Elimination in brief

A national strategy to eliminate COVID-19 in Lebanon is necessary.

What is elimination?
Elimination is the reduction to zero new cases within a geographical area, not to be confused with eradication which is complete and permanent reduction to zero cases worldwide.

Since there is no global definition for COVID-19 elimination, countries can specify this themselves. Effectively, this would mean zero or near-zero cases for a certain time period. We define COVID-19 elimination in Lebanon as having zero new cases for three months. Imported cases are likely to occasionally occur while the disease remains non-eradicated globally. However, these should swiftly be identified and further spread stopped.

Why is it necessary?
We know that it is not possible to ‘live alongside’ COVID-19. Numerous countries have attempted this, either allowing widespread disease transmission or mitigating the spread up to a certain level of daily cases. Such an approach has failed, as case levels are surging in many countries who have attempted this, including Canada, France, Germany, Italy, the Netherlands, Spain, Sweden, United Kingdom, and the United States.

It is not possible to live with any normality alongside such a new viral threat that has multiplicative potential. It is also not possible to effectively shelter vulnerable populations, nor is it ethical to expose society at large to a disease that leads to considerable fatalities, as well as long-term conditions and chronic disease. Within a matter of weeks a few cases could result in a surge that overwhelms hospital capacities, resulting in even greater deaths.

The most successful countries have been those who undertook strong containment and working towards elimination. These include Thailand, Vietnam, China and New Zealand.

Can it work in Lebanon?
Yes it can. The multiple inter-related crises we are facing limit our abilities to counter COVID-19, however, this makes it even more important to pursue strong containment and elimination.

The multiple crises inevitably have an impact in limiting population compliance with counter-COVID measures, especially when people have to struggle to earn their living on a day-to-day basis. A mitigation strategy that relies heavily on compliance is bound to fail. Even in financially wealthy countries this remains a challenge. For example, in the UK only 11% of people in contact with COVID positive persons were quarantining, while only 18% of those who developed symptoms complied with home isolation (Smith et al. 2020).

Lebanon’s hospital capacity is limited and would be unable to cope with the demand for hospitalization and intensive-care-units generated by a large or sustained surge. And considering the multiplicative potential of COVID-19, mitigation would mean constantly dancing close to the capacity limits, and rules out any near-normality in society.

In addition, it is becoming increasingly clear that long-term conditions and chronic diseases are developing among some of the survivors of COVID-19, including damage to the lungs, heart, kidneys, immune and nervous systems.

For these reasons, an elimination strategy is necessary in Lebanon, if we are to attain any measure of near-normality.

Read more at:
Thinking strategically for COVID-19: suppress and lift, to flatten or to crush?
Towards a Zero-COVID Lebanon: A Call for Action
An Endgame for COVID-19 in Lebanon – a Suppression and Lift Strategy: Crush the Curve, Don’t Flatten It.
“Toward a European Network of “green Zones” to Avoid Summer Collapse,” The OECD Forum Network