We are tired of COVID-19. Surveys suggest the majority of the United States thinks we need to move on, and many moved on a while ago. I’m tired, too — it’s been a long two years. When experts say almost everyone will get the virus, it can be easy to wonder why one should bother avoiding COVID-19 at all. With protective vaccines and a litany of other global, local and personal crises to focus on, it can feel reasonable to move on.
However, I think many people are making these judgments without fully understanding the risks at play. What does “moving on'' actually mean? As a society, we can choose how we approach COVID-19 moving forward, and we should not allow our desire to return to normal cloud our ability to assess and mitigate the genuine danger that the pandemic continues to pose.
Some say that controlling COVID-19 is pointless and that we should stop trying because the virus may be impossible to fully eradicate. But this argument is predicated on bad logic. Importantly, a disease’s continued existence does not mean ongoing mitigation is worthless. For example, just because we are unlikely to completely eradicate HIV or tuberculosis does not mean we should just get used to them and let them spread unchecked. Controlling COVID-19 is not black-and-white — cutting cases by half may leave a plethora of cases, but it will still likely save many lives.
Further, our prevention and treatment methods will continue to improve, becoming less intrusive and more effective with time. Billions of dollars have been spent on research into tests, vaccines and treatments, and this work will in all likelihood limit the impact of any single case of COVID-19 in the future.
Some say that with vaccines, COVID-19 becomes similar to a seasonal flu. While I completely support the vaccines, they aren’t perfect, and breakthrough COVID-19 is still causing significantly more deaths than the flu — so far, Rhode Island has recorded 400 breakthrough COVID-19 deaths. In the moderately severe 2018-19 flu season, 39 people died of flu-related causes in the state. That’s a significant difference, especially when considering that those breakthrough COVID-19 deaths mostly occurred during a period where other mitigation strategies such as masking were required. In 2022 so far, COVID-19 has remained the second leading cause of death in the United States, and has stayed in the top three for the vast majority of the pandemic. If the goal of public health is to prevent disease, injury and premature death, it seems absurd to give up on controlling one of the leading causes of mortality in the United States.
When it comes to actually mitigating COVID-19, the boogeyman of lockdowns is often referenced to argue against controlling the spread. The argument is simple: Fully mitigating cases of COVID-19 would require lockdowns, and lockdowns were a cure worse than the disease. But this entrenches a false dichotomy, forcing a choice between lockdown or a complete return to pre-pandemic normal. For one, we must remember that “normal” has always been a moving target — it was once normal not to wash our hands. “Normal” can change, and sometimes it should. While I think 2020-level restrictions are certainly unnecessary at this point, we should be open to ongoing and non-intrusive interventions when cases are increasing, as they are now. In addition to vaccines, policies such as proper ventilation, masking, testing and paid sick leave, while imperfect, can seriously reduce spread. To achieve a new “normal,” the government should provide funding to make these interventions continually accessible, because they aren’t presently.
We also need to strike back against the idea that a vaccination against or infection of COVID-19 gives one sufficient, durable immunity. COVID-19 is probably not a one-time deal — since our immunity to the virus declines with time from the last vaccination or infection, reinfections are becoming increasingly common. New variants, which are not guaranteed to be milder, could cause more severe disease and will likely find new ways to evade our immune systems.
Reinfections mean people will continue to get sick and die from COVID-19. Even if everyone survives their first bout with the virus, which itself is a flawed assumption given existing medical vulnerabilities in society, we all get older and more vulnerable to COVID-19 with time. What if your second or third round of COVID-19 comes after a cancer diagnosis, after you’ve developed heart problems or after you’ve had to take steroids that suppress your immune system?
Finally, there’s the continuing threat of long COVID-19. People with long COVID-19 have reported a dizzying array of symptoms, from extreme fatigue to brain fog to trouble breathing. While these symptoms range widely in severity, some people have become seriously disabled from long COVID-19. Vaccination decreases risk of long COVID-19, but research shows it does not fully eliminate the threat, decreasing the likelihood of developing certain symptoms by about half. That risk remains high, with research estimating the odds of symptoms persisting for at least a month at 5%. Further, COVID-19 isn’t solely a respiratory disease, and it can inflict damage across multiple organ systems: Research on 150,000 people infected with the virus showed that even a mild case of COVID-19 increased the risk for heart attacks, strokes and other cardiovascular diseases after recovery. Other studies indicate increased risk of neurological and gastrointestinal diseases and thrombosis after an infection. As it’s frequently put, an ounce of prevention is worth a pound of cure, so failing to cheaply control COVID-19 means consigning more people to costly long-term suffering.
COVID-19 mitigation is unpopular, and I wish we didn’t have to consider establishing a new “normal” to fight this disease. However, I don't think returning to the 2019 “normal” is responsible given the serious risks the virus continues to present to individuals and society. It’s worth it to try to avoid infection and advocate for structural mitigation. Doing nothing and forgetting the pandemic would be easy — that doesn’t mean it would be right.