There cannot be many people who wouldn’t want to return to the carefree ways of 2019. To be free from the concern that you might unknowingly spread a deadly disease to a loved one, a friend or the person next to you on the bus.
I’m afraid I have bad news for you, though. Our pre-pandemic world is gone, and it’s never coming back. We have a new disease in our midst. Despite the frequent comparisons, and contrary to what some would have you believe, COVID is not flu. It is both more transmissible and more severe.
We can’t hope to behave exactly as we did before COVID and expect the consequences to be the same. The outcome of going “back to normal” is that millions of people will catch COVID each year; businesses and schools will face regular disruption; and we will have a population that is generally less healthy than before the pandemic. This is distinctly not what normal life used to be like.
This is why the Westminster government’s proposals to remove free testing, scrap self-isolation for people with COVID and do away with the UK’s genuinely world-leading COVID surveillance systems are of such concern.
Mathematician John Edmunds, who sits on the government’s scientific advisory panel, Sage, confirmed last week that removing the legal requirement for self-isolation had not been discussed within the advisory group. Edmunds warned that axing this fundamental COVID-suppressing measure would be dangerous.
If the proposed moves haven’t come from the government’s own scientists, then where have they come from? These decisions appear to be politically motivated rather than guided by science and public health interests – moves designed to win favour with the public by restoring “freedoms” and to distract from the ongoing partygate scandal engulfing Number 10.
But on this, it seems that the government may have misread the room. A recent YouGov poll asked: “Do you think people should or should not be legally required to self-isolate if they test positive for COVID-19?” Only 17% of those polled said they thought people shouldn’t legally have to isolate.
Self-isolation is one of the most effective measures we have to limit COVID’s spread. Only those who actually have the disease are asked to isolate, making it one of the least restrictive disease-control measures on society as a whole.
And it’s not as if isolation for infectious diseases is without precedent. We exclude children from school when they have chickenpox, norovirus and E. coli among other infectious diseases. For vomiting and diarrhoea, you shouldn’t go in to work until 48 hours after the last episode. Despite relatively few people dying from vomiting and diarrhoea, it’s generally considered desirable to try to prevent the spread of a transmissible illness.
Many infected with COVID will be too ill to work even if the legal requirement to self-isolate is removed. Relaxing this requirement will not instantly solve the current COVID-related staffing crises many sectors are experiencing. Encouraging people to work while infectious will only serve to increase transmission and may lead to a spike in infections.
The irony in all this is that, with the removal of free COVID testing and the proposed dismantlement of the UK’s gold-standard infection survey, we may not even know if such a spike materialises. No government interested in protecting the health of its people can seriously believe it’s better to be less informed when it comes to tackling an infectious disease.
While some will welcome the removal of COVID monitoring as marking the pandemic’s end, what it really signifies is an end to caring about the people who will become infected. For a significant minority – the clinically vulnerable, elderly and children (the majority of whom are unvaccinated) – this will make life much more uncomfortable.
For these people, and many more besides, the clamour to “live with COVID” seems misplaced. We don’t reach a level of road traffic fatalities below which we decide to remove seatbelts, increase speed limits or raise the legal blood alcohol limit. Instead we continuously try to reduce traffic accidents with measures that don’t impinge too heavily on people’s lives. We should be trying to do the same with COVID. There may come a point when it’s appropriate to remove the remaining measures, but the scientific consensus is that we’re not there yet.
In the meantime, there are things we can do to restore as much of our pre-pandemic life as possible while minimising the disruption and ill health caused by COVID. Improving air quality through ventilation and filtration can dramatically reduce the risk of transmission in indoor settings. Getting the whole world vaccinated will not only protect people from severe illness but will reduce the potential for new variants to emerge. Improved sick-pay policies will help reduce presenteeism and mean people don’t have to choose between infecting colleagues or potentially losing their job.
Perhaps most importantly, we need a plan for how we will act to limit the impact of another wave – measures we can put in place rapidly to avoid the lockdowns that characterise the failure of public health measures. At a time when the UK is looking to scale down its COVID-surveillance capacity, we should be doing the opposite: ensuring we have the earliest possible warnings about new variants and indeed other emerging diseases.
If we want to talk about “learning to live with COVID”, then we have to demonstrate that we have learned from our experiences over the last two years. We should be striving to make improvements that will reduce the impact of COVID for all. If we close our eyes and pretend that nothing has changed – hoping for the things to return to how they were – then we will inevitably find ourselves in a new normal that is significantly worse than the old.