I question the use of the word and concept - “eliminate”. The only virus I know that mankind has “eliminated” - if we ignore the research labs in America and Russia that still store stocks of this virus - is smallpox, a variola or pox virus, also spread like COVID-19, that was believed to have originated form rhodents in Africa. Smallpox killed over 300 million people - a third of those who were infected (about 33 out of 100).
Small pox birthed the era of vaccination - people started intentionally infecting themselves with the pus from the skin lesions of infected people with varying success. Some people died from this but the risk was significantly less than death from getting the wild virus. As science evolved, a safer vaccine was created and in combination with the world’s population either having had the virus and survived it, or having been vaccinated against small pox, it was eradicated. COVID-19 however presents us with different challenges - it is much less deadly than smallpox but significantly more infectious or contagious which means it mutates faster. If it mutates too much, then it is like a new virus to our bodies, meaning that even if you have had COVID-19 before or been vaccinated to it, the new strain may be too different to the strain you had or were vaccinated against, and you can “get it again”.
Additionally, COVID-19 is an RNA virus and that makes it more challenging to make a vaccination. Even if we succeed, the development of a vaccine is a long process with the need for complex clinical trials. I would be wary of a vaccine that bypasses the strict and stringent testing for safety and efficacy in a rush to produce a vaccine to COVID-19. No vaccine, is without it’s risk of adverse effects in any case. What issues may arise around vaccination recommendations or requirements and how may this affect our individual power of choice, especially for those people who are low risk of getting seriously sick from COVID-19?
What are the effects of social isolation for different subsets of the population - each being affected in different ways. Elderly people dying without the presence of loved ones in their last days and visiting rights almost as strict as in prisons. How do we measure quality of life vs quantity of life today in the era of COVID-19?
What is the fallout for youth? What perspectives do they have and what are their hopes for the future? How will they cope with the uncertainty that lies ahead? Before COVID-19 we noted escalating levels of mental health issues that were unprecedented in this age group - anxiety, depression, addiction and suicide. In the face of COVID-19 and the strict rules and regulations needed to eliminate it - could these mental health issues become more of an issue in the longer term than COVID-19 itself? Are not a disproportionate percent of the population more negatively affected with current attempts to eliminate?
Domestic violence has become more prevalent than pre-COVID-19 times. With social distancing and isolation - how can affected people get the help they need? Especially the children who are not sent to school and women who no longer have the opportunity to go out in public.
Will we see an increase in stigmatisation? How will we as a society react when someone coughs in public because they have hay fever, asthma, COPD or sneeze because they have photic sneeze reflex that is stimulated every time the sun shines on their face? Will those vulnerable people in our population who need to protect themselves from COVID-19 be discriminated against for opting to work from home and be forced to disclose personal medical information to employers in the future? Will children of anxious or vulnerable parents be more socially isolated?
How will foreign travel for work or to visit friends and family affect our lives with quarantine and bio-security measures? Will Kiwi’s be more distant and less welcoming of foreigners because they may be the people who import COIVD-19 into New Zealand?
From a purely medical point of view, people are also suffering and dying because they cannot get treatment, see doctors or have surgery that they need for non-COVID-19 related issues and everything is more complicated and now takes longer. Waiting lists grow exponentially in a health care system that was already strained pre-COVID-19, most lab and other diagnostic testing are on hold and people cannot be properly examined. The way we work as doctors has changed and there is even more distance between us and our patients.
How realistic is elimination? Is it realistic to be one of the few countries in the world to have no community cases? Will we always be paranoid and fearful that it may be imported? Will it mean we become even more isolated from the rest of the world?
What is the true cost of elimination to each person in New Zealand? Can we even achieve it when the rest of the world has COVID-19 and will do so for years to come? Does the extra financial strain on New Zealand and it’s people to eliminate really make sense? Is “eliminate” a justifiable use of resources?
https://ourworldindata.org/smallpox#all-charts-preview
https://www.bbc.co.uk/history/british/empire_seapower/smallpox_01.shtml
