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Illustration: Toby Morris
Illustration: Toby Morris

OPINIONScienceSeptember 12, 2022

Siouxsie Wiles: Ditching Covid restrictions now could be a big and expensive mistake

Illustration: Toby Morris
Illustration: Toby Morris

Masks, tests, isolation and ventilation are still vital tools to protect us – and ultimately the economy – from what is still a highly infectious airborne virus.

Today’s the day the government is reviewing the traffic light system, or the Covid Protection Framework. Politically, I’d imagine ditching our Covid protections is looking like a fairly attractive option right now. But it would also be a big, and in the long term expensive, mistake.

Covid-19 is a serious disease, and it isn’t going anywhere

No matter how much we wished Covid didn’t exist, it now looks as though, globally at least, we’re destined to live with waves of infection at least for the foreseeable future. This is the new normal.  

It’s not clear how frequent the waves will be, as they are being driven by a combination of changes to the virus and waning immunity from infection and vaccination. So far this year there have been three waves of Covid-19 – the BA.1 wave, closely followed by the BA.2 wave, and then the most recent BA.4/5 wave. A new omicron variant, BJ.1, has been spotted which looks to be even more immune evasive. Will this one trigger a new wave in a few months, or will there be another variant by then?  

The good news is that we’ve come a long way since the pandemic started. Vaccines, antivirals and other medicines mean in the short term at least, Covid-19 is not the same infection it was even just a year ago. But what is abundantly clear is that Covid-19 isn’t “just a cold” or “like flu”.

There are two things about Covid-19 we mustn’t ignore. The first is long Covid. It’s estimated that 150 million people around the world currently have long Covid. While this obviously has a huge impact on the sufferers and their families, we shouldn’t underestimate the economic impact. Last week Bloomberg reported on a study by the Impact Economics and Policy think tank that estimated long Covid is costing the Australian economy the equivalent of A$100 million a week in lost output. That’s A$5.2 billion a year! Those figures are based on Treasury data that estimated 31,000 workers called in sick in June because of long Covid. Every wave of infection means more people with long Covid, and so more preventable suffering and economic fallout.

Speaking of economic fallout, long Covid is almost certainly just the start. Earlier this year, a big study found that people who had had Covid were at increased risk of cardiovascular problems, including strokes and heart attacks, for at least a year after their infection. This was the case even for people under 65 and those who didn’t have any of the usual risk factors, like diabetes or being overweight. This increased risk didn’t just apply to the old or to fat people or people with diabetes. We’re only just starting to understand the role other viruses might play in diseases like multiple sclerosis, Parkinson’s, and Alzheimer’s. What future health and economic burdens are we letting ourselves in for with Covid-19?

We still need a ‘Covid Protection Framework’

I think it’s definitely time for the traffic light system to be revisited. But I want to be really clear: we still need a Covid Protection Framework – one that protects us from a highly infectious airborne virus, which is what the virus responsible for Covid-19 is. Without any protective public health measures, we’ll just be accepting a whole lot of preventable infections, disability, and more disruptions to our daily lives and economy as a result.

The best public health measures are ones that work invisibly in the background or become so commonplace we don’t notice them anymore. Speed limits, seat belts, limits on how much you can drink when driving. Those are all public health measures. They aren’t just there to protect you. They are there to protect the wider public too.

Consider the Smoke-free Environments Act of 1990. Because of that, smoking is not allowed in indoor workplaces, including restaurants and bars. The law was brought in because of the overwhelming evidence that second-hand smoke is dangerous. In 2006/2007, 18% of people in New Zealand over the age of 15 were daily smokers. By 2020/2021 that had dropped to 9.4%. Are we thinking of getting rid of the Smoke-free Environments Act just because less people are smoking? Of course not, because second-hand smoke is still a health threat.

So is Covid-19.

Lots of sick and disabled people is bad for their and their families physical and mental wellbeing. But it’s also bad for the economy. So, what protections do we need in place to minimise this? Well, they are the ones people like me have been banging on about for ages. Masks are a good measure but are most effective if everyone is wearing one. Given they are what so many people want rid of – after all, they are a reminder that we are still in a pandemic – what else is there?

We need to keep testing and isolating

Rapid antigen tests must stay, and they need to be free so that access isn’t an issue. We also need a big public health campaign to teach people how to test properly, including swabbing the throat and then nose. Tests do need to be fit for purpose though, so they need to be regularly assessed to make sure they can pick up whatever variants are circulating.

I’d really like to see us using tests before doing things. Going to a restaurant or show or to visit someone? How hard is it to do a quick RAT? Because they can tell us when we are infectious, they are a great way of stopping infectious people from putting themselves in situations where they will infect other people.

Isolation needs to stay too. That’s how we break chains of transmission. To make it possible for people to isolate there should be a payment that goes directly to people who need to isolate. That will also help incentivise people to report their test result.

Air quality monitoring, ventilation, and air purification

As I said earlier, the best public health measures are those that are invisible. When we turn on the tap, we expect the water that comes out to be safe to drink. We need to start treating air the same. The first part of this is air quality monitoring which can be done by measuring CO2 as a proxy. We all breathe out CO2 and if we are in a badly ventilated space, the CO2 will build up. We can stop that build-up with good ventilation. Enough air changes, and that’s the equivalent of treating our drinking water so it’s safe when it comes out of the tap.

If good ventilation isn’t possible, then we need to get rid of the virus from the air. That’s where air purifiers come in. Air purifiers/filters can be part of a building’s ventilation system or provided as portable units – though they must always be the right capacity for the room they are being used in. I still can’t believe that at this stage in the pandemic more businesses haven’t embraced ventilation and air purification as a strategy to keep their workers and customers safe and healthy.

I’ve also written before about the “scores on the door” system proposed by the UK’s Independent SAGE group. This would work just like a food safety rating, or energy rating, to let customers whether an indoor space is safe for them to be in.  

As I’ve explained, there are lots of things we can and should be doing to live in this post-Covid world more safely. Our early response to the pandemic showed very clearly how a good health response is also good for the economy. Because people are the economy. Fighting against public health measures is ableist, inequitable, unjust and bad for the economy. We need to do better than that.

Keep going!