Does the Government have a clear long-term goal on tackling coronavirus? I’m not sure. Oh, yes, they want fewer infections, fewer admissions to hospital, fewer patients in intensive care and fewer deaths. We all do.
But do they aim to eliminate it altogether – zero-Covid UK, the handy phrase used by our publicity hungry Prime Minister? Or would simply controlling it do us, the economy, jobs and education more good?
Simon Thornley and colleagues from Auckland University in New Zealand think it might.
I’m afraid Boris Johnson is baying at the moon if he’s set on elimination. To date, the only globally erased disease is smallpox and it took 30 years to achieve and depended on a vaccine.
Experts can’t agree how we’d achieve elimination but at the very least there would have to be strict control measures, repeated lockdowns and closed borders. And a vaccine.
It’s clear that the nation, or some elements, are averse to containment of gatherings and movement. Plus there are the huge financial losses from curbing workplace freedoms, travel and employment.
Government seems blind to a sensible exit plan but it is essential we consider control versus elimination. Which can we achieve with the least damage?
But first, do we even know how deadly Covid-19 really is? Initially, the fatality rate (the ratio of deaths to infections) was high when the number of tests done was low.
Now that we have antibody tests it’s clear that Covid is more prevalent so the fatality rate is lower. It’s now estimated to range from 0.02% to 0.86%, in the same ballpark as seasonal flu.
We know there’s a strong correlation between age and the fatality rate. In New Zealand, the age distribution of Covid-19 deaths is similar to that in 2019-20, so it looks like Covid isn’t dramatically shortening life when compared with baseline survival.
To me, seeking elimination seems too heavy a cost to bear. And the New Zealand government’s analysis expressed as “quality adjusted life” shows the costs of elimination outweigh the benefits of extended lockdowns by a factor of 96:1. For the UK, the estimated costs of multiple lockdowns outweigh benefits by 10:1.
To my mind, a good strategy is control, as we learn to live with the virus and to manage it, while waiting for a vaccine. We’ve already had a taste of severe restrictions and we know how destructive they are.
Elimination is an unrealistic goal and comes with a price tag that will take generations to repay.