Covid. Permanent suppression or truly learning to live with it?

[GaolBhoAlba]

Interested to see where people are at, as we go into our third year of the suppression approach.

Its taken a while, but most have accepted that coronavirus is here to stay, and that restrictions serve only to suppress (they cant/wont eradicate). We hear the theory (and the phrase) 'learning to live' with it, but in practice we're nowhere near to learning to live with it. Indeed, we're still behaving as though we can eradicate it via repeated 'short term' suppression. Current thinking is as it was in March 2020 ie that if we suppress it for 'just a bit longer' it'll go away. It wont. Clearly we cant continue swinging between 'living with it' and 'suppressing it' - the uncertainty of a continued stop/start for business, education (planning life in general!) etc isnt feasible as a long term strategy; we need to decide one way or another.

So... are you in favour of accepting that our current way of living must become permanent and (obviously this list is not exhaustive) masks, distancing, limits on mixing, one way systems etc are how we must live now. Funding to support business/furlough is made permanent and we all pay extra to support same (because I suppose the alternative is hospitality businesses just close? Become part of the bygone era). Remote learning in schools is a fixture (and that will be based, not on illness, but on isolation rules) every time there is a peak (and funding will need to be, I dont know, redirected from schools to parents in order to allow this). WFH is made permanent and, again, funding redirected to allow same.
Or... are you in favour of truly 'learning to live' with it, relying on vaccine to do the heavy lifting (thus not counting cases and accepting, as with flu, hospitalisations and deaths), scrapping track and trace, scrapping isolation (thus allowing asymptomatic people - including teachers and NHS staff to live/go to work normally) and essentially returning to life as it was in 2019.

YABU - in favour of permanent suppression.
YANBU - in favour of truly learning to live with it.

@Squirrelblanket tbf covid is the straw that broke the camels back re: comparisons to previous years flu/winter demands. I’ve never known it to be so common to be advised that ambulance wait times can be hours. In October my elderly father had a heart attack and fall and we were advised that an ambulance would be up to two hours. My story isn’t uncommon and I dread to think what things are like now with much higher levels of staff absences.

We’ve (the collective UK we - I’ve personally not voted Tory) pretty much consistently voted for this, I’m in my forties and labour were only in power for thirteen years of my lifetime, the tories have had a damning hand in a lot of what we’re experiencing today.

@TeeBee

I'm in favour of removing restrictions, removing isolation and instead funding the NHS properly to deal with the percentage of people who will end up hospitalised.

How does that work then?

You can throw money about all you like, it still won't instantly create more healthcare professionals to actually care for people.

It isn’t a black and white decision, suppresssion v no suppression.

The Scientists are saying that hopefully Covid will become an illness that we live with like flu but even with flu, if a new strain was as transmissible as Covid and had the impact Omichron is having on hospitals and essential services,, then we would be taking measures to suppress it. The existing pandemic plan was for exactly that scenario. High case numbers come with an economic cost too, businesses in London have been hit badly by this wave without enough corresponding support and I know we will now lose several local independent businesses.

However much people want to go back to “normal” as a society we have to respond to the level of threat we face. It may be that this milder version has peaked and the current NHS crisis, especially in our local hospital , will not worsen as a result of people socialising at New Year and getting back to school etc. That the level of threat will recede to the point where we manage it like normal flu. Or it might not, and the whole country could face the problems London already is. We can’t know for certain what is coming in two weeks, let alone two months or two years.

Clearly with vaccines (and new and better ones in development) we are not where we were a year ago and that is a hopeful sign that we will never have to go back to the sort of full and disastrous lockdowns we have seen (and which could have been avoided if earlier and more effective suppression had kept case numbers down) . Though our local care homes are suffering staffing problems they are not getting outbreaks amongst residents which is a very hopeful sign.

However we do need to keep monitoring the situation, and especially learn the lessons and develop public health strategies to more successfully minimise the future threat of either more transmissible / deadly variants of Covid or entirely new viruses, just as Asian countries did after SARS and therefore have had a more effective response with less economic damage.

I would like to see that strategy guided by Science not ideology. At the moment we are being guided by a bunch of science denying right wing libertarians who hold too much power over their leader (whoever that leader might be since all the candidates are dancing to their tune) and ideology is guiding strategy.

OP your question is not properly put as it rules out the option, well articulated by your first respondent, for a blended approach. It is plain you do not agree with that approach (and your reasons are perfectly valid and possibly even cogent). But in raising the legitimate questions you do, you have ruled out that others, for decent reasons, may espouse a blended approach.

It is perfectly value for you to reject a blended approach. But it is not really making your discussion susceptible to intelligent debate for you to decide that such a plan is off the table even for discussion.

The trouble with AIBU, for important subjects of public policy, is the binary nature of the choices. It is much more nuanced than one option is unreasonable and the other not.

@Lavender24

can you imagine in the second world war people refusing to black out because they are bored of it?

A bombing isn't really comparable to what is now essentially a common cold though is it?

Let’s not forget how much Spanish flu was underplayed in order to keep the war effort going…

But yes I can’t imagine a virus with a 99% survival rate, which most of the country has been inoculated against, would bring the country to a house arrest standstill even 30 or 40 years ago.

I think a mixture of both will be needed, tbh. We can live with it until it gets to the point that hospitals are at risk of becoming overwhelmed and essential services start to buckle because of the number of people off sick and then take measures to mitigate transmission.

That requires careful management though, because of the time lag between infection and symptoms/hospitalisation. Because of the mutable nature of viruses, we can't rely on vaccination being effective on new variants.

Eventually, I think it will be like flu, where there will be an updated vaccine every year and the only people who get ill will be the unvaccinated and those unlucky enough to get a new variant. And I have no objection to wearing a mask in shops and other buildings to protect people.

We certainly can't afford to have almost 2,000 people a day being admitted to hospital, like there were the other day.

And imo Long Covid may turn out to be the elephant in the room. That's potentially a very big unknown.

As to just funding the NHS to deal with it, the fact is that our local hospital is in a state of emergency for two reasons. Firstly the level of Covid admissions, yes they are less ill or have been admitted for other reasons and turn out to have Covid but they are still taking up beds that have to be isolated from the rest, cared for by staff in PPE and infecting staff who are then absent. You can’t compare this to normal winter pressure because flu is not as transmissible. The second problem is that social care is in crisis, not just in terms of staff shortages due to sickness but also long term issues of funding exacerbated by Brexit. NHS Wards are jammed by elderly dementia patients with issues that would be better cared for with the specialist care available in fully staffed and funded care homes. I believe that should be via taxation including of the wealthy elderly (which will be me). The nettle no government has been prepared to grasp.

There are plenty of things they could be doing that would be beneficial for a post covid world while also reducing numbers. Air filtration in schools, better active transport infrastructure to encourage walking and cycling, an effective anti obesity campaign that targets the real causes like poverty, lack of cooking skills, supermarket promotions.

They're finding better ways to treat covid all the time, I'd far rather live a slightly restricted life and get it in a few years when the hospitals are not stuffed and they know more about things like preventing long covid.

Not even Starmer

[quote Julieandthejets]@Whichjab my previous post was in reply to your claim about covid killing more brits than WW2 eye 🙄[/quote]
She didn't say what you claim she said. She was talking about civilian deaths. Your statistics prove her correct.

@LadyMacbethWasMisunderstood

OP your question is not properly put as it rules out the option, well articulated by your first respondent, for a blended approach. It is plain you do not agree with that approach (and your reasons are perfectly valid and possibly even cogent). But in raising the legitimate questions you do, you have ruled out that others, for decent reasons, may espouse a blended approach.

It is perfectly value for you to reject a blended approach. But it is not really making your discussion susceptible to intelligent debate for you to decide that such a plan is off the table even for discussion.

The trouble with AIBU, for important subjects of public policy, is the binary nature of the choices. It is much more nuanced than one option is unreasonable and the other not.

A blended approach sounds very appealing. I think the majority of us would go for that IF it was possible. How does the blended approach work in practice? Ive not seen any proposition to a 'blended' approach that doesnt bring the same issues associated with the permanent suppression approach?

@GaolBhoAlba

Interested to see where people are at, as we go into our third year of the suppression approach.

Its taken a while, but most have accepted that coronavirus is here to stay, and that restrictions serve only to suppress (they cant/wont eradicate). We hear the theory (and the phrase) 'learning to live' with it, but in practice we're nowhere near to learning to live with it. Indeed, we're still behaving as though we can eradicate it via repeated 'short term' suppression. Current thinking is as it was in March 2020 ie that if we suppress it for 'just a bit longer' it'll go away. It wont. Clearly we cant continue swinging between 'living with it' and 'suppressing it' - the uncertainty of a continued stop/start for business, education (planning life in general!) etc isnt feasible as a long term strategy; we need to decide one way or another.

So... are you in favour of accepting that our current way of living must become permanent and (obviously this list is not exhaustive) masks, distancing, limits on mixing, one way systems etc are how we must live now. Funding to support business/furlough is made permanent and we all pay extra to support same (because I suppose the alternative is hospitality businesses just close? Become part of the bygone era). Remote learning in schools is a fixture (and that will be based, not on illness, but on isolation rules) every time there is a peak (and funding will need to be, I dont know, redirected from schools to parents in order to allow this). WFH is made permanent and, again, funding redirected to allow same.
Or... are you in favour of truly 'learning to live' with it, relying on vaccine to do the heavy lifting (thus not counting cases and accepting, as with flu, hospitalisations and deaths), scrapping track and trace, scrapping isolation (thus allowing asymptomatic people - including teachers and NHS staff to live/go to work normally) and essentially returning to life as it was in 2019.

YABU - in favour of permanent suppression.
YANBU - in favour of truly learning to live with it.

It’s not until your last sentence that ‘NHS’ gets a mention and then only in the context of staff’s way of life. Until we can get the medical system on a safe and stable footing there is no alternative but to accept that we must have a management plan.

Of course we are going to learn to live with it, just like the Spanish flu. We just need to do it in the right way at the right time, and rushing into it would be incredibly foolish.

Pandemics usually happen roughly every 80 years, we have been lucky in that this one was overdue. I don't see anyone still taking precautions because of any of the previous ones.

I am not here to argue for a blended approach. Merely stating my view that in opening your discussion, it diminishes the argument if some options are off the table even for debate.

I think the answer depends entirely on whether the health service can cope with it or not. If it can, then we can live with Covid in the same way we live with other viruses. If it can’t, we need measures to curb it. It’s in no one’s interests for the NHS to collapse.

It seems to me that the problem is that our health service has been run at 99% capacity for years and years. It’s been creaking at the seams every winter for a decade and a half. No one thought about what would happen if a new novel health threat appeared in addition to existing winter pressures. In order to learn to live with the virus we need to increase the capacity of our health service but that takes money and, more importantly, time.

For what it’s worth, I think we now have to learn to live with it (and provide proper support to people who are so vulnerable that the vaccine programme alone cannot properly protect them). I just waited to see the discussion more nuanced than I think AIBU is able to supply really.

It is not a black and white situation as others have mentioned. What I most of all want to see is competent government in the approach taken, which we do not have now.

For example, one minister saying more restrictions will be a last resort, then the next day another one announces a new restriction of sorts.

How does the blended approach work in practice? Ive not seen any proposition to a 'blended' approach that doesnt bring the same issues associated with the permanent suppression approach? Taiwan, South Korea, Japan even all had a more effective response and saw less economic damage because they bought in the public health strategies they developed as a result of SARS. Taiwan’s economy has actually grown.

Well Im not a healthcare professional or a policy maker so I might know nothing, but measures I would like to see include-

An ending of presenteeism culture. If you have any ailment that might be transmissible and can work from home, you should do so. Similarly children should not be encouraged to come to school when ill under the treat of sanctions.

A concerted effort to increase the number of healthcare professionals trained. Possibly a scheme where they get free funding and maintenance grants provided they work in the NHS following qualification for a set period of time. This won't help us instantly, but will bear fruit 5-10 years later.

Money given now to social care by increased taxation. A reorganisation such that the service works on weekends and holidays the same as it does Monday-Friday. This will ease pressure on hospitals in the shorter term by stopping people who don't medically need a hospital bed from using one.

If we did these things, in conjunction with vaccines then living with Covid without restrictions I think would be possible.

Pandemics usually happen roughly every 80 years, we have been lucky in that this one was overdue. I don't see anyone still taking precautions because of any of the previous ones See my comment above. We did have a pandemic in 2003 and the countries with that experience did take precautions this time because of that experience. The lessons were there to be learnt from them. Taiwan actually shouting was ignored in WHO meetings. We were too arrogant and entitled to take notice

We need to live with it.

That said, many people are still absolutely committed to the idea there is some set of halfway house Sensible Measures which would being covid rates down to almost 0 without causing much damage to anything else. Which would be lovely! But hasn’t worked for anybody anywhere on the planet, which is a bit of a hitch…

@Lavender24

can you imagine in the second world war people refusing to black out because they are bored of it?

A bombing isn't really comparable to what is now essentially a common cold though is it?

In the sense that your own carelessness could potentially injure or kill the people around you, it's pretty similar. Saying it's essentially a common cold is like saying a bomb will probably only blow your windows out. Sure it's a much more common outcome but you won't know until the bomb drops/ you or a loved one end up in ICU.

Short term we need some mitigation to stop the health service being overwhelmed.
Long term we need to invest in a better health service that isn’t as easily overwhelmed!

@SilverDragonfly1 it’s not a good analogy at all

Everyone was at risk of death during the blitz - nobody is immune to a bomb landing on them.

Whereas covid is only a risk to a small number of the population, it’s just the rest of the country is expected to shut their lives down for it as well.