At some point we all need to move on from the death and doom of Covid, live with Omicron and prepare for coming Sigma and Omega variants, writes Nicholas Agar
Jacinda Ardern is surely ready for the pandemic to be over already. That way she can take the triumphs of Aotearoa’s elimination strategy to the next election – scheduled for 2024. For a year and a half, we kept the virus out while the rest of the world burned. That’s worth celebrating.
But after the traumas of the Delta variant, we now wonder what fresh terrors Omicron will bring, and after that presumably the Sigma, Upisilon, and Omega variants of concern. At this point, Omicron seems to cause milder disease. But Covid has sprung surprises before. If things go badly, New Zealand risks becoming a nation whose approach to the pandemic differed from the disastrous management of the UK and US in taking a bit longer to arrive at essentially the same miserable outcome.
If the world had followed New Zealand’s eliminationist lead, then we might have had a clean end to the pandemic. We could relax and expect to come across Covid-19 only in history books.
Instead, we’ll need to content ourselves with a messy end to the pandemic. There’ll still be Covid-19 and variants of concern and vaccinations.
But being in a forever war against a virus with a seeming endless ability to thwart our cleverest responses is emotionally draining. Moreover, if the coronavirus continues to hog centre stage, we won’t be able to properly address other big problems like climate change and Aotearoa’s rising levels of inequality.
What we and the Prime Minister need is to find a way to mark the successful conclusion of a chapter in our nation’s struggle against the virus. We need to prepare for a messy end to the pandemic, accepting that we may never be entirely free of Covid-19 and its variants of concern. To do that we must recognise that some barriers to moving on are inside us.
The barriers within us
Technological progress has ambiguous effects. It offers mRNA vaccines, but it also changes us in ways that push a successful conclusion to the pandemic farther away. Tech advances have altered our expectations of medicine.
There’s no reason to believe our modern age is making us sicker. But sometimes it seems that way. New diagnostic techs for cancer don’t create more cancer but they can give the impression that cancer is on the rise. The modern age seems so carcinogenic in part because of the progress that we’ve made in diagnosing cancer.
People fear dying of Covid-19, but they also fear surviving it with ongoing serious symptoms. Some people who had mild cases of Covid-19 are stricken with post-Covid-19 syndrome or “long Covid.” These “long haulers” suffer a variety of symptoms including ongoing breathing problems, heart complications, chronic kidney problems, strokes, and temporary paralyses.
Post-viral conditions like long Covid are a comparatively recent discovery. The 19th century neurologist George Miller Beard used the concept of neurasthenia to describe fatigue, headaches, and emotional disturbances that we now suspect could be the first attempted diagnoses of post-viral syndrome. There must surely have been post-viral effects of the H1N1 virus that caused the Spanish ‘flu.
We can speculate about how physicians used to treating Spanish ‘flu – global death toll of 50 million – might have reacted to complaints from patients who seemed to have recovered but were still feeling the virus’s effects in the form of fatigue and emotional disorders.
Our diagnostic tools may mean that New Zealand doctors are kept busy diagnosing and dealing with Covid-19’s after-effects. This can be a drag on our need to move on.
We’ll know that we’re ready to move on when we stop obsessively counting deaths
Medical authorities worldwide watched with horror as Covid-19 caused the collapse of the healthcare system in Northern Italy in March 2020. In their book Failures of State, the Sunday Times journalists Jonathan Calvert and George Arbuthnott showed how the UK saved the National Health Service, but at a terrible cost in lives as patients judged too infirm were left to die at home.
The messy end of the pandemic could come when we’re confident both that Aotearoa’s hospitals won’t be swamped with Covid patients and that we won’t suffer the UK’s hideous death tolls.
At the pandemic’s outset there were many attempts to compare Covid with the ‘flu. According to the WHO, seasonal influenza causes between 290,000 and 650,000 deaths each year. It’s now apparent that SARS-Cov-2 is a much nastier virus than seasonal ‘flu. Comparisons between Covid and seasonal ‘flu were dangerous and misleading at the beginning of the pandemic. But we should expect a time when they become more appropriate. Like ‘flu, Covid-19 will occasionally kill, but also like ‘flu, it won’t be a national obsession.
We spent July and August 2021 alternating between national medal tables in the Tokyo Olympics and national coronavirus death tallies. The national death tallies made the pandemic seem like an Olympics from hell. It could almost have been a plot element from the sadistic South Korean Netflix hit Squid Game.
Sometimes we need to be reminded to count deaths. We tend to view driving as much safer than it actually is, so we occasionally need the wakeup calls of national road tolls. But sometimes we need to collectively move on and to cease obsessively counting deaths.
According to University of Otago researchers influenza kills about 500 New Zealanders each year. This is bad. But we don’t need daily reminders of these deaths “With today’s ‘flu death Timaru finally overtakes Oamaru in the national tally”. We got used to seasonal ‘flu. When we get used to Covid-19 in a similar way we will have moved on.