EDITORIALS Department of Preventive and Social BMJ: first published as 10.1136/bmj.n1794 on 15 July 2021. Downloaded from Medicine, University of Otago, Dunedin, Defining covid-19 elimination New Zealand Correspondence to: D C G Skegg Elimination is achievable and should not be confused with eradication
[email protected] Cite this as: BMJ 2021;374:n1794 David CG Skegg, Philip C Hill http://dx.doi.org/10.1136/bmj.n1794 Speaking about progress towards ending the covid-19 “zero covid” for a prolonged period. Even with border Published: 15 July 2021 epidemic in the United States, Anthony Fauci said: restrictions and strict quarantine, incursions of the “We will end the epidemic phase, and we will likely virus occur from time to time, leading to clusters of get somewhere between control and elimination, infections and occasional large outbreaks. In the more likely closer to control.”1 Now authorities in Australian state of Victoria, for example, a resurgence England are abandoning most efforts to control, let of covid-19 last year peaked at over 700 cases a day, alone eliminate, the infection.2 Throughout the before being extinguished after three months.11 pandemic, the word “elimination” has been used in Despite such setbacks, Australia and New Zealand different senses. Many confuse elimination with remain healthy economies with largely normal eradication, which normally means permanent community life, apart from temporary border reduction to zero of the worldwide incidence of an restrictions. Both are developing plans for a phased infection—as was achieved for smallpox.3 This reopening of borders. confusion helps to make the idea of eliminating The likely consequences of not aiming for elimination covid-19 seem impossible and not worth pursuing.