Much of the developing world also continues to face an increase in infections, giving the coronavirus a greater chance to replicate quickly, which in turn increases the risk of further mutations and spread.
England has lifted almost all coronavirus restrictions. Germany allows vaccinated people to travel without quarantine. The mandates for outdoor masks have largely disappeared in Italy. Shopping centers remain open in Singapore.
Eighteen months after the start of the coronavirus, governments in Asia, Europe and America are encouraging people to return to their daily routine and transition to a new normal in which metro, offices, restaurants and airports are once again full. More and more often the mantra is the same: we have to learn to live with the virus.
However, scientists warn that exit strategies from the pandemic may be premature. The rise of more transmissible variants means that even rich countries with abundant vaccines, including the United States, remain vulnerable. Places like Australia, which closed the border, are learning they can’t keep the virus out.
So instead of giving up on their roadmaps, officials are beginning to accept that progressive closures and restrictions are a necessary part of the recovery. People are being encouraged to change their view of the pandemic and focus on avoiding serious illness and death rather than infections, which are harder to avoid. And countries without COVID ambitions are rethinking those policies.
“You have to tell people: we’re going to get a lot of cases,” said Dale Fisher, a professor of medicine at the National University of Singapore, who heads the National Committee for Infection Prevention and Control at the Singapore Ministry of Health. “And that’s part of the plan, we have to let it go.”
For months, many residents of Singapore, the small Southeast Asian city-state, carefully studied the details of each new COVID case. There was a palpable sense of dread when infections first hit double digits. And with the borders closed, there was also a sense of defeat, as even the most diligent measures were not enough to prevent contagion.
“Our people are tired of fighting,” a group of Singaporean ministers wrote in an opinion essay in the Straits Times in June. “Everyone is wondering: When and how will the pandemic end?”
Officials in Singapore announced plans to gradually ease restrictions and chart a path to the other side of the pandemic. The plans include changes to control how many people become seriously ill, how many require intensive care and how many require intubation, rather than infections.
These measures are already being tested.
The outbreaks have spread to several karaoke venues and a major fishing port, and on Tuesday Singapore announced a tightening of measures, including a ban on all dining options. Commerce Minister Gan Kim Yong said the country is still on the right track, comparing the latest restrictions to “roadblocks” to the ultimate goal.
Singapore has fully vaccinated 49% of the population and cited Israel, which leads the way at 58%, as a model. Israel has made a turn to focus on serious illness, a tactic officials have called a “soft crackdown.” It is also facing its own spike in cases, ranging from the single digits a month ago to hundreds of new cases per day. The country recently reintroduced a mandate for indoor masks.
“It’s important, but it’s pretty annoying,” said Danny Levy, 56, an Israeli official who hoped to see a film in Jerusalem last week. Levy said he would wear his mask to the theater but found it frustrating that restrictions were again imposed as new strains of the virus entered the country due to poor testing and monitoring of inbound travelers.
Michael Baker, an epidemiologist at the University of Otago in New Zealand, said countries taking shortcuts towards reopening are putting unvaccinated people at risk and gambling with lives.
“Right now, I find it quite surprising that governments necessarily decide they know enough about how this virus will behave in populations to choose, ‘Yeah, we’re going to live with it,’” said Baker, who helped design the strategy for the elimination of COVID in New Zealand.
New Zealanders seem to have accepted the possibility of longer term restrictions. In a recent government-commissioned survey of more than 1,800 people, 90% of those polled said they did not expect life to return to normal after vaccination, in part because of lingering questions about the virus.
Scientists still don’t fully understand “long-term COVID,” the long-term symptoms that hundreds of thousands of previously infected patients still face. They say that COVID-19 should not be treated like the flu because it is much more dangerous. They are also unsure of the duration of immunity provided by the vaccines and how well they protect against the variants.
Much of the developing world also continues to face an increase in infections, making the virus more likely to replicate quickly, increasing the risk of further mutations and spread. According to the Our World in Data project, only 1% of people in low-income countries have received a dose of vaccine.
In the United States, where state and local governments do much of the decision-making, circumstances vary widely from place to place. States such as California and New York have high vaccination rates but require unvaccinated people to wear masks indoors, while others, such as Alabama and Idaho, have low vaccination rates but do not require masks. Some schools and universities plan to require campus students to be vaccinated, but several states have banned public institutions from imposing such restrictions.
In Australia, several state lawmakers this month suggested the country had reached “a fork in the road” where it had to choose between continuing restrictions and learning to live with infections. They said Australia may need to follow much of the world and give up its COVID zero approach.
Gladys Berejiklian, head of the Australian state of New South Wales, immediately rejected the proposal. “No state, nation or country on the planet can live with the delta variant when our vaccination rates are that low,” he said. Only about 11% of Australians over the age of 16 have been fully vaccinated against COVID-19.
Prime Minister Scott Morrison also pointed to calls for changes to the country’s COVID protocols. After announcing a four-phase plan to return to normal life on July 2, he has insisted that the power of the delta variant requires an infinite reprieve.
In places where vaccines have been widely available for months, such as Europe, countries have invested heavily in their vaccination programs as a way out of the pandemic and the key to keeping hospitalizations and deaths low.
Germans who have been fully vaccinated in the past six months can dine in restaurants without evidence of a negative rapid test. They are allowed unlimited private meetings and travel without a 14-day quarantine.
In Italy, masks are only required when entering shops or crowded areas, but many people continue to wear them, even if only as a chin rest. “My daughters scold me, they say they vaccinated me and I don’t have to wear a mask, but I’ve gotten used to it,” said Marina Castro, who lives in Rome.
England, which has vaccinated almost all of its most vulnerable residents, has taken the most drastic approach. The country lifted virtually all COVID-19 restrictions on Monday, despite the rise in delta-variant infections, especially among young people.
On “Friday Day,” as the tabloids called it, pubs, restaurants and nightclubs opened wide. Collection restrictions and mask requirements were also removed. People were seen dining and sunbathing al fresco, chin to cheek.
Lacking most of the rules, the government is urging people to use “personal responsibility” to maintain safety. Sajid Javid, Britain’s health secretary, who tested positive for the coronavirus last week, said last month the country had to “learn to live” with the virus. That’s despite polls suggesting the English public prefers a more gradual approach to reopening.
Authorities in Singapore, who reported an annual record of 182 locally transmitted infections on Tuesday, say the number of cases is likely to increase in the coming days. The outbreak appears to have delayed but not thwarted plans for a gradual reopening.
“You give people a sense of progress,” Singapore’s Health Minister Ong Ye Kung said this month, “rather than waiting for that big day when everything opens up and then you go crazy.”
