We have yet to arrive at the near-future dystopia described in Paolo Bacigalupi’s incredible novel The Windup Girl, but there are signs we’re moving in that direction.

In the novel, Earth has been catastrophically altered by climate change. Civilization is in ruins. Only the wealthy have the means to rise above the misery of daily life. The rest are, well, nobody cares about them.

Aside from steadily worsening climate change and our desperation to maintain the flow of cheap fossil fuels undercutting our inadequate efforts to mitigate the damage, we’re stepping across the threshold of a new phase in the Covid-19 pandemic: From now on, students and school personnel won’t be required to mask up. Data gathering is slacking off, and Covid-related restrictions are being dumpstered in our haste to Get Back To Normal.

I’m sure many will see the Bacigalupi citation as overly dramatic, but I’m beginning to glimpse a future where Covid is always a dangerous presence, taking a toll on the most vulnerable among us. And we become, if we haven’t already, inured to death tolls that used to scare us half to death. Figuratively. And we accept that many, many people will be disabled by long Covid. There’s a lot of bad news on that front, which I’ll get to.

I see a future where people like me will wear masks all the time and will abstain from crowded situations indefinitely. I’ve found myself wondering if I’d ever eat in a restaurant again or attend a concert or travel for recreational purposes. I sure don’t feel safe doing any of that now, and I have no idea when I will. And I find myself wondering if people like me matter anymore.

We have a number of exhibits to present. Let’s start with two tweet threads from epidemiologist (and very active tweeter) Eric Feigl-Ding. The first is about a new variant of Covid, BA-2, wreaking havoc in China. It’s bad. The port of Shanghai has been closed; major cities with millions of people are on lockdown; they’re starting to build temporary health facilities (remember those?); they’re making plans for dealing with an excess of corpses; and entire provinces have been shuttered. And the same variant has caused a 53% uptick in England, so it’s clearly on the move.

His second thread focuses on South Korea, which has been a Covid success story for much of the pandemic. SK is one of the most heavily vaccinated and boosted countries in the world, but BA-2, Feigl-Ding says, is “that efficient in finding unvaccinated and undervaccinated” people.

The takeaway from all of this: There’s real evidence that the next Omicron is already on the march. But hey, time to unmask! Go to the malls, good people! Go to parties! Go out to eat! Nothing to see here!

On to a new piece of research that shows long Covid to be a real threat among children and adolescents. You know, those young and healthy enough to be at low risk for serious Covid? It’s looking like they are just as susceptible to long Covid as anyone.

The research is what you might call a study of studies, aggregating every piece of research on long Covid in young people. (This is a common tool in medical research, putting all the studies together to identify commonalities.) It found that over 25% of children and adolescents who contracted Covid also suffer from long Covid. The authors caution that this is not the last word, and really it’s too soon to know how long Covid will play out over our lifetimes. We’ve only been living with coronavirus for two years.

A few days ago, a researcher named Hannah Davis posted a tweet thread outlining the “big reality gap” between those who follow the science and those who abide by increasingly permissive public health guidelines. She writes that Covid can have long-lasting effects beyond long Covid, weakening multiple systems in the body, perhaps forever. Here’s just one chilling prospect: “Researchers, including at NIH, have acknowledged a likely wave of early onset dementia.”

Yeah, I’ll be masking for the foreseeable future, thanks.

Now, Davis is part of a multidisciplinary team of experts who are themselves victims of long Covid, so maybe you think she’s biased. But her overview is supported by quite a bit of evidence.

Here’s a happy little piece on Axios entitled “How Covid can damage the brain.” It includes this scary line: “People infected with even mild cases showed cognitive decline, degeneration in parts of the brain, and brain shrinkage.” One doctor who operates a clinic for long Covid patients says the disease “is the third-most frequent neurological condition in the U.S. today.” Two other scientists say there’s an “urgent need” to research the disorders and develop therapies.

On to a new report from a team of public health experts outlining a roadmap to “the new normal,” which they say “will be different, and we must prepare for it.” They say preparations must be made to monitor the disease and new variants: Making rapid tests cheap and freely available, developing a robust disease surveillance system including “viral, environmental, genetic, immunological and zoonotic sampling to provide early warning and data.” They also recommend improving indoor air quality, sustained investment in developing vaccines and therapeutics, more research on long Covid, and addressing burnout among health care workers.

Speaking of “environmental” sampling, take a look at this.

This is a map from the Centers for Disease Control showing where wastewater is being tested for coronavirus. The colors indicate each location’s findings, but the thing that jumped out at me is how little of this testing is being done. It’s a proven means of predicting Covid outbreaks, it’s not that hard to do, and it ought to be high priority at a time when we’re relaxing other tracking mechanisms. To me, this is a sign that we haven’t begun to be serious about living with Covid long-term.

A couple of months ago, the University of Vermont Medical Center changed its employee sick-leave policy. From now on, employees who contract Covid must use up their vacation and paid sick days. If they’re still sick at that point, they’ll be granted Covid sick time. But they won’t have any time off whatsoever for the rest of the year and it’s unclear how UVMMC will deal with cases of long Covid, which is disabling a lot of people.

A UVMMC spokesperson described the policy as “sustainable and offered for the long term.” To me, the message is that management at our biggest medical center expects Covid to be with us, making people seriously ill, “for the long term.”

I don’t like the sound of that. At all.

So that’s what’s got me thinking that our shiny Covid-free future is still receding into the future. Perhaps long enough in the future that I won’t see the end of this, if indeed there ever is one. Meanwhile, I’ll be limiting my time in public indoor spaces, and wearing masks every time. I’ll be cooking at home, not going out. I’ll be doing more shopping online and less in local retailers, which I hate.

But I don’t want to get Covid, even a mild case, and risk being one of the many unlucky ones who suffer long-term damage. So I’ll still be wearing that thing the head of the CDC called “the scarlet letter of this pandemic.”

There’s an abundance of people in high-risk groups. Are they to be collateral damage in our rush to “get over” the pandemic? If so, we’re one big step closer to a dystopian future where human lives are fungible.