3 years into the COVID-19 pandemic, are we ready for what comes next? 2 experts aren't sure

Looking back on the past three years of the COVID-19 pandemic, Simon Bacon is worried.

In some ways, we're in the best shape we've been in terms of the virus itself, said Bacon, a professor of behavioural medicine at Concordia University in Montreal, who studies how people respond to public health policy.

He pointed to COVID vaccines that have helped to slow the number of deaths and hospitalizations, and the dominant circulating Omicron variants, which, although highly transmissible, are not as severe as previous strains.

"There's a general euphoria, I think, for most people because they get back to what they were doing before," he said.

But it's a growing sentiment over the past year that "COVID's not really a thing anymore," that causes him concern.

He noted there are still about 20 COVID deaths a week in Quebec.

"So it's like a small minibus of people that we lose every week because of COVID. So it's still around," he said.

"Best case scenario, this is the last variant that we have of any note and any other variants are very minor deviations and it sort of just fades away over time."

Worst case scenario, according to Bacon, is if a new, more infectious, more potent variant emerges.

He said the country will be "back to square one," because "nobody is really engaging in any preventative behaviours in any significant way" and governments have said they won't reintroduce mandatory measures.

"If it does come back are we ready to mobilize?" he asked.

"I'm not sure we are, which is a real shame, because we've just lived the last three years through this. You'd think if any time ever, whether we would be most prepared, it should be now. But we're probably not."

'Less smart now'

Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto, agrees.

"I think we are less smart than we were at the beginning of the pandemic, less prepared for the next thing," he said.

Furness contends politicians and most people have turned away from science over the past year and opted instead to  "go back to 'normal.'"

"We just really stopped talking about COVID, rolled back restrictions, oriented toward a discourse of personal choice and personal risk, which sounds good, except that you know it really excludes people and puts people at risk," he said. "And often the people who are excluded and put at risk are already marginalized.

"So I think we took a big lurch toward being less tolerant and less equitable, and also at the same time less healthy and less safe."

842 deaths so far

Their comments come as New Brunswick marks the three-year anniversary of the first presumptive case of COVID-19 in the province, and in Atlantic Canada.

The affected person, a woman aged between 50 and 60, from the southeastern part of the province, had returned from a trip to France.

The news came just hours after the World Health Organization deemed the coronavirus outbreak a pandemic, infecting more than 100,000 people in more than 100 countries.

New Brunswick recorded its first positive case the following day, when the national laboratory in Winnipeg confirmed the presumptive case.

Since then, COVID-19 has killed 842 New Brunswickers, including eight added to the death toll this week. That's more than one death for every 1,000 New Brunswickers.

A total of 606 people have been hospitalized because of COVID since Aug. 28, which is as far back as the province's COVIDWatch report data goes. Fifty-three people have required intensive care during that period, according to the report, and more than 14,000 cases have been confirmed by lab tests. The Department of Health did not respond to a request to provide pandemic totals.

Trust in government deteriorated

Bacon, who has been surveying people throughout the pandemic about what motivates them as part of the iCARE (International COVID-19 Awareness and Responses Evaluation Study) project, believes much of the current complacency regarding the virus is borne of people's frustration and dissatisfaction with how the government handled the pandemic early on.

At the beginning of the pandemic, trust in the government was very high, so people agreed to follow protective measures, such as masking and distancing, he said.

But that trust has deteriorated, according to Bacon, due in part to perceived inconsistencies in government rules.

He cites as an example Quebec allowing 250 people to gather in a church, but not allowing people to have friends over in their backyard.

"It's just not logical," he said. "So it undermines credibility."

So while people aren't inherently against masks, for example, they have become symbolic of government dictating what people should do, he said.

Shift from collective good to what's best for you

Bacon said there has also been a shift in government rhetoric.

Early on, messaging around taking protective measures focused on the collective good — helping to keep each other and the health-care system safe.

When governments started to remove protective measures, however, the messaging changed.

"'Well, we're putting this in your hands. It's all about you. You do what you think is right for you,'" Bacon said.

That chipped away at the greatest motivator behind all measures, which is protecting other people, he said. It also gave people permission to stop doing the things they associated with negative experiences and a negative period of "being managed" and told what to do.

"Of course your default behaviour is going to be, 'I don't have to worry about [doing] this.'"

Risk tolerance based on immediacy

In addition, many people are making decisions, such as whether to go to a crowded bar or a busy sporting event, and whether or not to mask or distance, based on a risk tolerance or risk perception built around immediacy, said Bacon.

"Most people are like, 'I'm willing to live with getting COVID because I'm not gonna end up in the hospital, I'm not going to die. It's going to be unpleasant, but it's going to be short-lived and I won't have to worry about any other consequences,' which may or may not be true," he said, referring to long COVID, or post COVID-19 condition, which is not yet fully understood.

Pendulum swung too far

Furness likens the situation to a pendulum that swung very far one way at the start of the pandemic, with people agreeing to be locked down, and has now swung in the opposite direction.

"All we're willing to talk about is personal choice — not looking at the health harm and, by the way, also economic harm that comes from having a disabled workforce," he said.

"We seem to be moving in the wrong direction."

He said some people are even questioning whether masks are effective at preventing transmission, even though that's been clearly established in population studies.

"The fact that we even are having that discussion at the year-three anniversary is disquieting to me because that science is actually incredibly straightforward."

Furness hopes the pendulum starts to swing back over the coming year to a position he describes as more sustainable, where "we actually do recognize what's going on, and we do apply science, and we do take careful stock of what we learned."

He suspects coronavirus is here to stay as a "really pernicious" year-round bug, with a high burden of disease and  disability, until a pan-coronavirus vaccine or excellent antiviral is developed.

"I think we're going to be in a holding pattern of really bad health and we're going to be in a pretty bad way socially and economically and physically until we sort of turn that next corner, and I don't know how long that'll be," he said.

"If we're talking in another year I might have more clarity, or maybe we'll have really good news by then, but it could be a multi-year thing."

Meanwhile, Bacon hopes to see more funding to study the pandemic — both the crisis itself to learn what worked and what didn't, but also the legacy of COVID, including its social and financial impacts.

A closer look at mental health, he said, is key.

"A lot of people, I think, have come out of this with some scars."