Sunday, July 18, 2021

Life Lately: Freedom Day and my roadmap for living with COVID-19

Enjoying the sun and glad to be free of my second self-isolation in seven months

Tomorrow is Freedom Day in England. Most measures for mitigating the spread of COVID-19 will be dropped. Mask-wearing in public and social distancing will no longer be mandated. I’m not sure how I feel. Having had COVID twice, both times with symptoms, these changes spark a little anxiety. But I also believe society needs to move on.

I don’t think COVID-19 is going anywhere. Given the respiratory nature of the virus and how far it has spread, I don’t think we’ll be able to eradicate this one like we did smallpox. I believe COVID-19 will become endemic, circulating in pockets and causing localized outbreaks. I’m not alone in thinking this. Smarter people who are more familiar with immunology have reached similar conclusions. (See here, here, and here). What this means is we need to learn to live with this virus, as we have with other viruses.

Lockdowns are a nuclear option. While they limit COVID deaths, they do so by ripping out the cancer with a chunk of healthy tissue. We need them sometimes, like when we first encountered this virus early last year and hospitals were at risk of being overwhelmed. But when the objective shifts to optimizing for the long-term health of the species, you start to question why we’re ripping out all that healthy tissue. We need to move forward cautiously, finding the balance between limiting death and protecting life.

This is easier said than done. Especially when the media goes into an orgasmic frenzy when case numbers rise – as they will. So where does this leave governments? How will they balance the demands of national security, a thriving economy, and public health in the age of COVID-19?
Another learning from Pale Rider is that the demands of national security, a thriving economy, and public health rarely align. Government officials defending the first two in a pandemic undermine the third simply by doing their job. How do you keep some economic activity going while keeping as many people as possible safe? - Me, Thoughts From Lockdown: On Pandemics, Slighted Gods, and Public Policy (April 2020)
I think our objective needs to shift from limiting COVID cases to limiting COVID deaths. Water is wet, stones are hard, and COVID cases will rise. What we’re now seeing is that we can delink deaths from cases thanks to vaccines.

"Vaccines are highly effective in reducing the risk of infection as well as transmission. Even if you are infected, vaccines will help prevent severe Covid-19 symptoms,"Singapore’s COVID-19 task force
We need to vaccinate, vaccinate, vaccinate. We ought to decentralize vaccine production (not Quality Control) so that factories in every country can produce vaccines for local use and potentially export. And we need to invest in messaging that connects with moderate anti-vaxxers, both for their protection and to help us get to herd immunity faster. We may also need booster shots, but that will become clearer over the next few months.

We all need to play our part, and governments and employers should make this easier. It should be quick and easy to get free COVID-19 tests at home. I like the UK’s lateral flow home tests which can be done at home and give results in 30 minutes and I’ve read COVID-19-breathalyzers (results in 2-3 minutes) are under development. Symptomatic people should be able to get paid time off work without fuss. Asymptomatic people should act to limit the spread, from voluntary self-isolation to wearing masks and social-distancing if they have to be out and about.

Governments need to invest in surge management by acquiring the ability to rapidly ramp up hospital beds if cases requiring hospitalization spike suddenly. The best treatment protocols need to be shared across the world and re-applied speedily. And if all fails, we’ll have our trusty old friend, a circuit breaker lockdown to give the system a breather.

I’m certain this approach is far from perfect. I’m just a guy with a blog, not a public health specialist or government official. I’ve not even mentioned long COVID to keep this from getting too long. But there are things I’ll be doing that I’m confident are sensible: I’ll get my second jab as soon as I can, I’ll continue to wear a mask on public transport, and I’ll avoid super-spreader events.


What I’m currently reading: Children of Virtue and Vengeance. I needed something fun and playful after last week’s serious read, and this is turning out to be such a good fit. I read Children of Blood and Bone in 2018 and loved it. Unfortunately I’ve forgotten much of the story so I’m having to double-check who is who as I go on.

What I’m currently listening to: In You, But Better; behavioral scientist Katy Milkman explains how we can use our minds to make better choices for ourselves and increase the chances that we stick to the healthy resolutions we make.

I’ve also been listening to Cameroon Rain City a LOT on Headspace, particularly between 04:00am and 07:00am. I use it to drown out the horrendous noise of the seagulls with pleasant 3D-recorded rainfall so I can get more sleep in.


Have a fab week!


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