THREAD: I keep being asked when we can go "back to normal" or "like it was before". My personal thoughts:
We've added a new disease to our population, more infectious and more severe than flu.
The world pre 2020 no longer exists - we may want it to, but it just doesn't.
Vaccines are amazing but do wane - esp vs sympomatic infection. Immunity from infection wanes too.
Surely Omicron has proven that high levels of antibodies in your population are no guarantee against v high levels of illness & disruption.
We *could* act as we used to & accept millions of people getting sick once or twice a year. Yearly education, business disruption. And gradually, a slightly sicker pop'n. That seems to be the current plan in UK and e.g. US.
But that's NOT the *old normal* - it's worse
We *can't* go back - but we *can* go forward *if* we accept we need some adaptations - driven by what we have *learned*.
Learning:
1. Outdoors is pretty safe - so let's invest research and funding into making indoor air as much like the outdoors as possible It's *not* easy, but it *is* possible - we did it with clean water, electricity infrastructure, CFCs, telephone and broadband... The best thing about cleaner indoor air is it works against *any* airborne disease and also reduces e.g. allergies.
2. Vaccinate the world as soon as possible - and keep working towards vaccines that are longer lasting and more variant proof.
3. Invest in global infrastructure to support surveillance of new variants of Covid *and* other new infectious diseases. There will be more.
4. Add permanent surveillance of Covid infection rates in UK to existing programmes for flu, measles etc in public health
5. Invest in understanding & treating longer term clinical impacts of Covid, inc organ damage & Long Covid + treatments (eg antivirals) for acute phase.
6. We need to urgently increase funding and staffing for NHS if it is expected to cope with regular Covid surges *and* existing backlogs *and* years of understaffing and not enough money. This includes *supporting* existing staff to stay..!
7. There *will* still be future surges. We need to have a plan to deal with these surges - as we do for other diseases. A plan which is supported by the rapid outbreak identification & rapid understanding of virulence & transmission we've learned to do so well in the UK! The plan might include (temp) reintroduction of large scale testing (inc better tests?), high quality masks in indoor spaces and - *if & only if* there is a serious threat from e.g. a new variant (or disease!) - further measures, such as targeted test, trace & isolate. A plan should *not* mean long national lockdowns, which represent a failure of public health systems. In fact, refusing to do the *learning* in "learning to live with Covid" is the biggest risk for such future lockdowns.
8. We also need to invest massively in reducing inequalities: in health, in housing, in workplaces, in sick pay, in education - this will make us more resilient to future outbreaks and reduce ill health and death - from Covid & everything else!
Both nationally & globally. Fundamentally, world is different now. Acting as if it isn't, which UK seems determined to do, may feel good in short term but will result in a new normal worse than the old one.
I prefer for us to build a new normal that's *better* than frequent sickness & disruption. 13/13
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