A return to pre-pandemic normal life seems impossible for the foreseeable future. In the absence of control measures, it would result in the rapid spread of coronavirus and many deaths.
About 70% of a population needs to be immune to establish herd immunity, a level of immunity in the population that stops coronavirus transmission. For the UK, with its 66 million inhabitants, this would require the infection of about 46 million people. At an estimated death rate of 0.5%, this would result in nearly a quarter of a million deaths.
This best-case scenario doesn’t consider the daily introduction of newborn babies, not yet immune to the novel coronavirus, nor that it appears unlikely that large proportions of the population will develop long-term immunity in response to a mild case of COVID-19. If immunity is short-lived, natural herd immunity will never be reached and the coronavirus will continue to circulate. The virus may also mutate and new variants may re-infect people immune to the original virus variant.
Only a small percentage of the population has been in contact with the coronavirus, so we remain as vulnerable to further waves of the disease as we were before the pandemic. Further peaks are inevitable as long as the virus is still spreading, making a return to normal out of reach. But perhaps the measures we have put in place to control the virus are not so bad. Indeed, we might want to consider keeping them.
Social distancing and thorough hygiene are the main measures that stop the coronavirus from spreading. Social distancing stops virus transmission through the air via exhaled droplets and is a very effective measure, although it does have negative effects on some people’s wellbeing and mental health.
Hygiene measures, such as hand-washing and disinfection, prevent virus transmission via contaminated surfaces. Both social distancing and improved hygiene prevent the spread of COVID-19 and other infectious diseases.
If we can maintain these measures, there will also be fewer cases of flu and the common cold. The spread of germs that cause diarrhoea, nausea and vomiting will also be reduced. More importantly, these measures could prevent the next pandemic, which could be much more deadly than COVID-19 or seasonal flu.
Different influenza virus strains circulate in birds, which have killed 30%-60% of infected humans and which are only a few mutations away from becoming easily transmissible between humans. And Mers, which is also caused by a coronavirus and is transmitted from camels to humans, kills around a third of those infected.
If these much more deadly viruses gain the capacity to spread as effectively from human to human as the novel coronavirus, the situation will be much worse than the current pandemic. Lifestyle adaptation now will help to protect us from future pandemics.
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Permanent change?
Given the acute threat of COVID-19, people may permanently change their behaviour, if circumstances enable them to. Habits that used to be socially acceptable may no longer be tolerated.
Since we can be infected when we are close to others and when we touch contaminated surfaces, people may change their attitudes towards all aspects of social contact associated with the spread of disease.
Working life may change and involve more working from home, reducing personal contact where possible (more online meetings), abolishing hot-desking and reducing shared equipment.
People may be less prepared to join crowds and crowded places and develop a new perception of a safe distance. Public transport, lifts and venues, such as sports stadiums, convention centres, theme parks and fairgrounds, may need to be adapted to this. And travelling may be reduced and more carefully planned.
There may also be less body contact, including shaking hands and hugging, and increased preparedness to wear face coverings and accept other protective measures in a wider range of situations.
More emphasis may be permanently placed on personal hygiene measures, such as hand-washing, combined with a higher awareness of the infection risk associated with objects that are touched by many, such as door handles, shopping baskets, handrails and filling nozzles, as well as shared equipment from gyms and sports halls, public toilets and rental services.
Based on their experience of the COVID-19 pandemic, people may avoid activities and places or demand and accept more thorough hygiene practices that would have been previously unacceptable.
Increased awareness of infection risks and hygiene may result in a society that is much better prepared to deal with the threats posed by infectious diseases. Similar changes have happened in the past. For example, the realisation that cholera is transmitted in contaminated water resulted in a permanent change of attitude towards sanitation.
However, if these changes in behaviours are to be attained and sustained, public policies need to recognise and address the precarious living and working circumstances that some poorer people experience and which will stand in the way of everyone adopting this new normal.
Martin Michaelis receives funding from the BBSRC.
Mark Wass receives funding from the BBSRC.
Michael Calnan has received funding from the ESRC,MRC and NIHR