Any country or region can eliminate COVID-19 with an action plan to reduce community spread until there are zero cases. Over two dozen countries and some of Canada’s Northern Territories and Atlantic Provinces already have successfully eliminated, or almost eliminated, community transmission. For them, life is largely back to normal. When COVID stops spreading, people stop dying. (statistics below compiled May 1, 2021)
What is Zero Covid?
● Zero Covid is an action plan to eliminate community transmission of the SARS-CoV-2 virus (COVID-19) region by region
● Zero Covid,[1] CovidZero,[2] or No-COVID[3] are terms used interchangeably to describe using science-based public health measures to eliminate SARS-CoV-2 in a region or country until there is zero community transmission in that region.[4]
● Zero Covid is more than flattening the curve — “flattening the curve” can result in a temporary reduction in cases and then exponential growth when restrictions are lifted too soon.
● With SARS-CoV-2’s high transmission rates, especially with the new variants of concern, outbreaks need to be stopped immediately. If new travel-related cases occur, testing, tracing, and isolation can help prevent community spread.[5]
● Just like one glowing ember left in a campfire can start a forest fire, it only takes one COVID-19 case to start a new outbreak.[6]
Why do we Need to Get to Zero?
● Living with COVID-19 in the world is a reality for now. Living with COVID-19 in communities or countries is a choice. We can stop transmission by changing policy.[7]
● If we follow the current path of “lite” lockdowns and re-opening before we get to zero community transmission, we could have further waves of COVID-19 extending well into the future.[8] [9]
● COVID-19 elimination creates the best outcomes for health, the economy, and civil liberties.[10]
● The majority of current COVID-19 cases in Canada are now variants of concern (VOCs).[11] These are identified as more contagious and/or more dangerous even for young healthy people[12] [13] [14] and are possibly more resistant to current treatment and vaccines.[15]
● 50% to 80% of people who had acute COVID-19 continue to have symptoms three months after the onset. Many of these symptoms are serious and can be debilitating.[16] [17] [18]
● Vaccines are a crucial part of the solution, but we also need to stop the virus from spreading further and mutating into potentially even more dangerous and vaccine resistant variants.[19] [20]
● Not going for Zero Covid means a devastating and continual toll on the physical and mental health of Canadians.[21]
● Not eliminating community transmission of COVID-19 is inequitable. Those living in low-income neighbourhoods, those with precarious housing, and Indigenous and racialized communities, many of whom are essential workers, are most at risk.[22] [23] [24]
● Going to Zero Covid has been repeatedly shown to be better for the economy, based on data from several countries including South Korea and Australia.[25] [26] [27] [28]
● Over 24,000 Canadians and over 3 million people worldwide have died from COVID-19,[29] [30] yet some regions in Atlantic Canada, the Northern territories[31] [32] and over two dozen countries have essentially eliminated community transmission. Taiwan, with ⅔ of our population, has had only 12 deaths since the beginning of the pandemic. Many countries who implemented Covid Zero policies have not seen a third wave. Some have not even had a second wave.[33] [34]
What is the Latest Science on Transmission?
● There is consistent, strong evidence that SARS-CoV-2 spreads mainly through airborne transmission through inhalation of aerosols at close proximity to an infected person and further away when ventilation is sub-optimal. While fomite (surface) and droplet transmission may contribute in some circumstances, the airborne route appears dominant.[35] [36]
● Virus aerosols accumulate in an enclosed space over time, and move through the air much like invisible cigarette smoke.[37]
● Viable SARS-CoV-2 can remain infectious in the air for hours and has been documented to infect others up to 15 m away.[38] [39]
● Almost half of all transmission is now thought to be through asymptomatic or pre-symptomatic carriers.[40]
Actions Leaders Can Take to Eliminate Transmission and Get to Zero Covid
There are slight variations in Covid Zero elimination strategies, but the core principles are the same:
● Adopt a proactive Zero Covid Strategy that responds to accurate data and current science with an explicit goal of COVID-19 elimination and communicate it clearly to the public.
● Implement science-informed public health measures such as test, trace, isolate, and support.[41]
● When they are needed, implement lockdowns with a goal to eliminate, rather than reduce, community transmission. Lockdown length should vary according to regional case numbers and rates of transmission and they should always be financially supported
● During lockdowns, only truly essential indoor workplaces, (i.e. grocery stores, pharmacies, etc.) should remain open with strictly enforced COVID-19 safety measures to prevent all modes of transmission, especially airborne.[42]
● All essential workers should have supported access to vaccines, adequate PPE and and paid sick days to address the disproportionate risks these workers face.[43]
● Update standards for air filtration and ventilation in shared indoor spaces to increase air changes per hour using protocols that reflect the current science on transmission.[44]
● Implement effective measures to stop transmission at our borders, including rapid testing and managed quarantine.
● Support other regions and countries in their efforts to eliminate COVID-19. The more regions and countries that implement Zero Covid, the safer everyone will be.[45] [46]
Actions Individuals Can Take to Stop Transmission
Follow your region’s public health guidelines and take extra precautions according to the most recent science:
● Avoid being with people outside of your household indoors unless it is for essential work.
● If you are required to work with others, avoid taking breaks and eating with coworkers in enclosed spaces. Stagger breaks and move activities such as eating lunch, etc. outdoors as much as possible.
● If you must be indoors with people from outside your household, maximize ventilation and air exchange by all means possible, including opening all windows and doors, using air purifiers that operate with basic HEPA air filtration, available extraction fans (in washrooms, above stoves, etc.), improving HVAC systems,[47] [48] and monitoring carbon dioxide levels (CO2) to ensure that the space is adequately ventilated.[49] [50] [51]
● Wear a KN95, N95, KF94 or similarly high efficiency mask/respirator.[52] Ensure the mask/respirator you are wearing fits well to your face to minimize gaps around the edges — you want to breathe through the mask/respirator, not around it.[53]
● When purchasing items, use delivery or pick up items curbside, outside of the store.
● Move activities entirely outdoors (including ventilated washroom facilities) wherever possible. Keep a safe distance and wear a mask when outdoors with those outside of your household.[54]
Advocate for Zero Covid:
· Contact your federal, provincial and municipal representatives and ask them to support Zero Covid
· Sign these open letters to get to Zero Covid Canada:
https://zerocovidcanada.org/take-action.
https://briarpatchmagazine.com/articles/view/suppress-the-virus-now-coalition-statement
RESOURCES:
Canada’s Federal COVID-19 Resource Page https://covid19resources.ca/
Masks, efficacy and where to source them in Canada https://masks4canada.org/
Updates on Data for every region in Canada http://COVID19Tracker.ca
Vaccines, how to get one (in Canada): https://vaccinehunters.ca/
Vaccines, questions answered: on zoom or phone-in options daily from 8–10pm EST https://covid19resources.ca/public/discussions/#VaccineQA
MORE INFORMATION ON ZERO COVID:
National: https://zerocovidcanada.org/
Quebec: COVID-STOP
BC Coalition COVID Zero Backgrounder: https://www.notion.so/COVID-Zero-Backgrounder-9f616de027ba40309691adf0043e85f4
Alberta: Go4Zero
International: https://www.endcoronavirus.org
International: https://zerocovidalliance.org
CONTRIBUTORS:
Gisele Gordon, Author, Writer/Researcher/Media Artist; Critically Reviewed by: Dr. Malgorzata (Gosia) Gasperowicz, Developmental Biologist, Dr. Tehseen Lahda, Pediatrician, Assistant Professor in the Department of Pediatrics in the Faculty of Medicine & Dentistry, Conor Ruzycki, PhD Candidate and Killam Scholar in Mechanical Engineering (specializing in aerosols) University of Alberta
[1] https://thetyee.ca/News/2021/04/02/Canada-One-Big-Pandemic-Response-Experiment-Zero-COVID/
[2]https://www.endcoronavirus.org/papers/covidzerostrategy
[3]https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00186-0/fulltext
[4]https://www.bmj.com/content/371/bmj.m4907
[5]https://www.endcoronavirus.org/papers/covidzerostrategy
[6]https://www.qpbriefing.com/2021/02/11/easing-public-health-measures-will-trigger-exponential-growth-of-variant-cases-ontario-science-table/
[8]https://www.spiegel.de/international/germany/interview-with-virologist-christian-drosten-i-am-quite-apprehensive-about-what-might-otherwise-happen-in-spring-and-summer-a-f22c0495-5257-426e-bddc-c6082d6434d5
[9]https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00143-2/fulltext
[10] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00978-8/fulltext
[11]https://www.ctvnews.ca/health/coronavirus/covid-19-in-canada-variants-now-more-than-half-of-new-cases-modelling-shows-1.5399468
[12] https://www.nature.com/articles/s41586-021-03426-1
[13]https://covid19-sciencetable.ca/wp-content/uploads/2021/03/Science-Brief_VOC-Prognosis_20210329_published4.pd
[14] https://globalnews.ca/news/7731485/covid-variant-cases-young-canadians/
[15]https://www.webmd.com/lung/news/20210318/cdc-who-create-threat-levels-for-covid-variants
[16] https://www.nature.com/articles/s41591-021-01283-z
[17] https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173
[18]https://www.npr.org/sections/coronavirus-live-updates/2021/04/22/989874986/people-with-severe-covid-19-have-higher-risk-of-long-term-effects-study-finds
[19] https://science.sciencemag.org/content/371/6534/1103
[20] https://www.medicalnewstoday.com/articles/coronavirus-variants
[21] https://www.ipsos.com/en-ca/covid-continues-take-heavy-toll-canadians-mental-health
[22] https://www.thelancet.com/article/S0140-6736(21)00215-4/fulltext
[23] https://news.harvard.edu/gazette/story/2021/04/with-covid-spread-racism-not-race-is-the-risk-factor/
[24] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00215-4/fulltext
[25]https://www.institutmolinari.org/2021/04/03/the-zero-covid-strategy-protects-people-and-economies-more-effectively
[26]https://theconversation.com/data-from-45-countries-show-containing-covid-vs-saving-the-economy-is-a-false-dichotomy-150533?
[27]https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/covid-19-saving-thousands-of-lives-and-trillions-in-livelihoods#
[28] https://thetyee.ca/News/2021/04/02/Canada-One-Big-Pandemic-Response-Experiment-Zero-COVID/
[29] https://www.worldometers.info/coronavirus/worldwide-graphs/#total-deaths
[30] https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html
[31] https://covid19tracker.ca
[32]https://www.thestar.com/news/canada/2021/03/18/how-does-canadas-east-coast-keep-weathering-covid-19-reforming-atlantic-bubble-to-mark-latest-victory.html
[33] https://ourworldindata.org/covid-exemplar-vietnam?country=
[34] https://www.endcoronavirus.org/countries
[35] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00869-2/fulltext
[36] https://www.bmj.com/content/373/bmj.n913
[37]https://time.com/5883081/covid-19-transmitted-aerosols/
[38] https://wwwnc.cdc.gov/eid/article/27/6/21-0465_article
[39] https://thetyee.ca/Analysis/2021/04/26/COVID-Variants-Aerosol-Transmission/
[40]https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774707
[41] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00370-6/fulltext
[42] https://covid19-sciencetable.ca/sciencebrief/fighting-covid-19-in-ontario-the-way-forward/
[43] https://www.medrxiv.org/content/10.1101/2021.02.15.21251572v2
[44] https://jamanetwork.com/journals/jama/fullarticle/2779062
[45]https://www.latimes.com/science/story/2021-03-11/perils-of-letting-our-guard-down-against-coronavirus-variants
[46] https://www.endcoronavirus.org/green-zones
[47] https://www.nature.com/articles/d41586-021-00810-9
[48] https://jamanetwork.com/journals/jama/fullarticle/2779062
[49] https://www.sciencedaily.com/releases/2021/04/210407143809.htm
[50]https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/guidance-documents/guide-home-ventilation-covid-19-pandemic.html
[51] https://ricochet.media/en/3423/there-is-still-time-to-address-aerosol-transmission-of-covid-19
[52] https://masks4canada.org/how-to-properly-make-buy-and-use-a-mask/
[53] https://www.youtube.com/watch?v=CoSb-HJJ5tk
[54] https://academic.oup.com/jid/article/223/4/550/6009483?login=true
