The benefits, costs and feasibility of a low incidence COVID-19 strategy

In the summer of 2021, European governments removed most NPIs after experiencing prolonged second and third waves of the COVID-19 pandemic. Most countries failed to achieve immunization rates high enough to avoid resurgence of the virus. Public health strategies for autumn and winter 2021 have ranged from countries aiming at low incidence by re-introducing NPIs to accepting high incidence levels. However, such high incidence strategies almost certainly lead to the very consequences that they seek to avoid: restrictions that harm people and economies. At high incidence, the important pandemic containment measure 'test-trace-isolate-support' becomes inefficient. At that point, the spread of SARS-CoV-2 and its numerous harmful consequences can likely only be controlled through restrictions. We argue that all European countries need to pursue a low incidence strategy in a coordinated manner. Such an endeavour can only be successful if it is built on open communication and trust. Copyright (C) 2021 The Authors. Published by Elsevier Ltd.

Automated summary

In the summer of 2021, European governments lifted most NPIs due to prolonged waves of COVID-19. However, without achieving high enough vaccination rates, the virus re-emerged. Different countries have adopted various public health strategies for autumn and winter, either aiming for low incidence through re-introducing NPIs or accepting high incidence levels. The study argues that a coordinated low incidence strategy is necessary, built on open communication and trust.