Nations learning to ‘live’ with the virus
Lockdowns easing around the world
SINGAPORE — England has removed nearly all coronavirus restrictions. Germany is allowing vaccinated people to travel without quarantines. Outdoor mask mandates are mostly gone in Italy. Shopping malls remain open in Singapore.
Eighteen months after the coronavirus first emerged, governments in Asia, Europe and the Americas are encouraging people to return to their daily rhythms and transition to a new normal in which subways, offices, restaurants and airports are once again full. Increasingly, the mantra is the same: We have to learn to live with the virus.
Yet scientists warn that the pandemic exit strategies may be premature. The emergence of more transmissible variants means that even wealthy nations with abundant vaccines, including the United States, remain vulnerable. Places like Australia, which shut down its border, are learning that they cannotkeep the virus out.
So rather than abandon their road maps, officials are beginning to accept that rolling lockdowns and restrictions are a necessary part of recovery. People are being encouraged to shift their pandemic perspective and focus on avoiding severe illness and death instead of infections, which are harder to avoid. And countries with zero-COVID ambitions are rethinking those policies.
“You need to tell people: We’re going to get a lot of cases,” said Dale Fisher, a professor of medicine at the National University of Singapore who heads the National Infection Prevention and Control Committee of Singapore’s Health Ministry. “And that’s part of the plan — We have to let it go.”
Officials in Singapore announced plans to gradually ease restrictions and chart a path to the other side of the pandemic. The plans included switching to monitoring the number of people who fall very ill, how many require intensive care and how many need to be intubated, instead of infections.
Those measures are already being put to the test.
Outbreaks have spread through several karaoke lounges and a large fishery port, and on Tuesday Singapore announced a tightening of measures, including banning all dine-in service.
Singapore has fully vaccinated 49% of its population and has cited Israel, which is further ahead at 58%, as a model. Israel has pivoted to focusing on severe illness, a tactic that officials have called “soft suppression.” It is also facing its own sharp rise in cases, up from single digits a month ago to hundreds of new cases a day. The country recently reimposed an indoor mask mandate.
Dr. Michael Baker, an epidemiologist at the University of Otago in New Zealand, said that countries taking shortcuts on their way to reopening were putting unvaccinated people at risk and gambling with lives.
“At this point in time, I actually find it quite surprising that governments would necessarily decide they know-enough about how this virus will behave in populations to choose, ‘Yes, we are going to live with it,’” said Dr. Baker, who helped devise New Zealand’s COVID elimination strategy.
Scientists still do not fully understand “long COVID” — the long-term symptoms that hundreds of thousands of previously infected patients are still grappling with. They say that COVID19 should not be treated like the flu because it is far more dangerous. They are also uncertain about the duration of immunity provided by vaccines and how well they protect against the variants.
Much of the developing world is also still facing rising infections, giving the virus a greater opportunity to rapidly replicate, which then increases the risks of more mutations and spread. Only 1% of people in low-income countries have received a vaccine dose, according to the Our World in Data project.
In the United States, where the state and local governments do much of the decision-making, conditions vary widely from place to place. States like California and New York have high vaccination rates but require unvaccinated people to wear masks indoors, while others, like Alabama and Idaho, have low vaccination rates but no mask mandates.
In Australia, several state lawmakers suggested this month that the country had reached “a fork in the road” at which it needed to decide between persistent restrictions and learning to live with infections. They said that Australia might need to follow much of the world and give up on its COVID-zero approach.
Gladys Berejiklian, the leader of the Australian state of New South Wales, immediately knocked the proposal down. “No state or nation or any country on the planet can live with the delta variant when our vaccination rates are so low,” she said. Only about 11% of Australians over age 16 are fully vaccinated against COVID19.
In places where vaccine shots have been widely available for months, such as Europe, countries have bet big on their inoculation programs as a ticket out of the pandemic and the key to keeping hospitalizations and deaths low.
Germans who have been fully immunized in the past six months can dine indoors in restaurants without showing proof of a negative rapid test. They are allowed to meet up in private without any limits and to travel without a 14-day quarantine.
In Italy, masks are required only when entering stores or crowded spaces, but many people continue to wear them, even if only as a chin guard.
England, which has vaccinated nearly all of its most vulnerable residents, has taken the most drastic approach. On Monday, the country eliminated virtually all COVID-19 restrictions despite the rise of delta-variant infections, particularly among young people.
On “Freedom Day,” as the tabloids called it, pubs, restaurants and nightclubs flung their doors wide open. Curbs on gatherings and mask requirements were also lifted.
In the absence of most rules, the government is urging people to use “personal responsibility” to maintain safety.