SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties

Oliu-Barton, Miquel; Pradelski, Bary; Aghion, Philippe; Artus, Patrick; Kickbusch, Ilona; Lazarus, Jeffrey V.; Sridhar, Devi; Vanderslott, Samantha

doi:10.1016/s0140-6736(21)00978-8

Cited by 148 publications

(109 citation statements)

References 13 publications

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“…The copyright holder for this preprint this version posted May 18, 2021. ; https://doi.org/10.1101/2021.05.14.21257229 doi: medRxiv preprint have had substantially lower COVID-19 transmission and mortality than other countries such as the UK 11 .…”

Section: Discussionmentioning

confidence: 99%

Symptom profiles and accuracy of clinical definitions for COVID-19 in the community. Results of the Virus Watch community cohort

Fragaszy

Shrotri

Geismar

et al. 2021

Preprint

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Background: Understanding the symptomatology and accuracy of clinical case definitions for COVID-19 in the community is important for the initiation of Test, Trace and Isolate (TTI) and may, in future, be important for early prescription of antivirals. Methods: Virus Watch is a large community cohort with prospective daily recording of a wide range of symptoms and self-reporting of swab results (mainly undertaken through the UK TTI System). We compared frequency, severity, timing, and duration of symptoms in test positive and test negative cases. We compared the test performance of the current UK case definition used by TTI (any one of: new continuous cough, high temperature or loss of or change in sense of smell or taste) with a wider definition that also included muscle aches or chills or headache or loss of appetite. Findings: We included results from 8213 swabbed illnesses, 944 of which tested positive for COVID-19. All symptoms were more common in swab positive than swab negative illnesses and symptoms were also more severe and of longer duration. Common symptoms such as cough, headache, fatigue, muscle aches and loss of appetite occurred early in the course of illness but were also very common in test-negative illnesses. Rarer symptoms such as fever or loss or altered sense of smell or taste were often not present but were markedly more common in swab positive compared to swab negative cases. The current UK definition had a sensitivity and specificity of 81% and 47% respectively for symptomatic COVID-19 compared to 93% and 26% for the broader definition. On average cases met the broader case definition one day earlier than current definition. 1.7-fold more illnesses met the broader definition than the current case definition. Interpretation: COVID-19 is difficult to distinguish from other respiratory infections and common ailments on the basis of symptoms. Broadening the list of symptoms used to encourage engagement with TTI could moderately increase the number of infections identified and shorten delays but with a large increase in the number of tests needed and in the number of people and contacts who do not have COVID-19 but might need to self-isolate whilst awaiting results.

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Section: Discussionmentioning

confidence: 99%

Symptom profiles and accuracy of clinical definitions for COVID-19 in the community. Results of the Virus Watch community cohort

Fragaszy

Shrotri

Geismar

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…We did not consider the economic impact of social distancing measures, as our study focused on the epidemiological, healthcare, and behavioral components. There is increasing evidence, however, that economic growth, public health, and civil liberties do not need to be in opposition in the management of the COVID-19 crisis, with countries aiming for elimination faring largely better than countries adopting mitigation strategies 28 . Also, we did not consider health impacts beyond COVID-19 that can result from a high pressure on the hospital system.…”

Section: Discussionmentioning

confidence: 99%

Adherence and sustainability of interventions informing optimal control against COVID-19 pandemic

Domenico

Sabbatini

Boëlle

et al. 2021

Preprint

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After one year of stop-and-go COVID-19 mitigation, some European countries still experience sustained viral circulation due to the B.1.1.7 variant. As the prospect of phasing out this stage through vaccination draws closer, it is critical to balance the efficacy of long-lasting interventions and their impact on the quality of life. Focusing on the current situation in France, we show that moderate interventions require a much longer time to achieve the same result as high intensity lockdowns, with the additional risk of deteriorating control as adherence wanes. Integrating intensity and duration of social distancing in a data-driven "distress" index, we show that shorter strict lockdowns are largely more performant than longer moderate lockdowns, for similar intermediate distress and infringement on individual freedom. Our study shows that favoring milder interventions over more stringent short approaches on the basis of perceived acceptability could be detrimental in the long term, especially with waning adherence.

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“…31 Elimination strategies as opposed to mitigation strategies have been more economically viable. 32 While many countries experienced a marked economic decline with a shock affecting both supply and demand, a country's resilience is likely to be influenced by its fiscal space and ability to borrow money to pay for financial support. Key issues for economic resilience include how fast countries will recover from the shock and how they will manage the issue of debt sustainability over the long term.…”

Section: Resilience In Different Systemsmentioning

confidence: 99%

Building a multisystemic understanding of societal resilience to the COVID-19 pandemic

et al. 2021

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The current global systemic crisis reveals how globalised societies are unprepared to face a pandemic. Beyond the dramatic loss of human life, the COVID-19 pandemic has triggered widespread disturbances in health, social, economic, environmental and governance systems in many countries across the world. Resilience describes the capacities of natural and human systems to prevent, react to and recover from shocks. Societal resilience to the current COVID-19 pandemic relates to the ability of societies in maintaining their core functions while minimising the impact of the pandemic and other societal effects. Drawing on the emerging evidence about resilience in health, social, economic, environmental and governance systems, this paper delineates a multisystemic understanding of societal resilience to COVID-19. Such an understanding provides the foundation for an integrated approach to build societal resilience to current and future pandemics.

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SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties

Cited by 148 publications

References 13 publications

Symptom profiles and accuracy of clinical definitions for COVID-19 in the community. Results of the Virus Watch community cohort

Symptom profiles and accuracy of clinical definitions for COVID-19 in the community. Results of the Virus Watch community cohort

Adherence and sustainability of interventions informing optimal control against COVID-19 pandemic

Building a multisystemic understanding of societal resilience to the COVID-19 pandemic

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