It’s extraordinary how quickly the Covid mask has come to feel like a historical artefact.

This year has been a time of joyously unbounded normality. Buses and trains are as full as they ever were; pubs and venues are stowed out. We can hug, shake hands, share food – all the things that in small and subtle ways bring joy to an ordinary day. Covid has become less and less intrusive in our lives. Even GP surgeries no longer require patients to wear masks in most circumstances.

As Covid has receded from the headlines, a mental shift has taken place; a lowering – even a switching off – of vigilance. When my daughter recently developed a sore throat after being on holiday, having spent time in crowded visitor attractions and motorway service areas, the possibility of Covid didn’t even occur to me. She was the one to suggest it. I found the tests at the back of a drawer. The result came back negative, which was a relief both in itself and because I interpreted it as a sign my amnesia about the wretched pandemic had been justified.

But it’s not over, is it? Not by any means. Public Health Scotland, the statutory body that exists to prevent disease and promote health, states that the pandemic has entered a “quieter phase”. These are surely carefully chosen words, underlining that Covid is still ongoing, that the threat the virus currently poses is lower than it has been before, but that this could be a temporary state.

Perhaps a very temporary state, as it turns out. In the past few days Prof Jason Leitch, Scotland’s national clinical director, has confirmed that cases are on the up, though from a low base. Two hundred people were admitted to hospital with Covid in Scotland last week and he’s worried about winter.

Prof Christina Pagel of University College London, a member of the government’s independent SAGE panel, suggests we are now in another Covid wave.

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A new subvariant of Omicron is circulating, called Eris, and in Denmark and Israel a further concerning variant called BA.6, with high number of mutations, has also been identified. So far, Eris doesn’t seem to be causing UK virologists the heebee geebees, but it’s a reminder that this microorganism is relentlessly evolving. There’s also anecdotal evidence of Covid making its way round whole offices full of people.

But at the same time, routine testing in hospitals and care homes is about to be scaled right back (though those discharged from hospital to care homes or hospices will continue to be tested). Some doctors, understandably, are unhappy about this. Routine Covid vaccination is now only available to over 65s, care home residents and those in a clinical risk group, as well as those in close contact with them.

So just how concerned should we be? What’s the sensible path here, that allows for maximum liberty but also protects the NHS as we go into winter? Can we really continue ignoring Covid, as so many of us are in the habit of doing?

No, we can’t. Last January, Nicola Sturgeon described the winter as “without any doubt the most difficult winter ever for the National Health Service”. In the last week of December, one in 25 people had Covid. More than 400 people admitted to hospital in the first week of January had Covid, though not all were in hospital because of it.

But here’s the thing: during the same week, more than 1,000 patients were also admitted with flu. Add to that an upswing in Strep A and other respiratory illnesses, and you understand why last winter was what the late Queen might have termed the NHS’s hibernum horribile.

It's this mix of bugs that could cause another gruelling winter this year. Lest we forget, in December 2022, more than a third of patients at A&E waited more than four hours. Fifteen per cent waited more than eight.

So could a few sensible, voluntary precautions in the autumn help prevent the sort of pressures we saw last year?

Which advice might be needed to limit transmission while minimally impacting people’s daily lives, in order to help protect the NHS?

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Jason Leitch urges those offered Covid or flu immunisations to take them. But he also says that, though it’s a “hard cultural thing” in a work or education environment, we should be staying at home if we feel unwell.

That is indeed challenging. Most parents send their kids to school with mild respiratory illnesses, partly because finding childcare at short notice is practically impossible, and partly because, in general, it’s not realistic to let mild respiratory illnesses stop you doing things. The Scottish Government’s official advice, while suggesting people stay at home if they have respiratory symptoms, also says that if you go out anyway, wear a well-fitting face mask.

Clearly most of us aren’t doing that any more. I saw someone wearing a mask in a shop the other day and noticed precisely because it was so unusual. Should we be getting back in the mask-wearing habit?

Masks in healthcare settings were phased out in May, against the better judgment of the British Medical Association. The Scottish Healthcare Workers Coalition has since called for their reintroduction, pointing out that healthcare workers are at much higher risk of getting Covid and at least four per cent are already living with post-Covid complications. They call the decision to withdraw them “flawed and dangerous”.

Should we be opting to wear them in GP surgeries, hospitals, on public transport and other crowded settings?

Should we also be avoiding elderly or immunocompromised friends and relations? Taking home Covid tests when we have symptoms, if we can afford them?

At present there are more questions than answers, as we wait to see how the new wave develops, but that will need to change as we get into the autumn months. It’s a drag to consider, but if we want to keep this pest of a pestilence at bay we might have to do a little now to prevent having to do a whole lot more later.