Learning to live with coronavirus

The start of the mass rollout of coronavirus vaccines promised a clear path out of the health and economic crisis that has gripped the world for the past 12 months. The emergence of mutated strains, particularly the South African variant and concerns over the effectiveness of the Oxford/AstraZeneca vaccine against it, has shifted the debate about how straight that path might be. The question now is not how quickly we go back to normality but what kind of normality that will be. The ever-changing threat that the virus presents means that some aspects of pandemic life may be here for the medium or even the long term. Any remaining hopes for the speedy eradication of Covid-19 look fanciful. 

It is a sobering message. Millions of people, including in the UK and Europe, are still living under extensive restrictions to stop the spread of the virus. The economic and societal damage, in the form of closed shops and restaurants and, in many countries, schools, is painfully evident. It is a reminder that the fight against Covid-19 is not a one-off battle with a definitive end point. Policymakers as well as the public need to be realistic about what is achievable in the long run. The world has learnt to live with flu, which kills some 500,000 people worldwide in an average year. In much the same way, the NHS in the UK has said it plans a mass campaign of booster jabs akin to annual flu jabs to help stay ahead of Covid-19 as it keeps mutating. 

The prospect of living with coronavirus in some form raises important considerations for public health policy. The most important is that it should not be taken as a green light to the lockdown sceptics. This is not the time to give up on social distancing measures and let the virus take its course. The overriding aim must remain to cut transmission rates. The lower the rates, the lower the probability of the virus mutating. It is also imperative that public confidence in vaccination programmes is not undermined. Vaccine hesitancy among adults remains an issue everywhere. In the UK, where the AstraZeneca vaccine is the mainstay of the government’s vaccination rollout, experts on Monday stressed that it is still likely to offer significant protection against serious illness from the South African variant.

The arrival of more dangerous mutations strengthens the case for greater global co-operation. The more widespread infections are allowed to remain globally, the greater the chance that more mutations will appear, ultimately reducing the efficacy of vaccines. A co-ordinated programme, involving more intensive genomic surveillance, will be needed to keep track of the virus and new mutations — both worldwide and at national and regional levels, to clamp down on local infections as soon as they occur.

Just as important is the development of new antiviral drugs that work against Sars-Cov-2. The pharmaceutical industry and governments have, rightly, thrown resources at developing vaccines but they should not neglect the therapeutic avenue. The spread of HIV has been controlled through the use of antiviral drugs. In addition, governments should target research and development efforts to help produce vaccines that can be adapted to prevent infection by the new variants. Genetic jabs using new mRNA technology will be particularly useful here.

None of this will be cheap. But the amount of money required is trivial compared with the human cost of failing to invest. Vaccines, drugs and surveillance offer a path back to something like what life was like before the pandemic, but it will not be a smooth nor speedy voyage.