April 21, 2020

Where do we go from here?

Where do we go from here? We are in the middle of a serious pandemic without a really clear idea of when it will end. Until there is a vaccine and really effective therapies, people will feel hesitant to really open up everything. All the epidemiological projections are just that projections and they change as new information is garnered. Social distancing has flattened the curve and protected our health care system from being overwhelmed for the most part. Flattening the curve has probably stretched it out into the summer. But here is the truth- we are not in charge no matter how much our elected officials say. The fact of the matter is that the virus, SARS-CoV2 is in charge. All we can do is be patient and smart and not do anything that goes against the scientific evidence. That is hard. But is some ways society has already changed and will likely remain changed. I hear many people saying that even if the government eases restrictions and stores and restaurants open, sports events with large crowds begin again, and churches are able to have large services, they are not going to change what they are doing right now. Most people feel it is not yet time to “open up”. In China, there are reports of people who are staying home and not going out as much. There is a feeling that this is going to be a long haul. The majority of people think it is too soon and we run the risk of having a second wave of covid-19 larger than the first.

Many persons are impacted in demanding ways. Those who are actively working as care providers in hospitals, clinics and emergency rooms as well as laboratories, those working in food industries from farmers to restaurant workers and on to agriculture workers are all significantly impacted. It is not pretty and you are exhausted. I get that. In response to the pandemic changes in health care delivery have been made. Some of the changes that have occurred such as the necessary expansion of telehealth is going to stay with us. Already, health care insurers have developed payment methods for telehealth visits. Somehow, I hope that the lessons learned will help us improve the health care system at all levels. We have learned from other countries both in the past and now that universal health care does not have to mean all government payment. Germany is a case in point as they have many health insurance companies, but everyone has health insurance and access to care. Certainly, the US system of care has been changed by this virus in major ways. What the virus is telling us is that science matters, and we have to let people know it matters a lot. There is no going back. Right now, the virus is in charge and we need to be patient as we strive to find cures, find a vaccine and change the culture of health care in positive ways. We need also to be patient with people who do not understand the science of the pandemic, who are frustrated and frightened or just persons who are trying to capitalize on the situation for their own power. I hope we can be up to the task and that the changes we have put into place and that we envision last. Overtime this virus will be tamed and hopefully we will have learned some important things. In education, those who have mastered on- line education, are going to continue to use these techniques. We can expand these techniques further from elementary to university education. There is so much more we can do to educate the general public about health and make them partners with us in improving health.

There are many other positive things that this virus has shown us. it is conceivable that the world’s population will work to preserve these positive outcomes. Most importantly, air pollution has decreased. In Los Angeles, one can see the mountains, in Beijing, breathing is easier, in Salt Lake City the air is cleaner for the most part. From the point of view of reproductive health this is a positive outcome. As the data regarding preterm birth, birth defects and sperm alterations accumulate we will learn how this has improved reproduction. Hopefully, this information will convince more individuals that we need to develop serious public programs to stop polluting the air we breathe. A few weeks ago, there was an article in the Wall Street Journal indicating that stocks of renewable energy (solar, wind, geothermal, hydroelectric) companies seem to be a good investment because they have long-term, fixed contracts and in the current economic environment this a good thing. There is a report from Scandinavia about a project to harness energy from ocean waves. These changes will also help mitigate the climate change that threatens our world and life as we know it.

It is imperative that we understand that we cannot go back to what life was like before this pandemic. At as personal level, we are slowing down a bit. I am able to take long walks every day and guess what, I have lost weight without even trying. I spend time watching the birds in the pine trees outside my window, I observe the trees leafing out. It feels good to be relaxed and I am healthier than before. I do not want to go back to the frenetic life I was leading before covid-19. I am reading more books and thinking more. I am writing stories about my life. I like what I am doing now. I meet with my book club on Zoom, I talk to my friends and family and I attend professional meetings on line. People are concerned about one another. They are more caring and I feel that. These are all the ways that the virus has impacted my life and I know that the virus has impacted your life as well. Let’s keep the good things we are beginning to learn.