The coronavirus has changed the world as we knew it. More than 5.5 million people have died from covid on the planet. Two years after its appearance, the virus has disrupted governments, economies and societies, and has created and eroded certainties over the months. When it seemed that the pandemic was under control, ómicron emerged. The authorities issued new restrictions and guidelines, the specialists have had to adapt their speech and the weariness and confusion has spread among the citizens. The Mexican epidemiologist Carlos del Río, professor of Medicine and Global Health at Emory University in Atlanta (United States), speaks in an interview about wear and tear, the lessons learned and the need to pause to reflect on the steps that will come to coexist with the virus. This is an edited and condensed version of their answers.
Ask. The increase in infections has caused a feeling that we are all going to get sick from covid sooner or later. Has Omicron brought us to that point?
Answer. In a way, yes. Ómicron is highly contagious and the possibility of becoming infected increases very significantly. The problem is that when compared to other variants, ómicron is highly infectious and that makes it different from what we knew.
P. In line with what the World Health Organization was pointing out this week, how costly is the narrative that omicron causes mild illness?
R. It is an expensive narrative because it makes many people think that the contagion will not happen to adults. I would say that it is a dangerous narrative.
P. How can we protect ourselves against the omicron advance?
R. The most important thing you can do is get vaccinated and get a booster. With that, the possibility of getting infected decreases, but also the possibility of getting seriously ill and ending up in a hospital is also very significantly reduced. That completely changes the equation.
P. From the outside, it seems that in the United States some measures such as the use of masks are more questioned than in other countries…
R. Yes, I think that in countries like Mexico, for example, there is less opposition to the use of the mask. The truth is that in Mexico much more is accepted. In the United States, part of the debate is due to the fact that there is a lot of opposition and I would almost say a ridiculous situation, in which many people reject what, in my opinion, should not be questioned.
P. Is that why we have seen such an impact of the pandemic in the United States?
R. Undoubtedly. There has been much more transmission because there are many more people who do not fully understand and do not even believe that this is real. It is truly worrying that there are still people who say that this pandemic does not exist.
P. What are the countries that are managing the pandemic better than the rest doing?
R. In my opinion, the countries that are doing the best job are those that have not politicized public health. The politicization of public health has had a high cost in all the countries where the political has been mixed with the technical.
Portugal is a good example. There has not been that absurd politicization of the pandemic that we have seen in several countries, including Mexico. In the United States and the United Kingdom there has also been a lot of politicization.
P. Two years after the pandemic, we continue to hear very different opinions from specialists and authorities. Has it always been like this or have political issues taken a greater role in this pandemic?
R. I think it’s two things. I do believe that there is more politicization, but I also believe that as the virus changes, opinions also change and recommendations are adjusted. What happens is that this creates uncertainty.
P. For the citizens it is suddenly confusing, one day they tell you to do something and two months later they tell you that it is useless. Does the population end up paying the cost of that?
R. Completely. Those changes of opinion have increased mistrust, without a doubt. It is a risk that we have taken. There is greater mistrust because simply and simply opinions are changing.
P. The authorities of the United States have begun the distribution of free covid tests at home, but the Government of Mexico does not see the application of tests as useful. What is your opinion about it?
R. Tests are very helpful. They are one more public health strategy, like wearing a face mask. Few tests have been done in Mexico and it has been a bad policy. Detection has not been seen as important, when it is a useful strategy and should be used more widely. In Mexico, a better job could have been done, but there has been a lot of opposition, also ridiculous.
P. What worries you most about the management of the pandemic in Mexico?
R. As everywhere, health personnel are tired. The hospitals are still saturated and it seems that there is not much interest from the federal government to deal with this great problem, which is the saturation of the hospitals. Things could be done to prevent excess deaths and overcrowding of hospitals, such as vaccinating more people.
P. What specific recommendations would you make to the Mexican authorities?
R. You have to be humble and change the discourse. I think that as the virus changes, you have to change the position you have. For example, until recently I was one of those who said that it was not necessary to apply a reinforcement. Today, with ómicron, we realize that it is necessary. So, we must be able to adapt the policy and the discourse to what is happening at the moment and not remain fixed in one position. That is, the tests may not have been necessary at first, but now they are. You have to be more willing to change the discourse and modify the policies that provide information as you go along. I think that would be a good strategy.
P. Did you need to make adjustments?
R. I think it’s very important to realize that this is a terrible pandemic. It has been very strong. We have to realize that we have been learning. Sometimes we think we have a strategy and that it works. And suddenly, the virus changes and we are facing other virus. At first, for example, it seemed to make sense to quarantine and close everything, but now not so much. Before, for example, it seemed to make sense to go to school in person, today it may not be. You have to adapt.
P. There is much talk of the transition from pandemic to endemic. What does this “new normality” look like and what does it require specialists to rethink?
R. It is difficult to know what is going to happen. Predicting the future in this pandemic has been very complicated, it has cost us all a lot of work. That said, maybe at some point there won’t be the spikes that there are now, there will be fewer cases and fewer infections. Therefore, that will bring the pandemic under control.
Endemicity will be the end of the pandemic. What that means is that, somehow, the virus is not going to end. It is not that covid is going to be eliminated, but what we are going to see little by little is that the virus becomes more generic, more like the flu today.
P. Can we expect the variants to come to be less damaging or dangerous?
R. It is possible, but it is also possible that the opposite happens. I think it’s getting into the field of speculation. We don’t know what’s going to happen, really. Part of what we have learned with this pandemic and what has been complicated is that the virus can change all the plans you had. It’s happened to all of us, right? People said that they were ready to go back to work and suddenly, the virus changes, omicron arrives and we have to rethink what we are doing.
It seems to me that this continuous rethinking and turning the rudder has caused a lot of uncertainty and distrust. People lose trust in leaders because they are changing their minds every day. I think that in this pandemic we have all made mistakes and we have learned from those mistakes, but it has been complicated. Hopefully, as omicron starts to give way, we’ll be walking towards a more normal situation. We’re going to have to learn to live with omicron.
This pandemic has been brutally strong. Something unprecedented. I believe that we have all been learning little by little and I believe that in the end we need to adapt, understand each other, think about the good and the bad, and according to that, improve. That is part of what we have to do. You have to start recognizing mistakes and correcting them. It’s still time to do it. All countries have made mistakes, but we must find a way to adapt to this pandemic. I think that is the most important point.
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