The downstream impacts will reverberate indefinitely, writes Derek Cheng.

It’s over. Kind of.

The lifting of the last remaining Covid restrictions last week signalled the end of a period of more than three years where, at its most acute, we were told to stay home and keep to our bubbles while the borders were indefinitely closed.

We largely stuck to the unprecedented restrictions and managed to strangle the virus to the point where some semblance of normal could resume. And each time a new variant or new vaccine or new treatment came along, discussions would ensue about what the “new normal” would be like.

Now we’re supposedly at the final “new normal”, where New Zealanders have no need to be mindful of any government restrictions, and living with the virus has become the inevitable reality.

But Covid hasn’t vanished.

It has already taken more than 3,000 lives while disrupting businesses, classrooms and hospitals in ways that continue to reverberate.

Staff shortages in the health sector were already under pressure, but Covid exacerbated this by forcing infected staff into isolation and pushing their mental and physical limits as the worst of the pandemic swept through hospital wards. Over the coming decade, the government now estimates New Zealand will need nearly 13,000 extra nurses and over 5,000 more doctors.

And the latest Education Review Office report says only 19% of school principals in 2023 believed their school had recovered from Covid disruptions.

Then there’s the death toll, on track to be around 1,000 this year, or twice as deadly as the flu.

Covid could unleash havoc again if a nastier, deadlier, more infectious and more vaccine-immune variant emerged. But there are a lot of “ifs” in that equation, and even if they all aligned, we would hopefully be starting in a far less vulnerable position.

We would have a high level of population immunity – from both vaccinations and previous infections – which would provide some sort of protection, and we would have treatments that were unavailable when the pandemic started.

More likely, Covid will just fade into the background as one of a number of diseases that we might get infected with. This will put an extra burden on hospitals and doctors and school attendance, but hopefully a manageable one.

Life will go on largely as it did pre-pandemic – especially if you’re younger, healthier, richer, and non-Māori or non-Pacific.

The limits of what is manageable will probably be tested less by the next surge in infections and more by the downstream effects of Long Covid – symptoms of Covid that last for weeks, months, even years.

Research suggests Long Covid might be linked to early stages of neurodegeneration, and even the likes of Parkinson’s disease. It also indicates you’re more likely to suffer Long Covid the less vaccinated you are or the more often you get infected.

And once you have it, there’s still a giant mystery over how long it might last and what can be done about it.

“Multiple potential Long Covid therapeutics are in development. However, none have been clinically proven at this stage,” says the Ministry of Health’s latest evidence brief about Long Covid, from November 2022.

And if, as evidence suggests, as many as 10 to 20% of those infected get Long Covid, that could mean major future knocks to the labour market and wider economy.

The evidence brief discusses this: the “widespread but hard to quantify” financial impact, including a reduced ability to work (which shrinks the workforce and productivity potential) and greater cost pressures on individuals, including lost wages, lost savings, and possibly more debt to cover healthcare costs.

Young people with Long Covid could even develop certain neuropsychiatric conditions – these can present as insomnia, anxiety, impaired concentration or fatigue – which “could potentially lead to a widespread economic burden for future generations”.

And then there’s the same equity question that has been repeatedly raised throughout the pandemic: how should the greater Long Covid burden for Māori and Pacific peoples be addressed?

It’s no great comfort that this part of the “new normal” is no different from the last one.

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