New Zealand was among the countries that opted for the Covid elimination or the Zero-Covid plan. The Zero-Covid strategy is when governments attempt to snuff out the outbreaks before they blow up, although North Korea might have taken that a little too seriously. Courtesy of WhatsApp memes, and on a more serious note, United States Commander Robert Abrams, who was deployed in South Korea, had claimed that President of North Korea Kim-Jong-Un had issued orders to kill people who were Coronavirus positive.
The Zero-Covid strategy, to clarify, does not involve any kind of capital punishment. It is simply a strategy of control that aims to keep the transmission of the virus as close to zero as possible, and ultimately aims to eliminate it from certain areas. Countries implementing such a strategy typically close down their borders and set up spaces for quarantining individuals. The strategy involves FTTIS – ‘Find, Test, Trace, Isolate and Support’. This means finding and testing for occurrence, tracing chains of transmission, isolating, and providing the necessary support. To understand this better, it can help to compare and contrast with the herd immunity approach and the containment or mitigation strategies.
A herd immunity approach is something that seeks to end pandemics by gradually allowing the population to be infected and develop antibodies, through natural experience or vaccinations. Nicole Han, the writer for an online magazine HYPE & STUFF, explains herd immunity using an analogy. If individuals are rooms, immunity is like a locked door; the community is the entire building and the viruses are like undesirable tenants. With more locked rooms, the virus cannot find places to grow and breed, and the chains of transmission get broken. The entire population doesn’t need to develop immunity either; as long as the bulk of the population is protected, the theory of herd immunity stays effective.
Another strategy is the containment or mitigation strategy. Does the phrase ‘flattening the curve’ seem familiar? This aims to prevent the health system from being overwhelmed and is implemented when community spread is already high and is affecting the health system. It is like a “Whoa, slow down” strategy. Applying the analogy used previously, mitigation strategy is something that is implemented when you realize that due to whatever reason, half your building is teeming with destructive tenants, and the building has started to break down. So, you go and lock all the doors, lock in both the normal and unwanted tenants, and wait it out.
The herd immunity strategy has its disadvantages, especially in the absence of a vaccine or even with sufficient supplies of vaccines. Without a vaccine, it is similar to the chickenpox parties that people used to have. Parents believed that it was better to engineer the contraction of chickenpox for their kids. This was because the symptoms are usually mild in children and also made them immune to subsequent infections. A coronavirus party without the vaccine, however, can be lengthy and costly, mainly for groups at a higher risk of severe disease. It will also disproportionately affect the economically and socially vulnerable population. But as mentioned before, herd immunity can also be achieved through vaccination.
Mitigation strategies are also flawed. What is the course of action after the number of destructive tenants goes down? The mitigation approach runs the risk of having persistent transmission, endless cycles of lockdown, and relaxation of restrictions again and again, which we are intimately familiar with. This pattern could adversely impact the economy, the health system, and community engagement.
Early preventive action starts sounding good in contrast. “Going hard and going early” keeps transmission under control right from the beginning and prevents health system overload as well. Going back to the building analogy, it is when you realize that a couple of viruses have moved in, and you lock them in and starve them out immediately so that the rest of the tenants in the building can go on living normally. In a way, it also protects the trust level of citizens, our social life, the economy, and the physical and emotional health of citizens and health professionals.
Several factors in India, like our huge population, homelessness, lack of regulation, make this challenging to implement effectively. New Zealand, however, was able to achieve significant control in the early months of the pandemic and soon the country reported very low numbers of cases. As a result of these measures, the country was also able to operate normally for much of the pandemic. End of story?
Well, not really, because there seems to be no end to the mutations and variations of the virus. Ever since countries around the world witnessed surges in cases due to the Delta variant, health authorities have been questioning if the Zero-Covid strategy is indeed the best solution. There are three angles to this. One, controlling the transmission is becoming more and more difficult; the Delta variant spread twice as easily when compared to other coronavirus variants. Two, vaccines are being rolled out in most countries. Three, strict lockdowns and closing down of borders now and then can be difficult for the economy and the population to handle, especially when there seems to be no end to the mutations and infections.
For instance, many New Zealanders have not been able to meet their loved ones, who have now been stuck outside the country for more than a year, and the country’s largest industry – tourism has been hit hard. Therefore, other countries like the United Kingdom, France, and Australia have decided to rely on vaccinations and have started to lift restrictions. New Zealand, which has adopted the Zero-Covid approach for the second time, is being called a ‘hermit nation’. Relying on herd immunity strategy without vaccine might be dangerous, but with vaccinations proceeding at a good rate, it might be worth a shot.
The delta wave has therefore made us question how long we can try to control and eliminate the cases. How long can we stick to the Zero-Covid strategy? Australian Prime Minister Morrison called the elimination strategy ‘absurd’. He said, “Covid is a new, different world. We need to get out there and live in it. We can’t stay in the cave, and we can get out of it safely”.
Surveys by the Indian Council of Medical Research have revealed that two-thirds of the Indian population have antibodies against the Covid-19 infection while the remaining one-third are still vulnerable. In July, Niti Aayog Member Dr. V.K. Paul said that India has not yet achieved herd immunity, neither through natural infection nor through vaccination. Also, as different states are seeing different trajectories of infection, herd immunity is not uniform. However, we retain the hope that through this process we can all get out of the ‘cave’ and live, safely.
Written by- Pragati Senthil Kumar
Edited by- Sameera Vasista