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Countries which aimed to eliminate COVID-19 registered fewer deaths, better economic performance, and fewer restrictions and lockdowns, according to an article in The Lancet.

A scientist from the Jenner Institute processing blood samples © © Credit: University of Oxford, John Cairns

Countries’ responses to the pandemic were compared by a team of experts led by Professor Miquel Oliu-Barton, Paris-Dauphine University, and Professor Bary Pradelski, French National Centre for Scientific Research and the Oxford-Man Institute, University of Oxford.

The team found that, on average, over the first 12 months of the pandemic, but also at almost all time periods, countries which focused on mitigation saw more deaths, negative GDP growth and more severe restrictions on civil liberties. COVID deaths per one million population were found to be 25 times lower in OECD countries which opted for elimination.

GDP growth, estimated on a weekly basis, had never fallen as far among these countries and is now back to pre-pandemic levels

Professor Pradelski notes, ‘We have seen that those countries which acted pre-emptively and took swift action against local outbreaks were able to control the virus, while others were always at least one step behind.’

Professor Philippe Aghion elaborates, ‘The stop-and-go strategy is detrimental for long-term economic growth because it prevents firms from long-term planning. Instead of investing in innovation, they accumulate cash to face the next lockdown. Instead of investing in skills, they hire on a short-time basis.’

The study also used the stringency index developed by Oxford to analyse policies that restrict people’s liberties, such as school, shops, and restaurant closures or movement restrictions.

Among OECD countries, liberties were most severely impacted in those that chose mitigation, whereas swift lockdown measures - in line with elimination - were less strict and of shorter duration.

Professor Miquel Oliu-Barton says, ‘Countries which have opted for elimination were able to create and protect green zones where life can return to normal. Some countries are already forming green bridges, allowing safe travel.’

By acknowledging that health, economic and civil liberty objectives are not in competition, aiming for elimination is the most effective and publicly acceptable way out of the pandemic, according to the paper.

With the proliferation of new variants of concern, it notes many scientists are calling for a coordinated international strategy to eliminate COVID-19.

Professor Devi Sridhar, University of Edinburgh, says, ‘The Biden-Harris administration seconded this view in April 2021 and stated that ending the COVID-19 pandemic is its number one priority and that this pandemic won’t end at home until it ends worldwide.’

Mass vaccination is key to returning to a usual life, says the team. But relying solely on vaccines has risks because of uneven roll out and uptake, time-limited immunity, and the emergence of new variants.

Oxford’s Dr Samantha Vanderslott, says, ‘History has proven that to control an infectious disease a combination of sustained public health measures is required, including effective communication and public engagement.’

Read the full paper in The Lancet:

SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties

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