With record numbers of new Covid-19 cases in countries around the world during the past month, the United States alone logged more than 1 million new infections per day over multiple days. This omicron variant, the latest and most infectious yet, is accompanying a shift in attitudes toward the coronavirus among public-health leaders, policy makers, and the public. Six doctors from U.S. President Joe Biden’s transition team of Covid-19 advisers published a set of three opinion articles in the medical the Journal of the American Medical Association (JAMA) in early January, recommending that the government transform its thinking about the virus. Rather than focusing on eradicating Covid-19, the doctors wrote, officials and healthcare professionals should be thinking about how best to help people live with it, as they now live with many respiratory viruses. Universities across the U.S. are already putting this approach into practice, as they loosen restrictions in order to keep schools open and in-person, even if new cases arise. What are these changes going to mean for day-to-day life?

Timothy Caulfield is the Canada Research Chair in Health Law and Policy at the University of Alberta. In Caulfield’s view, the answer begins with a fundamental recognition that Covid-19 is here to stay in the world. In surveys, growing numbers of people say they accept that they’ll catch Covid-19. In North America, people are altering their mental pictures of social life—wearing a mask in public would seem normal, and booster shots would be expected annual or semi-annual tasks. But, as Caulfield sees it, attitudes and expectations are powerfully shaped by people’s political ideologies, with major differences of opinion on public-health measures among committed Republicans and Democrats.

Michael Bluhm: As you and I speak across the U.S.-Canadian border, where are we in the pandemic?

Timothy Caulfield: We’re at a very challenging and somewhat hopeful time. Omicron is tremendously infectious. Despite some good news about hospital and death rates, this is still a very serious public-health issue and needs to be treated as such.

But it’s also invited a movement in how people consider the pandemic—from an immediate public-health emergency to more of an ongoing slog. You’re starting to see the public recognize that the pandemic won’t have a defined end. There isn’t going to be a finish line or a moment when we all spill into the streets and celebrate, like at the end of a war.

At the beginning of the pandemic, there was a lot of imagery around the pandemic as a war we were going to win. Unfortunately, that metaphor hasn’t played out. People are starting to recognize that this isn’t like World War II. This is much more like the “war on terror,” where it’s this ongoing slog that will require different tools at different times. It’s never going to end in the way that people perhaps envisioned it ending at the start of the pandemic.

Over the last couple of months, especially with omicron, this vision has become a reality not just for policy makers and scientists—who always knew it was true—but for most of the public.

That’s created some policy and communication challenges. Paradoxically, it’s led to more polarization. That’s where we are, and it’s not an easy place to be, because it creates real challenges for policy makers to signal to the public what’s next.

Gabriella Clare Marino

Bluhm: You mention an emerging belief that the pandemic won’t have a defined end. How else do you see the North American public’s thinking about Covid-19 changing?

Caulfield: If you look at surveys, we can see a shift. In Canada, where we’ve had stronger support for public health and more acceptance of vaccines and masks than in the United States, a very recent survey tells us that most Canadians are now resigned to the belief that they’re going to get Covid. Earlier, the belief was, If I do everything that I’m told—if I get vaccinated, wear a mask, do physical distancing—not only will I be protecting the community, I’ll reduce my risk of getting Covid. And now you have this sense that, Well, I’m probably going to get it anyway—and I might get it more than once. That’s a real resignation, and that speaks to the challenges that policy makers are going to have.

The other shift you’re seeing in the United States and in Canada falls on ideological lines. This resignation is fueling a belief that we should just give up, and we should just let omicron and Covid generally run their course. Surveys backing this up follow exact ideological lines: Those who are more conservative think that’s the path we should take. But those who lean more left feel that this is a sign that we have to have sensible and sustainable public-health measures into the future.

Earlier, the belief was, If I do everything that I’m told—if I get vaccinated, wear a mask, do physical distancing—not only will I be protecting the community, I’ll reduce my risk of getting Covid. And now you have this sense that, Well, I’m probably going to get it anyway—and I might get it more than once.

One of the real challenges now is that both sides are saying, See, I told you so. The right is saying, See, I told you—there’s nothing we can do about this. Covid is just going to take over. And those on the left are saying, See, I told you—we all need to be vaccinated, in order to reduce the burden on our healthcare system.

Both are using the uncertainty, the complexity, and the messiness of the data around omicron to support their agendas. It’s fascinating—and a little disheartening.

Bluhm: What kinds of challenges are policy makers going to face?

Caulfield: It is going to be more difficult for policy makers to create clarity on shared public-health goals or on why they’re implementing certain measures. It’s important to recognize, despite what science deniers or vaccine skeptics often say, that the goalposts have not moved.

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