An observer from the moon would think that the world has stopped. What oil embargoes, nuclear threats, earthquakes and tsunamis failed to do, an invisible virus has brought us to our knees – to lockdown. We are now part of a global, real-time experiment in public health epidemiology, medical care and social adaptation where the result is far from clear. This unsustainable situation is aggravated by uncertainty and lack of control. The questions are how this experience will improve future risk management, and how will it change our work and lifestyles?
The pandemic has highlighted slow government action, long-term neglect of health system infrastructure and demographic factors such as an elderly population (Italy) and those living alone (20-30% in Spain as against 60-70% in Sweden). Risk management protocols, essential to the military, have not been implemented. We may condone governments for being over-cautious, but we cannot forgive them for being ill prepared and for not internalizing the lessons from the epidemics of SARS (2003), MERS (2012), and Ebola (2014). Only South Korea, Japan and Singapore appear to have been organized as the mortality and morbidity data clearly show.
Yet, the current “cure” may be far worse than the disease, and the economic fallouts may be more destructive than the health consequences. When this pandemic is over, there are real possibilities of civil unrest and prolonged financial hardship. Therefore, contingency plans must prepare for such food security and economic outcomes. This requires a national advisory committee on disaster planning and responsible lines of communication between the government and the public. We can surely do without the daily body counting - as though there was a sports competition between countries, where, similar to the Mayan games, the winners were deified and put to death. Excess information causes anxiety and confusion – we have too many tabs open in our browsers.
But the situation is not all gloom and doom. Many positive fallouts could improve our lives from the “morning after.” I discuss them according to the sociotype framework for gauging coping strategies. The sociotype is a term that explains why you are what you are, and why you do what you do – and in particular, how you cope with adversity. The sociotype has three aspects – Context, Relationships and the Individual, and there may be overlaps between them. Stresses such as unemployment, financial insecurity, divorce or bereavement can affect all three areas.
Context: Our present experience is a sober exercise in preparedness, especially if a serious disease such as a variant of Ebola were to emerge in the future. As we are all “in the same boat”, there is now closer international cooperation and sharing of big data. There may well be a decrease in terrorism.
This pandemic will stimulate research into animals as a reservoir for zoonotic (animal-borne) illnesses, and implementation science to find vaccines and quicker diagnostic tests. New organizational solutions develop such as the transformation of hotel rooms to quarantine and treatment centers. The use of Telemedicine will change the culture of clinic visits.
There are immediate benefits for the environment from reduced pollution, especially air traffic, which must translate into action on climate change.
School and university closure has caused a long overdue revision of educational methods, utilizing internet teaching and reducing frontal lectures. Flexible office time schedules will allow working from home and establish the norm of virtual meetings. This will surely decrease traffic congestion. We have also created new online experiences such as museum tours, operas and theatre performances.
Relationships: There has been an increase in social solidarity, empathy and communication. Israelis are known for their resilience and sense of humor, which, on social media, have helped coping immensely. Increased family time is surely a bonus provided nerves are not frayed from close proximity. We have discovered technology, such as Zoom, for family support, encouragement, and boosting morale. How lockdown will influence the birth rate is not yet clear.
Individual: The current existential and surreal circumstances make us review time management, reconsider priorities and learn stress reduction techniques. Behavioral changes are necessary to control overeating, reduce smoking, and encourage exercise in a limited space (skipping?). Apart from spring-cleaning, there is now time to do all those things we never had any time to do.
Therefore, the answer to the question: will this pandemic be a transformational moment in world history, depends on whether we press the restart button or install a new upgraded operating system. The latter preferably, and thus, from this global public health experience, “out of the strong may come forth sweetness.”
The writer is a former director of the Braun School of Public Health of the Hebrew University – Hadassah Medical School.