There’s lots of good advice out there about combatting the Covid-19 disease as it continues to ramp up around the world. Official figures at the time of writing are ten million infected and half a million dead; the true figures are almost certainly far higher than that. But those numbers are rising daily – who knows where we’ll be this time next year.
There have been successes in eliminating human diseases in the past, smallpox in 1977, and polio (close to extinction but still persisting at low levels in Afghanistan and Pakistan). In both cases, progress was achieved by use of vaccines that provide lifetime immunity.
Is this possible for the SARS-CoV-2 virus that causes Covid-19? The simple answer is that we don’t know; many vaccine candidates are being developed, but it will be some time before we find out how effective they will be, nor do we yet know how long immunity might last.
A vaccine would help, but we do have some other ways to attempt eradication. Countries like New Zealand, South Korea, and Vietnam might give us a clue. By determined and sustained action the virus can be confined and eliminated so that only importing it from an external source can bring it back; we have seen this happen several times.
So here’s a strategy that is worth considering
- Use restrictions on movement and contact to reduce the size of the infection in a defined area. This has been done many times already in areas from whole nations to small districts. We know it works.
- Test and trace while cautiously lifting restrictions, re-imposing them quickly wherever there is a local resurgence.
- Once the defined area is free of virus, allow life to return to normal except for travel into the area. Use strict quarantine measures to contain new imports.
- When two or more adjacent areas achieve step 3, their common borders can be opened.
Such a strategy has the potential to rid larger and larger parts of the globe of Covid. Would it be easy to do? No, it would be hard work, costly and it would demand constant vigilence as well as coordination by a body like the World Health Organisation. And we won’t know if its possible unless we make the attempt. Would it be worth it? Almost certainly if we can get something like this agreed internationally and adequately funded. Less wealthy nations with limited health care resources would need monetary and practical help along the way. The economic costs of eradication would be very large, but the ongoing annual costs of living with Covid-19 will be larger still.
Maybe it’s too early to start a Covid-19 eradication programme, but it’s certainly time to begin conversations about one.