
BECOMING a covid-19-free zone sounds like the ultimate goal for any nation. Several countries around the world have come pretty close and, according to a group of independent scientists, the UK could join them. The group says that, as an island nation, the UK could introduce specific measures over the next year and follow in the footsteps of other island success stories, such as Iceland, Taiwan and New Zealand.
But closer scrutiny reveals that no country has truly eliminated the coronavirus from its shores and that doing so would mean making such large sacrifices in other areas of public well-being that it might not be worth it.
Earlier this month, Independent SAGE 鈥 a self-appointed group of scientists that provides advice with the intention of guiding UK government policy on the coronavirus 鈥 , known as elimination, within the next 12 months.
Advertisement
鈥淎chieving elimination would allow all social distancing measures to be lifted, schools to be fully open, the hospitality and entertainment industries to reopen fully, revitalisation of the economy and a sense of much needed normality for the population,鈥 the report said.
All the researchers New Scientist contacted agreed that elimination is a worthy goal. Most say it is theoretically possible for many countries, including the UK, to rid themselves of the virus even without a vaccine.
Success would require tough measures, however. The steps suggested in the Independent SAGE report are familiar ones. They include boosting test, trace and isolate programmes, maintaining lockdown policies and strictly restricting travel.
Such measures would be a departure from the current phased return to normal life proposed by the UK government. It recently advised people to return to office working and will soon offer to encourage dining out. Recent figures suggest England鈥檚 test and trace programme is only reaching about 80 per cent of infected people鈥檚 contacts, and it .
Tight restrictions on travel and border control would have costs for business, tourism and the broader economy.
The steps needed to move to elimination would have other costs. 鈥淚t鈥檚 really difficult to know [what the goal should be],鈥 says Kathleen O鈥橰eilly at the London School of Hygiene & Tropical Medicine. 鈥淚t鈥檚 all about balancing what鈥檚 feasible, what resources you have available and what the disadvantages are with putting your resources into one disease.鈥
Even those countries that have come the closest to reaching elimination are now in a constant battle to keep things that way. New Zealand was tentatively described as 鈥渧irus free鈥 early in June, when all restrictions except tight border controls were lifted. But the country has been reporting small numbers of new cases of covid-19 on a near-daily basis for the past month. As of 21 July, the Ministry of 午夜福利1000集合 reports . More individuals there could have symptomless infections, says Rajiv Chowdhury at the University of Cambridge. Scotland looked like it was close to elimination at the end of June, but it is still seeing a number of .
Elimination is worth aiming for if all we want to do is put an end to covid-19, says O鈥橰eilly. But lockdown has already significantly affected other areas of healthcare provision. In the UK, elective medical procedures have been delayed, cancer screening has been put on hold and thousands of people have avoided seeking care for serious health issues, including .
The balance is an even greater challenge in countries with more limited resources. Those that were well on the way to eliminating polio and measles via widespread vaccination efforts, for instance, have had during the coronavirus pandemic. 鈥淧olio virus is now spreading more, certainly in some African populations and in Pakistan,鈥 says O鈥橰eilly.
Given these difficulties, some scientists are proposing an alternative approach: eliminating the coronavirus as a public health concern. In practice, this would mean there are so few cases that people would be unlikely to come into contact with an infected person while on an outing or visiting a restaurant, says O鈥橰eilly. But how this relates to actual case numbers is unclear.
The Independent SAGE group suggests that having one case per million people in a population could be used to define having the coronavirus 鈥渦nder control鈥, but group member Gabriel Scally admits that this figure isn鈥檛 based on hard evidence about how the virus spreads.
Even this goal would mean significant, prolonged changes to behaviour in terms of social distancing, personal hygiene and mask wearing. 鈥淔rom what I鈥檝e seen so far, I鈥檓 not hopeful,鈥 says Chowdhury.
Eradication 鈥 having zero global cases of the virus 鈥 is an even bigger challenge. We have only ever eradicated one human disease, smallpox. That came about through a massive global effort, helped by a very effective vaccine. It was also much easier to see who was infected with the smallpox virus. For now, eradication of the coronavirus seems impossible. Even if a vaccine were developed, we don鈥檛 yet know how effective it would be or how long its effects might last.
Attempts to eliminate 鈥 or at least significantly lower 鈥 cases in one nation must also consider the global picture. 鈥淲e have to tackle this as a world issue,鈥 says Stephen Griffin at the University of Leeds, UK. This is why the US government鈥檚 decision to pull out of the World 午夜福利1000集合 Organization is so 鈥渦nproductive鈥, he says.
鈥淲e have to act together,鈥 says Griffin. 鈥淚f we don鈥檛, we鈥檙e going to have real trouble for the foreseeable future.鈥