Zero-COVID

A barrier on the state border of Queensland and New South Wales preventing interstate travel in April 2020 during the COVID-19 pandemic in Australia.

Zero-COVID, also known as COVID-Zero and "Find, Test, Trace, Isolate, and Support" (FTTIS), was a public health policy implemented by some countries, especially China, during the COVID-19 pandemic.[1][a] In contrast to the "living with COVID-19" strategy, the zero-COVID strategy was purportedly one "of control and maximum suppression".[1] Public health measures used to implement the strategy included as contact tracing, mass testing, border quarantine, lockdowns, and mitigation software in order to stop community transmission of COVID-19 as soon as it was detected. The goal of the strategy was to get the area back to zero new infections and resume normal economic and social activities.[1][4]

A zero-COVID strategy consisted of two phases: an initial suppression phase in which the virus is eliminated locally using aggressive public health measures, and a sustained containment phase, in which normal economic and social activities resume and public health measures are used to contain new outbreaks before they spread widely.[4] This strategy was utilized to varying degrees by Australia, Bhutan,[5][6] Atlantic and Northern Canada,[7] mainland China, Hong Kong,[8] Macau,[9] Malaysia,[10] Montserrat, New Zealand, North Korea, Northern Ireland, Singapore, Scotland,[11] South Korea,[12] Taiwan,[13] East Timor, Thailand, Tonga,[14] and Vietnam.[15][16] By late 2021, due to challenges with the increased transmissibility of the Delta and Omicron variants, and also the arrival of COVID-19 vaccines, many countries had phased out zero-COVID, with mainland China being the last major country to do so in December 2022.[17]

Experts have differentiated between zero-COVID, which was an elimination strategy, and mitigation strategies that attempted to lessen the effects of the virus on society, but which still tolerated some level of transmission within the community.[18][4] These initial strategies could be pursued sequentially or simultaneously during the acquired immunity phase through natural and vaccine-induced immunity.[19]

Advocates of zero-COVID pointed to the far lower death rates and higher economic growth in countries that pursued elimination during the first year of the pandemic (i.e., prior to widespread vaccination) compared with countries that pursued mitigation,[18] and argued that swift, strict measures to eliminate the virus allowed a faster return to normal life.[18] Opponents of zero-COVID argued that, similar to the challenges faced with the flu or the common cold, achieving the complete elimination of a respiratory virus like SARS-CoV-2 may not have been a realistic goal.[20] To achieve zero-COVID in an area with high infection rates, one review estimated that it would take three months of strict lockdown.[21]

  1. ^ a b c Anna Llupià, Rodríguez-Giralt, Anna Fité, Lola Álamo, Laura de la Torre, Ana Redondo, Mar Callau and Caterina Guinovart (2020) "What Is a Zero-COVID Strategy" Archived 3 January 2022 at the Wayback Machine, Barcelona Institute for Global Health – COVID-19 & response strategy. "The strategy of control and maximum suppression (zero-COVID) has been implemented successfully in a number of countries. The objective of this strategy is to keep transmission of the virus as close to zero as possible and ultimately to eliminate it entirely from particular geographical areas. The strategy aims to increase the capacity to identify and trace chains of transmission and to identify and manage outbreaks, while also integrating economic, psychological, social and healthcare support to guarantee the isolation of cases and contacts. This approach is also known as 'Find, Test, Trace, Isolate and Support' (FTTIS)"
  2. ^ "上海封城一个月:官方坚持"动态清零"政策不变 如何解除危机" (in Simplified Chinese). BBC News 中文. 2022-04-28. Retrieved 2022-04-28.
  3. ^ "Plano de Resposta de Emergência para a Situação Epidémica da COVID-19 em Grande Escala do Governo da Região Administrativa Especial de Macau (2.ª Versão)". Centro de Coordenação de Contingência do Novo Tipo de Coronavírus. 2022.
  4. ^ a b c Li, Zhongjie; Chen, Qiulan; Feng, Luzhao; Rodewald, Lance; Xia, Yinyin; Yu, Hailiang; Zhang, Ruochen; An, Zhijie; Yin, Wenwu; Chen, Wei; Qin, Ying; Peng, Zhibin; Zhang, Ting; Ni, Daxin; Cui, Jinzhao; Wang, Qing; Yang, Xiaokun; Zhang, Muli; Ren, Xiang; Wu, Dan; Sun, Xiaojin; Li, Yuanqiu; Zhou, Lei; Qi, Xiaopeng; Song, Tie; Gao, George F; Feng, Zijian (4 June 2020). "Active case finding with case management: the key to tackling the COVID-19 pandemic". The Lancet. 396 (10243): 63–70. doi:10.1016/S0140-6736(20)31278-2. PMC 7272157. PMID 32505220.
  5. ^ Phub Dem (22 January 2022). ""Living with virus" not an option for Bhutan: PM". Kuensel Online. Retrieved 31 May 2022.
  6. ^ Nima Wangdi (3 March 2022). "Fate of lockdowns in your hands now: PM". Kuensel Online. Retrieved 31 May 2022.
  7. ^ MacDonald, Michael (1 May 2021). "The COVID-Zero approach: Why Atlantic Canada excels at slowing the spread of COVID-19". CTV News. Retrieved 5 January 2022.
  8. ^ "Hong Kong is clinging to 'zero covid' and extreme quarantine. Talent is leaving in droves". The Washington Post. Retrieved 5 January 2022.
  9. ^ Lou, Loretta (26 March 2021). "Casino capitalism in the era of COVID-19: examining Macau's pandemic response". Social Transformations in Chinese Societies. 17 (2): 69–79. doi:10.1108/STICS-09-2020-0025. S2CID 233650925. Retrieved 26 March 2021.
  10. ^ "Malaysia, Thailand and Vietnam are leaving their zero-Covid policies behind, but they aren't ready to open up, experts warn". 22 September 2021.
  11. ^ "Scotland is aiming to eliminate coronavirus. Why isn't England?". Wired UK. ISSN 1357-0978. Retrieved 11 January 2022.
  12. ^ McLaughlin, Timothy (21 June 2021). "The Countries Stuck in Coronavirus Purgatory". The Atlantic. Retrieved 6 January 2022.
  13. ^ Hale, Erin. "After early success, Taiwan struggles to exit 'zero COVID' policy". Al Jazeera. Archived from the original on 1 January 2022. Retrieved 2 January 2022.
  14. ^ Fildes, Nic (18 January 2022). "Tonga volcano relief effort complicated by 'Covid-free' policy". Financial Times. Retrieved 18 January 2022.
  15. ^ Cite error: The named reference ourworldindata was invoked but never defined (see the help page).
  16. ^ Cite error: The named reference :2 was invoked but never defined (see the help page).
  17. ^ Bradsher, Keith; Che, Chang; Chien, Amy Chang (2022-12-07). "China Eases 'Zero Covid' Restrictions in Victory for Protesters". The New York Times. ISSN 0362-4331. Retrieved 2023-04-17.
  18. ^ a b c Oliu-Barton, Miquel; Pradelski, Bary S R; Aghion, Philippe; Artus, Patrick; Kickbusch, Ilona; Lazarus, Jeffrey V; Sridhar, Devi; Vanderslott, Samantha (28 April 2021). "SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties". The Lancet. 397 (10291): 2234–2236. doi:10.1016/S0140-6736(21)00978-8. PMC 8081398. PMID 33932328.
  19. ^ Bhopal, Raj S (9 September 2020). "To achieve "zero covid" we need to include the controlled, careful acquisition of population (herd) immunity". BMJ. 370: m3487. doi:10.1136/bmj.m3487. eISSN 1756-1833. hdl:20.500.11820/59628557-672e-47bb-b490-9c9965179a27. PMID 32907816. S2CID 221538577.
  20. ^ David Livermore (28 March 2021). "'Zero Covid' – an impossible dream". HART – Health Advisory & Recovery Team. Archived from the original on 2 January 2022. Retrieved 2 January 2022.
  21. ^ Mégarbane, Bruno; Bourasset, Fanchon; Scherrmann, Jean-Michel (20 September 2021). "Epidemiokinetic Tools to Monitor Lockdown Efficacy and Estimate the Duration Adequate to Control SARS-CoV-2 Spread" (PDF). Journal of Epidemiology and Global Health. 11 (4): 321–325. doi:10.1007/s44197-021-00007-3. ISSN 2210-6006. PMC 8451385. PMID 34734383.


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Zero-COVID

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