Tuesday 4 May 2021

'SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties' | The Lancet

 

An Occasional Reader (OR) sent me a link to this article in the Lancet magazine [WebArchive]. It purports to show that OECD countries that opted for elimination of the virus (ie, "Zero Covid") did better than those that opted for mitigation (ie, Control aka "Flatten the Curve").  And indeed that's the case if we look at the chart above, of deaths per million.

My comments:

1. The countries in the "elimination" category are: Australia,  New Zealand, Iceland, South Korea, Japan. Note:

a. They are all islands. Well, ok, Korea isn't quite an island, but its only land border has been closed since 1950 so it's effectively an island. Islands are obviously far easier to shut off from the rest of the world, as all these "eliminationists" did.

b.  They are relatively remote, especially the first three. Iceland? New Zealand? Seriously? And also tiny populations: NZ and Iceland together fewer people than in our Kowloon here in Hong Kong.

Taking these countries as exemplars is like giving a step ladder to a basketball player and then marvelling at how well he dunks the ball. 

2.  By contrast, the "mitigation" category countries all have land borders and much higher population densities than the "elimination" countries. Their GNP's also dwarf those of the "elimination" category (85:15).  So any comparative measures of how their economies have performed (chart below) are rather dubious. Your classic apples and oranges. 

3.  At the time all this was kicking off -- in Feb/March 2020 -- the talk was all of "flattening the curve" labelled here as "mitigation". I remember! That was believed to be the best strategy. The only strategy as I recall, the only one, "based on the science"!

4. I've said various times: there's many a PhD to be earned by analysing the connections between various levels of lockdown and the outcomes for this pandemic. This Lancet study is surely a contribution, but just that: a contribution. I don't buy its conclusion. Not quite yet, anyway. 

From the Lancet article

A better study would be the 50 states of the United States. They all handled the pandemic differently, depending on the Governor. Have a look at the difference between how each handled it and the outcome. That would be a more interesting study than the comparison of apples and oranges in the Lancet article. (Spoiler alert: Republican-run states did better than Dem-run ones).