Virus weariness, live-with-it tack raising red flags
Some people welcome shift in thinking; others see peril
Nations around the world are pivoting in their war against the coronavirus, deciding that crushing the virus is no longer the strategy.
Few countries other than China, which is still locking down cities, now use a “zero-covid” strategy. The phrase often heard now in the United States and many other nations is “live with the virus.” That new stance is applauded by some officials and scientists, and welcomed by people exhausted from the hardships and disruptions of a global health emergency entering its third year.
But some disease experts fear that the pendulum will swing too far the other way. They worry that many world leaders are gambling on a relatively benign outcome from the omicron variant surge and are sending messages that will lead people who are normally prudent to abandon the social distancing and mask-wearing known to limit the pathogen’s spread.
Epidemiologists say the live-with-it strategy underestimates the dangers posed by omicron.
“This notion of learning to live with it, to me, has always meant a surrendering, a giving up,” World Health Organization epidemiologist Maria Van Kerkhove said.
Virologist Angela Rasmussen of the University of Saskatchewan in Canada likewise fears that people are relaxing precautions prematurely.
“I understand the temptation to say, ‘I give up, it’s too much,’” Rasmussen said. “Two years is a lot. Everybody’s sick of it. I hate this. But it doesn’t mean actually the game is lost.”
The WHO officially declared a Public Health Emergency of International Concern on Jan. 30, 2020, when there were 7,711 confirmed cases of covid-19 and 170
deaths in China. Another 83 cases were scattered across 18 other countries — and no deaths.
Two years later, the virus has killed more than 5.5 million people, and the pandemic is ongoing. But the global health emergency has evolved — reshaped by the tools deployed to combat it, including vaccines.
Many nations continue to impose mask requirements, vaccination mandates and travel restrictions. Even the arrival of the ultra-transmissible omicron variant did not throw the world back into the previous winter, when the paramount goal remained stopping viral spread at all costs — much less back to the spring of 2020, when people were told to stay home, wipe down their groceries and not touch their faces.
Even officials in Australia, long a nation that sought to suppress the virus at all costs, have chosen to ease some mandates in recent weeks.
In South Africa, where officials first sounded the alarm about omicron, the government in December eased protocols, betting that previous encounters with the virus gave the population enough immunity to prevent significant levels of severe illness. The omicron wave there subsided quickly with modest hospitalizations, and scientists think one reason is that so many people — close to 80% — had previously been infected by earlier variants.
Omicron also appears to be less virulent — less likely to cause disease. The variant stiff-arms the front-line defense of antibodies generated by vaccines and previous infection, but researchers say it does not seem to be adept at invading the lungs or escaping the deeper defenses of the immune system.
In the short term, experts believe that omicron is essentially unstoppable but of limited threat to individuals even as it causes societal disruptions. Ali Mokdad, an epidemiologist at the University of Washington’s Institute for Health Metrics and Evaluation, said he believes that about half of the U.S. population will be infected with omicron during the next three months, with most cases asymptomatic.
“There’s no way to stop its spread — unless we do measures like China is doing, and you and I know very well that’s not possible in the United States,” Mokdad said.
NO UNIFIED RESPONSE
There is no unified global response to the pandemic. National strategies typically reflect elements of a country’s culture, wealth, government structure, demographics and underlying health conditions.
Geography is also a factor: New Zealand has managed to record only a few dozen deaths from covid-19, one of the lowest per capita tolls on the planet, by leveraging its isolation in the South Pacific.
Japan, Singapore and South Korea, nations with a long history of mask-wearing and aggressive measures to suppress epidemics, have managed to keep the virus largely in check without lockdowns or major sacrifices to their economies.
Peru, hammered by the variants dubbed lambda and gamma before the delta and omicron waves arrived, has had the deadliest pandemic per capita, according to the Johns Hopkins University coronavirus tracking site. The nations of Eastern Europe, with older populations and high vaccine skepticism, are not far behind.
Countries have different ways of documenting the pandemic, but some general trends are clear. Among the wealthiest nations, the United States has had an unusually high toll. According to the Johns Hopkins tracker, the United States ranks 21st in reported deaths per capita. Britain is at 28th, while Canada is 82nd.
A group of doctors who advised President Joe Biden during the presidential transition have urged a reset of the nation’s strategy to recognize the “new normal” of the virus, one that acknowledges it has little chance of being eradicated and will probably continue to cause typically mild illness and require vaccination boosters at a frequency yet to be determined.
Biden took office nearly a year ago vowing to crush the pandemic. His administration pushed for vaccinations and saw millions of people a day roll up their sleeves during the spring. On July 4, after caseloads had dropped, Biden assembled a crowd on the South Lawn of the White House for a celebration of independence from the virus.
But after a surge of infections and deaths from the delta variant, the Centers for Disease Control and Prevention revised its guidelines, saying even those people who were fully vaccinated should resume wearing masks indoors. The delta wave began to subside in the fall, but then omicron emerged in late November.
On Dec. 2, Biden detailed his plans for omicron by first announcing that there would be no lockdowns. He vowed to distribute 500 million rapid tests, and he has doubled the number in recent days. His covid-19 task force continues to emphasize the importance of vaccines, therapeutics and testing rather than restrictions on mobility and gatherings.
SHIFT IN THINKING
The strategic shift toward a live-with-it strategy in many nations, including the United States, has often gone without formal acknowledgment from national leaders. Spain is one of the exceptions: Prime Minister Pedro Sanchez has said he wants the European Union to stop tracking covid as a separate disease and recognize that it is becoming an endemic pathogen.
Across the Pyrenees, French nightclubs closed as omicron swept through. Indoor masking is required, regardless of vaccination status. In bars, patrons are not allowed to consume alcohol while standing up. France, like Italy and many other European countries, has implemented rules for vaccine passports.
Many global leaders, including those in the United States and Europe, have focused on vaccination as the key to mitigating the pandemic. The speed of omicron’s spread is the key factor in the equation that determines how much pressure it will put on hospitals — which are currently seeing record numbers of covid patients in the United States.
“If we just completely let everything go and allow the omicron epidemic to run its natural course, we’ll completely overrun our health system and be left in a situation potentially worse than what we experienced in early 2020,” said James Lawler, co-director of the University of Nebraska’s Global Center for Health Security.
He said he is not seeing the precautions from early in the pandemic, when he was among the first disease experts to sound an alarm about the extreme transmissibility of the coronavirus. Last week, he went to a grocery store and was virtually alone in wearing a mask. That’s the norm in Omaha, he said.
“There’s not a mandate,” he said. “Across the entire experience of humanity, we should have learned by now the only way to get high levels of compliance like this is to make it mandatory. That’s what happened with seat belts.”
Rasmussen, the University of Saskatchewan virologist, is among the experts who think people have misunderstood the concept of endemicity — which is the point at which a virus continues to circulate at low levels but is not generating epidemic-level outbreaks. She said she fears that some people hear the “endemic virus” talk as a sign that resistance is futile.
“People think that means we just give up,” she said. “They think ‘endemic’ means that we’re all going to get covid eventually. I’m hearing people say, ‘Why not just get it over with now, and I’ll be bulletproof?’ None of this is what endemicity means.”