There’s a progressive way to live with Covid that includes protecting the most vulnerable

'A public debate framed around ongoing restrictions versus an unacceptable right-wing conception of ‘living with the virus’ is therefore profoundly unhelpful.'

COVID

Mike Buckley is the director of the Independent Commission on UK-EU Relations and a former Labour Party adviser

Covid19 is not going away. We have known this basic fact for a long time but somehow the arrival of the Omicron variant has brought that grim reality home.

To make matters worse, not only is the virus not going away it is still finding new ways to mutate in ways which severely impact our immune system’s ability to keep it at bay, whether we gained immunity from vaccinations, a previous infection or both.

Many people who believed they were unlikely to be infected, reinfected or to become severely ill if they were unlucky enough to get ill, are now realising that avoiding this virus in the long run will be hard to do.

As US health reporter Helen Branswell put it in an interview this week, “I think we all have a date with COVID at some point. I just want to make sure that mine occurs when I have enough immunity on board that it’s just an inconvenience and not a serious health threat.”

That means coming to terms with the fact that avoiding the virus forever is not going to be feasible. All the more if the next, post Omicron, variant is even better at evading existing immunity than Omicron is today.

There are things we can do to make a new variant less likely. Gordon Brown has written, not for the first time, on the need for rich nations to invest in vaccinations for poorer nations, including the African nations where Omicron is thought to have originated.

“The new variant is not Africa’s fault,” he wrote in The Guardian. “Responsibility starts with the governments of wealthy nations that stockpiled hundreds of millions of vaccine doses and that, even when warned about the failure to vaccinate more vulnerable parts of the world, did too little as the virus mutated.”

Brown is right. Omicron should be proof that vaccinating rich nations’ populations is not enough, and that patent waivers and meaningful numbers of vaccine donations need to be actioned urgently if we are to reduce the likelihood of a yet more dangerous variant arriving months from now.

But even if the Western world’s governments do finally wake up to the futility of their current strategy one thing remains true: we will be living with this virus for decades and in all likelihood for the rest of our lives. There is no putting the genie back in the bottle, which means variants will keep coming, even if we can slow them down. Whatever we do next has to be seen in that context.

For some this means accepting defeat and pretending that we have no option but to open society and brace for the consequences. This is what politicians and commentators mean when they say that we must ‘learn to live with the virus’. The brutal implication is that some will live while huge numbers, including those most vulnerable such as the immuno-suppressed, elderly and already sick, would die.

This strategy also takes no account of the millions who would become ill for months or longer with Long Covid19. The NHS would be overwhelmed with the dying and the long term sick. The economy would grind to a halt as people learned to live in a society where only rarely would they feel safe enough to venture out to bars, pubs and social events.

For most of us this strategy is unacceptable. We care enough for ourselves, our family and friends, and the more vulnerable in our communities, to realise a better path must be found.

The good news is that it is available. In the short term we know how to control this wave and any that follow it. Scientists are clear that vaccinations are not enough and should be supplemented with masks, distancing, ventilation and support for those self-isolating.

That the Government remains unwilling to follow this advice, despite being two years into this, is the main reason in our case, hospitalisation and death numbers are among the worst in the developed world.  

In the medium term there is at least qualified good news. Immunity may not be working as we had hoped. Previous infection or vaccination does not guarantee that someone will not become infected or even that serious illness or worse will be avoided.

Nonetheless early evidence from South Africa suggests that Omicron causes – for most – a “milder” disease than prior strains. Their surge in cases was not followed by the expected surge in hospitalisations and deaths. Part of that may be due to specific mutations, but part is likely to be due to levels of immune memory in the population.

If that effect holds true elsewhere, says Yale public health lecturer James Hamblin, we should be reminded that preventive efforts do matter. We are effectively making this disease milder. We are beating this virus in ways not reflected by case numbers.

The fact that most people who are hospitalised or die are unvaccinated, while an uncomfortable truth, should also encourage us to see this as a battle we can win. Every choice to wear a mask, stay away from a crowded space or isolate before seeing a vulnerable person gives us more time to vaccinate the unvaccinated, boost the unboosted and install ventilation in schools, care homes and other public settings.

A public debate framed around ongoing restrictions versus an unacceptable right-wing conception of ‘living with the virus’ is therefore profoundly unhelpful.

It removes the possibility of a discussion of the one humane way ahead we have before us: doing all we can to increase population immunity in the safest way possible, which means vaccinations and boosters, while making our public spaces as safe as we can, which means masks and distancing in the short term and large scale investment in state of the art ventilation systems for the medium and long term.

This is why it is so damaging that the Government have wasted 18 months in which they could have been installing ventilation systems in schools and other public buildings, at the same time requiring hospitality venues to do the same. We know they work. Many developed nations – and many poorer ones too – began investing in school ventilation in summer 2020. Here in Britain we have not even begun. The same is true with vaccinating children.

There is no denying there are dark days ahead. Omicron is upon us. Millions remain unvaccinated. Scientists tell the Government that waiting for more data on Omicron will mean it is too late to prevent a devastating next wave, yet the Government still sit on their hands. It is not hard to predict what comes next.

But looking further ahead the path out of this, a progressive version of ‘living with the virus’, if you will, is clear. It means vaccinating all who are willing, including children. It means partnering with other nations to vaccinate the world as quickly as we can, if necessary advocating for a temporary patent waiver to ensure the farthest reach of available vaccines.

It means investing in ventilation and making it easier to socially distance in public spaces including schools, hospitals, transport hubs and offices. It means accepting vaccine passports for now to ensure that public spaces are as safe as possible, and to send the message to the unvaccinated that their choices have consequences.

As Omicron passes and immunity gradually rises – ideally through vaccination and where unavoidable through infection – we should reach a point where for most contracting Covid19 holds little fear. The hard truth is that it is unlikely to stop taking lives in our lifetimes, but the good news is that the number of those losing their lives is likely to dwindle to a level that as a society we accept just as we accept annual flu deaths.

For now we should do all we can to slow infections. The more we flatten the curve the less hospitals will become overwhelmed and the more time we buy to vaccinate the unvaccinated, including children. Letting the virus rip through unvaccinated people may get us to endemicity quickest, but it will also kill the most people along the way.

What this means for those of us opposed to the right’s version of ‘living with the virus’ but who also do not relish recurrent lockdowns is that we must speak up for a more progressive agenda. There is a way through this pandemic which minimises loss of life and long term ill health and which, in the end, gets us as close to safety as possible in a world where Covid19 persists.

For us to get there our Government – and the world’s governments – need to make better choices. It’s up to us to help them get there.

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