In 1836, John Wilkinson wrote, “One of the artifices of Satan is to induce men to believe that he does not exist.” The sentiment was echoed in the 1995 movie The Usual Suspects, “The greatest trick the Devil ever pulled was convincing the world he didn’t exist.” For those who are not of a religious disposition, the greatest trick ever played might be the attempted disappearance of COVID-19 as a cause for public concern.

Governments around the world did not tell people it was safe to resume their pre-pandemic behaviour. Most official guidance said it was up to people to assess their own risk and decide what they were prepared to do in light of the existence of a novel pathogen. Many people took this to mean it was safe to resume pre-2020 behaviours and have learned the hard way that there is a big difference between 2019 and now: a new virus has been added to the landscape of pathogens and it is one that can still exact a hefty toll in the form of Long Covid.

While telling individuals to assess their own risk, many governments have removed the tools for people to do so, dismantling testing regimes1-3, free vaccine programmes4, surveillance5,6 and free treatment provision7. Anyone who wants to understand the true risk posed by COVID-19 is effectively flying blind. And yet, despite these efforts to force COVID-19 below the radar, a recent YouGov poll in the UK showed that half of those who expressed an opinion believe the pandemic isn’t over8. That’s probably because people are experiencing for themselves that repeat infections are not always milder or have seen friends, family or colleagues deal with the toll of Long Covid.

Since the early days of the pandemic, some scientists have been selling the idea that T cells – an arm of the immune system that targets infected cells – might already offer protection as a result of prior exposure to other coronaviruses9, or that the protection offered by T cells will last years if not decades10. Others have assured us that SARS-CoV-2, the virus that causes COVID-19, will become akin to a common cold and that infection would be protective11.

Instead of protection that lasts years, immunity from infection can be measured in months12-14, and there is no sign SARS-CoV-2 has become a common cold. Instead, studies have shown that there is an interplay between dose, immune response, and variant. We’ve previously written about one such study, which demonstrates that even prior immunity against the same variant can be overcome with sufficient dose exposure15.

Such findings suggest that the continued evolution of the virus shouldn’t be our only concern and that additional protection must be afforded to those with weaker or dysfunctional immune systems or those who are repeatedly exposed to high doses of SARS-CoV-2. One such group is teachers, and recent work by a team in New Zealand has demonstrated an ongoing risk to teachers and healthcare workers16. One teachers’ union in New Zealand has spoken out about the risks its members face17.

We’ve written about staff shortages and the ongoing great retirement, which is putting pressure on the economy, businesses and public services18. There is no doubt vaccines have reduced the worst acute impacts of COVID-19, decreasing morbidity and mortality, but they have not completely halted the more insidious effects of SARS-CoV-2. We still do not know what causes Long Covid, which can be experienced as one of more than 200 symptoms affecting any organ in the body, and for which there is no effective treatment19,20.

Public health officials in New Zealand are being very clear that each infection is a roll of the dice21. We’ve previously shared details of the national and international agencies that are advising people that the best way to avoid Long Covid is to avoid infection22, and it is interesting to note that even some of the scientists who assured the public that COVID-19 would become akin to a common cold are telling people infection is best avoided if at all possible, that air quality should become a priority, and that mask wearing should be normalised23-25. On the issue of air quality, it is worth noting that the World Health Organization has finally recognized SARS-CoV-2 as an airborne pathogen26 with many implications for indoor air quality27.

While we wait for policymakers to catch up with the ongoing risks of SARS-CoV-2 infection and implement policies to better protect people, if you are infected, it is still worth doing whatever possible to reduce the impact of infection, and the leading antiviral against SARS-CoV-2, Paxlovid, has been shown to lead to better outcomes28. An alternative in the form of a widely available over the counter combination therapy might be of interest to people in countries where Paxlovid is not available. Details of the combination therapy are available in the Lancet, which recently published the results of a successful clinical trial29.

Governments are trying to assimilate COVID-19 into our lives by ignoring it. They are assuming it will just fade into the background as it becomes part of the landscape of common illnesses we face. Scientists who specialize in Long Covid30, public health agencies22 and others who are responsible for safeguarding health are warning that this is not happening17, and that the virus poses a significant ongoing risk. Until governments are prepared to confront reality and adopt clean air policies that make life safer for all31, we must continue to participate in the greatest confidence trick, in which governments and certain sections of the media, aided and abetted by scientists who have staked their reputations on optimistic pronouncements, pretend we don’t need to make lasting changes to adapt to a novel pathogen.

For advice on how to reduce your risk of COVID-19, click here.