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COVID-19 Options; New Zealand Hard Elimination, Sweden's Light Suppression

In late July, Dr. Gigi Foster, Professor, Director of Education, School of Economics, with a PhD in economics, University of Maryland, and a BA, magna cum laude in Ethics, Politics, and Economics, Yale University, made the suggestion that Australia "... can follow in the footsteps of many other countries in the world, some of which have not had lockdowns as strict as we have had here, such as again, Sweden - and look at the death tolls in those countries.." Indeed, Dr. Foster is quite correct, one should look at the empirical data. Because the argument that Australia should follow "the Swedish model" when managing COVID-19 has become a bit of a talking point among some in the community who feel that the economic damage is too much compared to the lives saved. Some, such as commentator Andrew Bolt, argued that all that the movement restrictions was doing was saving a few months off the lives of the elderly. The Prime Minister, Scott Morrison, has confirmed that as far as the National Cabinet is concerned, Australia will be following a path of suppression, rather than elimination.

Let us look at the evidence, and how well suppression has worked in Sweden, which has community social distancing, minimal movement restrictions, no mandatory masks, and an excellent health-case system. First, with any sort of comparative analysis, one should compare the nation in question with those who have similar conditions to ensure a close correlation for policy comparison. The following is as of August 5, 8.38am AEST (Denmark is August 10, 11.02pm, because I didn't include them originally), from world meters.

Sweden 8,034 cases per million, 569 deaths per milion, 80,193 tests per million
Norway 1,726 cases per million, 47 deaths per million, 83,880 tests per million
Finland 1,350 cases per million, 60 deaths per million, 68,718 tests per million
Denmark 2,557 cases per million, 107 deaths per million, 302,951 tests per million

Quite clearly, Sweden's lax suppression policy has been an absolute disaster compared to its neighbours; Australia should not follow Sweden's model, especially given their own increasing doubts on its effectiveness; the numbers do not lie. Australia, in comparison, on a state-by-state level, has engaged in a strong suppression model with the following results, and by way of comparison, New Zealand's policy of "go-hard, go-early" and seek elimination, rather than suppression.

Australia 734 cases per million, 9 deaths per million, 175,348 tests per million
New Zealand 313 cases per million, 4 deaths per million, 94,714 tests per million

Anyone who advocates the Swedish approach is effectively arguing for 10x as many cases, 63x as many deaths, and to half the number of tests. By the facts alone, NZ is twice as successful as AU and AU is tens times more successful than Sweden, in terms of cases. Strong suppression is better than lax suppression, as data shows that Melbourne's stage 3 restrictions in July prevented 19,000 additional infections. An elimination strategy is better than a strong suppression strategy. Whilst the argument paraded about is that minimising suppression measures is necessary for the economy (because an abstract noun is far more important than a visceral person in the minds of some), it has been discovered that keeping people alive and healthy has economic benefits as the country reached one-hundred days of being virus-free.

True, there has been a recent outbreak, cause currently unknown, in New Zealand and the country has reacted appropriately by re-imposing movement restrictions. Which, it is readily acknowledged, quite expected. A strategy of elimination is just that, a strategy. It reduces the number of infections to zero, but is aware that re-infection (from oversight, from outside sources) is possible. A combination of an elimination strategy, plus a hard suppression strategy subsequent creates an environment where infection numbers can be kept low.

On-topic, there is no herd immunity without a vaccine when it comes to this virus. Russia is planning to launch a nationwide vaccination campaign in October with a coronavirus vaccine that has yet to complete clinical trials, which one must ask "What could possibly go wrong?". In the United States, Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, has noted that any potential vaccine, perhaps next year, will only be 55%-60% effective. In other words, various restrictions will still have to apply. Vaccine research is valuable, giving us all sorts of new information and knowledge about the virus, but it does not seem that they will not be the magic bullet that we have come to expect, and we must be prepared for the very real possibility that this will never go away.

The final matter worth considering is whether such harsh measures are economically acceptable, both to lives and livelihoods. Sweden's economy has contracted, although not as badly as other countries that had a harsher initial experience and response to the virus. No longer part of the EU, the United Kingdom's results are truly woeful, and the United States is even worse. Elimination strategies again, provide some benefits in these circumstances; whilst movement restrictions and isolation are certainly a challenge to mental health, the single group that suffers the greatest suicide risk are those who have contracted and recovered from COVID-19. Another modest benefit is that the deaths caused by influenza have also declined dramatically.

From the available evidence at hand, an elimination strategy first and strong movement restrictions second seems to be the approach that allows the lowest number of infections and deaths, the best secondary effects (reduced suicide, reduced associated disease deaths), and allows for the most rapid economic recovery. With the prospect that COVID-19 will be with us in some form perhaps forever, it is time that we move away from a society that "fluctuates between being half-complacent and half-paranoid", as was warned in April and adopts, with sober senses, the best possible stategies that provide life and security for all equally.

Commenting on this Story will be automatically closed on October 14, 2020.

Comments

I was confronted by a numbskull on an ALP forum who was seriously arguing that Iceland should be a model.

Iceland 5,853 Cases Per Million 29 Deaths Per Million

New Zealand 322 Cases Per Million 4 Deaths Per Million
(As of 8.31 AEST. August 16)

New Zealand, in terms of cases, is about 15x more successful than Iceland and in terms of deaths, 7x more successful.

By way of comparison, AU has 902 cases per million and 15 deaths per million.

Just so we know, anyone who argues for the "Iceland model" is saying that we should have almost 6x as many cases and almost 2x as many deaths.

Or maybe, anyone who advocates an Iceland approach doesn't know how to do basic math. They probably use raw numbers when per capita equivalent values are appropriate, right?

They either don't understand math or they want to double our death rate. There is no third alternative.

https://www.facebook.com/groups/1418068105173941/permalink/2701008160213...

Mary-Louise McLaws — whose career as an epidemiologist and advisor to the World Health Organisation has seen her work on responses to HIV/AIDS, and also SARS — is watching closely, too.

"I think New Zealand is still the poster country of the world," says McLaws, who believes the "very decisive, very fast" move to a stage 3 lockdown by the Ardern Government this week is "exactly what an outbreak epidemiologist would have done".

"New Zealand has been faultless when it comes to the handling of this outbreak," she says. "They have handled it with the right respect for the reality of this virus. You don't muck around with it."

https://www.abc.net.au/news/2020-08-15/new-zealand-coronavirus-new-cases...

Sweden recorded its highest death toll in 150 years in the first half of 2020, in a count not seen since an infamous famine in 1869.

https://www.news.com.au/world/coronavirus/global/coronavirus-sweden-has-...