The idea of "living with Covid" is as old as the pandemic itself, but in Ireland and much of the world it has so far remained an aspiration rather than a reality. Cohabitation has proved impossible. In wave after wave, infection and death rates have been too high, and the risks to health services too great, to allow even an approximation of ordinary life to continue. You don't live with Covid, it turns out. Either you keep it out – as China has done, albeit with increasing difficulty – or you put life on hold until the wave breaks.
That began to change with the arrival of effective vaccines over the course of 2021, which gradually allowed richer countries – if not, to the world’s shame, poorer ones – to relax restrictions on social and economic life. Some of those advances went into reverse as the more transmissible Omicron variant moved rapidly around the world in recent weeks, resulting in surging infection numbers and the reimposition of public health curbs in Ireland and elsewhere.
Now a new and different cycle has begun: despite huge case numbers, high levels of vaccine- and infection-acquired immunity combined, perhaps, with the less severe effects of Omicron itself, hospital admissions and deaths have until now stayed significantly lower than in previous waves. Global vaccine production is now close to 1.5 billion doses a month, so there can be no more excuses for the the scandal of vaccine inequity.
Covid-19 is not going away, but it is reasonable to hope that the end of the pandemic is now within reach. With the virus set to become endemic, the planning for actually “living with Covid” should begin now. In Ireland, the next key step, assuming the current wave peaks this month, will be to choose the right moment to ease current restrictions responsibly. It would help if more data were available on how many of the 900-odd people in hospital with Covid are there because of Covid, and how many ICU patients are there because of Omicron. That will give policy-makers a better sense of the short-term outlook. The importance of maintaining high test-and-trace capacity and a standing mass immunisation programme capable of rapid activation could not be clearer.
Beyond the next reopening, however, serious planning must get under way to adapt for the longer-term challenges posed by an endemic Covid-19 and the other pandemics that we can assume will follow. That means better crisis preparedness, more investment in public health structures, an expansion of hospital capacity and stronger surveillance to detect novel pathogens in real-time.
It means rethinking building ventilation requirements, working to better protect high-risk settings and addressing the social inequalities that were so badly exposed by the crisis of the past two years. It means, in other words, rethinking the way we live.