Growing movement led by medical professionals pushes for COVID-zero strategy

Photo: Fans watching early round play at the Australian Open, Jan. 2021. (Paul.Francis / Flickr CC)

This article originally appeared in Ricochet's French edition and has been translated.

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Eliminate the new coronavirus with strict measures, without waiting for a vaccine and without yo-yo-ing between ineffective half-restrictions and none at all — this is the call of a growing movement of doctors and experts across English Canada and Quebec.

In its Dec. 14 issue, the Canadian Medical Association Journal asked, “Should Canada aim for #CovidZero?”

Yes, without a shadow of a doubt, replied Dr. Andrew Morris, a Toronto infectious disease specialist, alongside other healthcare professionals.

Two weeks later, the COVID Strategic Choices Group developed the “Canadian Shield,” a new strategy to fight COVID-19 with the following objectives:

  • reduce new cases by 75 per cent by the end of January;
  • maintain steady new COVID case declines from February through April;
  • achieve fewer than 40 new COVID cases per day across Canada by May 1;
  • allow a fuller opening of Canada’s economy and society throughout the summer; and
  • sustain near-zero COVID levels until widespread vaccination makes this plague a memory.

In Quebec, a group called COVID-STOP is also planning to promote this strategy. The group is led by Dr. Marie-Michelle Bellon, who is associated with the COVID unit at Notre-Dame Hospital, and includes physicians, epidemiologists, engineers, and scientists. (In the interest of transparency, I would like to point out that I attend the meetings of the COVID-STOP coalition, though I do not hold any leadership or organizing role. You can listen to my interview with Geneviève Pettersen on QUB Radio on Feb. 4 about the COVID-zero strategy.)

Australians are willing to accept extreme lockdowns because these measures are effective

“The decisive issue at stake today is the choice between the yo-yo status quo strategy vs. the COVID-zero strategy,” stated epidemiologist Michel Camus, a member of COVID-STOP. According to him, the current strategy — repeated lockdowns and reopenings, half-lockdowns and half-reopenings, stricter and then less strict restrictions — “perpetuates the pandemic and its public health, social, psychological, and economic toll.”

Proponents of the zero-COVID strategy argue that strict lockdowns are a form of “short-term pain for collective gain.”

They draw inspiration from the achievements of countries in the Asia-Pacific region, particularly Australia and New Zealand, which decided not to simply manage the coronavirus and “flatten the curve” but to eliminate COVID-19 altogether.

Australia sets an example

On Feb. 1, a young security guard at a quarantine hotel in Perth, Australia, tested positive for COVID-19 after experiencing minor symptoms. Perth, Australia’s fourth-largest city, immediately imposed a full lockdown. The city’s two million residents spent the week confined to their homes without resistance. “One Case, Total Lockdown: Australia’s Lessons for a Pandemic World,” read the headline of an article in the New York Times.

This was the first case the Western Australian state had seen in 10 months. Contact tracing teams immediately tested the people living with the security guard. Even if they were negative, they were placed in a state-run quarantine facility. The teams also identified a dozen places where the security guard would have been in contact with other people.

Perth isn’t an outlier. In Sydney, a city of five million, several cases were discovered just before Christmas. The city closed its beaches and imposed a regional travel ban. Over the next two weeks, there wasn’t a single instance of community transmission. Brisbane, with a population of two million, imposed a 12-day lockdown after finding just one case of the U.K. variant.

Australians are willing to accept extreme lockdowns because these measures are effective, and they know it’s better to suffer for a few days to limit the number of sick and dead, as well as to be able to return to normal life afterwards.

Since the beginning of the pandemic, Australia has had a total of 909 deaths — less than the average number of deaths per day in the United States or the United Kingdom. Proportionally, this is 15 times fewer deaths than in Canada.

The #COVIDzero movement points out that in Canada, the Atlantic provinces and Nunavut have done much better than Quebec, Ontario and the rest of the country.

Australia imposed quarantines on travellers as early as March. It has strictly limited travel between regions and maintained a strong tracking system. As a result of these radical and swift actions, Australians are living an almost normal life. Offices and restaurants are open. Gatherings are allowed. And resuming Thursday, after a brief lockdown kept fans out for several days, thousands of tennis fans will again be able to attend the Australian Open in Melbourne.

New Zealand’s number 1, Canada’s 61st

An Australian think tank, the Lowy Institute, has compiled the COVID-19 rankings of 100 countries. New Zealand tops the list, and Australia places eighth among countries that have best managed the pandemic. Meanwhile, Canada ranks 61st. Given that half of the cases and deaths in Canada have occurred in Quebec, Quebec would certainly be at the bottom of the pack if it were a country.

From the outset, New Zealand has aimed for the total elimination of the coronavirus. The country, which has a population of five million, has suffered 26 deaths. Quebec has close to 10,000 deaths for a population barely twice as large. Taiwan, with a population of 24 million, has nine deaths; Vietnam, 35; and Thailand, 82.

Of course, Australia and New Zealand are islands. But not Vietnam, Thailand or South Korea. The main reason for their success is that they closed their borders as early as February last year. After that, they did not hesitate to act strictly, points out Swiss Policy Research in an analysis entitled “The Zero-Covid Countries.”

In Quebec, the first wave was caused by travellers returning from abroad, especially after the spring break. Now, the risk that hangs over our heads is that the new U.K. variant, much more contagious and possibly more deadly, will spread like wildfire. The U.S. Centers for Disease Control estimates that the new variant could become dominant in the United States before the end of winter. There is little chance of escaping it here as well, unless borders, both international and domestic, are completely closed and quarantine tracking and surveillance are significantly increased.

The new U.K. variant has already made its appearance in Quebec. A student arriving from Great Britain did not listen to quarantine instructions and went to visit family members in Montreal and the Eastern Townships. As a result, she passed the variant on to three other people. The extent of the variant’s spread in Quebec is not known at this time.

Not only are quarantines poorly monitored, but tracking is deficient to say the least. Testimonials abound in this regard. One comes from a retired nurse who has worked all her life in public health and who offered to help with tracing in Montreal on a voluntary basis. Public health did not want to provide her with a computer more powerful than her old one and therefore refused her services.

The #COVIDzero movement points out that in Canada, the Atlantic provinces and Nunavut have done much better than Quebec, Ontario and the rest of the country. A contributor to Ricochet described how Newfoundland took the bull by the horns. The chief hygienist’s watchword: quick action. As a result, the province mourns four deaths. None in Prince Edward Island, 24 in New Brunswick, 65 in Nova Scotia. Nunavut prohibits the entry of non-residents and requires its returning residents to undergo a 14-day quarantine at designated sites at government expense. There has been only one death in Nunavut since the beginning of the pandemic. [Note: Since publication of the original article in French, Newfoundland has seen an outbreak of the U.K. COVID variant.]

Strict measures recommended

Advocates of the COVID-zero strategy believe it’s possible to reduce the number of new cases to almost none between now and the month of May through the following measures:

  • near-complete closure of airports;
  • mandatory quarantine and monitoring of the small numbers of people who will continue to arrive from abroad;
  • strict limits and monitoring of travel within Canada between, and even within, provinces;
  • much more extensive testing;
  • much more systematic contract tracing;
  • total isolation and monitoring of infected people and their contacts, possibly in designated areas (as Nunavut is doing); and

If the new, more infectious U.K., South African, Brazilian or other variants start to spread, some believe it will be necessary to consider a lockdown at least as strict as that which was decreed in mid-March, which included closures of workplaces, businesses and schools. In April, Quebec’s Institut national de santé publique had warned the government against a hasty reopening of schools, emphasizing that children can become major spreaders of the coronavirus. At the time, the INSPQ stated that reopening risks provoking a sharp increase of the diseases in the adult population. What was true last April will certainly be true again if the new variants spread.

Contrary to what the signatories of the Great Barrington Declaration and other supporters of a laissez-faire approach say, radical COVID measures do not hurt the economy. The opposite is true: these measures help the economy, allowing it to resume normal functioning once the virus is eliminated or nearly eliminated.

Lastly, an effective strategy is much less deleterious for mental health, as people cease to be tossed between hope and despair.

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