Policy analysis of suppression and mitigation strategies in the managementof an outbreak through the example of COVID-19 pandemic

Abstract

Objective: The objective of this study is to review the containment approaches adopted by countries to control COVID-19 pandemic. In our analysis, we have used Bacchi’s framework for interpretive policy analysis and examined the measures countries have taken and discussed the premise underlying containment strategies. We have included in our analysis United States of America, United Kingdom, Netherlands, Sweden, Denmark, Norway, Germany, Italy, Turkey, South Korea, Singapore, Japan and China. There are essentially two strategies that are used in the management of an outbreak: suppression or mitigation. Suppression strategy aims to lower the basic reproduction number (Ro) below 1 and thereby reduce the number of infected people or eliminate the person-to-person transmission. Mitigation approach, on the other hand, aims to generate community (herd) immunity by allowing the controlled infection of people. In this approach, the aim is not to bring Ro under 1 but to mitigate the health effects of the outbreak. It is seen that given the epidemiological features of the disease, the scope of the virus, and the limitation of the intervention resources at hand, the suppression approach is accepted more widely by the countries in terms of Covid-19 pandemic. In contrast, the mitigation strategy is approached with suspicion. The approach aiming to achieve herd immunity seems more suitable for situations in which it is possible to protect the high-risk groups by administrating vaccine. These evaluations should be carried out following the circumstances of the country in question. It is essential to form an evidence-based plan that is appropriate for the national context. It should be kept in mind that the solutions for the fight against the virus do not solely consist of those ready-made implementations by choosing one option over the other and that mixed models could be brought to the agenda when required.