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The Guardian - UK
The Guardian - UK
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Debora MacKenzie

False narratives about Covid left us with millions of deaths – will we challenge them now?

ICU at the Western General Hospital, Edinburgh, in May 2020.
‘The first narrative we got wrong was the widespread assumption that infectious disease is only a problem for poor countries.’ Photograph: Murdo MacLeod/The Guardian

All big experiences in our lives have two realities. There is what really happened. And there is the narrative, the story we tell ourselves and each other about what happened. Of the two, psychologists say it’s the narrative that matters most. Creating coherent stories about events allows us to make sense of them. It is the narrative that determines our reactions, and what we do next.

Two years after the World Health Organization (WHO) finally used the word “pandemic” in its own story about the deadly new virus from Wuhan, narratives have multiplied and changed around the big questions. How bad is it? What should we do about it? When will it be over? The stories we embraced have sometimes been correct, but others have sown division, even caused needless deaths. Those stories aren’t finished – and neither is the pandemic.

As we navigate what could be – if we are lucky – Covid’s transition to a present but manageable disease, it is these narratives we most need to understand and reconcile. What has really happened since 2020? And how does it still affect us now?

The first narrative we got wrong was the widespread assumption that infectious disease is only a problem for poor countries. Most western countries failed to prepare as the virus raced across Asia – until horror stories began emerging from Italian hospitals. By then, in some places, it was too late.

At least once we agreed a response was needed, most people were on board. “It may seem hard to believe today,” marvelled US pollsters at the Pew Research Center in a 2021 report, but in March 2020 there was “strong bipartisan support” for shutdown measures.

But that initial consensus frayed faster than many remember. Two months later the US was widely split along party lines, and remained that way, with Republicans rejecting control measures and insisting Covid was mild, even a hoax. A year after that, just before the more deadly and contagious Delta variant hit, three in 10 Americans said the pandemic was over.

Similar divides emerged in England, where Brexit supporters shared an “anti-establishment narrative” with US Republicans. Researchers have found that local support for Brexit was the strongest factor associated with higher Covid deaths and lower vaccination rates in British voting districts after October 2020, possibly because this group rushed to abandon protections: separate polling found Brexit supporters were most keen to drop masks.

At the government level, Downing Street seemed to follow two narratives of its own: a libertarian preference for individual responsibility over collective action, and the conviction that we could either save lives or the economy, not both. This led to its plan in March 2020 to not actively contain the virus, as the WHO insisted and as east Asian countries were already doing, but to let it spread until everyone was immune. That only changed when epidemiologists calmly explained how many deaths it would entail.

The Covid memorial wall at the embankment, London, May 2021.
‘Is Covid over? No.’ The Covid memorial wall at the embankment, London, May 2021. Photograph: Daniel Leal-Olivas/AFP/Getty Images

The trade-off between death and wealth too was disproved when Asian countries that locked down early and hard had fewer deaths and fared better economically. But in England both that and the individual responsibility narrative persisted. Jeremy Farrar, until recently a Sage member, described the repeated decisions by Downing Street to lift restrictions too soon or reimpose them too slowly as “libertarian”.

These narratives and their effects are still with us. They clearly informed England’s recent “living with Covid” plan for dropping masks, closures, testing, even viral surveillance from April, even though cases of the even more contagious BA.2 version of Omicron were already climbing

True, vaccines and antiviral drugs have blunted Covid’s impact, and getting vaccinated is a personal responsibility. But infectious disease is always profoundly collective, whether or not leaders find that ideologically congenial. Omicron is better than its forebears at breaking through our immunity. The many people whose age or medical condition makes them more likely to die if that happens, or who have suppressed immunity – perhaps only because they need an arthritis drug – cannot take “personal responsibility” for avoiding Covid if they must return to the office, surrounded by maskless people exercising their “individual freedom” to exhale asymptomatic Omicron.

Meanwhile, even people who accepted Covid was serious and required a collective response have assumed the narrative would end with Covid going away, and 2019-style normality returning. Even some scientists initially hoped the virus would mutate too slowly to evade our immunity, we would contain its spread, and it would die out like its relative, Sars, in 2003.

No such luck. We all want the disruption and anxiety to stop, but we won’t achieve that with policies that pretend the pandemic is over when it isn’t.

Moreover, things could get worse: the virus will keep evolving as long as it circulates, and Covid has shown that another widely held narrative, that diseases always evolve to be milder, is mere wishful thinking. And it looks set to keep circulating. So far, vaccines do not stop vaccinated people from catching and spreading it.

So, of course, do the many people who remain unvaccinated. For some, the narrative of mistrust of science or government means they refuse. Others simply live in poor countries, and rich countries insist on another widely approved narrative: vaccinate our own first, even if that lets the virus keep evolving elsewhere, possibly into one that comes back to us and evades our vaccines. Between that and the many animal species that can host it, Covid will not go away.

The best we can hope for is that one day we will not need to disrupt our lives to live with it. Some disruptions will become normal: more working from home, masks, testing. Better vaccines, drugs and treatments for long Covid will, we hope, make the disease less likely to kill or damage, at least those with access to them. Eventually Covid may infect us all as children, leaving lasting if partial immunity, perhaps becoming just another common cold. Living with Covid is, in fact, how this comes out, although we will not be there by April.

But that isn’t the end of the pandemic story, only this chapter. Even if we fight Covid into normality, scientists agree there will be another pandemic, and more likely sooner than later. To stop that we must learn to spot and contain worrying outbreaks.

To do this we must see through yet another misleading story: an “outbreak narrative” that portrays pandemics as primarily a sudden and unexpected battle between microbe and hero scientists seeking the cure. This cuts out the long backstory of deforestation, wildlife trade or risky farming that makes it more likely germs will jump from animals to us in the first place. These are causes we could address for a fraction of the cost the diseases spawned that way already cost us.

But our experience – our story – of Covid, locked down until scientists found the vaccine, strengthens the outbreak narrative. Governments may assume they can react after the next one strikes too, without spending on being prepared. But a closer reading shows we were incredibly lucky: we found safe, effective vaccines faster than expected (vaccines for some coronaviruses have proved impossible), and meanwhile the disease wasn’t too deadly. Sars was 10 times more likely to kill you once infected.

We desperately need a multinational effort to watch for new infections, and devise remedies. The WHO says we need to spend $31bn annually.

Will we? As always it depends on the narrative. Is Covid over? No. Will there be another pandemic? Yes. Can we stop it? Maybe. It may all depend on the stories we tell ourselves now.

  • Debora MacKenzie is a science journalist and author of Stopping the Next Pandemic: How Covid-19 Can Help us Save Humanity

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