The benefits, costs and feasibility of a low incidence COVID-19 strategy

Thomas Czypionka¹, Emil N Iftekhar², Barbara Prainsack³, Viola Priesemann², Simon Bauer², André Calero Valdez⁴, Sarah Cuschieri⁵, Enrico Glaab⁶, Eva Grill⁷, Jenny Krutzinna⁸, Christos Lionis⁹, Helena Machado¹⁰, Carlos Martins¹¹, George N Pavlakis¹², Matjaž Perc¹³, Elena Petelos¹⁴, Martyn Pickersgill¹⁵, Alexander Skupin⁶, Eva Schernhammer¹⁶, Ewa Szczurek¹⁷, Sotirios Tsiodras¹⁸, Peter Willeit¹⁹, Paul Wilmes⁶

Affiliations

¹ Institute for Advanced Studies, Vienna, Austria, and London School of Economics and Political Science, London, UK.
² Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany.
³ University of Vienna, Vienna, Austria.
⁴ RWTH Aachen University, Aachen, Germany.
⁵ Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
⁶ University of Luxembourg, Esch-sur-Alzette, Luxembourg.
⁷ Ludwig-Maximilians University, Munich, Germany.
⁸ University of Bergen, Bergen, Norway.
⁹ Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece and Institute of Health and Medicine, University of Linkoping, Linkoping, Sweden.
¹⁰ University of Minho, Minho, Portugal.
¹¹ Department of Community Medicine, Health Information and Decision Sciences of the Faculty of Medicine of the University of Porto, Porto, Portugal.
¹² National Cancer Institute, Bethesda, USA.
¹³ University of Maribor, Maribor, Slovenia, and Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
¹⁴ Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece and Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
¹⁵ The University of Edinburgh, Edinburgh, UK.
¹⁶ Medical University of Vienna, Vienna, Austria.
¹⁷ University of Warsaw, Warsaw, Poland.
¹⁸ National and Kapodistrian University of Athens Medical School, Athens, Greece.
¹⁹ Medical University of Innsbruck, Innsbruck, Austria, and University of Cambridge, Cambridge, UK.

PMID: 35005678
PMCID: PMC8720492
DOI: 10.1016/j.lanepe.2021.100294

Review

The benefits, costs and feasibility of a low incidence COVID-19 strategy

Thomas Czypionka et al. Lancet Reg Health Eur. 2022 Feb.

. 2022 Feb:13:100294.

doi: 10.1016/j.lanepe.2021.100294. Epub 2022 Jan 2.

Authors

Affiliations

¹ Institute for Advanced Studies, Vienna, Austria, and London School of Economics and Political Science, London, UK.
² Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany.
³ University of Vienna, Vienna, Austria.
⁴ RWTH Aachen University, Aachen, Germany.
⁵ Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
⁶ University of Luxembourg, Esch-sur-Alzette, Luxembourg.
⁷ Ludwig-Maximilians University, Munich, Germany.
⁸ University of Bergen, Bergen, Norway.
⁹ Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece and Institute of Health and Medicine, University of Linkoping, Linkoping, Sweden.
¹⁰ University of Minho, Minho, Portugal.
¹¹ Department of Community Medicine, Health Information and Decision Sciences of the Faculty of Medicine of the University of Porto, Porto, Portugal.
¹² National Cancer Institute, Bethesda, USA.
¹³ University of Maribor, Maribor, Slovenia, and Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
¹⁴ Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece and Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
¹⁵ The University of Edinburgh, Edinburgh, UK.
¹⁶ Medical University of Vienna, Vienna, Austria.
¹⁷ University of Warsaw, Warsaw, Poland.
¹⁸ National and Kapodistrian University of Athens Medical School, Athens, Greece.
¹⁹ Medical University of Innsbruck, Innsbruck, Austria, and University of Cambridge, Cambridge, UK.

PMID: 35005678
PMCID: PMC8720492
DOI: 10.1016/j.lanepe.2021.100294

Abstract

In the summer of 2021, European governments removed most NPIs after experiencing prolonged second and third waves of the COVID-19 pandemic. Most countries failed to achieve immunization rates high enough to avoid resurgence of the virus. Public health strategies for autumn and winter 2021 have ranged from countries aiming at low incidence by re-introducing NPIs to accepting high incidence levels. However, such high incidence strategies almost certainly lead to the very consequences that they seek to avoid: restrictions that harm people and economies. At high incidence, the important pandemic containment measure 'test-trace-isolate-support' becomes inefficient. At that point, the spread of SARS-CoV-2 and its numerous harmful consequences can likely only be controlled through restrictions. We argue that all European countries need to pursue a low incidence strategy in a coordinated manner. Such an endeavour can only be successful if it is built on open communication and trust.

PubMed Disclaimer

Conflict of interest statement

TC was supported by the EU Commission, grant agreement No 101016233 (PERISCOPE). SB was supported by Netzwerk Universitätsmedizin, project egePan (01KX2021). ACV's institution was supported by Ministry of Culture and Science of the German State of North Rhine-Westphalia. EGl was supported by the Luxembourg National Research Fund (FNR) with Public funding support with payments to the host institute as part of the COVID-19 Fast-Track grant research project CovScreen (COVID-19/20201/14715687). EGr has received payments for a manuscript on the history of pandemics. JK is employed by a project funded by the European Research Council, European Union's Horizon 2020 research and innovation programme (grant agreement no. 724460). CL received grants from the University of Oxford, National Centre for Smoking Cessation and Training, UK, Horizon 2020, EUROPEAN COMMISSION, and Pfizer Inc, royalties from Olvos Science, payment for expert testimony from Word Health Organization and European Commission, has a patent for Cretan Iama Olvos Science, and is on the advisory board for Pfizer Helas and Vianex SA. GNP received grants and royalties from Novartis, FNIH, Gilead Grants, managed through NIH, and is the chair of the Nemitsas Prize Award Committee. MPi was supported by Wellcome Trust [grant numbers: 209519/Z/17/Z; WT106612MA], MRC [grant number: MR/S035818/1], ESRC [grant numbers: ES/T014164/1; ES/S013873/1], and British Academy [EN160164]. ESz's lab receives funding for other projects from Merck Healthcare. ST's institution received grants due to his role as Co-investigator-PI in study under the European Union's Horizon 2020 research and innovation programme, Grant Agreement, No 883441, under the agreement and control of the Special Committee for Research Grants of the University of Athens, Athens, Greece. PWilmes’ institution received grants from the European Commission's Horizon 2020 programme including the European Research Council (CoG 863664), the Luxembourg National Research Fund, and the University of Luxembourg, and owns patents. PWilmes received honoraria for being on two PhD juries at the University of Copenhagen and for the Maud Menten lecture at the University of Western Ontario, and for membership of the scientific steering committee for a clinical trial by 4D Pharma plc. and he is Co-speaker of the Research Luxembourg COVID-19 Task Force. Vice-president of the Luxembourg Society for Microbiology. All these were unrelated to this article. All other authors declare no competing interests.

References

1. Devine D, Gaskell J, Jennings W, Stoker G. Trust and the Coronavirus Pandemic: What are the Consequences of and for Trust? An Early Review of the Literature. Political Studies Review. 2021;19:274–285. - PMC - PubMed
1. Schernhammer E, Weitzer J, Laubichler MD, et al. Correlates of COVID-19 vaccine hesitancy in Austria: trust and the government. J Public Health (Oxf) 2021 doi: 10.1093/pubmed/fdab122. published online May 5. - DOI - PMC - PubMed
1. Harring N, Jagers SC, Löfgren Å. COVID-19: Large-scale collective action, government intervention, and the importance of trust. World Development. 2020 doi: 10.1016/j.worlddev.2020.105236. - DOI - PMC - PubMed
1. Iftekhar EN, Priesemann V, Balling R, et al. A look into the future of the COVID-19 pandemic in Europe: an expert consultation. Lancet Reg Health Eur. 2021;8 - PMC - PubMed
1. Siggins MK, Thwaites RS, Openshaw PJ. Durability of immunity to SARS-CoV-2 and other respiratory viruses. Trends in Microbiology. 2021 Apr 8 - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The benefits, costs and feasibility of a low incidence COVID-19 strategy

Affiliations

The benefits, costs and feasibility of a low incidence COVID-19 strategy

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous