Are pandemic restrictions done for good? If not, what will trigger action again?

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With COVID-19 hospitalizations falling steadily, vaccination numbers continuing to climb (albeit too slowly, especially for boosters) and infections levelling off (probably, though we’ve largely given up on testing), easing pandemic restrictions makes sense.

It’s also a politically wise move. Even those who have followed the rules most assiduously are getting fed up as we plod into year three of the pandemic.

Public health interventions should be proportionate to threats. And the public should be rewarded for doing the right thing, like getting vaccinated.

Dropping the use of vaccine passports, mandates, mask rules, crowd-size restrictions and so on was always the plan.

The challenge is getting the timing and scope of the easing right. As Mike Ryan, director of emergencies at the World Health Organization said recently: “Time and time again governments have tried to get back to normal and have overshot that runway by opening up too early.”

The relaxing of restrictions has nothing to do with the protests, which are led by insurrectionists hiding behind calls for lifting vaccine mandates, though the horn-honkers will try to take credit.

In the coming days and weeks, the COVID-19 rules will change markedly, an almost “return to normal” in most jurisdictions. There is a period of tranquillity ahead, especially with spring coming. There is a seasonality to the spread of coronavirus.

But, going forward, the real challenge is: What happens when infections shoot up again, or when hospital beds, and more importantly intensive-care beds, start filling up with pandemic patients again?

Will we have the stomach to reimpose restrictions if COVID-19 rears its ugly head again in the fall (as it has done in the past two years), especially if we are slammed with a new, more deadly or infectious variant? If we drop vaccine mandates and passports now, will reinstating them be possible later?

Will we respond better in the sixth wave than we have in waves one, two, three, four or five?

The problem today, unfortunately, is the same as it was in the summer of 2020, when, after the shock of being hit full force by COVID-19, we relaxed then-strict lockdowns.

Time and time again, politicians earnestly announce that some rules are no longer needed but they never discuss the metrics for reimposing restrictions.

Early in the pandemic, we were most worried about case numbers and the positivity rate. Now, after widespread vaccination, it’s the strain on hospitals that matters.

But what’s the trigger point for action?

Governments seem to have been guided by licking their fingers and holding them up to get a sense of the public mood. That dubious approach is getting more so as the pandemic becomes more politicized and partisan, and anger seethes on both ends of the spectrum, from the so-called freedom proponents to the rule-followers fed up at being treated with contempt.

At this point in the pandemic, we seem to have become inured to projections, and disinterested in data.

Some politicians, like Saskatchewan Premier Scott Moe, have taken this head-in-the-sand approach to absurd lengths by decreeing that the province simply won’t release daily data on COVID-19 cases, hospitalizations and such.

We can probably largely agree that “out of sight, out of mind” is not the wisest approach, scientifically, if not politically.

But what is?

It’s a given now that COVID-19 is here to stay, that the virus will be endemic. But there is also a widespread misunderstanding that endemic is a synonym for harmless.

What it really means is that rates of an infectious disease are static. Tuberculosis, for example, is endemic, but it infects about 10 million people and kills 1.5 million every year.

Globally, COVID-19 killed about 1.8 million in its first year, and almost four million in its second year. In Canada, about 15,000 people died in both 2020 and 2021.

We don’t know the collateral damage of public-health measures, from delayed surgeries to mental-health impacts. Nor do we know the long-term impact on the health of the millions who were infected and recovered, but we do know “long COVID” is real.

Throwing off restrictions is a welcome respite, but we can’t pretend the pandemic is over. Nor we can forget that the rules, however disliked, saved many lives.

We all have a role, through our individual and collective actions, in determining what the future will bring.

Ultimately, “learning to live with the virus” will be about what level of COVID-19 mortality and morbidity is acceptable in Canadian society.

“Freedom” has a price.

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