‘Living with Covid’ does not have to mean ditching all protective measures | Coronavirus
Reports on Sunday that free lateral flow tests could be axed under a strategy of living with Covid within weeks were met with a swift backlash. The government promptly denied the suggestion that free tests could soon be scrapped.
The story highlights a gulf in opinions on what “living with Covid” might look like, with some saying we will achieve this only through continued caution and others equating the phrase to ditching all Covid measures and partying like it’s 2019.
Wherever your instincts lie, it is not surprising – or even undesirable – that the mass testing of asymptomatic people is being reviewed.
The policy was rapidly brought in at a time when, faced with a new, highly infectious variant of unknown virulence, it made sense to throw everything we had at Omicron to slow down transmission and to minimise disruption caused by essential workers having to self-isolate. With case numbers wildly outstripping the UK’s laboratory testing capacity, lateral flow tests continue to be vital for tracking case numbers.
However, these tests are not ultimately “free”. More than £6bn in public funding has been spent on lateral flow test kits. As the Omicron wave recedes, the use of lateral flow tests needs to be justified as part of a wider public health policy. Undoubtedly, the tests pick up some cases that would have gone under the radar. They also provide reassurance to people.
However, we need much better real-world evidence on the most effective way to target testing. It is likely that this would continue to include screening healthcare workers and carers of vulnerable people. It is not clear, in the future, that it would extend to people routinely monitoring themselves before attending social events.
Some question why the government is even thinking about how we can “live with Covid” in the same week that case numbers have hit record highs. But mapping out the path to normality does not have to equate to misguided optimism that we have already arrived at this destination.
In advice given in November, before the emergence of Omicron, Sage scientists predicted it would take “at least five years” for Covid-19 to settle into an endemic state and that this path would be critically dependent on factors such as the rate of waning of immunity and chosen policies on vaccination and surveillance. Active management would be required for at least the next five years, during which time there would remain a realistic risk of “epidemics of sufficient size to overwhelm health and care services”, they said.
While five years may sound disappointingly distant, the advice also reminds us that we are not powerless in steering our course and that, as time goes on, the uncertainties will decrease. We know now, for instance, that immunity against severe illness appears to be holding up well and that second boosters will not be immediately necessary. Within the next few months, it will become clear whether we can hold off until the autumn, which would bring Covid boosters roughly in line with annual flu jabs.
“Living with Covid” does not have to mean reversing every protective measure. If better ventilation and face masks reduce the impact of winter respiratory illnesses, that is a positive, even if the NHS is no longer under imminent threat of being overwhelmed. We will also need to remain vigilant about the threat from new variants, which could still cause big setbacks. There is no guarantee that another variant, more infectious and more virulent than Omicron, could emerge in the future. Scientists say that supporting global vaccination efforts will be crucial to securing the path to normality.
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