Managing risk

Living with COVID-19 in the years to come

The course of the COVID-19 pandemic has taken the world by storm. But when is the storm going to end, and how? Given that business, investment and the economy benefit from certainty, what can we be certain of now?

Predicting the future is always dicey, especially in the face of so many unknowns. But starting from the things we can be reasonably sure of, it’s fair to say we won’t be going back to the ‘old normal’. While approved vaccines will probably get us past the worst in the medium term, the sequel in terms of disease and the longer-term effects on industry and the economy are likely to roll on for years.

Future scenarios for people’s health

From experience to date, three things seem fairly well-established.

One is that the virus that causes COVID-19 will go on mutating and coming up with new variants.

Another is that a small proportion of the population will not be vaccinated or will neglect re-vaccination in future years if that’s what’s recommended to avoid sickness from future variants.

And a third is that the long-term effects some people experience after a bout of illness with COVID-19 will go on being debilitating for those individuals and will probably also have some consequences for their family members, and indirectly, for health services.

Consequences of failure to vaccinate

The experience of other countries where the vaccine rollout is more advanced than it is in Australia gives us an indication of how things are likely to play out if a significant proportion of the population remains unvaccinated. In the United States, despite reports that by early August more than 70% of the population had received at least one dose of a vaccine, hospitals in areas with lower levels of vaccination are overwhelmed with severely ill unvaccinated patients.

The problem for intensive care units in hospitals is that a very sick COVID-19 patient takes up a bed for much longer than most other ICU patients, who usually need only a few days of intensive care. So, if an ICU is full of COVID-19 patients who might take up a bed for several weeks, that bed is no longer available for victims of heart attacks, strokes and car accidents, along with many others.

Compared to many other countries, Australia is relatively well-resourced in terms of health infrastructure and trained personnel, and the system is currently able to cope. But the extra care needed by very ill COVID-19 patients has obvious consequences for health services, as personnel and facilities are redeployed and re-purposed to accommodate the new COVID-19-related needs. This is already happening – in New South Wales, for example, personnel from public health dental units in some hospitals are being transferred to vaccination hubs and retrained to operate in contact tracing areas.

‘Long COVID’

While it only surfaces every so often in the media coverage, ‘long COVID’ – the long-lasting side effects of a COVID-19 infection – are very real and can be severely debilitating to sufferers.

It’s often assumed that for ‘mild’ COVID-19 cases – where there’s no pneumonia, no shortness of breath or low oxygen levels and no abnormal chest images or other complications – it’s all over in a few weeks. Unfortunately, this isn’t necessarily so, with some people experiencing on-going ill-effects for up to 17 months after infection.

In unvaccinated people who get COVID-19, estimates are that between 11 and 18% will end up with ‘long COVID’, measured as those who still have symptoms 12 weeks after recovering from their initial infection.

Symptoms reportedly include a wide range of issues including memory loss, cognitive dysfunction, reduced aerobic capacity, micro-clots in blood samples, impaired oxygen extraction, damage to the nerves of the cornea, immune dysfunction and many other health effects. And research to date has indicated that these effects are just as common in 18-29-year-olds as in people over 70.

Future scenarios for business

Many commentators have pointed out that considerable numbers of employees, having got more of a taste of working from home, are likely to want to go on ‘teleworking’ if feasible, given that the technology and software infrastructure in many organisations has been geared up for this purpose during lockdowns.

As well as possible drawbacks, this could have several advantages, such as smaller and more affordable premises for head offices, less traffic on the roads with consequent savings for individuals as they burn less fuel and environmental benefits in lower pollution levels.

And online operations are likely to replace face-to-face dealings with customers where this is practicable, as numerous media reports have shown.

The long-term effects on industry sectors dependent on travel and tourism and global supply chains – not to mention government debt – remain to be seen, but one thing is for sure: things will never be quite the same again.

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