We Must Adopt a “Zero COVID” Strategy to Defend Against New and Old Coronavirus Variants

The recently reported genetic changes to the coronavirus that have been identified in the UK and South Africa pose new and additional risks to our health and prosperity. These new variants are reported to significantly increase transmissibility from human to human. These variants have already spread well beyond South Africa and the UK and likely are already present in the United States. With hospitals and healthcare workers already stretched, we must take immediate action to minimize importation and further spread of this highly transmissible pathogen. Stopping transmission is also important because it denies the virus the opportunity to evolve mechanisms to evade antivirals and vaccines.

In view of the new variants, many countries in Europe and elsewhere are restricting travel. In the United Kingdom even domestic travel has been curtailed and stronger physical distancing measures implemented. These actions are reflecting the fact that the wide-spread adoption of vaccines are still many months away and unless transmission is curbed, many more lives will be lost and economic impacts will be severe.

We therefore recommend the following measures to be adopted in the US, at the state and the federal level:

1. Limit non-essential travel and require all incoming travelers to quarantine in designated isolation centers for 14 days upon arrival. Banning flights from just the UK and South Africa will be insufficient.

2. Limit all non-essential interaction in shared indoor spaces to drive down transmission.

3. Strengthen widespread adoption of isolation, testing, contact tracing, and quarantine.

4. Adopt a “Zero COVID” strategy to eliminate the virus as rapidly as possible, followed by opening up areas where community transmission has been eliminated (a “Green Zone” exit strategy).

5. These actions must be accompanied with support from the federal, state, and local governments to meet the financial and other needs of citizens during this challenging period. This will require monetary support for people who can’t work during lockdowns; housing and other necessities for those who must isolate or quarantine; access to masks and other pharmaceutical and non-pharmaceutical interventions; and mental health support for individuals and groups.

We should base these options on the largely successful “Zero COVID” strategies of several countries: New Zealand, Australia, Thailand, Taiwan, and Vietnam. These countries instituted strict lockdowns, opening up areas where community transmission was eliminated (a “Green Zone” exit strategy). They have largely prevented new transmission through strict quarantines on incoming travelers. When imported cases do occur, they are immediately squashed by aggressive contact tracing and quarantine procedures, and short local lockdowns. Schools, restaurants, bars, hotels, movie theaters, concerts, and sporting events largely operate normally, as COVID-19 has been largely defeated in these countries. They are enjoying normal social activities and prosperous economies.

After almost a year since the onset of the pandemic, it should be clear that measures a day late and a dollar short result in more infections, deaths, and economic damages. The US has had 18 million documented COVID cases, 320,000 deaths, and staggering economic losses and unemployment. Failure to adopt a Zero COVID approach will add millions of cases, hundreds of thousands of deaths, and trillions of dollars of economic damages.

The COVID Action Group stands ready to help in the development and implementation of these options.