Where is COVID-19 going?

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This is a question that pastors and church leaders will be asking as we head into 2022 and approach the 2nd anniversary of the pandemic being declared. We want to know what will happen in terms of the risk of illness, hospitalisation, and death so that we can help our congregations prepare for what might be to come. We are also aware that ongoing anxiety about the virus alongside any new restrictions that might come in is likely to affect attendance both for people gathering to worship and for events and regular activities we put on.  Then there are other questions and concerns. Will measures that whilst many accept as necessary in an emergency become the norm because that raises huge concerns about authoritarian control. 

So, I wanted to talk a little here about what we might be seeing happen in the longer term. What we’ve seen with the Omicron variant of course is how uncertain things can be and how the picture can change so dramatically. All the pointers in the autumn were looking good and it seemed possible that Britain could get through the winter without needing nee measures.  However, Omicron proved to be gar more infectious that any of the previous variants and came with a drop in vaccine efficacy.  The result was that we saw a step un lateral flow testing, vaccine passports brought in across the whole country, mask wearing return to indoor venues in England and limits on gathering sizes re-introduced in Scotland and Wales. 

On the positive side, the Omicron wave doesn’t seem to have been as severe in terms of serious illness with the level of vaccination and prior infection playing a part in that (this gives us some clues as to what is coming up next).  The good news is that hospital numbers have stayed well below the levels seen in previous waves even with a wave three times the size of the first two. Additionally, ICU numbers have remained flat. However, the sheer size of the wave means the numbers requiring hospital treatment, combined with the number of NHS staff having to self-isolate means that the NHS has still experienced heavy pressure.  So we need to be careful about being dogmatic in our assumptions about what is to come.

However, the dominant, mainstream view right now seems to be that we are moving towards endemicity. What endemicity means is that the virus is not going away, we are not going to eradicate it. However, we are no longer going to be in a pandemic situation where cases are growing exponentially around the world. The virus is likely to be around but we will see significant seasonal fluctuations just as we see specific seasonal peaks in other illnesses such as influenza and the common cold.[1]

Endemicity does not describe the seriousness of the illness. It’s possible for an illness to be endemic and mild as the common cold is but it can also be serious. Influenza is serious in a similar way to COVID-19 in that older and clinically vulnerable people remain at significant risk of hospitalisation and death.[2]

However, what a significant number of virologists have been suggesting for some time is that what we are likely to see is that over time (this could be a number of years) our experience of the virus will become less severe. Whilst I understand that it is possible that a ne variant will be intrinsically milder, the expectation seems to be less that this will happen and more that over time our level of immunity will grow through the vaccines training our bodies to respond and through repeat exposure to the virus.   Children and younger people will grow up building  up that immunity. However, older people will still remain vulnerable.

It is important to note that we are talking long term there. So, what can we expect in the short term. There is perhaps at the moment greater short term uncertainty than long term. We know that endemicity is the long-term direction of travel but we don’t know what bumps and unexpected turns we can take. 

However, what we can say is that at the moment, we are seeing case numbers fall dramatically. This means that we will potentially be back to where we were before Omicron potentially within the next week.  This means that the outlook should be of reduced pressure on hospitals starting to ease the NHS crisis by the early February. However, it will take longer before we begin to see the number of deaths coming down again.  It is expected that this will lead to an easing of recent restrictions from the end of January. 

The big question is what happens after cases have dropped to pre Omicron levels. One possibility is that as vaccine efficacy wanes we see cases stabilise and plateau at what would be still high rates at least until the summer when we can all get out in the fresh air. We may even see some further Omicron driven spikes.  Another possibility is that because so many people were infected over a short period of time, this has boosted herd immunity and we see a further drop off so that cases reduce to very low levels. However, we will at least be in the same situation we wer ein for most of the autumn, if not better. I expect therefore the different UK countries to be under the same restriction regimes as for the Autumn (no restrictions in England, face masks in Scotland and Wales).

Attention will turn increasingly towards what it means to live with COVID.  I would expect the following to be in the mix. First of all, we will still need to provide additional protection for the elderly and vulnerable. This will primarily be through annual booster vaccinations but targeted to those most in need.  Secondly, living with COVID means that we will not want to allow the virus to cause significant disruption to life. Therefore, I would expect there to be a reduction in testing and reporting. I suspect also that through the summer, the decision will be taken that isolation when testing positive is no longer required unless symptomatic. There may be provision for a retune to isolation and testing regimes, potentially localised to counter seasonal outbreaks at least over the next few years but those needs will reduce in time too.

This is important because of the significant division there is between viewpoints. I think we need to learn how to live with a polarised society and a polarised church for a while too. That is going to be challenging.  Some will not be satisfied as long as the shadow of restrictions hangs over us. Further, the anti-vax agenda will continue to push it’s own narrative with anything and everything negative being linked to the vaccine. 

Meanwhile, there are those who have been convinced that the only way we can be safe from COVID 19 is when it is completely eradicated. Be prepared for some people to remain highly anxious for a long time to come. This means we can expect a significant proportion of people to remain relucntant to get involved with in person church activities. You will still be getting those emails and barbed comments for some time to come from both sides too with some accusing you of recklessness and others accusing you of compromising with the world.

What this means for church leaders I think is that whilst the pandemic is nearly over, its after effects could be long lasting.  My advice would be

  1. Keep the main thing the main thing. Continue to remind people and yourself that our job is to make disciples.
  2. Pray that God will guard your own heart to keep you trusting his sovereignty and loving others.
  3. Learn patience.
  4. Support one another.  All of those support networks that we found so helpful for lockdown will become increasingly not less crucial over the next few years.

[1] See Epidemic, Endemic, Pandemic: What are the Differences? | Columbia Public Health

[2] This is discussed here Endemic Covid: Is the pandemic entering its endgame? – BBC News

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