If containment is not possible, how do we minimize mortality for COVID-19 and other emerging infectious disease outbreaks?

Andreas Handel; Joel Miller; Yang Ge; Isaac Chun-Hai Fung

This illustrates the importance of factoring in mortality among specific groups when deciding on the type of interventions to implement. Of course, it is worth emphasizing that there is still large uncertainty about the combined impact of our available interventions on the spread of COVID-19. The speed with which COVID-19 initially overwhelmed health systems in many countries, as well as the ability of several countries, to drive cases down successfully, suggests that the current best approach is to implement all feasible interventions against COVID-19 to suppress the disease. As the situation is monitored, it will become clear if we can accomplish elimination. If this is unlikely, and we are in a situation where interventions cannot be sustained long enough to prevent a resurgent epidemic, some interventions should be relaxed. Mitigation should then focus on allowing 'controlled spread' toward herd immunity in such a way that the most vulnerable populations are protected most, and the health care system remains functional. This might mean re-opening schools before re-starting other activities mainly frequented by adults or the elderly.