What will “living with the virus” actually mean?

Over the last few weeks, and especially since the end of Matt Hancock’s tenure as Health Secretary there has been a notable shift in the government’s language regarding the future of the UK’s response to Covid-19. When he announced the further extension of restrictions at the start of June, the Prime Minister used a phrase that hadn’t been much heard since the disastrous Christmas relaxation. He said we were going to have to learn to “live with the virus” – a line he has repeated again this week and which was taken up by new Health Secretary, Sajid Javid, and others.

As infections accelerate again and new variants continue to emerge, what does “living with the virus” actually mean?

Those who want to move out of restrictions are keen to point out that we live with risks as a society all the time – you could get hit by a car or struck by lightning at any time – but we go on living our lives and cope with that risk.

That is true. But living with those risks is not the same as ignoring them or doing nothing about them.

About three people in the UK, on average, die of lightning strikes every year (about 50 are struck in total) – but we take significant action to protect ourselves. We put lightning rods on high buildings, we built our electric supply system to minimise risks of passing surges on, my mother (and perhaps yours) would unplug every item in the house when a storm passed over and we tell each other to do practical things (like not standing under tall trees or poking the sky with metallic poles). All this for a risk that is infinitesimal.

And we do far more to protect ourselves against injury in car accidents. We force people to pass tests to drive. We teach children rules for crossing the road. We tightly restrict speeds and create a whole complex set of rules that people must abide by and then we spend vast amounts of money policing those rules. We force people to have insurance to discourage careless driving. We force carmakers to pursue ever more onerous rules to make their cars safer. We make ourselves wear seatbelts. We dig up roads and reshape towns. All to live with the risks posed by cars. And it has worked. Despite the fact that the number of people travelling on our roads has steadily increased – nearly trebling since the early sixties (in the early 1960s only around 25% of households owned a car, now it’s closer to 80%) – the number of fatalities on British roads has fallen from 8000 a year to under 2000. We have changed our whole society to manage the risk of living with cars – and continue to do so – even though the number of road traffic deaths are far lower than the number of people currently dying each day from the Covid-19.

So, if “living with risks” that are relatively small have required such deep responses (how we build things, how we think, how we behave) why is it that the language of the increasingly lockdown-sceptic government appears to suggest that “living with risk” means doing nothing, removing all restrictions, letting the disease rip?

We are going to have to live with this virus – it’s not showing any signs of going away and, even with widespread vaccinations, it’s going to continue to infect relatively large numbers of people (because the vaccines don’t offer perfect protection) and small numbers of people are going to get seriously ill and small numbers are going to continue to die. Even if the vaccines continue to be effective against new strains, then the final level of risk is probably going to end up significantly more than getting struck by lightning and probably higher than getting killed in a car crash.

The question, then, is what does living with that risk entail? Vaccinations programmes certainly, the government has accepted that, but we modify our behaviours and our environment for lesser risks: we do not let road traffic accidents rip because they are just a natural effect of having cars. So what are we expecting to change to mitigate the risk from this virus? What should our future look like? What is the post-pandemic equivalent of seatbelts and speed bumps? The continued requirement for ubiquitous hand sanitizer and masks would not be popular amongst some, but they’d save more lives (not just from Covid-19, but as we’ve seen this year from flu and food poisoning, both of which have declined precipitously, amongst other transmissible diseases) than any road safety measure.

Instead of pandering to the lockdown sceptics and making rash promises about irreversible steps and never going back, government and ministers might be better planning for and preparing society for the changes needed to “live with the virus”.

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