Global eradication of Cavid-19 is likely feasible, and more so than for polio, though considerably less than it was for smallpox. This is a comparative score of technical, sociopolitical, and economic factors for all three infections, published in the online journal BMJ Global Health.
Vaccination, public health measures and the global interest in achieving this goal, as a result of the enormous financial and social destruction wrought by the coronavirus pandemic, make eradication possible.
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But the main challenges are in ensuring high enough vaccine coverage and being able to respond quickly enough to variants that can escape immunity, say the authors.
To estimate the feasibility of eradicating Covid-19, defined as ‘the permanent reduction to zero in the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts’, the authors compared it with two other viral scourges for which vaccines were targeted. /are available – smallpox and polio – through a range of technical, socio-political and economic factors that are likely to help achieve this goal.
They used a three-point scoring system for each of the 17 variables. These include: factors such as the availability of a safe and effective vaccine; lifetime immunity; impact of public health measures; effective government management of infection control messages; political and public concern with the economic and social impacts of the infection; and public acceptance of infection control measures.
Smallpox was declared eradicated in 1980 and two of the three poliovirus serotypes have also been eradicated globally. The mean (total) score in the analysis amounted to 2.7 (43/48) for smallpox, 1.6 (28/51) for Covid-19, and 1.5 (26/51) for polio.
“While our review is a preliminary effort, with several subjective components, it appears to place COVID-19 eradication in the realm of being possible, especially in terms of technical feasibility,” they wrote.
They recognize that, in relation to smallpox and polio, the technical challenges of eradicating Covid-19 include low vaccine acceptance and the emergence of more transmissible variants that can evade immunity, potentially outpacing global vaccination programs.
“However, there are limits to viral evolution, so we can expect the virus to eventually reach peak fitness and new vaccines can be formulated,” they explain.
“Other challenges would be the high initial costs (for vaccination and updating of health systems) and obtaining the necessary international cooperation in the face of ‘vaccination nationalism’ and the ‘unscientific aggression’ mediated by the government”, they admit.
Persistence of the virus in animal reservoirs may also hamper eradication efforts, but that doesn’t appear to be a serious problem, they suggest.
On the other hand, there is a global desire to fight the infection. The massive scale of Covid-19’s social and economic impacts across most of the world has generated “unprecedented global interest in disease control and massive investment in pandemic vaccination,” they note.
And unlike smallpox and polio, Covid-19 also benefits from the additional impact of public health measures such as border control, social distancing, contact tracking and mask use, which can be very effective if implemented well. .
Updating health systems to get rid of the virus can also help control other infections and even help eradicate measles, they suggest.
“Collectively, these factors can mean that an ‘expected value’ analysis can ultimately estimate that the benefits outweigh the costs, even if eradication takes many years and carries a significant risk of failure,” they wrote.
Covid-19 elimination, defined as ‘zeroing the incidence of infection caused by a specific agent in a defined geographic area as a result of deliberate efforts’, has been achieved and maintained for long periods in several jurisdictions in Asia. Pacific region, providing proof of concept that global eradication is technically possible, they note.
They recognize that their study is preliminary and that more extensive and in-depth work is needed. The World Health Organization, or a coalition of national-level agencies working in collaboration, needs to formally review the feasibility and desirability of trying to eradicate Covid-19, they conclude.
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