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Illustration: Toby Morris
Illustration: Toby Morris

ScienceJuly 20, 2022

Siouxsie Wiles & Toby Morris: Can we get off the Covid merry-go-round?

Illustration: Toby Morris
Illustration: Toby Morris

Rather than succumbing to fatalism over our chances of getting Covid, we need to redouble our efforts to break the dangerous cycle of infection and reinfection. 

Earlier in the pandemic, director general of health Ashley Bloomfield described the pandemic as a rollercoaster ride we hadn’t bought a ticket for.

Professor Christina Pagel, a member of Independent SAGE, recently described the “living with waves of mass infection” pandemic strategy as a negative feedback cycle. High numbers of infected people mean high numbers of people off sick. Some people will develop long Covid and may never recover. More illness leads to pressure on the health system. More illness also means sick workers and customers, which leads to disruptions to businesses and services and damages the economy. That leads to people working when infectious, which means more exposure and more infections. Given each infection is an opportunity for the virus to mutate, that means more chances of the virus becoming more infectious and more immune-evasive, which means more infections…. and we’re back where we started.

If we stick with Dr Bloomfield’s analogy, that makes the strategy the UK, New Zealand and so much of the rest of the world is following more like being on an out-of-control merry-go-round. One that’s going so fast that people are falling off and lying in a crumpled heap around it.

If you don’t think you’re going to be one of the people flung off the merry-go-round, think again. A new pre-print (a study that’s not yet peer-reviewed) describes how Covid is potentially more debilitating and deadly the more times you get it. The study used the vast electronic healthcare databases of the US Department of Veterans Affairs to look for veterans who had tested positive for Covid between March 2020 and September 2021. They found approximately 310,000 of them, and 38,926 had been reinfected by the time the first omicron wave subsided. Some had had Covid more than four times.

Now, the study mostly involved men and as I say, hasn’t yet been peer-reviewed, but the researchers showed that those veterans who got Covid more than once had more than twice the risk of dying and three times the risk of being hospitalised within six months of their last infection. They were also at higher risk of developing a whole heap of issues, including fatigue and diabetes, and lung, heart, digestive, kidney and neurological problems. And the more infections they’d had, the higher the risks.

In other words, you do not want to be getting Covid over and over again.

It’s not all doom and gloom!

Before you fall into a spiral of doom, I want you to know there is a way to ride the merry-go-round more safely. And, you’ve guessed it, it involves using the tools we know reduce transmission: wearing good-quality masks, improving the quality of indoor air, and isolating when infectious.

Japan has a great culture of mask-wearing and they are paying attention to air quality. Look at this tweet from someone going to the cinema. The cinema is monitoring CO2 levels as a proxy for how well ventilated it is, and therefore how safe.

Here’s how it works. The ambient level of CO2 in the air is about 450 parts per million. We breathe out CO2. That means the more people there are in a room and the worse the ventilation is, the higher the CO2 levels will be. The higher the CO2 level, the more the air you are breathing in has recently come out of someone else’s body. Different places have set different thresholds but the consensus seems to be that at about 800-1,000 parts per million is where you are starting to enter the danger zone and so should be taking action, which could be as simple as opening a window or door. In rooms where that’s not possible is where filtration is needed. The CO2 levels will still be high, but the air you are breathing will have been cleaned of any viruses.

By providing CO2 data in real-time, people can choose whether the environment is safe for them or not. Our workplaces should all be doing this! And in hospitality and retail places it’ll help customers decide where is safest for them to visit.

By paying attention to how the virus spreads and working to minimise that, Japan is faring far better than countries like the UK and now New Zealand.

It’s going to take a global effort to stop the Covid-19 merry-go-round, and that’s clearly not going to happen. Japan shows us one way to ride out Covid-19 pandemic in a way that will save lives and livelihoods. Let’s follow their lead. We can’t afford not to.

Keep going!