Unclear conclusions on SARS-CoV-2 elimination versus mitigation – Authors' reply

• Published in: The Lancet (British edition) 2021-10, Vol.398 (10311), p.1566-1567
• Main Authors: Oliu-Barton, Miquel, Pradelski, Bary S R, Aghion, Philippe, Artus, Patrick, Kickbusch, Ilona, Lazarus, Jeffrey V, Vanderslott, Samantha
• Format: Article
• Language: English
• Subjects: Classification; Coronaviruses; Correspondence; COVID-19; COVID-19 vaccines; Disease transmission; Economic analysis; Epidemiology; Pandemics; Public health; Qualitative analysis; Severe acute respiratory syndrome coronavirus 2; Viral diseases
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(21)02228-5

Country strategies to control SARS-CoV-2 vary across many parameters but can be crudely grouped into countries that aim for elimination (ie, maximum action to control SARS-CoV-2 and stop community transmission as quickly as possible) or mitigation (ie, action increased in a stepwise, targeted way to reduce cases so as not to overwhelm health-care systems).1 Our classification is based on a qualitative analysis of policy documents, communication by government officials and advisers (eg, through press releases or other public communication), and lockdown dates and their severity with respect to case and mortality reports. The classification of a country's pandemic response into one of two categories is by virtue imperfect, particularly as responses change over time (eg, we considered only the first 12 months of the COVID-19 pandemic) and also vary within countries (eg, many countries used a zoning approach, adopting public health measures dependent on the epidemiological situation of each city, state, or region).2 Notably, Japan used local interventions as early as March, 2020, aiming to eliminate virus clusters by spatially targeted interventions.3 Gold suggests that a country-by-country analysis could strengthen our findings. Focusing on annual data allows us to include non-Organisation for Economic Co-operation and Development countries, unlike in our original analysis,1 and consider cumulative deaths associated with COVID-19 in 2020, year-on-year growth change in gross domestic product in 2020 compared with in 2019, and the mean stringency index throughout 2020.