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.

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.

Exactly. And I do wonder what people mean when they say ‘we need to learn to live with it’ while it’s apparent that the health service is struggling to cope with it. What does ‘living with it’ mean against that background? Does it mean that people who become very ill with Covid shouldn’t receive hospital treatment and should die at home? Or does it mean that we should just allow hospitals to be overwhelmed and it’ll become a matter of luck whether we receive medical care if we need it - just cross your fingers it’s someone else’s child who gets meningitis?

@RandomLondoner

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

This was the exact quote I replied to covid has killed more Brits than the Nazis

The Nazis killed hundreds of thousands of Brits. More accurate would be for the OP to say ‘covid has killed more Brits than were killed in bombings on British soil during WW2’. But that doesn’t sound quite so alarmist does it.

I think you are quite mistaken in your thinking. The aim initially was to surpress in order to save the NHS from being overwhelmed. It was never thought that it could or would be eradicated. Any restrictions have been in place to keep numbers to a level where the NHS can cope. As it seems to be becoming more deadly I'm sure we will have less and less restrictions as time goes on

Surely a bigger issue with the Covid/Blitz analogy is that wars actually end, so there is a defined period in which to act, not an indefinite way of life? We didn’t keep blackout curtains up forever. What’s the Covid equivalent to Hitler shooting himself and the German army surrendering?

[quote Lifeisnteasy]@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.[/quote]
I disagree with you.

Covid is a risk for everyone - but it's a bigger risk for some than others. (The elderly, people with co-morbidities)

Bombs were a risk for everyone - but it was a bigger risk for some than others (people that live in cities or near other places of high interest to the people bombing)

We need to really overhaul our social care and healthcare services, with a proper long term plan focusing on expanding the numbers of qualified staff and keeping conditions good enough they want to stay working. At the very least we need to know that its not just 'manage it like flu' as flu still exists so its manage it like covid and flu together. We had a system which ran at very high capacity as standard and regularly struggled in winter.

I think pandemics risk becoming more common. There were deadly flu outbreaks in the 1950’s and 1960’s but most people didn’t travel much, population density was lower etc. so there was generally less capacity for global spread.

The WHO describes HIV/AIDS as an epidemic others consider it a pandemic.

More recently we’ve seen Swine Flu and SARS plus other localised issues such as MERS, Ebola, Zika and Nipah. 60 years ago the risk of these localised viruses spreading globally would have been pretty low. With modern travel the risk is higher.

I wonder if we will have to rethink our perception of pandemics post Covid that we live with the risk and have a suite of measures that can be brought in quickly if needed.

What restrictions does England have at the moment?

Masks are optional (anyone can claim a medical exemption and not give details), pcr/lft testing is optional (if I don't have to give medical info to not wear a mask, then I don't have to give medical info to anyone about any potential symptoms), isolation is optional as its based on an optional positive pcr test, and vaccines are optional.

@LadyMacbethWasMisunderstood

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.

Its my impression that, when people refer to a 'blended approach', theyre talking about PRN restrictions ('as required'); and that serves only to prolong the issues business, education, staffing (all the things I mentioned) currently face. How can it be considered a long term solution when its already proving unfeasible?

Its easy for unaffected people to say its 'only' been two years. Not so easy when you're hanging by a thread to your livelihood.

Mostly people are using the term ‘learning to live with it’ to mean doing whatever they want and ignoring the inevitable consequences of the health system collapsing. I don’t get the feeling they mean that they’ve accepted that people will die of easily preventable non-Covid causes and they are fine with it, and willing to take the risk of their family and friends being among them.

We currently have minimal mitigations in place that in practice impact very little on day to day life in terms of actions we are obliged to take as individuals.

I am assuming you are in England.

In Scotland they have shut nightclubs, maximum numbers of 100 at standing indoor events, 200 at seated indoor events, 500 outside. So at the moment no theatre, no pantomimes, no concerts, no trade shows/exhibitions etc. No standing at a bar, table service only , you must make a reservation and can only stay 2 hours. Masks in shops/public spaces never went away and have been in place since summer 2020. Masks in classrooms since August 2020. People being asked not to mix. Capacity caps in shops/supermarkets, one way systems.

And despite Queen Covid's attempts to do it oh so differently in Scotland, we're in no better/worse position than anywhere else in the UK.

It all needs to stop now. Stay at home if you feel ill, just as you would with the flu, Ebola or any other infectious disease. And that's it.

@Footnote

Mostly people are using the term ‘learning to live with it’ to mean doing whatever they want and ignoring the inevitable consequences of the health system collapsing. I don’t get the feeling they mean that they’ve accepted that people will die of easily preventable non-Covid causes and they are fine with it, and willing to take the risk of their family and friends being among them.

The NHS is not fit for purpose and has not been for decades. We need to get over this attitude that the NHS is some sort of sacred cow which can never ever be reformed and must not be criticised. Chucking more and more good money after bad to prop it up.

Are the NHS staff off with covid 19 or due to isolating.

We are still need to understand how much vaccines work and are effective
Learning to safely as possible learn to live with it I presume.
I have worked through out in a role that requires extensive people contact. I am fed up off masks as I know they are rather pointless but wear them anyway

You have to put something else in place if you want to get rid of the NHS. If you just let it implode, people will die of trivial things. Private healthcare won’t step in seamlessly.

I think, given where we are NOW (note I said now! ie in the advent of vaccine, anti virals, knowledge), that isolation rules have WAY more potential to overwhelm the NHS than coronavirus.

Its also noteworthy that the NHS has not actually become overwhelmed at any point of the pandemic.

You would assume correctly @MarshmallowFondant, but I can only assume that the OP is also talking about England (happy to be corrected) and I have no political voice when it comes to scotland, wales or NI and their covid strategies.

@Cornettoninja

You would assume correctly *@MarshmallowFondant*, but I can only assume that the OP is also talking about England (happy to be corrected) and I have no political voice when it comes to scotland, wales or NI and their covid strategies.

Im Scots living in Scotland, though yes referring to the UK as a whole (the most impactful mitigations, such as isolation, apply to the UK as a whole).

Okay @GaolBhoAlba. Thanks for clarifying

Suppression was with the hope that vaccines, and drugs to treat COVID would be found which thankfully came to pass, and to allow the NHS to cope. Unfortunately the NHS is still under strain and worldwide vaccination is a long way off.

The NHS is not fit for purpose and has not been for decades. We need to get over this attitude that the NHS is some sort of sacred cow which can never ever be reformed and must not be criticised. Chucking more and more good money after bad to prop it up.

I agree that it is hugely problematic and overly-sanctified and requires reform.

That doesn’t mean we should allow it to collapse overnight.

This isn’t about protecting the NHS as a sacred cow. It’s important to realise what the sudden collapse of the NHS would actually mean. It would be a catastrophe. It wouldn’t just affect ‘the elderly’ and ‘people with underlying health conditions’. All of us, no matter how healthy, would just have to hope to avoid getting sick or being involved in an accident.

Admittedly, there are some Tory nutters out there who think the collapse of the NHS - and the death and suffering that would come with it - is a price we have to pay in order to reform it.

You know, it's embarrassing that so many people are falling for the same old privatisation tricks and tactics. You'd think having seen them all before and experiencing the huge price hikes in the cost of their basic utilities post-privatisation that people would be a bit wiser. Not to mention Brexit.

Be really, very careful what you wish for when you decry and bemoan the NHS. No, it's not perfect and improvements are needed, especially to the funding model and the postcode lottery of service provision but throwing the baby out with the bath water is not the way forward.

Always remember that medical debt is the biggest reason for personal bankruptcy in the USA. And that's not due to plastic surgery that due to the cost of looking after a chronically sick family member.

There are some key issues we need to resolve including;

We not have enough healthcare professionals in this country, we aren't training enough and we aren't treating the ones we have well enough.

We don't have enough hospital beds. This has been a deliberate cost saving drive taking us down to an unmanageable levels of beds and this is why we have struggle for beds every winter.

There are too many different organisations operating so care isn't patient centric in the community. This needs a total reorganisation and transformation in care delivery.

Etc etc.

But throwing huge contracts for cherry picked bits of healthcare than can make money to private organisations is not the answer.

@GaolBhoAlba

I think, given where we are NOW (note I said now! ie in the advent of vaccine, anti virals, knowledge), that isolation rules have WAY more potential to overwhelm the NHS than coronavirus.

Its also noteworthy that the NHS has not actually become overwhelmed at any point of the pandemic.

You say that theyve not become overwhelmed but thats because the majority of routine outpatients/routine surgery etc was cancelled, even a lot of urgent stuff was cancelled!

So this still had a knock on effect on the care people received for none covid conditions/waiting times

The health board I work for sent out an email just before christmas saying that yet again routine outpatients & surgery was being cancelled

But by the same token I do agree we cant just keep grinding to a halt constantly, the only solution is to increase funding, efficiency & capacity of the NHS

But in reality that takes years as HCPs take years to train

The thing is believing there needs to be an overhaul and in particular increasing staffing and beds doesnt mean someone feels it has to be reformed to a us style healthcare. Its always painted as our system or the US with no reference to many other good systems. However with the trend for selling off public things for private profit or having private companies make profits for public services, i think lots of us worry that is what reform would mean.

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

I looked after someone born in the 1990s who has had a necrotic lung because of covid. Young, fit and healthy. Absolutely zero health problems before this.

If this person survives that lung will need cut out and covid patients are not candidates for lung transplants. They'll be in hospital for the best part of this year. There's no way they'll be able to go back to their job again. They have young kids and a mortgage.

Like you, they and their family thought "it was just a cold" and decided they knew better than those of us who have been bloody experiencing totally unavoidable deaths for the best part of 2 years.

Its a specialist cancer centre I work in BTW. I can't remember the last post op cancer patient I looked after because we are full of unvaccinated covid patients. We are all sick of this, we are sick of resuscitating people younger and fitter than us. Sick of suppirting yet ANOTHER family shocked that it's taking out someone they love when the partners, kids, parents etc who caught it with them were all OK. We want to go back to our specialities and start treating patients for other diseases again.

We can't and won't do that until we stop being full of covid patients.

I have family and friends abroad and the healthcare workers there are nowhere near as burnt out as us. My sibling in particular lives in a European country with very very strict mask mandate and vaccine passports (you can't even go to an outdoor market or swimming pool with a negative test) and guess what - hospitals are pretty empty of covid, economy is doing ok because people are all living pretty normally again and spending money in bars and shops. Nothing is shut down. THAT is the "new normal" we mean.