How to live with Covid
As the Omicron wave subsides in regions across the world, more governments, politicians and health officials are telling us it’s time to start “living with the virus.”
But what does that mean? And how do we do that?
For guidance, I connected with more than a dozen epidemiologists to ask about the next phase of the pandemic and how they’re approaching it.
Living with the virus “is an acknowledgment that eradication of SARS-CoV-2, like what we did with smallpox, is not feasible,” said Maria Sundaram, an infectious disease epidemiologist at the Marshfield Clinic Research Institute.
Instead, we’ll need to rely on an arsenal of tools — including vaccines, paid sick leave and masks — to coexist with the virus while reducing our own risk and protecting others.
Eventually, the thinking goes, we’ll get to a point where the coronavirus is incorporated into other common viruses we are used to dealing with all the time, said Pia MacDonald, an infectious disease epidemiologist at RTI International, a nonprofit research institute. “We should each reflect on how we live with other viruses that routinely circulate, such as influenza, respiratory syncytial virus, noroviruses and others.”
That’s going to require a huge mental shift and acceptance of “a new element of manageable risk in our lives,” said Eduardo Franco, the director of the Division of Cancer Epidemiology at McGill University. “It means reacquiring behaviors, attitudes and social norms,” that have always been part of who we are.
In practice, this readjustment will vary widely for different people depending on our personal health circumstances and the needs of those closest to us.
“My family has moved away from restricting our activities as the Omicron surge has receded,” said Kate Eisenberg, an assistant professor of family medicine at the University of Rochester. “We do not have anyone with high-risk health conditions in the household, and we’re all vaccinated and boosted.”
Eisenberg is currently planning some family trips, including air travel, and she is allowing her 12- and 15-year-old children to participate in most social activities. She has been avoiding indoor dining and crowded indoor settings, but as cases continue to come down, she plans to go out more.
“I am taking my daughter to a Billie Eilish concert this weekend, which we’ve really been looking forward to,” she said. “We do still wear well-fitting masks, take home tests before getting together with friends and family, and assess the level of risk and local case levels before we go out.”
For MacDonald, the drop in cases has made her more comfortable entering other people’s homes without a mask, and having her older parents over for visits.
“I will still wear a mask to the grocery store for the foreseeable future and opt for restaurants that have good ventilation and where tables are well spaced out,” she said. “So long as cases are not surging locally, I will take advantage of mixing with my community at music, movie, theater and other venues, though will likely wear a mask out of habit.”
For many Americans, however, any big adjustments are still on hold until young children can get vaccinated.
“Our children are both in child care, and we’ll go into uncrowded shops, museums and libraries with masks on, though we don’t do any indoor dining and haven’t flown on a plane,” said Julianne Meisner, a clinical assistant professor at the University of Washington School of Public Health.
But after her 1- and 3-year old are vaccinated, she said, “we’re planning to resume indoor dining and take some trips to visit family and take some outdoorsy vacations. But we’ll have our eye on what’s going on and be ready to revisit plans if local transmission goes up or health care capacity begins to suffer.”
After we’ve spent two years of living in fear of the virus, being asked to “live with” it now may seem daunting. But in many ways, we’ve been preparing for this moment since the outbreak and it can be easy to forget how far we’ve come.
“For the first year of the pandemic, I routinely received questions from friends, family, patients and acquaintances about how to think about risk in different situations before making decisions,” Eisenberg said. “Now, hardly anyone asks those questions and most people have settled on their own conclusions about what works for them.”
Are you ready?
We recently asked readers: “Are you ready to live with the virus?” It’s a hot topic: Nearly 3,000 of you wrote in. Thank you to everyone who shared their thoughts. If you’d like to continue the conversation, you can tell us how you feel in the comments section here.
“It’s time to start living with Covid by normalizing it. It’s a virus. It will keep mutating. It’s never going to be ‘over,’ no matter how long we make concessions. And if it’s never over, as a nation, we can’t grieve, find closure, adapt and help each other and our kids find silver linings and hope. We need to begin the healing process. We need to allow the healthy to start living.” — Ariele Taylor, Bay Area, Calif.
“If ‘living with the virus’ means letting down my guard, then NO. I’m not remotely ready. I’m prepared to wear masks for the rest of my life, if need be. I’m not going to get casual about Covid. I’m 74. I’m already dealing with fibromyalgia. I don’t want long-Covid on top of that! For me, masking up when I go out is an inconvenience I can live with.” — Kathryn Janus, Chicago
“Yes, we need to stop dividing citizens over vaccination choice and vaccine passports for good. We haven’t been able to enjoy restaurants, festivals, museums or any kind of travel because of this requirement, due to different vaccine statuses in our family. I am sympathetic to the most vulnerable and immunocompromised, but unless the government can approve more viable treatments for Covid, they are not the only people fighting to survive this pandemic. We have exhausted teachers, business owners, restaurant staff, grocery store clerks, pharmacists, retail workers — all bearing the brunt of restrictions that they need to enforce on an equally exhausted population. By living with the virus, we are equipped with knowing what to do if we get infected, we have new protocols to self-isolate, to wear masks, or even get vaccinated if one feels unsafe. Beyond that, there is not much more we can do as a person.” — Dahlia, Montreal
“I am ready! I want to travel with my family, do my job in full capacity and have my child in school without a mask if they choose. It has been long enough and it’s time to let people start choosing which precautions they want to take. You can wear a mask for the rest of your life should you choose. No one will ever stop you from doing that.” — Stacy Foster, Portland, Ore.
“I’m 66 with a recent cancer diagnosis. If we just decide that precautions (vaccinations, masking and testing) aren’t really needed anymore because we’re ‘living with it,’ then we are relegating the most vulnerable (i.e. elderly) to a life of isolation and unreasonable restrictions in order to allow younger, less vulnerable people to ignore the risks they pose to the more vulnerable.” — Therese Hoffman, Toledo, Ohio
“Aren’t we already living with the virus? How are most people’s daily lives really being impacted right now? Most states no longer have mask mandates and vaccines are only mandated for health care workers. Restaurants and bars are open. Concerts are happening. Aside from health care workers and those at-risk, it seems like most have returned to normal?” — Brandi C., Vancouver, Wash.
“We’re past the time of waiting it out. I’ve accepted the addition of a yearly Covid vaccine to my flu vaccine regimen. I’ll continue to wash my hands, stay home when I’m sick, and maintain a healthy distance from others, just like I did in the pre-Covid era. But I’m over all the fear-mongering. We must ask ourselves: Is all of this really worth not living?”— Jaime, Ridge Farm, Ill.
“I don’t feel ready to ‘live with the virus.’ Part of me wants to, but my husband and I have spent the last two years being hyper vigilant to the point that I can’t fathom what normalcy would look like. I know that if I attempted to ‘live with the virus,’ I would likely feel a level of anxiety I don’t care to experience.” — Danielle Lovell, Carrboro, N.C.
“As a health care provider, I’ve been ‘living with the virus’ since March 2020. It’s absolutely consumed my professional life and spilled over greatly into my personal life as well. I don’t know that I’ll ever stop living with it, in the sense that there is some trauma from the last two years that will stick with me, probably forever. I want desperately for this to be over, but I am terrified of continued surges that will overwhelm our already fragile health system. I’m devastated at the thought of losing more lives to this. But I get that the current restrictions are taking a toll. I don’t know what the right answer is.” — Elizabeth, Brooklyn, N.Y.