almost certainly outweigh the benefits.
Overall, the Lancet study does not provide a strong case for “elimination” of COVID-19. And in fact, a survey by Nature of 119 experts found that 89% believe it is “likely” or “very likely” that SARS-CoV-2 will become an endemic virus. As Michael Osterholm – an American epidemiologist – noted, “Eradicating this virus right now from the world is a lot like trying to plan the construction of a stepping-stone pathway to the Moon. It’s unrealistic.”
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Why worry? We are essentially at or beyond the threshold of Herd immunity: Britain, where almost 70% of adults now have COVID antibodies.We are in a strong position wrt this virus.
there’s no need to worry now and there was no need to worry last april or last march either. its a mild sniffle that only kills the terminally ill and has only taken UK overall mortality back to 2008 levels. I didn’t see any panic back then
Well indeed, so you have to ask yourself why those in the driving seat do still seem/pretend to be worried.
facebook and google are in the driving seat
I was thinking primarily of the PM and the Cabinet, plus SAGE, in the UK at least. Facebook and Google are indeed on the long list of entities who have been a force for bad during this madness.
Interesting that only if you click on the full author list is the dreaded Devi Shridhar revealed as being one. What a surprise (not!)
are politicians allowed to buy shares?
Beyond that, if T cells were tested. What fun to be able to agree with Fon.
What has NZ’s test cycle rate been? Why was there a big flu surge there early last year? How do you show the rest of the world that you are in control and have beaten nature? Theatrics?
NZ is living a ‘normal’. life – sealed off from the world, with panic always gibbering at its elbow, and snap lockdowns every couple of months as a sniffler gets loose. And so it will remain. The world’s biggest open prison.
Yes, I used to hanker after taking a holiday to NZ. In more idle moments might have thought about relocating there. Not any longer.
Again – no proper cost/benefit analysis, even if you accept the barmy premise.
There is no cost.
Not to those people that matter – as far as they are concerned. They’ve been living like kings for the last year.
It feels like there’s now a mad race on between the anti-lockdown pro-lifers, who are demanding their freedom back thanks to herd immunity, antibodies etc, and the Big Pharma/Big Tech “pro-covid” faction that desperately needs to keep the pandemic going just long enough to force their vaccines and digital IDs on all of us. Who gets to the door first?
On the plus side Bacofoil is still in production so you’re sorted.
It’s amusing to see people who are themselves wearing non-functional masks and visors, leaving their shopping in quarantine in the garage for 3 days and being vaccinated with a vaccine that isn’t a vaccine against a virus which is only marginally more threatening than seasonal influenza, accusing sceptics of being tinfoil hatted conspiracy theorists.
Literal tin foil hat wearers calling everyone else tin foil hat wearers.
Yes we can all eliminate the virus.
All we have to do is become exactly like China and the job is done.
Which I suspect is what authors like these want.
exactly. and why even bother to eliminate something so mild. Might as well go for ‘zero athlete’s foot’ policy
My athlete’s foot players me up something rotten, I’d go for that, as long as I can have my liberty back.
We don’t really know what happened in China.
I think he was joking.
Probably was, but Rick H makes a good point. Half the planet followed what they thought China did, hoping to achieve the result they thought China achieved. We based the most expensive state action in global peacetime history on the actions of and information from a totalitarian regime that few would have given much credit to for truthfulness up to now.
Why haven’t opposition and journalists and ordinary people called out the lockdown zealots on this?
Wuhan’s famously draconian lockdown didn’t even bring covid under control (it reduced R from 3.9 to 1.3 IIRC). China actually beat the virus in China by a form of test and trace where the suspected infected and their contacts were actually rounded up into quarantine facilities rather than being allowed to self-isolate at home.
Many other East Asian countries were to imitate them (and New Zealand did eventually adopt this practice, but far too late to have been decisive in their own success) but as far I know the only country outside the Pacific region to try it was Israel. And for them it didn’t work out (although they have of course redeemed themselves with their top-notch vaccination programme).
I doubt we can know the true status of CoViD-19 in China. As to causation of any drop in prevalence, we can’t even be sure about this for countries we regard as reasonably open and honest.
See my other comment, quoting from “SARS : how a global epidemic was stopped”. Elsewhere, in that report, the authors explain why they can’t even be certain that containment measures explain the disappearance of the, less transmissible, SARS. (https://apps.who.int/iris/handle/10665/207501)
China beat the virus by putting out bulletins saying they’d beaten the virus.
Zero Covid is a sensible strategy if your objective is to have an excuse to impose draconian restrictions on the freedom of your citizens, in order to fulfil other policy objectives.
But as a public health policy, it’s insane, barking mad, scientifically illiterate and should be thrown in the policy skip along with vaccine passports, masks and vaccines which aren’t vaccines.
In most countries, coronavirus is already endemic. In a few, it is not. But it is those countries – the ones aiming for Zero COVID – which have the problem now. The vaccines, it is clear, are not the solution, as they do not prevent transmission or infection.
So these countries are faced with a future which either involves:
isolation of their countries from the rest of the world, with all of the economic and social impacts that would mean, together with the constant need for “snap lockdowns” and the wider risks to the immune systems of its populations with their ongoing lack of exposure to other viruses from the rest of the world
or
at some point, having to “let the virus rip” to use a topical expression, while protecting the vulnerable.
The latter would of course be the correct thing to do but would be politically difficult given what has been invested in the “zero COVID” narrative.
Aus and NZ are in a real pickle now.
Aus and NZ are in a real pickle now.
I had this very same thought the other day when I read recently about a cluster of cases in Australia that spread to NZ triggering yet another panic and a bunch of snap lockdowns. New Zealand achieved ‘zero covid’ because it completely shut its borders to the entire world. You can’t live in isolation for ever – and all this isolation policy is doing is storing-up much bigger problems for the future. It would have been a much better policy to let people carry on as normal as possible while using all resources available to protect the elderly and the vulnerable.
(Exactly as Giesecke predicted)
“It would have been a much better policy to let people carry on as normal as possible while using all resources available to protect the elderly and the vulnerable.”
A bit like those highly distinguished academics said at Great Barrington and were promptly cancelled from social and mainstream media.
No way will zero covid countries open their borders because they are sufficiently vaccinated for herd immunity. This issue is that the leaders of those countries may be too afraid to reopen their borders even then because it’s likely that a few unlucky sods (likely those whose immune systems were already so weak that the vaccine doesn’t work) will die of Covid never the less, and the populace has been whipped up into such a frenzy that they’ll (metaphorically) crucify whoever reopened the borders.
Why? Herd immunity will be gained by vaccines.
zero covid strategy is BIG TECHS strategy… this way we can be more and more dependent on them for longer
In this the alarm should be loud and clear. Big Tech have an investment in keeping the lockdowns alive and their consumers held captive. There is arguably a clash of interests and currently the power held by Big Tech means that there can be no balancing of those interests; the equation is slanted all one way.
I’ve bookmarked this article and the Lancet article for future reading and comment, but I’ll probably never get to it, but here’s my first takeaway:
The authors’ binary classification (elimination vs. mitigation) is not the classification we’ve been debating over the past year, suppression (lockdowns) vs. mitigation (“herd immunity”). Of the 5 OECD “elimination” countries (Australia, Iceland, Japan, New Zealand, and South Korea), “elimination” the majority (Japan, Iceland, and SK) never had lockdowns – whereas the majority of “elimination” countries did have lockdowns, several of them more than one. (If I do write about this, I’ll tot up the statistics).
Instead the authors are classifying countries in terms of outcomes (elimination = little COVID vs. mitigation = lots of COVID) instead of actual strategy. By classifying all of OECD Europe as ‘mitigation’, the differences between the countries’ actual strategies can be ignored.
Which fits Team Lockdown’s defensive strategy they’ve been using since last October, to defend lockdowns by changing the subject.
A good analysis.
Beyond that – it’s essentially predictive modelling – and we know all about that.
Exactly. If Japan has “zero COVID” it’s more likely because their population aren’t very susceptible to it, not because it was government policy.
When they wrote “Countries that consistently aim for elimination – i.e., maximum action to control SARS-CoV-2 and stop community transmission as quickly as possible”, this doesn’t describe what Japan did, at all.
Indeed: neither Japan nor South Korea are really “zero covid”. South Korea of course is an example of containment via extremely effective test and trace (of a kind likely too invasive for Westerners to tolerate), while Japan is still something of a mystery.
“Certain characteristics of the SARS virus made containment possible. Infected individuals usually did not transmit the virus until several days after symptoms began and were most infectious only by the tenth day or so of illness, when they develop severe symptoms. Therefore, effective isolation of patients was enough to control spread. If cases were infectious before symptoms appeared, or if asymptomatic cases transmitted the virus, the disease would have been much more difficult, perhaps even impossible, to control.” (Emphasis added)
Source: https://apps.who.int/iris/handle/10665/207501 (page “243” = 254 in viewer).
The population of Japan have very high levels of D3 in their system, and the elderly population of Japan are the healthiest in the world.
Japan seems to have had four waves of Covid, each worse than the one before it. Anybody here got any idea what would lead to such an infection history? It can’t be lockdowns (as I don’t think Japan had any) and it’s not the right shape to be caused by seasonality.
A pattern of Covid infection driven by seasonality would look like that of Sweden (or of other European countries with very bad first waves): one big wave at the start of the pandemic and another big wave in the late autumn and winter, but almost nothing in the summer.
I expect Labour and the vast majority of Tories are thrilled at this report. Gotta keep that pot boiling !!!
Zero Covid strategy is a money making machines…
Amazon, Apple, Facebook, Google, Microsoft and Netflix profits have soared in 2020 to 2021 to unprecedented billions. In the second quarter of 2020 Amazon had reported a 40% sale increase amounting to $88.9 billion dollars and Twitter reported a 34% growth increase.
The services offered by the Tech giants have become indispensable to a world in lockdown. Their power has increased exponentially and with this they have developed an unfettered power to control who appears on their platforms and the information that is permitted to be published.
It wouldn’t surprise me if some of the US teachers’ unions which are vehemently opposed to in-person education, turned out to be on the take from tech companies with an interest in online learning
Well done – You say it all… It is glaring people in the face and they refuse to see it…
Let us not forget Big pharmaceutical
Baloney, the Lancet and some of the LDS article. Islands plus S Korea/Japan which are representative of a lot of East Asian country experience. S. Korea never locked down, that is a fallacy. East Asian countries experienced SARS1, they have some inbuilt immunity. They also don’t use ACE inhibitors as in the west. Its one of the tragedies of SARS2/covid that the link between illness and recipients of ACE inhibitors ( and statins) has been completely covered up. Yet S Korean scientists pointed to this over 12 months ago.
https://www.upi.com/Health_News/2021/04/26/coronavirus-ace-inhibitors-risk-mice-study/5471619450818/
Devi Schrider is an author so it should be ignored immediately. Depressingly the Mail is running this story without suggesting it is what it is, batshit crazy.
The idea that you can pursue a zero-covid policy in a country that is heavily dependent on international trade is clearly nonsense. But this is pretty much what you would expect from the Lancet, which seemingly promulgates the idea that the entire country revolves around the NHS and we should all bow down and worship it.
Well China is an exemplar of zero covid as well as being the champion exporter par excellence.
The issue isn’t with international trade in general, but with international trade by truck. Countries in the Asia/Pacific region tend to do amost all their international trade by easily-quarantinable means: the crews of container ships need never leave their vessels, while those of cargo aircraft can be isolated within airports until they fly out again.
By contrast, making truck transport Covid-safe would mean changing drivers anytime trucks cross borders, which would impose a serious limit on throughput. A Covid-secured border crossing between China and Vietnam took roughly 150 trucks per day, but the number of trucks crossing the English Channel daily is closer to 7,000.
Many of the better-known Asia/Pacific countries never had to deal with the issue of cross-border truck traffic because they never had any in the first place. Australia and NZ are far enough away from any other country that the labour cost of having a trucker babysit his cargo across the sea would outweigh the savings in time (and thus money) that roll-on roll-off could enable. Taiwan also won’t have roll-on roll-off access from mainland China because of the state of war that exists between the two regimes.
What are they proposing to do about the (ahem) bats?
The ones in the labs?
While the linked tweetstorm by Devan Sinha (eerily similar name to one infamous zero covid advocate!) is certainly a sterling demolition of the wider zero covid cause, it doesn’t actually have much to say about the first wave in particular. That seems to indeed to be fairly simple: major Western nations were highly connected (as Noah had said), weren’t culturally amenable to sealing their borders quickly (as East Asian countries were), and didn’t have extra time to react due to favourable seasonality in the critical early weeks (as Australia and NZ did thanks to being in the southern hemisphere).
Dr Sinha seems more concerned with addressing the query that goes something like “in August 2020 the UK had fewer Covid cases per capita than Victoria, so why could Victoria go to zero but not the UK?”
His point on this question is that the whole Dictator Dan bargain of “harsh lockdown now, so you can get your freedom back when the country is covid-free” cannot work in a country like the UK because it has too many essential arrivals from abroad (truckers crossing the Channel, and people crossing the Irish border whose openness is a GFA requirement) to offer the “freedom back”.
Australia and NZ averaged roughly one quarantine breach for every 18,000 arrivals (even though returnees had to test negative before they were allowed to fly in) with about 40% of those breaches resulting in lockdowns.
Just a question: if the UK had decided on a “zero covid” strategy back in March 2020, wouldn’t it have meant in practice that the government would spend the first lockdown reconfiguring the UK’s trade patterns to eliminate international truck traffic (either by Chunnel or by roll-on roll-off ferries) in favour of using only container ships as the Pacific zero covid countries do?
Did any MPs (of any party) explicitly suggest such a policy, and if not do you think it is because they considered it practically impossible, or was it because they didn’t believe the British public wouldn’t tolerate a “seal the borders until vaccination” policy?
Just a question: if the UK had decided on a “zero covid” strategy back in March 2020, wouldn’t it have meant in practice that the government would spend the first lockdown reconfiguring the UK’s trade patterns to eliminate international truck traffic (either by Chunnel or by roll-on roll-off ferries) in favour of using only container ships as the Pacific zero covid countries do?
Did any MPs (of any party) explicitly suggest such a policy, and if not do you think it is because they considered it practically impossible (due to time delays and/or lack of port staff), or was it because they didn’t believe the British public would tolerate a “seal the borders until vaccination” policy?
As Ivor Cummins notes, the population of Japan in particular, but also other East Asian countries have very high levels of Vitamin D3 in their systems.
That would certainly help, but Japan is clearly using some kind of suppression method (even if not the kind of lockdowns seen in Western countries) because the shape of their infection curve doesn’t look like one which seasonality would generate.
A very interesting thread about the futility of zero covid for UK with interesting data.according to Prof Balloux, all chances for zerocovid in UK was already minimal in the end of 2019.This thread should be read regarding the Lancet article discussing zerocovid options.
https://twitter.com/DevanSinha/status/1387828825061564422
That exact tweetstorm was quoted in the original article: it’s the link at “It’s very unlikely that large, highly connected countries like France, Italy or the US would have been able to contain the virus during the deadly first wave.”