WORLDVIEW: Here’s what “living with Covid-19” really means

Despite natural human optimism, a Covid-19 vaccine remains a distant dream. Even if some of the promising early candidates prove effective, we are a long way away from rolling out a safe and thoroughly tested shot to the broad public..But, on the flip side, even in the absence of a vaccine we can't keep living the way we are now. Lockdowns will have to lift, or our societies and economies will collapse. Together, these two facts equal one conclusion: we will have to rebuild our lives so that we can live alongside Covid-19..This is something we are capable of doing. Human societies are flexible and can adapt to new realities and restrictions. That doesn't mean, however, that it will be pleasant..___STEADY_PAYWALL___.The best metaphor I have heard for what needs to happen is this: We need to move from an "abstinence-only" approach to a "safe sex" approach..Lockdown and extreme social distancing is the abstinence-only approach to dealing with Covid-19. It is an attempt to avoid all risk, to ensure that we have zero chance of exposure to the virus..There is a lot (like, a lot) of research that shows that abstinence-only approaches to sex ed don't work. In the sex education world, abstinence-only approaches don't delay the age when teens first have sex, don't reduce the spread of sexually transmitted diseases (STDs), and don't reduce teen pregnancies..There's a simple reason for this – the approach advocated (no sex until marriage) isn't realistic. Teens are experiencing hormone surges that compel them to experiment sexually and forbidding them from doing so is about as effective as forbidding them from doing anything else, which is to say not effective at all..What's worse, because they have been taught that the only safe way to have sex is to not have any, they don't know how to make sex safer through the use of contraception and barriers to STDs. So, they get pregnant and get infected with STDs at a higher rate than teens that are taught how to be safer..Lockdown is an abstinence-only approach and it is failing for the same reason – it isn't realistic. We can't realistically remain locked in our homes forever. We have to get out to meet people, to see friends, to do work, to shop and do the other things that create our economy and society. But, because we are not getting a decent education in "safe sex", we don't really have a good sense of how to get out and live our lives more safely..What we need to do is start to have "safer sex" – we need to redesign our lives so that we can reduce the risk of Covid-19 transmission without totally destroying the fabric of society. We are not going to get to a place where life becomes risk-free. The risk of Covid-19 outbreaks will remain with us, just like the risk of HIV infection is present in every sexual encounter. But we can structure things so that we minimise the risk without abandoning the risky activity (think using condoms, trusted partners, PrEP, and other interventions – people can still have sex, they just have to be prepared)..What will this look like in practice?.Well, it will mean the use of masks in public indoor places (outdoor transmission risk seems lower, and may not necessitate mask use, although the jury is still out, as for many aspects of the coronavirus). It will mean changing the layouts of stores, offices, cinemas, and other gathering-places so that people can be a couple of metres apart. It will mean much more hand washing and much more frequent deep cleaning of shared spaces like the toilets at work. It will mean improving air circulation in buildings, eliminating surfaces that are repeatedly touched like the buttons in elevators or door handles..It will certainly mean a lot more restrictions at old age homes – better cleaning, better training for staff, and the use of personal protective equipment. New rules for visitors are also needed to prevent friends and family from bringing the virus into a place full of vulnerable people..We will have to stop having meetings in crowded rooms at work. We will have to do a lot more remote working. We will have to think seriously about how to make aeroplanes safer. We will have to keep travel restrictions in place, to some degree at least..All of this means that living with Covid-19 won't be as fun as living without it. But we will get used to that, just as we have gotten used to having safe sex..Living with Covid-19 also probably means that our societies are going to have to accept a certain number of additional deaths, particularly among older people. Sweden, which chose not to implement a full lockdown, has a death rate that is twice as high (on a per 100,000 people basis) as that of the US. Swedes chose to trade human lives for less disruption. It's a trade-off we may all need to make. But we still let people smoke even though we know for a fact that it kills them and imposes enormous healthcare costs on the rest of us. So, there is precedent for this type of trade-off. It's just something we need to discuss honestly and openly..Society needs to reopen. But it also needs to change. We need to accept the loss of some freedoms and norms in order to minimise the risk of an outbreak while maintaining what is essential to life. Covid-safe life won't be as fun as life was before, but the important thing is that life will go on.

WORLDVIEW: Here’s what “living with Covid-19” really means

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