SUPPRESION, ELIMINATION, ERADICATION

Suppression of a virus means reducing the number of cases to a level seen as acceptable to a
country’s government. Community transmission continues. A higher rate of death and disability
caused by the virus is accepted. The damage to the economy in the long term is greater, along with
all its impacts. Inequality in particular is exacerbated. The policy difference between an elimination
strategy and a suppression strategy lies in the strictness and timing of restrictions and the extent to
which the public health system has been adequately resourced to find, test, trace, isolate and
support people infected with the virus and their contacts. This is effectively the UK policy, which at
the time of writing has led to 4.2 million cases and 123,000 deaths.

Elimination of a virus means that there is no ongoing community transmission in a country or region.
Cases and small outbreaks still occur, imported through travel, but they will not lead to sustained
community transmission if there is a good public health system which can quickly stamp out spread.
Elimination can be achieved in any relatively rich country through:

• Reducing transmission to zero by temporary restrictions, including closure of non-essential

workplaces
• Permanent improvement of virus safety in all workplaces (more space, improved ventilation
and high-standard personal protective equipment)
• Setting up border controls
• Stamping out any new outbreaks
• Supporting international efforts to reduce transmission globally

The measles virus has been eliminated from the UK despite mutating more rapidly than Covid-19.
This is the policy that has been applied to Covid-19 in New Zealand and has resulted, at the time of
writing, in 2,384 cases and 26 deaths. This is the policy promoted by the Zero Covid Campaign.

Eradication of a virus means that it no longer exists globally, except in laboratories. This has only
been achieved for smallpox. It is unlikely that eradication of Covid-19 can be achieved for three
reasons: people without symptoms can spread the virus, countries are too interconnected globally,
and there are animal hosts.