Like one in 13 Britons this week, I am convalescent. 12 days ago I tested positive for covid-19 and, to be frank, it hasn’t been the best fortnight. It isn’t, for me at least, just a bad cold. Almost two weeks on and I am still testing positive, I still have a hacking cough, shortness of breath and feel utterly exhausted.
My whole family succumbed at the same time; it’s difficult to recover when you have two children under five isolating with you, needing through-the-night nursing care when sick and, later, constant entertainment and provision of snacks when recovered. In short, this isn’t an experience I’d like to repeat any time soon. But I most likely will.
The pillow-bound pundits of Twitter say the government’s strategy for “living with covid” means we have to start treating it like the flu. Those most vulnerable get their jabs, and we take our own personal precautions, but we no longer live our lives in fear of infection. Only those who are most unwell (that is, hospitalized) will be tested. On we go.
But flu and covid are not comparable, however much we’d like them to be. In 39 years I’ve only had the flu only once. There are now many people reporting their third or fourth infection with covid in two years. As testing is abandoned and the virus spreads more rapidly than in the past, that number will only rise. It means living with high rates of reinfection. It means a very large and ever-growing number of working days lost to sick leave.
Living with covid means what we’re seeing in snapshot this Easter – untenable pressure on the health service, schools limping along on a skeleton staff, airlines canceling flights en masse, holidays cancelled, supermarket shelves being emptied and tills closed due to lack of staff – in perpetuity. Maybe we’ll have some respite over the months of high summer, but then we’ll be back into another whiteknuckle autumn in which public services barely hold fast.
It means, also, that those in crucial public service roles – teachers, doctors, supermarket workers, bus drivers – will continue to face a greater exposure. They will have no choice but to risk exposing their relatives and friends in turn. And moreover, those in those public-facing roles who earn the last will have no economic power to manage that risk: lateral flow tests are a highly discretionary spend amid a cost of living crisis.
What “living with covid” really means is living with a two-tier system that exacerbates every health and wellbeing inequality that already exists in this class-ridden nation.
Without free NHS testing, the ability to control our own exposure and that of our friends, relatives and colleagues becomes a matter of privilege. Those who can afford to pay for lateral flow tests will choose to continue using them: when they are carrying the virus they will make decisions based on that knowledge. They will work from home if they can, isolate and avoid vulnerable family members, avoid infecting colleagues and friends. They will tell those with whom they have been in close contact that they too have been exposed; those people can then, by turn, make decisions that protect the most vulnerable in their circles.
Meanwhile those who are unable to identify covid in themselves – with or without symptoms – will have no luxury of choice. They may also work for employers who grant them no option to avoid work when symptomatic. As we saw in the earliest days of the pandemic, when rogue employers force those working in underground industries – such as Leicester’s illegal sweatshops – to break national rules and work through illness, it spreads rapidly. We’ll see the same pattern on a much larger scale.
For the wealthiest, it’s possible to buy yourself a lower risk of third, fourth or fifth time covid exposure. For the poorest, there is no choice: your chance of repeat infection, and with it your chance of long covid, is exponentially higher.
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This is a moment of reckoning with who we are as a society. In a sense, we already live this way: we know the chances of dying of treatable and preventable diseases are always higher towards the bottom of the income scale. But are we willing to accept it now, in these baldest of terms? Are we happy to be living in a country in which only those who can afford to buy a lateral flow test that syncs with an NHS app (and not all cheap ones do) can provide their covid status to grant them access to a loved one who lives in a care home?
There are good arguments for not funding tests indefinitely, not least the environmental case against the plastic waste they create. I personally disagree, but I understand the argument against mass testing and it is cogent. What makes less sense is this: no access to testing for symptomatic people; forcing covid-positive people into work; no government support for sick pay; no mask mandate to reduce transmission and helping the most vulnerable feel more confident about public spaces.
David Oliver, a critical care doctor who has worked on the covid wards throughout the pandemic, tweeted the following yesterday [Tuesday]: “Only around per cent of people injured in UK road traffic accidents die from their injuries, but I don’t hear too many calls to scrap speed limits, scrap drink driving or phone-at-wheel restrictions or remove quality standards for in- car impact protection. ‘Learn to live with the RTAs’”
If we’re going to “live with it” we need to be honest about ourselves about what kind of a life that is. Are we really comfortable with this?
George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.