We can live with the virus? This is dangerous wishful thinking

Humans have ‘lived with’ awful diseases indefinitely before. It is not an outcome to choose

Despite the clear evidence that Covid is airborne, the Department of Education has not mandated any mask for primary school pupils, nor high-quality FFP2/N95 masks for all pupils. Photograph: iStock

Despite the clear evidence that Covid is airborne, the Department of Education has not mandated any mask for primary school pupils, nor high-quality FFP2/N95 masks for all pupils. Photograph: iStock

 

When will this end? If wishful thinking could solve problems, Covid-19 wouldn’t have spread to Europe and other countries, and would have instead been like the first Sars virus, which didn’t make a significant impact here.

Or, it wouldn’t have spread beyond Italy. Or after our first lockdown eliminated the initial wave we wouldn’t have reimported it, starting off the whole awful cycle of exponential growth in cases and emergency lockdowns again. Or new, more infectious variants wouldn’t keep emerging.

If wishful thinking worked, we would have got away with crossing fingers and hoping that the Delta variant wouldn’t arrive in Europe and spread so fast.

We have lived through multiple occasions where we hoped for the best but didn’t adequately prepare for the worst, and this has not served us well.

The latest manifestation of wishful thinking is the idea that we can “live with the virus”, with the declaration that it will become, or already is, endemic, like flu. Many people use “endemic” to imply a mild disease with low case levels. But this is not what endemic means (endemicity simply means that the disease has a constant baseline level). Neither of these outcomes is guaranteed or even to be expected. Having already seen the virus evolve to be more transmissible, and partly vaccine resistant, multiple times in the space of a year, it would be foolhardy to bet on that not happening again.

People assert, with enviable confidence, that all infectious diseases become milder over time, but many examples – such as smallpox, polio, measles and cholera – contradict this wishful thinking. Humans have been “living with” malaria since prehistoric times, and it remains a deadly disease that cuts short the lives and blights the prospects of hundreds of thousands of people every year. Others state confidently that humans will adapt to the virus, but I doubt that, when saying this, they are aware that this is survival of the fittest, a scenario involving a great deal of death. This is a costly, and very slow, adaptation.

Wish it away

What seems to be at the root of these kinds of comments is a wish for all of this to be over – for us to be relieved of the mental and physical burdens of this pandemic. We have spent so much energy trying to make assessments of what is safe for us, or our loved ones, to do; contriving and arranging our surroundings to try to minimise the risks; caring for family members and friends who became sick with Covid, or are medically vulnerable; worrying about those who are sick with something else, the management and treatment of which has become harder, and where the waiting lists have become longer. This is exhausting.

The Irish people have been amazing through all of this. Our compliance with lockdown measures was generally excellent, and our vaccination uptake is the envy of the world. But we should not let the knowledge that things could have been worse distract us from the fact that it didn’t have to be this bad.

How can we justify exposing our children to the risk of disease and long Covid when there are such simple steps we could take to make it safer?

While the Irish people have done all that was asked of them and much more than could have been expected, the same cannot be said for our Government. Despite many claims to the contrary, the Government has not taken the evidence-based decisions that could have had us living without the endless daily burden of Covid restrictions.

The preparations for the return to school are a case in point. Despite the clear evidence that Covid is airborne, the Department of Education has not mandated any mask for primary school pupils, nor high-quality (FFP2/N95) masks for all pupils, nor have they provided clear guidelines on acceptable ventilation standards and Hepa filtration to ensure good air quality.

Never before have our children been congregated in school with such high levels of Covid in the community. These cases are concentrated in the unvaccinated, which is now predominantly the younger population, for reasons quite beyond their control. These are the very groups who are about to return to mass gatherings in the form of classes and lectures over the coming weeks.

Simple steps

How can we justify exposing our children to the risk of disease and long Covid when there are such simple steps we could take to make it safer? It is not enough to hope that the academic year will go smoothly – we need to actively make it safer by interfering with the virus’s ability to transmit from person to person.

One way to picture the end of the pandemic is as the end of the daily burden of having to worry about Covid and carry intrusive mitigation measures. This could be achieved if we managed Covid like we manage measles. This isn’t something any of us feels in our daily lives, yet we have successfully eliminated the otherwise endemic measles virus from Ireland through a combination of a population vaccination programme and well-resourced public health monitoring and containment. For Covid this would additionally include air-quality standards (with the added bonus of being effective no matter the variant and no matter the airborne disease) – and who doesn’t like fresh air?

If we persist in simply wishing this were already over, instead of taking the evidence-based steps to actually block transmission and actively end this, then we might find ourselves having these same conversations again and again in coming years. That is something I really wish will not come to pass.

Aoife McLysaght is professor in the Molecular Evolution Laboratory of the Smurfit Institute of Genetics in Trinity College Dublin

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