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'Major revolution in thinking' — Covid-19 study urges WHO to encourage NZ's elimination strategy

A trio of Covid-19 experts say an elimination strategy is the optimal response to the coronavirus and are urging the World Health Organization to encourage other nations to follow New Zealand's lead.

The Auckland Harbour Bridge usually sees about 170,000 vehicles each day, but during the initial lockdown in March there were only a trickle of essential workers. Source: 1 NEWS

New Zealand is one of few nations to follow the elimination strategy, out performing other nations that took less drastic approaches when cases started popping up.

The United States and Europe were among those that instead opted for a "suppression strategy" or "mitigation strategy", which means to flatten the epidemic curve further than with mitigation but still without expecting to end community transmission. These approaches are largely consistent with plans designed to mitigate or suppress pandemic influenza.

However, a University of Otago and Wellington study by well-known Kiwi names throughout the pandemic — professors Michael Baker and Nick Wilson — as well as professor Tony Blakely at the University of Melbourne, revealed how an elimination strategy can be more successful.

Baker, who is an epidemiologist, said in a statement this morning that the obvious benefits of rapid elimination include greatly reduced case numbers, a lower risk of health sector overload, fewer overall deaths and an opportunity to avoid serious health inequities, such as the catastrophic effect of previous pandemics on Māori.

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Professor Michael Baker says next year’s vaccine rollout is a relief but could take months before it’s effective. Source: 1 NEWS

"Elimination may now provide the preferred approach to managing emerging pandemics, which is a major revolution in thinking in this area," he said, adding that the goal of elimination was a major departure from pandemic influenza mitigation.

"Experience indicates that elimination of Covid-19 has been successful in several jurisdictions, albeit with occasional outbreaks from border control failures that need to be managed rapidly and effectively."

Baker said the paper was about summarising what nations like New Zealand and Australia had learned during the pandemic, as well as to share those lessons with other countries struggling with Covid-19.

"Over the course of this year, we have been in regular contact with overseas colleagues, particularly in the UK, who are advocating for their governments to take an elimination or ‘zero Covid’ approach. The emergence of an apparently more infectious virus variant is just another reason to eliminate this infection."

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Professor Nick Wilson of Otago University says if the strategy changes from “eliminate” to “mitigate”, it could see two thirds of the population infected. Source: Breakfast

However, one of the biggest reasons nations are reluctant in the approach is the belief it means a sacrifice of the economy, then would lead to more hardship and negative health impacts, Wilson said.

"Our preliminary analysis suggests that the opposite is true. Countries following an elimination strategy – notably China, Taiwan, Australia and New Zealand – have suffered less economically than countries with suppression goals."

He said the analysis was based on gross domestic product (GDP) projections for all of 2020 from the International Monetary Fund.

Now, Baker, Wilson and Blakey want the World Health Organization to provide more support for countries pursuing elimination as a response to the pandemic, including improved ways of reporting data from countries using the approach.