Since the declaration of the novel coronavirus as a pandemic by the World Health Organization, a variety of strategies have been implemented to combat its spread. Among these strategies, two predominant approaches have emerged: elimination and mitigation. Elimination, also known as the 'Zero-COVID' strategy Public Health News Analysis China's Zero COVID Policy – An Insight Author : Dr Aninda Debnath Updated on : March 13, 2023 Public Health Interventions, Zero COVID Policy, COVID-19 In terms of short-term benefits, the Zero-COVID-19 strategy has been shown to prevent avoidable infections, hospitalizations, and deaths caused by the virus. Since the declaration of the novel coronavirus as a pandemic by the World Health Organization, a variety of strategies have been implemented to combat its spread. Among these strategies, two predominant approaches have emerged: elimination and mitigation . Elimination, also known as the 'Zero-COVID' strategy , is primarily adopted by island states such as New Zealand, Australia, Singapore, Japan, South Korea, Vietnam, mainland China, Hong Kong, and Taiwan. Zero-COVID approach seeks to achieve a goal of zero deaths by vigorously containing the virus through short-term lockdowns, followed by stringent find, test, trace, and isolate measures. It places a strong emphasis on the protection of lives at all costs. On the other hand, countries such as India, the United States, the United Kingdom, and Sweden have implemented anti-pandemic measures that follow a mitigation strategy. This approach employs relatively lenient or relaxed measures to restrict virus transmission. (1)(2) Benefits of Zero-COVID strategy One of the main arguments for justifying the Zero-COVID strategy is based on societies' overarching duty to protect human life, whereby every COVID-19 death is considered unacceptable. This argument suggests that since the Zero-COVID approach has a better track record in terms of saving lives than the mitigation strategy, it should be favoured over the latter. In terms of short-term benefits, the Zero-COVID-19 strategy has been shown to prevent avoidable infections, hospitalizations, and deaths caused by the virus. In comparison to societies that adopt a "living with COVID-19" mitigation policy, individuals in societies that implement the Zero-COVID-19 approach typically have much lower rates of COVID-19 infection. For instance, an analysis of COVID-19 data from 72 countries conducted in 2020 revealed that the elimination strategy provides significantly greater protection to society members in terms of COVID-19 deaths, when compared to other anti-pandemic measures. (3)(4) Multiple studies have shown that the Zero-COVID approach is more effective in saving lives than the mitigation strategy. For example, Oliu-Barton conducted a study comparing countries that adopted the Zero-COVID-19 approach with those that adopted the mitigation approach, and found that countries that implemented Zero-COVID had COVID-19 death rates that were 25 times lower than those that adopted the mitigation strategy. (5) Overall, the argument in favour of the Zero-COVID approach is that it provides significant short-term benefits in terms of preventing COVID-19 infections, hospitalizations, and deaths, particularly when compared to the mitigation strategy. Argument against Zero-COVID strategy It is important to note that health equity concerns are not exclusive to the Zero-COVID strategy, but can also arise under the mitigation approach. In particular, marginalized communities can be disproportionately burdened by the pandemic and the societal responses to it, especially when such communities are already facing structural racism or poverty. (6) For instance, the implementation measures, such as physical distancing and quarantine, may not be feasible or effective for individuals living in crowded and under-resourced communities. Such communities may lack access to adequate healthcare services, personal protective equipment, and information on how to protect themselves against COVID-19. As a result, these communities may face a higher risk of infection and more severe outcomes, including hospitalization and death. (7) Research has found that strict lockdowns can have a significant impact on health services for individuals with chronic diseases, such as heart disease, stroke, chronic kidney disease, and cancer. The diversion of medical resources to combat the pandemic can compromise routine check-ups and follow-up treatments for these patients, leading to negative consequences. During the recent Omicron wave in Shanghai, strict lockdowns resulted in interruptions in regular medical care and limited treatment resources, causing havoc among residents. For instance, individuals requiring dialysis were unable to receive treatment due to hospitals' policies of no admission without a negative polymerase chain reaction (PCR) test for COVID-19. These findings indicate that while lockdowns may be an effective measure for controlling the spread of COVID-19, they can have unintended consequences for individuals with chronic health conditions. (8) Therefore, it is essential to consider health equity concerns in the development and implementation of any pandemic response strategy. This includes taking into account the unique circumstances and needs of marginalized communities and ensuring that measures are in place to address any adverse impacts on their health and well-being. Such efforts may include targeted outreach and education, provision of resources and support, and partnerships with community organizations to build trust and foster engagement. (9)(10) Change in strategy The change from a zero-COVID approach will come with many advantages, but also great challenges. Advantages The change should also better balance the control of COVID-19 versus other diseases, as the zero-COVID approach has occupied vast public health resources. Moreover, living with the virus in a highly vaccinated population can lead to robust herd immunity against various SARS-CoV-2 variants through repeated natural mild infections Challenges COVID-19 cases will surge rapidly and stay high for months. Healthcare systems could be overwhelmed by too many patients, which could increase greatly the COVID-19 fatality rate. Conclusion The Zero COVID strategy can be effective in controlling infectious diseases, especially in the early stages of an outbreak when little is known about the disease and there are no effective measures to control it. However, with the advent of vaccines and wide vaccination coverage, as well as a decreasing case fatality rate, it may be more advantageous to opt for a mitigation strategy rather than a Zero COVID approach. Vaccines have been developed and deployed at an unprecedented pace, providing significant protection against the virus and drastically reducing the risk of severe disease and death. This has enabled governments to shift their focus from the elimination of the virus to the management of its impact on society. Instead of trying to completely eradicate the virus, mitigation strategies focus on reducing the transmission and severity of the disease while keeping the economy and society open. Furthermore, a Zero COVID strategy may not be feasible in the long term as it requires strict and often draconian measures, such as complete lockdowns, which can have severe economic and social consequences. Mitigation strategies, on the other hand, can be adapted to the changing situation and can be less disruptive to daily life while still being effective in controlling the spread of the virus. References 1. Coronavirus disease (COVID-19): Variants of SARS-COV-2 [Internet]. [cited 2023 Feb 24]. Available from: https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-variants-of-sars-cov-2 2. Su Z, Cheshmehzangi A, McDonnell D, Ahmad J, Šegalo S, Xiang YT, et al. The Advantages of the Zero-COVID-19 Strategy. International Journal of Environmental Research and Public Health. 2022 Jan;19(14):8767. 3. Frontiers | Asymptomatic Transmissibility Calls for Implementing a Zero-COVID Strategy to End the Current Global Crisis [Internet]. [cited 2023 Feb 24]. Available from: https://www.frontiersin.org/articles/10.3389/fcimb.2022.836409/full 4. Helliwell JF, Norton MB, Wang S, Aknin LB, Huang H. Well-being Analysis Favours a Virus-Elimination Strategy for COVID-19 [Internet]. National Bureau of Economic Research; 2021 [cited 2023 Feb 24]. (Working Paper Series). Available from: https://www.nber.org/papers/w29092 5. Oliu-Barton M, Pradelski BSR, Aghion P, Artus P, Kickbusch I, Lazarus JV, et al. SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties. Lancet. 2021 Jun 12;397(10291):2234–6. 6. Open letter from African intellectuals to leaders over COVID-19 [Internet]. [cited 2023 Feb 24]. Available from: https://www.aljazeera.com/features/2020/4/17/open-letter-from-african-intellectuals-to-leaders-over-covid-19 7. Saalim K, Sakyi KS, Fatema-Tuz-Zohra, Morrison E, Owusu P, Dalglish SL, et al. Reported health and social consequences of the COVID-19 pandemic on vulnerable populations and implemented solutions in six West African countries: A media content analysis. PLOS ONE. 2021 Jun 16;16(6):e0252890. 8. Kluge HHP, Wickramasinghe K, Rippin HL, Mendes R, Peters DH, Kontsevaya A, et al. Prevention and control of non-communicable diseases in the COVID-19 response. Lancet. 2020;395(10238):1678–80. 9. Bai W, Sha S, Cheung T, Su Z, Jackson T, Xiang YT. Optimizing the dynamic zero-COVID policy in China. Int J Biol Sci. 2022;18(14):5314–6. 10. Jecker NS, Au DKS. Does Zero-COVID neglect health disparities? J Med Ethics. 2022 Mar;48(3):169–72. ! Widget Didn’t Load Check your internet and refresh this page. If that doesn’t work, contact us. Join the team Public Health Chronicle! APPLY NOW

Maryland Sees Tenfold Increase in Whooping Cough Cases Content Editor: PHC Editor November 4, 2024 at 5:48:07 PM Whooping Cough, Maryland, Pertussis, Vaccination, Public Health Maryland has reported 121 confirmed cases of whooping cough (pertussis) as of October 22, 2024, a significant rise from 11 cases during the same period in 2023. The Maryland Department of Health notes that this surge aligns with national trends, as the United States returns to pre-pandemic levels of pertussis incidence. Health officials emphasize the importance of vaccination, particularly for infants and those in close contact with them , to curb the spread of this highly contagious respiratory disease. Symptoms of whooping cough include severe coughing fits, a "whooping" sound when breathing in after coughing , and potential complications like pneumonia, especially in young children. The state is intensifying public health campaigns to raise awareness and encourage timely immunizations to protect vulnerable populations. Previous Next

National Media Delegation Praises NIV Pune’s Viral Research Efforts Content Editor: Dr. Lopamudra July 12, 2025 at 5:29:52 PM Virology, Viral Diseases A delegation of national media representatives toured NIV Pune to observe its pioneering work in viral disease control . During the visit, scientists demonstrated their critical contributions to public health security. Dr. Naveen Kumar, Director of NIV, presented recent breakthroughs including surveillance of COVID-19 mutations , containment of Guillain-Barré Syndrome cases , and progress on made-in-India vaccines targeting Mpox , Kyasanur Forest Disease, H5N1, and Japanese Encephalitis. The institute marked a technological milestone with NAKSHATRA - India's inaugural High-Performance Computing system dedicated to viral genomics , enhancing research capabilities. Since its 1952 founding, NIV Pune has served as India's frontline defense against viral threats through swift diagnosis and epidemic control measures. Previous Next

Antimicrobial resistance: A global health threat Content Editor: Dr. Sivanthiga June 22, 2024 at 12:30:00 PM Antimicrobial Resistance, Sustainable development Goals, Research findings The study used the six-year data set (from Jan 2017 to Dec 2022) from the Indian Council of Medical Research Antimicrobial Resistance Surveillance Network (IAMRSN). The results revealed a global health threat of escalating levels of antimicrobial resistance. Associations between higher antibiotic resistance and lower Sustainable Development Goals (SDG) achievements were established. The AMR trends in pathogen groups such as gram-negative, gram-positive organisms, Enterobacteriaceae were identified. An AMR scorecard for targeted interventions based on demographics was proposed. Cefotaxime resistance emerged as a potential early indicator for emerging carbapenem resistance, suggesting a novel surveillance marker ; thus, ‘indicator antibiotics ’ were introduced. The following recommendations were made: Implement proactive surveillance of AMR to align with WHO GLASS standards. Vigilantly monitor escalating carbapenem resistance. Tailor treatment guidelines based on demographics. Develop targeted interventions using AMR scorecards. Emphasize associations between AMR and SDG to help in policymaking . Click here to read more. Previous Next

CDC issues level 2 travel advisory for Chikungunya CDC issues level 2 travel advisory for Chikungunya Content Editor: Dr Urmimala November 22, 2024 Centers for Disease Control and Prevention Travel Advisory, Chikungunya, Outbreak, Global Health Following a rise in the number of US travelers returning from Telangana, India, diagnosed with Chikungunya , the Centers for Disease Control and Prevention released the Level 2 Travel Advisory notice . The Advisory includes: Symptoms of the disease- fever, joint pain, muscle ache, rashes . Route of Transmission- Vector-borne- Mosquito (Aedes aegypti and Aedes albopictus) bites Modes of Prevention- Self protection - wearing long sleeve clothes, using insect repellants Recommending Vaccination for all aged 18yrs and above travelling to areas of outbreak- with restrictions for certain groups like pregnant women and immunosuppressed. The four levels of travel advisories are meant to inform travellers about the global health risks of traveller to different areas of the world and the level of precautionary measures required. The recommendations are as follows- Level 1 for practicing usual precautionary measures for a disease Level 2 for practicing enhanced precautionary measures Level 3 for recommending reconsideration for travel due to non-essential reasons Level 4 to avoid all travel. Click here to read more.

Combating infant and child mortality: India's research and program initiatives Combating infant and child mortality: India's research and program initiatives Content Editor: Dr Shayari December 12, 2024 Press Information Bureau National Health Programs, National Health Mission, Health Research The Indian government, through the ICMR and the M inistry o f H ealth and F amily W elfare, is implementing a comprehensive strategy to reduce newborn and child mortality and improve overall health outcomes. Key Takeaways: 1. ICMR Research Initiatives: The ICMR is conducting extensive research, including the "Sankalp" program to reduce neonatal mortality to the single digits, research on reducing stillbirths, studies on childhood respiratory diseases (which reveal differences from Western data), and projects focusing on the first 1000 days of life, sickle cell disease screening, and birth defect surveillance. 2. National Health Mission (NHM) Programs: The NHM is implementing numerous nationwide programs to improve newborn and child health. Key initiatives include establishing specialized newborn care units (SNCUs and NBSUs ), promoting mother-newborn care (MNCUs and KMC ), providing home-based care (HBNC & HBYC ), ensuring free treatment under JSSK , implementing universal immunization (UIP ), promoting breastfeeding (MAA ), combating pneumonia (SAANS ) and diarrhea (STOP Diarrhoea ), screening children under RBSK , managing malnutrition in NRCs , addressing anemia (AMB ), and providing extensive capacity building for healthcare providers. 3. The ICMR is forging dynamic partnerships with stakeholders, including national/state pediatric associations and NGOs, to amplify research and implementation endeavors. Click here to read more.

Global Report on Food Crises Global Report on Food Crises Content Editor: Dr. Urmimala Maiti May 8, 2023 UNICEF Food Crisis, Global health The Food Security Information Network (FSIN) and Global Network Against Food Crises (GNAFC) have come up with a joint analysis report, "Global Report on Food Crises ." The Report shows 258 million people across 58 countries in 2022 were in acute food insecurity . The main drivers of acute food insecurity are Conflict Economic crisis Extreme weather conditions . South Sudan had a food crisis of the highest severity. More than 50% of people in the seven countries who suffered "Catastrophe " (extreme starvation, malnutrition, and death) belonged to Somalia . For Further reading, click here

NMC's guide to professional conduct in e-book form Content Editor: Dr Urmimala Maiti October 20, 2023 at 12:30:00 PM Medical Ethics, Professional Conduct The National Medical Commission has launched an e-book on "Professional Conduct Review" based on case reports. Some of the aspects addressed by the book include: Good Doctor-patient relationship and The importance of skills and competence in eliminating communication gaps Prioritizing proper documentation of history and examination findings to avoid medical negligence Not claiming to be a specialist unless he/she possesses the required qualifications. Regulations on the signboard state that it should not be unusually large, put upon a chemist shop where he does not work or stay The signboard shouldn't contain any information other than- name, qualification/ degree earned at a university, name of the specialty, and registration number of the state medical council. The document also contains information on ethical guidelines for research and the role of informed consent. Previous Next

Health security risks and the growing plethora of disinformation Health security risks and the growing plethora of disinformation Content editor: Dr. Anubhav Mondal February 23, 2024 WHO News Section Cyber attacks, Public health emergency WHO collaborated with the following agencies to produce two reports that provide a clearer understanding of health security risks posed by digital tools and how to reduce their likelihood and severity. INTERPOL, The United Nations Office on Drugs and Crime (UNODC), The UN Office of Counter-terrorism, The UN International Computing Centre (UNICC), The UN Interregional Crime and Justice Research Institute, The CyberPeace Institute The first paper, "Examining the Threat of Cyber-attack on Health Care During the COVID-19 Pandemic ", emphasizes the far-reaching real-world consequences of cyber-attacks on health care. The second report, "Understanding Disinformation in the Context of Public Health Emergencies: The Case of COVID-19 ," examines various techniques to counter disinformation. Click here to read more.

"Ekushey February" - What it is about? "Ekushey February" - What it is about? February 22, 2023 UNESCO Historical Events, Prespectives The world celebrates International Mother Language Day to promote linguistic and cultural diversity, as well as multilingualism on February 21 every year since 1999. Theme : “Multilingual education – a necessity to transform education” Aims to celebrate ways of expressing the world in its multiplicity, committing to the preservation of the diversity of languages as a common heritage and working for quality education – in mother tongues – for ALL. UNESCO believes in the importance of cultural and linguistic diversity for sustainable societies. It is within its mandate for peace that it works to preserve the differences in cultures and languages that foster tolerance and respect for others. Multilingual and multicultural societies exist through their languages which transmit and preserve traditional knowledge and cultures in a sustainable way.