By Tom Frieden, The Washington Post: The five stages of grief provide a useful framework for thinking about crises caused by the pandemic. Although the concept sometimes oversimplifies a complex process, there are core truths: People tend to accept harsh realities gradually and with difficulty. People don’t necessarily proceed through all the stages or in linear order. But recognition of the pandemic’s impact, and widespread embrace of the final stage, acceptance, could speed our collective path to new, post-pandemic normal.
Covid-19 has upended lives around the world. Millions of people are mourning deaths. Hundreds of millions have lost jobs. We are acknowledging, and grieving, these losses and the life rituals — family get-togethers, graduations, weddings — disrupted by the pandemic. No one has been unscathed.
Familiar stages of grief have been visible. At first, world leaders and even many experts in respiratory disease were in denial, hoping that the coronavirus would disappear. The pandemic provoked anger — at China, immigrants and the (essential) public health measures imposed to reduce spread. Some have tried to bargain, suggesting that the pandemic would be mild, harming “only” the elderly and infirm, or might even fizzle. Others succumbed to depression and considered giving up on control measures, hoping to magically achieve “herd immunity.”
These responses are understandable. But the sooner people come to terms with the reality of the pandemic, the quicker we can prepare for lasting changes to the ways we work, learn, relax, govern ourselves and even treat one another.
Details will emerge in the coming weeks and months, but some aspects of our changed lives are already clear: There will be more remote learning and telework and fewer in-person meetings. Travelers may have more space on planes, trains and buses. They’ll probably also face new barriers, including periodic border closures and quarantines. Schools and workplaces will better accommodate people vulnerable to severe disease, such as the elderly and those with underlying health conditions. Universities may shift to more online learning; many could close or be forced to adopt different economic models, including lower tuition. Facilities will change, too: Chairs and tables can no longer safely be close together for now. More elevators and doors are likely to be made touch-free, hand sanitizer and masks will be abundant, and disinfection will become routine.
Our leisure habits will shift. Instead of large indoor gatherings, we’ll enjoy the outdoors. We may go to fewer restaurants and bars, at least for a while, but, as many already have in lockdown, we’ll find alternatives to meaningfully connect with people and groups. When the gym reopens and I’m able to play squash again, my partners and I will skip a match if we feel unwell; we’ll enter the court through a sanitized doorknob, might wear masks and won’t shake hands after the game. Professional athletes will learn to compete without in-person spectators, at least for a time, and may skip the high-fives after touchdowns or home runs.
In the long run, covid-19 will make health care safer. Hospital-associated infections have been one of this country’s leading causes of death; as hospitals adopt measures to control covid-19, they can reduce other preventable infections too. The pandemic could also make health care smarter: To improve personal and community resilience, people with chronic diseases need to receive better care. This crisis is poised to force overdue changes that will make health care more convenient and efficient, with clinicians shifting to telemedicine and administrators making electronic health records interoperable.
The pandemic may change where and how we live. Elderly people may increasingly choose to remain with family as they age rather than relocating to retirement communities or nursing homes. Cities may lose some of their luster as density and public transit, once so central to urban life, may hamper efforts to tamp down disease transmission.
When it comes to our collective investments, there may be more appetite to adequately fund global health and strengthen international institutions to protect against future threats. If we’re rational, we will address many gaps in epidemic prevention around the world, including support for communities and enforcement to close exotic animal markets. Perhaps there will be broader recognition that government has essential, irreplaceable functions — and should be held accountable for protecting citizens.
Of course, effective treatment could minimize the health and economic harms of the pandemic. And if a safe, effective and accessible vaccine is developed, we could return to a largely pre-covid reality, with most people gaining appreciation for the value of vaccines.
But at this point it’s clear: Our lives will be altered by the pandemic for months or years to come. As a society, we may become more reliant on younger people and those already exposed to the virus, and more attentive to shielding the vulnerable. Caring for others and prioritizing the collective good could lead to a positive societal change: First by necessity and then by choice, we may come to accept that we are all in this together.
Tom Frieden is a former director of the Centers for Disease Control and Prevention and a former commissioner of the New York City Health Department. He is president and CEO of Resolve to Save Lives, a initiative that is part of the public health organization Vital Strategies.