{"id":2713,"date":"2023-02-21T20:51:27","date_gmt":"2023-02-22T02:51:27","guid":{"rendered":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/?p=2713"},"modified":"2023-02-21T20:51:30","modified_gmt":"2023-02-22T02:51:30","slug":"worlds-failure-to-wipe-out-covid-bodes-badly-for-next-pandemic","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/2023\/02\/21\/worlds-failure-to-wipe-out-covid-bodes-badly-for-next-pandemic\/","title":{"rendered":"World’s Failure to Wipe Out Covid Bodes Badly for Next Pandemic"},"content":{"rendered":"
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(Bloomberg<\/a>) Virus elimination has fallen from grace, leaving experts divided on how best to contain infectious diseases. <\/p>\n\n\n\n

For much of the past century, a strategy known as elimination<\/a> was the gold standard for dealing with deadly new viruses. But China\u2019s abrupt reversal of its Covid Zero policy, which took it to an extreme, has cast doubts over the approach and left a gaping hole in the world\u2019s game plan for the next pandemic. <\/p>\n\n\n\n

Even outside China, elimination measures like stay-at-home<\/a> orders proved politically unpopular and difficult to carry out. With some medical experts doubting whether airborne respiratory<\/a> pathogens can be suppressed, global public health officials are now without a consensus on how best to contain new infectious diseases.<\/p>\n\n\n\n

Early in the pandemic, proponents argued elimination was morally, scientifically and economically superior<\/a> to so-called mitigation approaches, such as slowing the spread<\/a> of disease through physical distancing and limiting social gatherings, or letting the virus loose<\/a> among the young while protecting more vulnerable members of the population. <\/p>\n\n\n\n

As cases spread throughout the world, the full weight of the policy emerged, demanding strict border controls,\u00a0lockdowns and extensive testing and contact-tracing. But it also required fast action and global coordination, which was difficult to achieve.<\/p>\n\n\n\n

\u201cIn hindsight, people could have said let\u2019s throw everything we can at this pandemic and try to stamp it out,\u201d said epidemiologist Michael Baker, who was the architect of New Zealand\u2019s early elimination Covid response<\/a>. \u201cI think we had a reasonable chance of doing it. But the opportunity is very early on in a pandemic. Once there\u2019s global distribution, you\u2019ve got a huge challenge.\u201d<\/p>\n\n\n\n

China\u2019s experience, marked by months-long lockdowns, isolation and family separations, showed simultaneously that elimination was possible and that it came at a cost too high for most countries, especially democratic ones, to bear.  <\/p>\n\n\n\n

The first example was in Wuhan, where Covid pervaded the city in late 2019 and was wiped out less than five months later. <\/p>\n\n\n\n

Proof of Concept<\/h2>\n\n\n\n

\u201cIt was quite a revelation that China was able to stop transmission in 2020 in Wuhan,\u201d said Baker, who recently became the director of the Public Health Communication Centre in New Zealand, a non-profit group designed to improve the way medical information and research is conveyed. \u201cThat was the proof of concept.\u201d<\/p>\n\n\n\n

New Zealand, which had a little more of a heads up, followed China\u2019s example. It halted the march<\/a> of Covid with an intense, two-month stay-at-home order, plus other measures like contact tracing and quarantines. A handful of other governments in Asia also pursued the policy, including in Hong Kong, Australia, Taiwan, and Singapore, with varying degrees of success. Vietnam, Laos and Mongolia, with long borders and limited resources, also used it.<\/p>\n\n\n\n

The initial benefits were clear. All were able to curb infections until pharmaceutical interventions like vaccines and antivirals were developed. During that time, health care providers learned how to best treat patients, such as giving them steroids and positioning them on their stomachs, which boosted survival rates.<\/p>\n\n\n\n

Per-capita death rates in Covid Zero countries came in far below those that opted for mitigation, also known as flattening the curve.\u00a0Japan and South Korea, which didn’t pursue elimination but where social distancing and masking\u00a0were followed closely, also fared well in suppressing deaths. While President Xi Jinping\u00a0touted China\u2019s success<\/a>\u00a0at saving lives, the unrelenting restrictions long after vaccines became widely available triggered\u00a0protests<\/a>\u00a0and dragged on the economy. Experts said the severity of China\u2019s approach may have tainted the world\u2019s perceptions of elimination measures which, when applied less harshly, have helped to contain deadly diseases like polio, measles and SARS. <\/p>\n\n\n\n

\u201cIt created a false alternative in which a draconian, individual rights-destroying lockdown was seen as one option, and the other was to do nothing,\u201d said Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security.<\/p>\n\n\n\n

China imposed a tracking system that forced millions of people to routinely get\u00a0laboratory-run PCR tests<\/a>\u00a0to do things like go to the office, eat in a restaurant or ride the subway. Simply being in the proximity of someone who later tested positive could\u00a0lead to home confinement or being taken to a quarantine camp.\u00a0 <\/p>\n\n\n\n

In Shanghai, 25 million people were locked down<\/a> for two months in 2022. In other cities, workers fled manufacturing plants that used closed-loop systems that kept them inside the factories. Residents scaled fences and shoppers rushed exits when rumors of infections cropped up, for fear of being forced into weeks of isolation. Protests, once unheard of, erupted<\/a>. <\/p>\n\n\n\n

In the face of such discontent, China\u00a0abruptly dropped<\/a>\u00a0its stringent elimination measures in December.\u00a0Infection rates soared, with the government estimating 37 million people a day were getting infected at one point.<\/p>\n\n\n\n

China wasn\u2019t alone in grappling with the costs of elimination. Thousands of Australians caught outside the country when Covid flared were\u00a0denied re-entry<\/a>\u00a0for more than 18 months, while Melbourne endured six lockdowns over 262 days in a bid to keep the virus out. New Zealand\u2019s \u201cGo Hard, Go Early\u201d approach was also criticized when tough lockdown steps led to rising unemployment and domestic violence. Both countries have since seen a change in leadership.\u00a0<\/p>\n\n\n\n

Public Revolt<\/p>\n\n\n\n

Even governments that decided against elimination, opting instead to flatten the curve, struggled to persuade people to follow basic control methods. In the US and many parts of Europe, topics like mask-wearing<\/a> and immunizations<\/a> for high-risk people became political quagmires, despite studies showing they slowed infections and saved lives. <\/p>\n\n\n\n

It was particularly difficult to persuade people to accept things like online schooling and social isolation without knowing how long the pandemic would last. Especially in the early stages, health officials were\u00a0unsure which mitigation measures would prove successful or how long it would take to develop pharmaceutical interventions.\u00a0<\/p>\n\n\n\n

\u201cWe were hoping we could switch this thing off,\u201d with immunity from vaccination or previous infection preventing transmission of the virus, said Jodie McVernon, director of epidemiology at the University of Melbourne\u2019s Doherty Institute. \u201cThose hopes were relatively short lived. We moved on from the idea that we can immunize the world and turn the infection off.\u201d<\/p>\n\n\n\n

The nature of Covid, with its mutations and hyper-infectivity, made elimination particularly challenging. <\/p>\n\n\n\n

\u201cWhen you are dealing with omicron, there is no threading the needle,\u201d McVernon said. \u201cOnce omicron was out of the bottle, there was no squeezing the genie back in.\u201d<\/p>\n\n\n\n

A unified global response is now even less\u00a0likely<\/a>\u00a0in the next pandemic. The number of emerging infectious diseases continues to grow due to global warming and development in\u00a0rural areas that are home to wild animals, which act as hosts for many viruses.<\/p>\n\n\n\n

Countries that were able to initially follow an elimination strategy are likely to pursue it again, while those that couldn\u2019t are unlikely to be swayed by the example set during Covid, said Chen Xi, an associate professor specializing in aging and public health at Yale University in Connecticut. <\/p>\n\n\n\n

\u201cIt all comes down to a country\u2019s culture and political governance structure.\u201d <\/p>\n<\/a><\/div><\/div>","protected":false},"excerpt":{"rendered":"

(Bloomberg) Virus elimination has fallen from grace, leaving experts divided on how best to contain infectious diseases. For much of the past century, a strategy known as elimination was the gold standard for dealing with deadly new viruses. But China\u2019s abrupt reversal of its Covid Zero policy, which took it to an extreme, has cast doubts over […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":false,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[11],"tags":[],"class_list":["post-2713","post","type-post","status-publish","format-standard","hentry","category-covid"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/2713","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/comments?post=2713"}],"version-history":[{"count":1,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/2713\/revisions"}],"predecessor-version":[{"id":2714,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/2713\/revisions\/2714"}],"wp:attachment":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/media?parent=2713"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/categories?post=2713"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/tags?post=2713"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}