JUST LIVING WITH COVID

Everybody’s headed for a hole in the ground. ~ Warren Zevon & Duncan Aldrich 

It’s been 25 months and more than 5.5 million global deaths since the insidious Covid-19 pandemic began. The World Health Organization (WHO) properly declared a public health emergency of international concern a month after this virus was first discovered in Wuhan China. How long will the Covid-emergency last? How long should it last? When can we just live with Covid?

Coronaviruses began infecting humans in 1965. They caused the SARS and MERS outbreaks in 2002 and 2012, respectively.

Virologists believe Covid will be with us for a very long time, just like the H1N1 virus that jumped to humans producing the 1918 Spanish Flu, which killed 675,000 Americans. The H1N1 virus is still with us; it’s now one of the strains in the seasonal flu virus.

Despite politicians’ and policy-makers’ fervent proclamations that Covid will be “conquered” and “vanquished,” it won’t be. Why? Because it’s a virus, it mutates constantly, forever. It won’t surrender even to our fully-modern medical technology. Like every other infectious disease-producing virus, it’s here for ages. The single exception to this eventuality was the smallpox virus that was eradicated world-wide in 1979, nearly 200 years after a vaccine was first produced, and after killing an estimated 900 million humans during its reign.

As we enter the third year of this pandemic, the question has been raised: how we can learn to live with Covid on an ongoing basis. Other questions include determining what continuing, non-emergency policies will sustain our ability to live, play and work alongside the presence of Covid, like we have done with the flu virus and many others.

Several prominent former members of President Biden’s Covid-19 Advisory Board have recommended creating “New Normal,” non-emergency health policies that will allow us to survive more safely with Covid. Their recommendations essentially involve strengthening the role of US public health agencies by improving and sustaining public health infrastructure. Such strengthening would involve significant, continuing federal and state funding, which, perhaps wisely, they did not enumerate.

The mystery isn’t only about what our Covid policies should become, after suffering so much in this enduring pandemic. There are others as well.

Because they don’t leave any fossils, it remains mysterious as to what viruses really are and have been. Many scientists believe proto-viruses began replicating on Earth several billion years ago. They have a giant head start; the earliest modern homo sapiens have been doing this for perhaps 300,000 years.

These virologists subscribe to the virus-first premise: Long, long ago, viruses evolved from molecules of protein and nucleic acid, before cells first appeared on Earth. Thus ironically, viruses themselves contributed to the development of cellular life.

The first human virus was scientifically identified in 1881, the yellow fever virus. During the past century scientists have changed their minds several times about what viruses are. They were first seen as poisons (the word “virus” is derived from the Latin term for poison, venenum), then as an elementary life-form and finally as biological chemicals.

Virus devaluation to inactive chemicals began 86 years ago, when biochemists determined that viruses are not alive. On their own they cannot produce life-required metabolic functions, such as conversion of food/fuel into energy to run cellular processes.

Viruses’ hosts provide these necessary functions, not the virus itself. Unfortunately, viruses can and have infected virtually every earthly life-form, from humans and insects to tobacco plants and bacteria. Some virologists believe viruses may occupy an enigmatic grey area between living and nonliving. Perhaps similar to what certain Dems believe Trumpists are.

They may not be alive, but the microscopic Covid viruses have affected hundreds of millions of people during the past two years, and will continue to do so all the way to its omega variant (which is 9 variants after omicron, if you never had to memorize the Greek alphabet like I did long ago) and beyond. This virus’s persistence – which, politicians, policy-makers and the rest of us should have previously acknowledged – has precipitated growing relevance for changing short-term, emergency policies to ones that support our need learn how to “live with it” (the Covid virus) over the longer-term.

It can’t be an emergency forever, as an infectious disease expert aptly phrased our current policies.

How can policies be changed from considering Covid not as an emergency, but as an ongoing epidemic? Increasing Covid vaccination rates is the most important objective for living with it. Shown below is one of a growing number of pop-up vaccination clinics.  Regrettably, it’s also the most problematic, given the political caste and personal reluctance that now surrounds vaccination. Next in line is widespread use of masks. The fragile nature of some healthcare systems also poses problems.  

A pop-up vaccination clinic in action.

Achieving this objective will be challenging and increasingly expensive. The “easy arms” have already been injected. At the moment, the US has a fully-vaccinated rate of 63%, much below what epidemiologists used to, but no longer talk about in terms of Covid’s Herd Immunity rate might be.

Medical personal directly involved with immunization describe the current process of getting reluctant folks to be inoculated as “a very grinding, slow process” that’s akin to “medical trench warfare.”

This is especially true after the Supreme Court’s misguided decision last week to block government-mandated shots by companies with more than 100 workers, who employ 67% of our labor force. The Supremes can no longer be relied on to support public health, among other issues. Itself a tragedy within a tragedy.

Interim policies that have been recently initiated should increase availability of take-home Covid tests and oral anti-Covid medicines. Other “living with it” policies once hospitalizations stabilize and decline may ultimately include modifying restrictions on: mask usage, isolation periods, travel, public and private meetings, social distancing, K-12 and college closings, restaurants, quarantines and business hours/operations.

To be successful in reducing Covid’s substantial negative externalities, such guidelines require everyone to comply. Those who willingly damage public health by non-compliance of vaccination and eased, non-emergency Covid-mitigation policies should result in added limitations-consequences for those people. Such compliance consequences would be completely consistent with existing, mandated inoculations in order for children to attend day care, pre-K and K-12 schools.

“Living with it” policies will require “get with it” public compliance. Here’s to a brighter, healthier future.