Scoring the feasibility of covid-19 eradication using smallpox and polio as benchmarks

Aim: Given the availability of both public health and social measures (PHSMs) and safe and highly-effective vaccines against covid-19, we aimed to assess the feasibility of covid-19 eradication, relative to the benchmarks of smallpox and polio (albeit only 2 of 3 polio serotypes eradicated to date). Methods: Our scoring system was partly based on previously published factors favouring the eradicability of vaccine-preventable diseases. But it was also supplemented by additional technical, socio-political, and economic factors that we considered relevant. Results: On our scoring for eradication feasibility using a three-point scale and across 17 variables, the mean (total) scores were smallpox at 2.7 (43/48), then covid-19 at 1.8 (30/51), and then polio at 1.5 (26/51). More specifically for covid-19 eradication, animal reservoirs may potentially prevent it; but the main challenges are probably around the high upfront costs and achieving international cooperation. Nevertheless, an advantage for covid-19 eradication over these other diseases is that effective PHSMs can complement vaccination and there is very high global interest in covid-19 control (due to the massive scale of the health, social and economic burden). Conclusions: In this preliminary analysis, the feasibility of covid-19 eradication globally seems slightly more feasible than for polio, but much less than for smallpox eradication. There is a need for a more formal expert review of feasibility and desirability of attempting covid-19 eradication by the World Health Organization or coalitions of national health agencies.