Living with Covid: What does a future with coronavirus look like?

By Digital Content Producer Amani Hughes

As Covid Plan B measures are scrapped in England and Health Secretary Sajid Javid says the Omicron variant of coronavirus is "in retreat", is the pandemic almost over?

Experts have warned the virus will not just disappear from our lives, but what does that mean in terms of living with coronavirus?

ITV News has spoken to three experts – an epidemiologist, a psychologist and a GP – to get their take on what ‘living with Covid’ could look like.

Listen to our coronavirus podcast on what a future with Covid looks like

Epidemiologist

“When people say endemic, a lot of people use it to mean different things, endemic can be that the disease is present in a population and will remain present,” Paul Hunter, Professor in Medicine at the University of East Anglia tells ITV News.

And this is the likely trajectory that Covid-19 is now taking – that the disease will be “with us for decades to come”.

There are many endemic infections across the world – some more severe that others, malaria for example killed 627,000 people in 2020, the World Health Organization reports, but Professor Hunter is confident evidence is pointing to Covid becoming less severe over time.

“We are already seeing that with the Omicron variant being substantially less severe than previous variants,” Prof Hunter says.

So as the severity of this disease diminishes, how much longer will restrictions, mass testing and self-isolation need to continue for? And what about vaccines?

The answer to that remains hard to pin down, some scientists say 2022 is the year we get back to normal, but Prof Hunter explains it’s difficult to predict, giving a timeframe from this spring to two year’s time.

However, there will come a point when the virus will struggle to maintain itself, as most people will have built up immunity, either through vaccinations or by having the virus and recovering.

The 1918 Spanish Flu pandemic ended not necessarily because the virus mutated and became weaker, but because of the immunity that was built up from previous exposure.

“In this pandemic and like Spanish flu or indeed the Russian flu, once you’ve experienced it a few times, the chances that you’re going to get severely ill is substantially reduced,” Prof Hunter explains.

“What we see is that the infection can still spread and can potentially spread quite rapidly, but it doesn't, as readily, make people as sick that they need to go into hospital or intensive care units.

"An example of this is [at the moment], even though case numbers are astronomical compared to what they were this time last year, occupation of intensive care beds is lower, and is actually falling despite the fact that we're still at a very, very high level of infections.”

In terms of antivirals, to treat severely ill people and prevent them from being admitted to hospital in the first place, the UK has bought millions of drugs – namely molnupiravir and Paxlovid.

If the drugs are administered early enough in the course of the infection, they can actually reduce the chance of people ending up in hospital and speed up their recovery, Prof Hunter explains.

The focus group of those receiving the drugs will likely be those most at-risk – immune compromised people and older members of society – which is important as this will “reduce the disease burden on society”.

And vulnerable people are likely to be the target of any further vaccination campaign, Prof Hunter explains, rather than administering boosters to healthy, younger people.

It is likely that younger people will be reinfected with Covid for many years and will build up that strong protection against severe disease over time. Whereas those who are older and more vulnerable will almost certainly need an additional vaccination every year, as they do with the flu jab.

When it comes to mass testing, Prof Hunter knows it has to continue for now, as the virus is still causing severe harm. But we will reach a point when testing will become redundant?

“At some point, maybe this year, maybe next year, we will want to stop doing anywhere near as much testing as we are now, particularly for mild infections, and then at that point how do you know it’s Covid and it’s not just another cold? You won’t, and ultimately I think people will drift back to work and we will revert to the sorts of behaviours that we had before Covid,” Prof Hunter says.

But he added: “The one question, and I don’t know the answer to this, is how long that will take and whether or not we still have a degree of nervousness.”

However, Prof Hunter expressed his optimism for a future and the ‘new normal’.

“I would be very surprised if in five, six year’s time, you could come into society and notice any major differences to what the situation was like in 2019.

"I think we will revert pretty much back to normality.”

Psychologist

There are shades of grey when it comes to people’s behaviour as we transition to a ‘new normal’ in a post-pandemic world, as Dr Nilufar Ahmed, a social sciences lecturer at Bristol University and a chartered psychologist, explains.

“As we move on in the next few weeks, months and years, we'll be adapting our behaviours in the way that we've learned to adapt them already,” Dr Ahmed tells ITV News. “So there's nothing to be scared of, but it is being prepared for that and navigate what's right for you.

“So, some people will be hugging each other, and that might scare you and you must feel able to say no, I'm not ready for that yet. It's not a hard no, it’s just not yet. Move at your own pace.”

For two years we learnt to be cautious, staying two metres apart and being afraid of the consequences if we did not adhere to the rules – all the changes we went through are now engrained in our mind. So as Dr Ahmed say it’s about “setting boundaries and working out what’s right for you”, especially with friends and family.

In the run-up to Christmas, as Omicron surged through the UK and in lieu of any strict restrictions on our movements, people started to self-police themselves, to ensure they could spend the festive period with loved ones.

Dr Ahmed believes this behaviour will continue and people will do their own risk assessments before important events.

“The complexity with this is if you aren’t allowed to work from home. For example, you’ve got a good friend’s wedding coming up in a couple of week’s time, you really want to be able to be sure that you’re going to be well enough to go, but you need to pop into the office or you work in a crowded environment, and that can add to your stress because you have to take extra precautions.”

There is a danger that a post-pandemic world will also exacerbate social inequality, Dr Ahmed warns. This was seen during the pandemic, especially with the emergence of home-learning and children not having access to an equal education.

Free lateral flow tests will be phased out and will only be available in high-risk environments, such as hospital and care homes and it’s likely we will have to start paying for Covid tests.

“Some people just simply won’t be able to afford it,” Dr Ahmed says. “Even if we’re only talking a couple of pounds, it becomes inhibitive. If you've got a large family and you need to test quite regularly, then it becomes about when am I testing? Is it for big family events or is it for every day, or when I'm going into work or going to pick the kids up from school.

“The transmissibility remains the same, whether the events are big or not and so those decisions are quite complex for people to make.”

Self-isolation rules have dramatically changed since the start of the pandemic, if you tested positive for Covid you had to self-isolate for 14 days in the early days of the outbreak, this went to 10, then seven and recent guidance has now changed the self-isolation period to five days.

This trajectory points towards a point in the future when the isolation period will be scrapped altogether - Boris Johnson says it's his intension to end isolation rules in the coming weeks - but will society continue to isolate whenever they get ill?

Dr Ahmed agrees it will as people “will be more cautious about going into work with any sort of cold” but she also believes the behaviour of powering through and commuting to work, even when under the weather, will return in the long-term.

However, she says not every employer will be happy to allow someone who’s ill into the office, which is when hybrid working will come to the fore.

Looking towards the future and the ‘new normal’, Dr Ahmed spoke of her excitement and believes the connection with community around you will continue.

“When you had lockdown, you were limited to such a small space and actually that invigorated relationships, and that can have a really positive impact on personal relationships but also on the planet as well.”

GP

During the pandemic, GPs had to stop seeing patients face-to-face and appointments moved online, but as we transition out of the pandemic, what does the future look like for general practice?

A hybrid option for the patient to choose – in person, telephone or online, GP registrar Dr Sonia Adesara says.

She told ITV News the pandemic has meant GP surgeries have adapted and become more efficient, instead of patients collecting their prescription from the doctor, prescriptions are sent straight to pharmacies, test results are being sent to patients via text messages, rather than bringing them into clinic and there’s more of a reliance on technology over face-to-face contact.

However, this does not work for everyone, especially elderly patients, those without a mobile phone and people who would prefer to see a doctor in person, including those with mental health problems.

“I don't think we can use model that’s 100% virtual, I think those options need to be available and I think there needs to be patient choice about that,” Dr Adesara says.

“If a patient wants to have a face-to-face consultation, then I think that should be facilitated because there'll be some people that don't feel comfortable talking about things over the phone, but do feel more comfortable, or more able to explain their issues, face to face.”

But the GP says the use of technology and video consultations has meant clinics can see more patients per day, especially as people no longer have to book time off work but can have a virtual appointment in their lunchbreak.

Dr Adesara adds: “I think it's just about giving the doctor and patient that flexibility to decide what's best for that particular patient and knowing that it'll be different for different people.”