What 'Learning to Live With COVID' Really Entails

If we're not actually learning from what works, we are just learning to accept preventable suffering, disability and death.

By Ryan McGreal

Posted February 16, 2022 in Blog (Last Updated February 16, 2022)

When people say,“we need to learn to live with COVID”, what they usually mean is: “we need to surrender to COVID and give up on trying to protect the health and safety of vulnerable people”.

Whereas, actually learning to live with COVID implies carefully applying what we know - vaccines and boosters work, indoor air filters work, N95 and equivalent masks work - across our society and especially to protect people most at-risk of serious illness.

Actually learning to live with COVID implies ensuring that all workers who come down with illness can recover at home with pay so they don’t have to risk infecting their coworkers.

Actually learning to live with COVID implies building up our healthcare and public health system to engage in comprehensive proactive monitoring and trigger early interventions to stop exponential case growth before extreme measures (like stay-at-home orders) are needed.

Vaccines work. Instead of abandoning vaccine passports to mollify the <10% minority who reject modern medical science, we should redefine “fully vaccinated” to include boosted after 6 months - and clearly explain why this is important to keep everyone safe.

High-quality fitted masks work. Mask rules should be updated to require N95 or equivalent in mixed indoor congregate settings as long as COVID transmission is still a significant risk, not abandoned altogether.

We didn’t backtrack on seatbelt rules just because some people were annoyed to wear them.

In the mid-1800s, the city of Chicago literally raised their streets and buildings as much as 14 feet to reduce the risk of cholera - and they did it without the benefit of modern science and technology.

We need our own raise-the-streets megaproject to filter and clean indoor air everywhere. Even aside from preventing COVID transmission, the corollary health benefits would be enormous.

The 19th century was the era of big public health projects - plumbing to every building, water and wastewater treatment on a massive scale - and they took these huge swings at a time when the germ theory of disease was still hotly debated and viruses hadn’t been discovered yet.

This set the stage for the extraordinary gains in life expectancy and quality of life over the 20th century. Those big investments paid enormous dividends on sheer livability.

Now that we know so much more about the determinants of health, what on earth are we waiting for?

And I don’t just mean against COVID. In Hamilton, Ontario, where I live, the wealthiest census tracts have an average life expectancy 21 years longer than the most impoverished census tracts. That should be unconscionable, but most people just shrug it off.

It should not come as a surprise to anyone that the major social determinants of health - income, job security, living conditions, racial discrimination, social inclusion - are also significant risk factors for exposure and severity of COVID infection.

The suffering and harms related to the pandemic - the disease itself, but also the collateral damage of our blunt efforts to contain it - have disproportionately fallen on racialized people, people with low incomes and insecure jobs, people living in substandard housing.

A pandemic of infectious disease has collided with a pandemic of socioeconomic exclusion and wealth inequity.

These are not immutable laws of nature. They are the predictable consequences of deliberate policy choices made over the past 40 years.

It didn’t have to be this way.

It doesn’t have to be this way.

Instead of learning to live with the abhorrent ideology that some people are expendable and disposable, let’s learn to live within the applied knowledge of all the things we can do to reduce harm and lift every person out of needless, preventable suffering and early death.