Vaccines are amazing but do wane - esp vs sympomatic infection. Immunity from infection wanes too. Surely Omicron has proven that high levels of antibodies in your population are no guarantee against v high levels of illness & disruption. 2/13

We *could* act as we used to & accept millions of people getting sick once or twice a year. Yearly education, business disruption. And gradually, a slightly sicker pop'n. That seems to be the current plan in UK and e.g. US. But that's NOT the *old normal* - it's worse 3/13

We *can't* go back - but we *can* go forward *if* we accept we need some adaptations - driven by what we have *learned*. Learning: 1. Outdoors is pretty safe - so let's invest research and funding into making indoor air as much like the outdoors as possible 4/13

It's *not* easy, but it *is* possible - we did it with clean water, electricity infrastructure, CFCs, telephone and broadband... The best thing about cleaner indoor air is it works against *any* airborne disease and also reduces e.g. allergies. 5/13

2. Vaccinate the world as soon as possible - and keep working towards vaccines that are longer lasting and more variant proof. 3. Invest in global infrastructure to support surveillance of new variants of Covid *and* other new infectious diseases. There will be more. 6/13

4. Add permanent surveillance of Covid infection rates in UK to existing programmes for flu, measles etc in public health 5. Invest in understanding & treating longer term clinical impacts of Covid, inc organ damage & Long Covid + treatments (eg antivirals) for acute phase. 7/13

6. We need to urgently increase funding and staffing for NHS if it is expected to cope with regular Covid surges *and* existing backlogs *and* years of understaffing and not enough money. This includes *supporting* existing staff to stay..! 8/13

7. There *will* still be future surges. We need to have a plan to deal with these surges - as we do for other diseases. A plan which is supported by the rapid outbreak identification & rapid understanding of virulence & transmission we've learned to do so well in the UK! 9/13

The plan might include (temp) reintroduction of large scale testing (inc better tests?), high quality masks in indoor spaces and - *if & only if* there is a serious threat from e.g. a new variant (or disease!) - further measures, such as targeted test, trace & isolate. 10/13

A plan should *not* mean long national lockdowns, which represent a failure of public health systems. In fact, refusing to do the *learning* in "learning to live with Covid" is the biggest risk for such future lockdowns. 11/13

8. We also need to invest massively in reducing inequalities: in health, in housing, in workplaces, in sick pay, in education - this will make us more resilient to future outbreaks and reduce ill health and death - from Covid & everything else! Both nationally & globally 12/13

Fundamentally, world is different now. Acting as if it isn't, which UK seems determined to do, may feel good in short term but will result in a new normal worse than the old one. I prefer for us to build a new normal that's *better* than frequent sickness & disruption. 13/13

Prof. Christina Pagel - @chrischirp.bsky.social "Welcome to postnormal times. It’s a time when little out there can be trusted or gives us confidence. We live in an in-between period where old orthodoxies are dying, new ones have yet to be born, & very few things seem to make sense." [Ziauddin Sardar]

@JaneEdwards56 pedro sadly, with the way policy is going, it's a more dangerous or a more lonely world for CEV people. Or both. I wish it wasn't but CEV people's needs have been shoved to one side as they are just not compatible with current plans. :-(

Prof. Christina Pagel - @chrischirp.bsky.social Nita W #FBPE 🇬🇧🇪🇺 We can’t go back to normality. The experience we’ve all gone through means that normality now resides in the utopian past. We can’t plonk it back onto our lives. We’ve changed..

Prof. Christina Pagel - Prof. Christina Pagel - @chrischirp.bsky.social.bsky.social Thank you @chrischirp. I can completely understand people wishing to return to a way of life we’ve lost, aI think, if we’re honest, we’d all like that. The ways forward that you’ve outlined are constructive and doable. I hope humans achieve them.

Prof. Christina Pagel - @chrischirp.bsky.social @ros_hutchinson Thank you so much for your excellent and informtive thread with such useful information for us to digest.

Prof. Christina Pagel - @chrischirp.bsky.social Madam X Dance 🌹@jazzaoxon.bsky.social We shouldn't even think about going back. We should go forward and develop the new practices we have been using, such as more working from home, less commuting and wearing masks whenever we have a respiratory infection just as they have done in the Orient for many years.

Sherry Trout Prof. Christina Pagel - @chrischirp.bsky.social Ashish K. Jha They didn’t go back to normal life changed. medicine and infection control changed. Vaccinations became more easily available. Countries in Asia adopted mask wearing during respiratory virus outbreaks. International plans for dealing with pandemics were set up. Etc etc