It is necessary to ensure low cases even if eradication is impossible

France’s routes will be locked for the third time on Friday, the latest instance of a government taking emergency measures after attempts to deal with the pandemic failed. In this context, many experts advocate a more hawkish “Zero Covid” strategy to keep the spread of the virus as low as possible, even if it is difficult to eliminate the virus.

France imposed multi-prison measures against 16 regions, including the Paris area, on Friday to address a resurgent epidemic following two nationwide deadlocks in 2020.

The rapid jab programs in Israel and the UK seem to show a way out of this strenuous cycle, but the EU’s slow rollout of vaccines makes this solution seem remote to many on the continent.

At the same time, several countries in the Asia-Pacific region famously avoid the Groundhog Day-like recurrence of lockdown by stamping on the virus initially – with New Zealand registering only 26 Covid-19 deaths after adopting this strategy.

For many experts, this is a shining example of what non-drug interventions can do – suggesting that European countries have been defiant when they only try to deal with the pandemic through on-and-off containment measures. Instead, say many proponents of the Zero Covid strategy, governments should adopt a Hawkish strategy to keep transmission as low as possible when vaccines are rolled out.

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Jowharspoke with Claire Standley, an assistant professor at Georgetown University’s Center for Global Health Science and Security, about how to interpret the Zero Covid target and how the spread of the virus can be minimized in the coming months.

How would you define the Zero Covid goal?

When people say Zero Covid, they do not always talk about the same thing and it has led to a lot of confusion in the public debate about it and has led to some of the controversy surrounding it. Then there is the very strict definition of Zero Covid – saying that we should eliminate the virus completely.

I think the latter is probably an impossible, if commendable, goal. It would require an unmatched level of international cooperation, which has not exactly been the hallmark of the pandemic so far. It is also the nature of the disease itself that makes it unlikely: the fact that it has asymptomatic transmission. And it’s also a zoonotic disease: we’re not talking about eradicating SARS-1, for example in part due to unknown; the virus can still be found in animal reservoirs.

On the other hand, widespread uncontrolled transmission – even with policies to protect the vulnerable – has not worked so well. It has had a very high human cost, especially since it is difficult for the authorities to say exactly who will be at risk of serious illness. We can try to protect the elderly, for example, but there are a large number of people in the younger age groups who have had severe attacks of Covid, sometimes without obvious underlying conditions.

Evidence shows that attempts to protect the elderly while spreading the disease to younger people do not work. In Germany, the Robert Koch Institute of Public Health publishes a kind of heat map of cases by age group over time. With that you can really see that last summer was low transmission, towards the end of the summer the incidents for young people increase – but even with recommendations for the elderly to limit the exposure, you see very quickly in the autumn a huge increase of all age groups. Meanwhile, some of the new variants may have difficulty, even in younger age groups, as there are many unknowns related to them.

What could the situation be like if Covid-19 became endemic?

It is difficult to know exactly what this virus looks like at this stage. But we have a basic data point for this in that we already have endemic coronavirus. There are four very common human coronaviruses that circulate as colds.

So there is a precedent for seeing how Covid-19 can become less virulent through mutation and / or increased population immunity. In the case of extensive vaccination, its impact can be reduced, as with the flu.

How low will vaccines give Covid-19 transmission?

It is a miracle that they have developed so quickly and seem to be so safe and effective – and they are a critically important part of our strategy. We will have problems until we get some immunity. In countries that implicitly or explicitly tried to build it naturally with a herd immunity strategy, it led to the collapse of health systems and lots of avoidable deaths.

Some evidence from the very rapid jab expansions in Israel and the United Kingdom suggests that vaccines play a role in reducing transmission but will not do so completely. We should not expect cases to disappear by vaccination alone. it is not a complete panacea. And when you have vaccinated less than half of your population – as many countries do – there is still a high risk that the number of cases will increase. So it will still be necessary to ensure low transmission through other public health measures such as physical distancing and wearing masks.

When it comes to making Covid much less of a threat, it depends on how fast vaccines can be rolled out and what the uptake rate is. It’s a big question whether young people should get a jab; Some US states allow 16- and 17-year-olds to take them, but in most countries it is only 18 years and older.

What do you say to the libertarian argument that further locking would be too much?

There is a logical connection between what some say and argue that a further set of restrictions – or another lock – would not differ from the previous ones and would result in some form of authoritarian state. Having said that, we really need to be careful about ensuring that civil liberties are not adversely affected by any new policy that may increase the invasion of privacy or allow for greater interference in personal life.

Most people who advocate continued strict restrictions to bring cases down to very low levels do not argue for more control from the government. they only argue for the same policy that has been used in the past.

That said, I understand that many people are very tired of restrictions, so I wonder how high compliance with locking can be at this stage.

In the EU countries, the coming months will be extremely challenging, with the slow rollout of the vaccine, the fatigue with the pandemic that everyone is experiencing and the feeling of few politicians feeling comfortable with the economic consequences of further barriers.

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