CovidZero: How to end the pandemic in 5 weeks

CovidZero is an EXIT strategy.

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It is unlike the usual strategy called "living with the virus" "mitigation" "flattening the curve" or "allowing the disease to become endemic" with or without a vaccine which is passive, reactive, ineffective and massively costly in lives, long term health, and the economy.

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CovidZero is proactive with a goal of normal life as it was pre-pandemic by eliminating the virus. We need to do this as fast as possible to save lives, save livelihoods and minimize the time we must take extraordinary actions.

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It also minimizes the risks from new virus variants that can be more rapidly spreading or resistant to vaccination.

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CovidZero is adaptive based upon local conditions and the strengths and capabilities of the community. Setting the goal and using all available capabilities to get there has been shown to work in Australia, China, New Zealand, Taiwan, Thailand, Vietnam, and Atlantic Canada.

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CovidZero is a real world strategy that requires hard work, persistence and collaboration. It is worth doing because the alternative is much worse. Going all out reduces both the health and economic costs.

The key steps are:

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1.Galvanizing everyone to the CovidZero goal as the primary action is a community action. Everyone should be focused on getting to CovidZero. This includes support and advocacy by community organizations, social networks, healthcare organizations, businesses, and government.

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2.Use strongest possible action to prevent transmission. Start with a 5 week mandatory period with stay at home orders. Only minimal essential services should be allowed using maximal transmission prevention protocols (delivery,curbside pickup,mask wearing,air purification)

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3.Implement travel restrictions and quarantines. Prevent importing cases into nations, states, communities, neighborhoods, even city blocks through strict travel restrictions.

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The smaller the local area protected by travel restrictions the faster is the process of getting to zero locally. Then use a Green Zone Exit Strategy opening up protected CovidZero areas and connecting them by travel progressively over a few weeks.

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4.Use rapid community based case identification with supported isolation and quarantines. This prevents family and household transmission, while providing care for individuals who are sick,

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with testing, contact tracing and coordination by public health and medical organizations.

Testing should include symptom based, mass testing, and other methods such as sewage testing.

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5.Ensure a livelihood for all. Vulnerable individuals and businesses should receive financial and other assistance. This includes employment assurance, mental health and other support by the community, businesses and government.

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Regular check-ins with individuals and families by the community makes both rapid case identification and other forms of support possible.

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6.Rapid vaccination of high risk individuals. Focus on disease severity (age and prior conditions) and essential employment needs (healthcare and other essential workers). Mass vaccination may help with transmission prevention and should be used as one of,not the only,tool.

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CovidZero is robust to social conflict as individual communities can achieve success for themselves. It is robust to individual behavior and doesn’t require 100% compliance.

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Most people care about their families and communities and given the opportunity to get to a clearly desirable goal will do their part, especially if it can be done rapidly.

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The opportunity of the CovidZero EXIT strategy is to control the virus and to eliminate it locally and progressively in larger areas and return to normal.

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The rate of decline of cases can be very rapid and economic costs are dramatically lower because of the short period of time of the action. This will save lives and save the economy.

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Patience is still required at the end as the number of cases become small so that community transmission stops. Each case has to be treated like a murder as even one case of community transmission can grow exponentially.

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Still, stopping localized outbreaks with short term action by contact tracing and even localized lockdowns (“fire fighting") is vastly preferable to living in a burning building.

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COVID Zero: How to end the pandemic in 5 weeks

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pngs attached

links to pdf
endcoronavirus.org/papers/covidze…
necsi.edu/covidzero-how-…
Video by @WicMar watching her favorite basketball team @NZBreakers in Auckland in November in a full arena

#COVIDzero in New Zealand

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More from @yaneerbaryam

10 Jan
Update: LongCovid and male infertility

Several articles have shown potential COVID harm to male fertility. A new article is much more explicit.

Massive damage to germ cells (cells that become sperm) indicates potential loss of male fertility.

1/ Image
This autopsy study doesn’t show effect of mild cases. However, studies of mild and asymptomatic cases indicate the virus can reach multiple organs. The ACE2 receptor is highly expressed in testes.

2/
Title: Pathological and molecular examinations of postmortem testis biopsies reveal SARS-CoV-2 infection in the testis and spermatogenesis damage in COVID-19 patients

nature.com/articles/s4142…

3/
Read 11 tweets
9 Jan
The 7-day average of both daily cases and daily deaths in Mexico are seeing record highs.

Mexico City reported more than 5,700 excess deaths per million during the outbreak, and hospitalizations are surging in recent weeks.

Cases in Germany have decreased from peak but daily deaths are still at highest levels.

Germany recently surpassed the US in daily deaths per capita.

Yesterday they reported 1,152 deaths.
UK has a rapid surge in daily deaths reflecting rapid spread of new variant.

Yesterday: 1,162
Today: 1,352 (a record high)

bbc.com/news/uk-555941…
Read 4 tweets
8 Jan
Breaking: Coronavirus Update

Irish Chief Medical Officer and his team estimate that transmission rate R has more than doubled in 3 weeks, from 1.1-1.3 to 2.4-3.

Ireland reports a new record in daily cases: 7832. ImageImage
In Ireland, roughly 25% of recent samples that were sequenced (47 out of 189) are confirmed to be the B.1.1.7 variant.


Doubling time for hospital admission is currently ~5.5 days.
Texas reports their first case of the UK B.1.1.7 variant. The infected patient is a man between the ages of 30-40 years old in southwest Harris County and has had no history of traveling. Image
Read 7 tweets
5 Jan
California reports more cases of the new UK variant: 6 total cases so far: 4 in San Diego, 2 in San Bernardino.

Hospitals near Los Angeles continue to fill, as the Army Corps of Engineers arrive at several hospitals to aid in oxygen delivery systems.

nytimes.com/interactive/20…
Similarly, the new variant has been identified in NY as the state experiences uncontrolled community spread. The case was identified in a man in his 60s in Saratoga County who had no recent travel history.

See county-level cases here:
endcoronavirus.org/us-counties
England, Scotland, and Lebanon announce new lockdowns.

England:
nytimes.com/2021/01/04/wor…

Scotland:
bbc.com/news/uk-scotla…

Lebanon:
reuters.com/article/us-hea…
Read 4 tweets
4 Jan
Full lockdown in Scotland for January. To be clear what is needed is not just stay at home order. Need daily briefings, early community based case finding, rapid testing, contact tracing, supported isolation and quarantines, travel restrictions and a Green Zone Exit strategy.
England lockdown: Need to add daily briefings, early community based case finding, rapid testing, contact tracing, supported isolation and quarantines, travel restrictions and a Green Zone Exit strategy.

upi.com/Top_News/World…
Read 6 tweets
4 Jan
India continues to see progress in reducing both daily cases and deaths. They authorized two COVID-19 vaccines on Sunday.

Several regions are seeing very low case rates. See more on India’s states and union territories here:
endcoronavirus.org/india-states-ut
Israel continues to report rising cases and deaths, as their Health Minister suggests stronger measures: “there is no avoiding a full-blown lockdown, including closing schools.”

timesofisrael.com/health-ministe…

Israel is currently leading the global race to vaccinate their population.
As the UK sees a new high in daily cases, and rapidly rising daily death tolls, Boris Johnson signals 'tougher' measures are ahead for the UK as coronavirus variant spreads.

businessinsider.com/boris-johnson-…
Read 4 tweets

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