In new research published in The Lancet, countries that aimed for COVID-19 elimination (maximum action to control COVID-19 as quickly as possible) were compared to countries that opted for mitigation (interventions to reduce cases to protect health-care systems) 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 Oxford-Man Institute, University of Oxford.
They found that over the first 12 months of the COVID-19 pandemic, not only on average but also at almost all time periods, countries that focused on mitigation had more deaths, negative GDP growth and more severe restrictions on civil liberties.
Professor Bary Pradelski noted, 'We have seen over the past year that those countries that 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.'
The study showed that COVID-19 deaths per 1 million population have been 25 times lower in Organisation for Economic Co-operation and Development (OECD) countries that 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 Philippe Aghion (Collège de France, LSE, INSEAD) elaborated, '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 researchers from the University of Oxford to analyse the strictness of containment and closure 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 said, 'Countries that 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.'
The paper argues that 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. It also notes that with the proliferation of new SARS-CoV-2 variants of concern, many scientists are calling for a coordinated international strategy to eliminate COVID-19. Professor Devi Sridhar, University of Edinburgh, highlighted that '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".'
The authors uphold that mass COVID-19 vaccination is key to returning to a usual life. Nevertheless, relying solely on vaccines to control the pandemic is risky due to their uneven roll out and uptake, time-limited immunity, and the emergence of new variants. Dr Samantha Vanderslott, Social Sciences Researcher on the Oxford Martin Programme on Collective Responsibility for Infectious Disease, said 'History has proven that to control an infectious disease a combination of sustained public health measures is required, including effective communication and public engagement.'
The article was originally published on the Oxford Martin School website, 29 April 2021.
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