Countries That Aimed For COVID ‘Elimination’ Instead Of ‘Mitigation’ Fared Better In Pandemic
The implementation of COVID-19 restrictions and social distancing measures in South Korea in early March 2020.

A handful of five countries that forcefully acted to eliminate COVID-19 transmission fared better over the duration of the pandemic than others – experiencing far fewer deaths, faster economic recovery, and the preservation of a greater range of personal liberties, according to a sweeping review, published in The Lancet on Thursday. 

The review of policies adopted by the 37 member states of the Organisation for Economic Co-operation and Development (OECD) compared COVID-19 deaths, gross domestic product (GDP) growth/contraction, and severity of lockdown measures during the first year of the pandemic – which was declared in March 2020. 

Countries that took the maximum action to curb community transmission and contain SARS-CoV2 – including Australia, Iceland, Japan, South Korea, and New Zealand – had an average death rate that was 25 times lower than those countries that implemented restrictions in a more stepwise, targeted manner, according to the group of French, British and Spanish  researchers. 

COVID-19 deaths, GDP growth, and strictness of lockdown measures for OECD countries choosing SARS-CoV-2 elimination versus mitigation.
Economic Growth Rebounded in Early 2021

Just as importantly, GDP growth returned to pre-pandemic levels in the five “elimination” countries in early 2021, while economic growth for the other 32 OECD countries that pursued a mitigation approach remained negative until the end of the study period in early March 2021, according to the review, co-authored by a number of senior UN and national government policy advisors, including Ilona Kickbusch, founder of the Geneva Graduate Institute’s Global Health Centre, and Devi Sridhar of the University of Edinburgh.

Civil liberties also were most strictly constrained in countries that chose mitigation. By contrast, swift measures taken in the early weeks of the pandemic were categorized as less strict on a ‘stringency scale’ applied by the researchers, lasting for a shorter duration. 

Life in New Zealand is back to normal after strict travel limits and one lockdown eliminated the virus on the island nation.

Countries that chose SARS-CoV2 mitigation included Germany, France, Israel, Poland, the United Kingdom, and the US. Most of these countries were forced to impose new national lockdowns in the first quarter of 2021 following renewed surges in cases. 

“Countries opting for elimination are likely to return to near normal: they can restart their economies, allow travel between green zones, and support other countries in their vaccination campaigns and beyond,” the authors state. 

Assessment Ends Before Vaccination Campaigns Kick In

The assessment, however, ended just before the impacts of mass vaccination campaigns began to kick in over the course of March and April in Israel, followed by the United Kingdom and the United States. 

In Israel, for instance, which had recorded one of the  world’s highest infection rates, per capita, in January, with over 7,000 new cases daily, new infections dropped to about 120 daily in late April, when 60% of the population had either vaccine- or infection-related immunity. A rapid economic recovery, meanwhile, has seen it leap ahead of Canada to become one of the top 20 richest OECD nations, based on per-capita GDP – following economic contraction in 2020.  

It remains to be seen, however, how rapidly disease burden will decline and economies reignite in other OECD countries as vaccine rates tick upwards – and what will become of low- and middle-income countries where vaccines have yet to even reach large proportions of the population.  

Maintaining Other Public Health Measures Will Remain Essential, Even With COVID Vaccines

According to the authors, a swift path to elimination is easier now than ever over the past year due to the existance of COVID-19 vaccines and better testing.

But while COVID-19 vaccines are critical to ending the pandemic, they cannot be the sole tool to contain the virus due to their uneven and inequitable rollout, the time-limited immunity, and the emergence of new variants, which could threaten the efficacy of the vaccines, the authors stated:

“History shows that vaccination alone can neither single-handedly nor rapidly control a virus and that a combination of public health measures are needed for containment.” 

And so other public health measures will remain critical to preventing new waves of infections, a rise in mortality, and the proliferation of new SARS-CoV2 variants. 

“With the emergence of variants of concern, the more likely (if not the only) path to elimination is to combine several potent tools,” Bary Pradelski, co-author of the article and Professor of Economics at the French National Centre of Scientific Research, told Health Policy Watch.

The elimination of the SARS-CoV2 virus also will require a more coordinated international strategy, as opposed to separate government COVID-19 responses that have led to varying outcomes, since the pandemic is only going to end anywhere once it is under control everywhere. The authors concluded by stating: 

“National action alone is insufficient and a clear global plan to exit the pandemic is necessary.”

Image Credits: Wikimedia, The Lancet, Mona Masoumi.

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