Eliminating Covid-19
“You can’t go back and make a new start, but you can start right now and make a brand new ending.”
— James R Sherman (Rejection, 1982)
Two years ago, we heard about the first human cases of Covid-19, the disease caused by SARS-CoV-2. Those countries which had contained and eliminated SARS-CoV-1 in 2003–2004 applied what they had learned. Elsewhere, there was a different story.
Different countries applied different strategies to tackle the same virus, even within the EU. The pandemic has many inter-dependent issues, including the environment, mobility, freedom, the economy, public health, workplace, geopolitics and democracy.
Covid-19 has disrupted the lives and livelihoods of billions of people all over the world. Those who were already less well off seem to have suffered the most. Not to mention those, particularly women, having to combine working from home with home schooling their children.
On 16 December 2021, Julie Guégan and Obhi Chatterjee hosted the first Together-Ensemble session in the series Towards global collaboration. Each session of this series aims to focus on a complex, global issue.
The session took place against the background of uncertainty about the impact of the Omicron variant of Covid-19 since its detection at the end of November 2021, as well as public unrest about the reimposition of lockdown restrictions in several European countries. People’s patience is running out.
How have some countries managed to avoid the high death rates we have seen in Europe? We seem to be at a crossroads. Is it viable to continue a strategy of ‘flattening the curve’ to keep serious cases within the capacity of intensive care units with a cycle of lockdowns and reopening? Or are there alternatives?
That is why it seemed useful and timely to start this new series of Together-Ensemble with a session on Covid-19, to learn how different strategies around the world have played out over the past two years and to reflect together on the most appropriate global approach, not only for this pandemic but for any pandemic.
Opening conversation
To help stimulate the discussion, participants heard the perspectives of three pandemics experts.
Cécile Philippe, President of the Institut économique Molinari in Paris, explains how these strategies compared in terms of economic impact, health outcomes and individual freedoms (liberty and mobility).
Professor Walter Ricciardi, scientific adviser to the Italian Health Minister for the coronavirus pandemic and President of the Italian National Institute of Health, shared his ‘behind-the-scenes’ experience of the Covid-19 up to now.
Professor Yaneer Bar-Yam, who is an expert in quantitative analysis of pandemics and President of the New England Complex Systems Institute, explained the reasons and steps needed to implement an elimination strategy.
After hearing the opening remarks from the experts in the videos above, Julie Guégan and Obhi Chatterjee had a longer conversation with them, addressing questions from the participants. [The recording of the full conversation will be added soon.]
Workshop questions
Over 60 participants stayed on to take part in a deeper reflection of the issues raised by the experts. In two rounds of discussion in groups of 4 or 5 people, they considered the following questions:
How might a world prepared to address pandemics look?
Participants were invited to think about pandemics in all their complexity to reflect on this question. This included considering how countries could be better prepared for whenever their might be another pandemic, or indeed another variant of Covid-19.
How might we balance our needs for freedom and public health?
This question was intended to reflect on a trade-off which policymakers and politicians have had to confront in handling the Covid-19 pandemic. It was also supposed to address the debate between the mitigation and elimination strategies. During the subsequent plenary discussion, we aimed to bring out the next steps needed for global collaboration.
Shortly before the end of the session, John Ryan (Acting Deputy Director-General for Health and Food Safety at the European Commission) provided the concluding remarks. He has been responsible for coordinating the European Commission’s response to the Covid-19 pandemic.
Afterwards, we asked participants to share their answers to the following question:
What will you do to encourage a global mindset in your work?
Outcomes
The following issues emerged from the workshop:
- Lessons of the SARS-CoV-1 pandemic (2003–2004) had not been learned by countries other than the mainly Australasian countries which had been affected directly by the earlier pandemic.
- This led to a lack of preparedness globally to deal with the Covid-19 pandemic. Even so, Western countries appeared reluctant to learn from others, such as Italy (which was in lockdown a month before the rest of Europe) and Australasian countries (eg this webinar organised by the Open Government Partnership and Apolitical in May 2020). A global pandemic treaty is not expected to be agreed before 2024 at the earliest.
- Throughout the pandemic, crisis communications need to be crystal clear and based on the latest available science, so that everyone knows how to protect themselves and avoid spreading the virus. However, initial guidance from the WHO that Covid-19 was spread by droplets, rather than being airborne, has led to highly variable instructions by Governments to limit transmission of Covid-19, instead of the same basic message worldwide.
- This has also left the door open to misinformation campaigns and deep polarisation on social media on issues such as masks vs no masks, vaccines vs no vaccines, airborne vs droplets, elimination vs ‘flattening the curve’, etc.
- The reason behind the reluctance to warn people that Covid-19 is transmitted as aerosols was perhaps partly due to a scientific error dating back to 1910 and partly to avoid Governments having to invest in upgrading office/school/… ventilation systems before telling people to go back to offices/school/… . As a result, Governments put the responsibility on people to protect themselves without explaining properly how to avoid catching Covid-19 (masks, ventilation, filtering, etc).
- Those countries with a caring culture performed better in health, freedom and economic outcomes during the pandemic. Although western governments have been keen to reopen after periods of lockdown, this recurrent cycle of lockdown-vaccine-reopening-variant-lockdown-vaccine-etc has led to a longer period of uncertainty, harmed the economy and has made people’s lives unpredictable.
- Public authorities should be completely open and transparent with people and apply the precautionary principle (rather than hoping for the best). Throughout the pandemic, people need to know why their government is asking them to take certain actions, what they need to do to protect themselves and others, as well as what the objective of the government’s strategy is so that they know when to expect the measures to end.
- In the EU, since health is the responsibility of each EU Member State, the European Commission cannot currently do more than make recommendations and coordinate certain actions (eg mutual recognition of vaccination certificates). This is now evolving, with the steps towards a global pandemic treaty.
- Countries which have already eliminated Covid-19 continue to have to limit international arrivals, particularly from countries which have chosen to let the virus continue to be transmitted. The ongoing risk of variants with exponential growth, as we are now seeing with omicron variant, as well as the risk of neurological problems from ‘long Covid’ in an increasingly knowledged-based economy, suggest that it will be economically unsustainable and unpopular to let the virus continue to exist.
- In the absence of economic, health or civil liberties advantages of the ‘flatten the curve’ strategy, the elimination strategy should be given serious consideration. The elimination strategy (through ‘zoning’) has a proven track record in controlling viral infections in animals.
- Since “high incidence in one country puts the low-incidence strategy in a neighbouring country at risk”, any “strategy can only work effectively if European countries stop acting as if they could fight the pandemic on their own.” *
Related links
*Towards a European strategy to address the COVID-19 pandemic (Lancet, August 2021)
Professor Michael Bang Petersen on the psychology of crisis communication to motivate a fatigued public (Twitter, December 2021)
The elimination strategy continues to protect people, economies and freedoms more effectively (Institut économique Molinari, September 2021)
We should not dismiss the possibility of eradicating COVID-19: comparisons with smallpox and polio (British Medical Journal, August 2021)
The 60-year-old scientific screwup that helped Covid kill (Wired, May 2021)
Ten scientific reasons in support of airborne transmission of SARS-CoV-2 (Lancet, April 2021)
Our world in data - Covid-19 pandemic data
How you could contribute to this global conversation
You are welcome to use the above videos and workshop questions to run your own workshop(s), or to inspire a workshop design which is more appropriate for your organisation or community. Our only request is that you share the outcomes of your conversations on social media using the hashtag #TogetherEnsemble and #COVID19. We look forward to learning from the outcomes of your workshop(s).
