Elimination, Not Mitigation, of COVID-19 Yields Best Outcomes for Health, Economy and Civil Liberties

While countries such as New Zealand, Japan and Australia have chosen to fight COVID-19 by adopting an elimination strategy—i.e. maximum effort to reduce the spread of the virus as quickly as possible—many other countries, such as Canada, Mexico, France and Spain, have opted for a mitigation strategy—actions aimed at reducing coronavirus cases so as not to overwhelm health care systems.

Which strategy is better? Which has achieved the best outcomes in terms of health, the economy and civil liberties?

According to a new comment just published in The Lancet, countries that have followed a COVID-19 elimination strategy have seen fewer deaths, better economic performance and fewer restrictions.

According to a new comment just published in 'The Lancet', countries that have followed a COVID-19 elimination strategy have seen fewer deaths, better economic performance and fewer restrictions.

The analysis described in the article—of which I am pleased to be a co-author—was led by Miquel Oliu-Barton (Paris Dauphine University) and Bary Pradelski (French National Centre of Scientific Research, Oxford Man Institute, University of Oxford). In the article, we compare the COVID-19 response measures of various Organisation for Economic Co-operation and Development (OECD) countries during the first 12 months of the pandemic.

Our conclusion is that deaths from COVID-19 (per 1 million population) have been 25 times lower in countries opting for elimination. Moreover, in countries with an elimination strategy, decreases in weekly GDP growth have consistently been smaller than in countries opting for mitigation. In fact, elimination-oriented countries have recently seen their GDP growth return to pre-pandemic levels.

In contrast, on average and in nearly all time periods, mitigation-oriented countries have reported more deaths, negative GDP growth and more severe restrictions on civil liberties. Those countries that took preventive measures and acted quickly against local outbreaks were able to control the virus, while other countries were always one step behind.

The Lancet's figure: COVID-19 deaths, GDP growth, and strictness of lockdown measures for OECD countries choosing SARS-CoV-2 elimination versus mitigation OECD countries opting for elimination are Australia, Iceland, Japan, South Korea, and New Zealand. OECD countries opting for mitigation are Austria, Belgium, Canada, Chile, Colombia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Israel, Italy, Latvia, Lithuania, Luxembourg, Mexico, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, the UK, and the USA.

Global Call for Coordination

The comment in The Lancet argues that national action alone is insufficient and that a global pandemic exit plan is necessary. Countries that opt to live with the virus are likely to pose a threat to other countries, especially those that have less access to COVID-19 vaccines. Moreover, with Europe’s summer tourist season rapidly approaching, a coordinated elimination strategy could prevent further economic and political divergence between northern and southern European countries.

National action alone is insufficient and a global pandemic exit plan is necessary

Mass vaccination against COVID-19 is the key to returning to normal life. However, relying solely on vaccines to control the pandemic is risky due to their uneven rollout, the likelihood of time-limited immunity and the emergence of new viral variants. History shows that controlling an infectious disease requires a combination of sustained public health measures, including effective communication and public engagement.

In conclusion, we are urgently calling for coordination among countries, and for a commitment to the strategy of maximum virus elimination. This is the only way to stay one step ahead—not behind—in the race against the virus.

More information

Miquel Oliu-Barton, Bary S R Pradelski, Philippe Aghion, Patrick Artus, Ilona Kickbusch, Jeffrey V Lazarus, Devi Sridhar, Samantha Vanderslott. SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties. The Lancet. Comment. 28 April 2021. doi.org/10.1016/S0140-6736(21)00978-8.