Getting Back to the `New Normal'

CREDIT CDC

#15,162

The most common question I get asked by friends and family right now is when are things going to go `back to normal?' -  at least here in the United States.  While I have no firm date to give them, I do tell them that whenever we get there, `normal' may look a lot different from what it did just 3 months ago.

At some point, our `lockdowned' lifestyle will end.  Whether that will happen in 30, 60, or 90 days - and whether we'll see the need for additional lockdowns next fall or winter - are simply unknowable. 

We've pretty good evidence now that extreme social distancing can `flatten the curve', lowering both COVID-19 hospitalizations and deaths. That in turn protects our healthcare delivery system, and saves may more lives in the process.  That is very good news, indeed.

What we don't know is what happens when those restrictions are relaxed, or removed completely. Will the virus spring back after a few weeks?  Or will it stay suppressed?

While China's narrative suggests that it is possible to quash the virus, and then slowly restart the economy, the data we get out of China is often `authorized and sanitized for the CCP's protection'.  China's economic data is always suspect, and many have strong doubts over their account of the  number of COVID-19 cases and fatalities. 

Italy, which appears to be several weeks ahead of the rest of the world in their pandemic curve, may be the first country we are reasonably able to observe coming off of its lockdown.  How rapidly, and successfully, that can be accomplished remains to be seen. 

Assuming our lockdown can be relaxed in the next 30 to 60 days, and that we don't immediately see a resurgence of community spread of COVID-19, there are always concerns that the virus will come back in the fall. Any respite, while welcomed, might only last a few months.

We should be in better shape to deal with a second wave by the fall - more PPEs, more ventilators, etc. - but there are no guarantees that it won't require similar round of social distancing.  Hopefully we'll have some proven pharmaceutical interventions by that time, but a vaccine will still likely be a year or more away.

It is worth noted that having a vaccine, and getting it into the arms of hundreds of millions of Americans (and billions of people worldwide), are two entirely different matters. 

And of course, no matter how successfully we manage to subdue the virus in this country, what happens in the rest of the world will still affect us. Diminished food production, problems with the global supply chain, and governmental and economic instability around the world could have serious knock-on effects for our country, and the rest of the world.

It is fair to say that over the next couple of years this pandemic will alter political, societal, and economic landscapes all around the world.  The attack on 9/11 fundamentally changed the way Americans, and many others, felt about their personal safety and national security. 

This pandemic is likely to become a watershed moment as well.  

It is possible that poor pandemic responses, combined with a severe economic downturns, could topple governments, or foment revolution in some countries. We may see regional conflicts over scarce resources, such as food, water, or medicine.  

New alliances will be forged, while others will deteriorate. Some nations, and individuals, will see opportunities in the chaos, and try to exploit them. Many authoritarian regimes will use the pandemic as an excuse to further ratchet down individual freedoms, or to remove their opposition. 

The world as we knew it, will change in ways we can barely imagine today. 

New heroes (likely HCWs) will rise, while others less noble may find their stock has fallen greatly. Some fortunes will be made, while others will be lost.  And amid all of it will be loss and grief unlike anything this country - and much of the world - has seen in decades.

No one will come out of this pandemic unscathed.

The psychological impacts, and the knowledge that this could happen again, will leave an indelible mark on society, much in the way that the Spanish Flu, the Great Depression, and two World Wars did for our grandparents' generation.

After a shaky start, that `greatest' generation became more resilient - eschewing the wild, irresponsible ways of the 1920s - and eventually buckled down to work and save, to fight and win a world war, and spark the mid-20th century economic boom.   

The notion that things will go back to `normal' in 60 or 90 days, naively assumes that most of these global pandemic side effects can be avoided, or that we can somehow separate ourselves from the problems of the rest of the world.  Neither is likely. 

While flattening the curve is our first, and most important challenge, there will be many more pandemic related obstacles ahead. And we must be prepared to meet new challenges that may persist - not for weeks or months - but for years to come.

We are literally moving into uncharted territory.  That doesn't mean we can't or won't ultimately prevail.  But we do need to have a realistic sense of the enormity of the job that lies ahead, and gird ourselves accordingly.