Moving forward to a new reality

The decision when, and to what extent, the current COVID-19 restrictions may be lifted is not one to be taken lightly.

Prime Minister Robert Abela hinted at the issue’s complexity, when he said in an interview this week that: “The numbers are what they are because of the way we operated and managed to contain the pandemic. The temptation is to act hastily, but it would be a mistake. It would be imprudent to remove restrictions all at once.”

Indeed, the government is now faced with a delicate balancing act between reigniting economies, and protecting people’s health. But while one would understandably expect priority to be given to people’s health, over economic concerns... the reality is that the two are inextricably intertwined.

Ultimately, the coronavirus is not the only health issue that may threaten to overwhelm our health services. Prolonged self-isolation also poses an incremental health risk (both physical and mental) in its own right; and with all energies focused on COVID-19, keeping the restrictions
in place indefinitely may result in other neglected health issues also rising to crisis propositions.

In the immediacy, however, the economy has to be up and running, if the national health services are to continue operating at their full capacity. Yet all the same, relaxing restrictions now also entails the risk of undoing all the good work done so far.

It is now clear that when the peak of the first wave has passed, most of us will not have been infected with COVID-19, and will still be vulnerable to being infected, passing on the infection or becoming ill.

Even though Malta has a high rate of testing, we cannot assume that enough tests are a precondition for release from the semi-lockdown. Without increasing the rate of testing, releasing the lockdown will need to be gradual to prevent a second wave.

Certainly, it is too early to say if people who have recovered from COVID-19 have developed protective immunity. As we saw this week, after a few days of getting just two and finally zero cases, we suddenly had the reappearance of eight cases at once.

So it is clear that it would be unwise to return to business as usual when the lockdown ends. What we need is fast and accessible testing for virus surveillance, and a sensible strategy to contain small outbreaks without compromising vital services.

As the Hal Far tent village case also shows us, it is critical to carefully plan how to protect people at high risk of severe complications: that means that hospitals, homes for the elderly and other institutions which house vulnerable people should be top priority areas for self-isolation.

However, it is also reasonable to extend hospital facilities to other vital services, such as hospital appointments, so as to ensure continuity of care for many people who need it.

Any hope for a quick transition is therefore misplaced. As WHO senior advisor Natasha Azzopardi Muscat warned, “this is not going back to normal, but moving forward into a new normal.”

This ‘new normal’ may also require a radical rethinking of our usual approach. Difficult decisions will need to be made about who can return to work. Not everyone can work effectively from home; while those who can should continue to do so regardless of the relaxed restrictions...

Jobs may also need to be ranked in order of degree of importance to society and the economy. Those in the most important jobs should return to work first. Workplaces able to practise social distancing will be safer than those that require workers to be close together. Temperatures may be taken at the factory gates or office entrance.

Certainly, mass gatherings should still be banned, and congregating in pubs and restaurants, theatres and cinemas greatly limited.

Unfortunately, this is bound to raise controversy: as it creates winners and losers in Maltese society, affecting social cohesion. Even today, the construction industry, one of the Labour Party’s main donors, is still open for business as usual. This is an example of one group of winners that seems to be carrying out its economic activity unhindered.

It is also why we need government to be transparent in its policy to exit the lockdown; and to involve the public in order to invest any such strategy with the trust it requires.