We have to learn to control COVID-19 numbers without formal restrictions

By Martin Michaelis and Mark Wass. The COVID-19 pandemic is unlikely to end soon. Hence, the only chance to live sustainably without formal restrictions is a voluntary change in behaviour that keeps COVID-19 spread under control.

Concerns about the Indian B.1.167.2 variant of SARS-CoV-2, the coronavirus that causes COVID-19, are increasing in the UK and around the globe. Surge testing has been introduced in areas of the UK where the Indian variant has been detected and changes to the vaccination schedule are proposed. Nevertheless, we may be seeing the beginning of another COVID-19 wave in the UK and experts propose delaying the opening planned for 21st June in England to prevent or reduce another spike of COVID-19 infections, hospitalisations, and deaths.


These issues illustrate a wider problem: The pandemic is not over. The situation has relaxed in the UK in recent months due to lockdowns and the vaccination roll-out. However, this does not reflect the global situation. Peru has just readjusted its official COVID-19 deaths numbers after a data review from under 70,000 to over 180,000. This means that Peru is the first country that has officially lost more than 0.5% of its population due to COVID-19. This and many examples of anticipated underreporting of COVID-19 deaths suggest that the official number of just above 3.5 million COVID-19 deaths is a substantial underestimation.


The continued spread of COVID-19 around the world means that no country is safe from the reintroduction of the virus. Peaks are occurring even in countries like Taiwan and Vietnam, which have had COVID-19 under control from the beginning of the pandemic. Hence, nobody is safe until everyone is safe.


It will probably take until 2023 or perhaps longer before large parts of the world have been vaccinated, and in the meantime new variants may emerge that are not covered by the current vaccines. Although it should be possible to adapt the available COVID-19 vaccines quickly, there will also a time delay before sufficient supplies are produced. Hence, it seems that we will not be able just to vaccinate COVID-19 away.


Taken together, this means that we will have to learn to live with COVID-19 in a way that does not result in repeated waves and lockdowns. The main message that we all should have understood based on previous experiences is that we need to stop an increase in COVID-19 transmission as early as possible. If we wait until we are sure that we are seeing a new wave, it is too late to control it without drastic measures. Thus, we need to intervene earlier to keep numbers pre-emptively low. This appears to be the only sustainable way to control COVID-19 without further sweeping restrictions and lockdowns.


Notably, formal restrictions are always only the second-best option. It is much better to choose ourselves the measures that we are happy to take to avoid COVID-19 transmission than having to comply to rules imposed on us by others. To be able to do this, we will have to learn how to recognise situations of increased infection risk and avoid them. This includes voluntarily following the ‘Hands, face, space, and fresh air’ rules as much as possible, even if there is no legal requirement to do so. This will also mean prioritising what we do and focusing on things that are really important to us and not doing everything that is possible just because it is allowed. If we do not learn to adapt our behaviour in a way that it enables a meaningful life but also reduces virus spread, we may well be caught in recurrent cycles of tightened and loosened restrictions for the foreseeable future.