Political Spotlight: Learning to live with Covid

The difficulty of prediction is central to one of the world’s most pertinent questions: how will the Covid-19 pandemic play out, and how will we learn to live with coronavirus?

In Scotland, restrictions are once again being eased, after the Omicron variant was found to result in less hospitalizations than first feared, and a return to some semblance of normality is expected in the coming months.

However, in an address to the Scottish Parliament on January 5, First Minister Nicola Sturgeon said that “adapting to the ongoing challenge of COVID is inescapable”, and in her most recent Covid update to the Parliament, on January 25, warned “there are uncertainties still ahead and the virus continues to be unpredictable”.

“All of this means that while our return to more normality can be made with confidence, we should still exercise some caution,” added the First Minister.

During the address, Sturgeon also made it clear that more variants will emerge, and that Scotland must “be prepared for a range of circumstances”.

“I was struck by the remarks made by the head of the World Health Organisation yesterday,” said the First Minister.

“He said - and I quote – ‘learning to live with Covid cannot mean that we give this virus a free ride’.

“He also warned - and again I quote - that ‘globally, the conditions are ideal for more variants to emerge’.

“It is clear therefore that we must continue to learn from experience and be prepared for a range of circumstances.”

According to one of the First Minister’s Covid advisors, the “range of circumstances” is likely to include reintroducing restrictions – meaning recently regained freedoms could be short-lived.

Professor Mark Woolhouse, an epidemiologist, and a member of the Scottish Government’s Covid Advisory Group, says governments will need to be “light on their feet” and be able to implement restrictions as and when new variants become apparent and put further strain on health services.

This is because planning for coronavirus, in the same way world health services plan for annual flu, requires predictability – a characteristic of Covid-19 and its fast-developing variants does not share with flu or the common cold.

Governments throughout the world were caught on the back foot by the Omicron variant, necessitating rushed social distancing measures and restrictions on businesses in an attempt to stop hospitalisations, caused by the generally milder but far more transmissible variant, overrunning health care systems.

“I don't think novel coronavirus in the next few years is going to be as predictable as the common flu,” said Woolhouse, “so I think I think we are going to be more flexible and the timing of vaccinations, for example, is a good illustration of that I mean - with flu we know when to vaccinate which is typically last autumn/the first half of winter, with a vaccine that is tailored to the variants of flu that we’re expecting to encounter.

“I don't think we're going to settle down into that sort of rhythm for novel coronavirus soon – and the reason that I say is it’s not yet apparent there will simply be one variant a year. The variants have been coming on more frequently than that – we’ve experienced some in the summer – so if that continues, an annual vaccination of itself would not be enough.

“We have to be more responsive. I can’t say we know enough yet about how to keep a lid on coronavirus, certainly in terms of a public health burden, that we can plan in advance.

“We need a health service that is light on its feet, as it has been for the last two years, remarkably and admirably so.”

The good news is that Covid-19 is likely to one day become a regular respiratory infection, similar to the common cold, showing that a future free from lockdowns is very possible.

The issue, according to Professor Woolhouse, is that although Covid-19 is likely to become less harmful – crucially resulting in fewer hospitalisations and less pressure on health services – the timescale for this is so large that further cycles of lockdown restrictions and subsequent easing could continue for decades.

“A perfectly good working hypothesis for how this is going to play out is that in the long term - and I'm talking about a lifetime, literally – everybody is exposed is to SARS-CoV-2, almost everyone during childhood,” said Woolhouse.

“That exposure won’t give them full immunity, it’ll give them some immunity against disease but certainly won’t give them full immunity against subsequent infections, so they’ll get it again, and the reason you won’t see any severe illness in older people, sixty-plus – is because they will have already had it several times already.

“But you can see, immediately, it’s going to take quite a while before we have a situation where all the elderly people in the population have already had multiple exposures in their youth to this coronavirus.”

So, while the next generation may one day live in a world free from the worries of Covid-19, those alive in the present are likely to continue in the cycle of governments introducing and then repealing social restrictions according to scientifically based risk and, as some would believe, politics.

And that has also led to differences in approach by the devolved governments of the UK. And while in England, Boris Johnson has taken what some have described as a more cavalier approach to the wearing of face masks and getting back into the office from as early as last week. In the meantime, the Scottish Government is still preparing for a more cautious “proportionate return to hybrid working”, rather than a full return to offices, and still requiring people to wear face masks in some public places, giving some indication as to how the future of office-based work will look in Scotland.

In a statement issued following the easing of restrictions, the Scottish Government’s finance and economy secretary, Kate Forbes MSP, said: “Thanks to our collective efforts to stop Omicron spreading, case rates are slowing and so it is possible to resume a measured and proportionate return to hybrid working. This will be welcome news for many thanks to the significant benefits to businesses, to staff and to the wider economy however we must remain cautious.

“We know how quickly Covid can spread and so this must be a phased and flexible return to hybrid working, with employers and employees working together, including with their trade unions where appropriate, to decide the most effective balance of home, flexible and hybrid working.”

However, the damage to traditional office working - and to the town centres that are supported by it - may already be done.

According to research carried out by Strathclyde University’s Fraser of Allander Institute during October, more than quarter of Scottish firms say they are permanently cutting office space in response to increased homeworking.

The shift could have serious consequences for the economy too, as half of the firms surveyed say it has worsened productivity, with more than half also saying it has made it more difficult to collaborate and to manage staff.

The survey of around 500 firms also found 70 per cent of tourism and hospitality businesses expected to cut staffing in the next few months, and 20 per cent of all companies.

It’s no surprise then, that the idea of further restrictions – of facemasks, working from home and social distancing – can be distressing for businesses that have suffered drastically reduced profits and productivity due to working from home guidance and tight rules on hospitality.

The Scottish Conservatives’ Covid recovery spokesperson, Murdo Fraser MSP, says he fears “another cycle of restrictions”.

“I think what the business community in particular are looking for is certainty and stability,” said the Mid Scotland and Fife region MSP, “because the switching on and off restrictions that we've had for the best part for last two years, has been incredibly damaging to business confidence in particular. “I think what the business community in particular are looking for is certainty and stability,” said the Mid Scotland and Fife MSP, “because the switching on and off restrictions that we've had for the best part for last two years, has been incredibly damaging to business confidence in particular. And those enterprises which are only now starting to get back on their feet.

“Their biggest concern is that we find ourselves in a few months’ time back in another cycle of restrictions which would be incredibly damaging to their future prospects. And what many of them are saying to us is the range of restrictions they have had with Omicron, it really has to be the last, because if they go through this again, they will simply not be able to survive.

“So, I think we have to learn from Omicron, we have to recognise that the reaction to Omicron was overstated. It probably wasn't necessary to go as far in terms of bringing restrictions that we did, and I think we have to learn from that experience, in the event that further variance come along in the near future.”

According to Professor Woolhouse, the future of how we live with Covid will be learning to embrace the unpredictability of the virus and learning to be flexible in our working and social habits.

“If it’s not going away, our hospitals will need the capacity to deal with that,” says Woolhouse.

“So, we can’t expect that the health burden post-pandemic will be lower than pre-pandemic, it’s the other way round – it will be higher because this virus will continue to circulate and it will put some people in hospital, hopefully at a lower and lower rate but still not low enough.

“Then there’s flexibility. At the moment we can’t predict when the waves will come, we certainly can’t predict how severe or infectious of how good at immune escape the next variant will be, so I do think we have to be flexible.”