Living with Covid: Adapting to the Ongoing Challenge

Living with Covid: Adapting to the Ongoing Challenge

Amidst the ongoing attention to Covid-19, a recent surge has been observed, not only in viral activity but also in the resurgence of concern surrounding the virus.

Headlines have been quick to report a surge in transmission and a rise in Covid-related hospitalizations, sparking debates in some regions about the necessity of reinstating mask mandates. People are increasingly anxious about the implications of the latest subvariant, BA.2.86, for the upcoming fall and winter seasons and whether forthcoming booster shots will effectively combat it or any future variants. While these concerns are valid, it is crucial to recognize our current reality in coexisting with SARS-CoV-2: Covid is here to stay.

Jennifer Nuzzo, an epidemiologist and director of Brown University’s Pandemic Center, aptly puts it, “Covid’s never going to be over. You need to set expectations accordingly. It is never going to be over.” Covid has now become akin to influenza, RSV, rhinoviruses, and numerous other pathogens that exhibit periodic increases in transmission activity throughout the year, followed by declines, making people experience symptoms such as coughing, sneezing, fever, feeling unwell, and sometimes necessitating medical care or resulting in fatalities. It is true that Covid currently ranks as the most severe among these pathogens, causing more annual deaths than influenza did in the past. However, experts emphasize that our current experience with SARS-2 is markedly different from what it was a year ago.

While the number of new hospital admissions is indeed rising, it is essential to consider the broader context. Deaths and hospitalizations are considerably lower than in previous years. For instance, in the last week of August 2021, there were nearly 86,000 new hospital admissions, compared to 37,000 during the same period the previous year, and only 17,400 this year.

Unfortunately, this critical context is often absent from headlines and social media posts, which sensationalize statistics without providing a proper understanding of the situation. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, emphasizes the need for context, stating, “There’s no context to that. Are we doubling 650 deaths a week? Or are we doubling 15,000 deaths? We just have to help ourselves understand that we’re in a different place. We’re going to see Covid activity indefinitely into the future.”

This is not to downplay the seriousness of Covid; it remains a significant threat to some individuals. While many experience mild symptoms similar to a cold or the flu, it can lead to hospitalization, death, or long-term symptoms known as long Covid. Epidemiologist Bill Hanage points out that the United States has already recorded approximately 100,000 Covid deaths this year, with three and a half months still remaining. In a typical flu season, such a death toll would be deemed catastrophic.

Despite the trauma inflicted by the pandemic, experts emphasize that we are no longer in its acute phase and must shift our focus toward long-term coping strategies with Covid. We need to consider which mitigation measures, if any, we are willing to reinstate and how to adapt to living with Covid as an ongoing presence.

Osterholm suggests discussing whether schools should temporarily close in areas with high absenteeism, treating these closures more like snow days rather than prolonged shutdowns, as seen during the pandemic. He emphasizes that it’s time to shift from avoiding the virus entirely to learning how to live with it.

Part of the challenge lies in the language used and the tone of news coverage. Experts like Hanage believe that terms like “surge” can be unhelpful, as they imply a level of cases that threatens hospital capacity, which is not the current situation. Caitlin Rivers, an epidemiologist at Johns Hopkins Bloomberg School of Public Health, acknowledges the difficulty in conveying the situation accurately but emphasizes the need to provide a sense of scale and context.

Justin Lessler, an epidemiologist at the University of North Carolina, raises concerns that normalizing Covid’s presence may lead to underestimating its significance. He suggests framing the situation as a yearly epidemic starting in some places earlier than expected rather than using terms like “surge.”

Another challenge in communication is the relative lack of data compared to previous years, as many countries, including the United States, have reduced their data collection efforts. This limited data makes it even more crucial to understand the ongoing increase in cases and hospitalizations.

Furthermore, the emergence of new subvariants has generated significant attention and concern. However, experts caution against attributing all changes to variants and emphasize the role of human behavior in driving these changes. They also suggest that we should not assume that new subvariants will necessarily lead to increased transmission or severity unless there is concrete evidence to support such claims.

Adjusting to life with Covid as a part of the mix of respiratory diseases can help us make more sustainable decisions regarding mitigation efforts. Additionally, tempering reactions to fluctuations in cases can prevent Covid fatigue and ensure a more effective response when necessary.

In conclusion, while Covid remains a threat, it is essential to acknowledge that we are in a different phase of the pandemic. By understanding and adapting to our ongoing coexistence with the virus, we can make informed decisions and better manage its impact on our lives.