More and more people have been asking for a return to normal, and with omicron waning, governments are starting to act. The UK, for example, is removing its remaining public health measures, including mandatory self-isolation of COVID cases and free testing. However, the inescapable truth is that—unless the virus mutates to a milder form—the “normal” life we are returning to will be shorter and sicker on average than before.
We’ve added a new significant disease to our population. COVID is often compared to flu, as if adding a burden equivalent to flu to a population were fine (it isn’t). In fact, COVID has been and remains worse. COVID’s infection fatality rate—the proportion of people who die once they’ve caught it—was initially about ten times higher than for flu. Treatments, vaccines and prior infections have since brought the fatality rate down, but it’s still almost twice as high as for flu—and yes, this still holds for omicron.
The impact is then worsened because COVID is so much more transmissible. It also has a similar or worse longer-term impact on the heart, lungs and mental health than other respiratory diseases, and a higher rate of long-term symptoms. Vaccines have been incredibly effective at reducing severe illness and death, but they’re not perfect. New variants have tested vaccine defenses, and protection against infection—and to a lesser extent severe illness—wanes after a few months.
While we’re unlikely to lose all protection against severe illness and death, the sort of return to normal being attempted in countries such as the UK, Denmark and Norway will result in many people facing repeated COVID reinfections over the coming years. The large majority will cope, but some will die, and more will be left with lasting ill health. Many with mild illness will still need time off work or education, and as we have seen with omicron, the aggregate effects can be hugely disruptive.
In short, the world pre-2020 no longer exists—we may want it to, but it just doesn’t.
How to live post-COVID
The last 150 years have seen vast improvements in public health, with dramatic reductions in deaths from malnutrition, infectious diseases, environmental diseases, smoking and road traffic accidents to name a few.
For communal problems we have developed communal solutions, from vaccines to controls on pollution, passive smoking, unsafe driving and other ills. There’s nothing normal about upending decades of progress by simply accepting a serious new disease like COVID without actively attempting to mitigate it.
The good news is that we can mitigate it. We can accept that the world has changed and make adaptations based on what we have learned from the last two years. Here are eight key changes that can reduce the future impact of COVID:
Such plans should enable us to avoid long widespread lockdowns. Refusing to learn to live with COVID by pretending the old normal exists is in fact the biggest risk for future lockdowns.
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