In April I achieved a level of optimism about the pandemic which was entirely new. The success of the vaccine programme in the UK, combined with the lockdown, was delivering results that exceeded expectations. Numbers of cases and deaths weren’t just declining, they were tumbling. The BBC’s map of COVID infections was changing from the deep colours of danger to the lighter greens of relative safety. Everything looked set for joyful reunions on May 17, as indoor visits and restaurant dinning become possible. This optimism began to level off as reports of a new and more transmissible strain of the virus began to circulate.

The primrose path that seemed tantalisingly close has been replaced by the prospect of a more fraught road ahead. This is a narrow path with steep falls in either side. There is the real risk that tomorrow’s easing of restrictions will accelerate the transmission of the new strain. Given the huge response to vaccination in the UK this may appear to be excessively pessimistic. However, we are now experienced in COVID-19 and know that wherever there is an opportunity this virus thrives. Even with the shield of immunity for many, the pandemic will find the cracks in our defences. The people who haven’t been vaccinated; the people for whom the vaccine will not work as it should; the people whose health means that even mild symptoms push them into crisis. A much more transmissible version of the virus will find these people and fill the beds of the NHS.

What’s even more remarkable about the 1918 flu, say infectious disease experts, is that it never really went away. After infecting an estimated 500 million people worldwide in 1918 and 1919 (a third of the global population), the H1N1 strain that caused the Spanish flu receded into the background and stuck around as the regular seasonal flu.

The History Channel

This is quite depressing. As millions of people across the world continue to be infected, the changes that take place in the virus through transmission will intensify. When it came to the flu pandemic following the First World War the reduction of infection took place in a world where travel was enjoyed by the few, and a lot of journeys happened very slowly. Will COVID-19 recede so quickly in a world where normality in the West means an immense amount of rapid international travel? In the first lockdown in the UK it is calculated that there was a ‘74% reduction in the average daily number of contacts’. Normalised Western interactions in the 21st century are the perfect conduit for a disease that can be asymptomatic and spreads with remarkable ease among human beings. The role of ski resorts in gathering, infecting and dispersing people around the world is a microcosm of the global village.

Eleven months into the pandemic, we know that ski resorts played a significant role in seeding the pandemic across Europe 

World Health Organisation, Regional Office for Europe 16 December 2020

Both with the UK Government’s initiative to incentivise visits to restaurants, and the prospect of eased restrictions for Christmas, well-intended stimulus to human interaction fuelled transmission. The disheartening experience is that, as easing of measures approaches, time and again we have found the way ahead vanish in mists of uncertainty. The key difference this time is the high rate of vaccination – a factor which may turn the tide of any new surge. The simple fact is that we don’t know. However, we do know enough about the consequences of making a mistake in the freedoms we allow to incline us towards caution. It’s not what anyone wants to hear, but the reality of risk for the NHS, for care home residents, and for vulnerable individuals and communities cannot be discounted.

The government initiative (‘Eat Out to Help Out”), which cost around £500 million, caused a significant rise in new infections in August and early September accelerating the pandemic into its current second wave.

The University of Warwick

While it is unclear what will unfold this week (and it may take two weeks to emerge) there is every sense that the path ahead is narrowing. Too many times we have failed to give the risks associated with the virus the respect they deserve. Of course we need to resume near-normal living as soon as possible. We know that there are many twists and turns in the pandemic, and harmful consequences can arise where least expected. Nevertheless, some risks are clear and should be avoided as far as possible, especially when so much is unknown.

As we chart the way ahead there must be a balance between the devil-may-care attitude of abandoned caution, and the doom-mongers who can only see risk on the horizon. A hundred years after the last pandemic, when that virus is still with us, we need to learn to live with the reality of COVID-19. As the first pandemic to occur in an age of rapid and plentiful transportation, the solutions we find to live with the virus will need to be new and innovative. Otherwise this won’t be a blip at the start of the 2020s – but the beginning of a decade of damaging restrictions.