A ‘new norm’ after the coronavirus pandemic - North Carolina Health News
By Greg Barnes
It’s hard to find an upside in all of this. The coronavirus has killed thousands of people across the country and sickened hundreds of thousands more.
It has shuttered big factories and small businesses alike, leaving millions unemployed. It has crippled the economy and drained large savings from personal retirement accounts. It has made the poor poorer still.
When the virus finally releases its grasp, few if any of us will be better off, at least in the short term.
But what about the future?
Can we possibly expect to find any silver linings after this nightmare ends?
North Carolina Health News posed that question to a doctor, an economist, a psychologist, a health workforce researcher and two environmentalists.
“A new norm”
Dr. Sallie Robey Permar directs Duke University’s Permar Research Laboratory, which studies immune protection against mother-to-child transmission of neonatal viral pathogens. Permar, a pediatric physician, holds a medical degree from Harvard and a doctorate degree in microbiology/immunology from Johns Hopkins.
Permar said the coronavirus “may create a new norm for our society.”
One way the coronavirus could do that, she said, is by teaching society that we don’t always have to be in the office; that it’s OK to work from home when practical.
“How much commuting do we actually have to do?’’ Permar said. “How much in-person work do we actually have to facilitate? We will all be more comfortable with virtual options for connecting.
“I think there will be a higher comfort level and acceptance of working from home and being involved virtually than there has been in the past. That will lead to less commuting as well as less air travel.”
Michael Walden, an economics professor at N.C. State University for more than 40 years, agreed with Permar’s assessment and expanded upon it.
In a column posted on N.C. State University’s website, Walden noted that working from home has been around long before what he calls the “Virus Crisis.” He expects it will grow vastly in popularity afterward.
“Companies can save money on buildings and workers can save time by not commuting by tele-working,” Walden wrote. “Although tele-working is certainly not suitable for all jobs, I would expect that with more companies and workers experiencing tele-working during the Virus Crisis, the technique could become much more popular in coming years.”
Permar sees the shift as inevitable.
“I think that this experience will help people get over that fear that ‘if I don’t see my employees at their desk, they may not be working,’” she said. “I do think it will change employers’ point of view and therefore their comfort level with allowing more flexible working options.”
Walden said the coronavirus and tele-working could also result in people trading crowded cities for less expensive life in small towns.
“One impact of the Virus Crisis might be a reconsideration of small town and rural living,” Walden wrote. “People may think that, while the current virus will pass, others may come in the future. And with tele-teaching, tele-medicine, and tele-working likely increasing in use, rural isolation will be lessened.”
Permar said the coronavirus has already taught us that telemedicine — doctors seeing their patients through a televised call — can have tremendous benefits.
“As a health system, we’ve been toying with the option of telemedicine for literally years but never could really get over the hump of trying to understand how we can achieve it within all of the regulation of patient privacy, as well as how it would be reimbursed,” Permar said. “Those things were solved, literally overnight, with this pandemic, and it will mean that there will be a pathway to continue these operations for the future.”
It could also mean less burnout for health care providers and save patients from having to travel to see their doctors, often toting their children or elderly parents with them, she said.
China and supply chains
Speaking about the global economy, Walden believes China’s image and economy will suffer because of the coronavirus. The coronavirus is believed to have originated in China, Walden points out, and some believe the country was not forthcoming about its spread early on.
“I expect more consumers in the future will refrain from buying any product made in China,” Walden wrote. “Domestic sellers could go out of their way to advertise that their products do not originate from China.”
China is the largest supply chain source for American businesses. Walden predicts that many U.S. companies will be motivated to either cut themselves from foreign supply chains, or at least scale back.
“The upside is a revival of domestic supply chains will create more jobs and more earnings in the U.S.,” Walden wrote.
Sandra Wartski earned a doctorate degree in psychology from Widener University and now works as a family psychologist at Silber Psychological Services in Raleigh, where she has been for 27 years.
Wartski recalled a visit with a girl in middle school who had recently finished reading Anne Frank’s “The Diary of a Young Girl.”
“She said, ‘Well you know what, at least we don’t have to be silent like Anne Frank and her family did when they were hiding from the Nazis,’” Wartski said, quoting the girl. “She says ‘We’re quarantining like they were. We don’t have to be silent.’’’
In some ways, it’s a matter of perception. The 12-year-old girl saw the bright side of a bleak situation. Other people, Wartski said, struggle to cope with social isolation and related issues brought on by the coronavirus.
Wartski could not begin to guess how many are in each camp.
“Could I even make a percentage on it?” she asked. “Is it 50-50 or 70-30? I’m not even sure that I can do that.”
But she does know that, for some, the isolation caused by the pandemic has helped them in different ways.
“Suddenly, everything is stopping and slowing down,” Wartski said. “I see this already with a lot of my clients who were on high speed, you know, in the express lane, and I gotta go here and I got to do that.
“At first it’s a real shock to the system to know ‘I can’t go anywhere, I don’t have to go anywhere.’ And then there’s a settling in. Maybe it is actually enjoyable to sit back and talk to my family or … play games or, you know, read this book that I have been meaning to read forever and not be distracted by 12 errands.”
Wartski finds the kinds of activities families are doing together now heartwarming — such as helping their elderly neighbors or putting teddy bears in their windows for children to count on walks or simply singing and playing games together.
“We don’t often have the space and the time where we are forced to do that and then lo and behold, it actually ends up being somewhat soothing and comforting and enjoyable,” she said.
Wartski said she hopes that feeling will remain long after the virus is gone.
But she can’t say that it will.
She compares life after the pandemic to what typically happens after a hurricane. People help their neighbors. They cut up one another’s fallen trees, drag waterlogged furniture to the curb and grill food from powerless freezers.
Sometimes, the bonds last forever; other times they are only fleeting.
“My guess is it will (last) for a little bit,” Wartski said.
The health workforce researcher
When a major event happens in this country, it often triggers a calling for people to enter a career they may have thought little about beforehand.
Hordes of people became soldiers and firefighters after 9/11 or journalists after Watergate.
Will they be motivated to enter the health care profession after the pandemic?
Erin Fraher is optimistic that they will.
For about 15 years, Fraher has directed the Program on Health Workforce Research and Policy at the University of North Carolina. Her job is to examine ways to best educate and deploy health care professionals.
The enormous publicity nurses and physicians have received during the pandemic has elevated them to hero status. Fraher said that is expected to open the doors in North Carolina to a health care profession in which the average age of a physician is now 50.7 and the average age of a practicing nurse is 52.3.
“I think it is a rallying cry,” Fraher said. “I do think that these health care workers who were invisible are becoming heroes and I think that’s amazing and terrific and may attract more people into the health care workforce.”
But she cautions that the pandemic could also create a downside.
“The other side could be that our health care professionals feel that they have been failed, that the lack of proper protection, that the lack of ability to function in an environment where they feel safe, could in fact dissuade some people from going into health care,” Fraher said. “So I think it might be an overall situation where we see more people going in, but I think if you were risk averse, this might be deeply disturbing for you or for, say, your parents as they were thinking about paying for your nursing school or paying for you to become a respiratory therapist.”
Perhaps the biggest silver lining the pandemic could create is that it will generate a better understanding and appreciation of the difficulties — both physically and mentally– that health care professionals face, Fraher said.
“I hope what it does, frankly, is encourage hospitals and health care systems and employers who may have taken their health care workforce for granted — assuming that they sort of grow on trees,” she said. “They may actually have a deeper appreciation for their workforce.”
By now, many people have seen the before-and-after pictures showing incredible reduction of air pollution in China, India and Los Angeles that are floating around the internet.
The N.C. Department of Environmental Quality and the advocacy group Clean Air Carolina say it is too early to tell whether the absence of vehicles on the road and the decrease of factory production caused by the pandemic will have a similar — though much smaller — impact in North Carolina.
Calvin Cupini, the citizen science manager for Clean Air Carolina, said more time will be needed to determine whether the virus has led to a decrease in air pollution in our state.
Cupini and DEQ spokeswoman Zaynab Nasif say air pollution in North Carolina has declined considerably in the past 20 years, partly as a result of the Clean Smokestacks Act of 2002, new vehicle emissions regulations and a push toward renewable energy.
Most of North Carolina’s air pollution, especially in the Charlotte area where Clean Air Carolina is based, comes from vehicle emissions, Cupini said.
Cupini said he expects the pandemic to result in a reduction in air pollution, but just how much remains to be seen because ozone and particulate matter take time to mix in the atmosphere.
How long those reductions will remain is also anyone’s guess.
Rachel McIntosh-Kastrinsky of Clean Air Carolina said any short-term reductions could benefit vulnerable North Carolinians with heart and respiratory problems who contract the coronavirus.
McIntosh-Kastrinsky pointed to a recent Harvard University study that shows a small increase in airborne particulate matter creates a 15 percent increase in the likelihood that someone will die from coronavirus.
“The study results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis,” the researchers reported.
McIntosh-Kastrinsky said there is a chance that when social distancing and other restrictions are lifted, air pollution will increase as people get back outside, “which could negate many of the benefits.”
Tele-conferencing could go a long way toward reducing those vehicle and airplane emissions, she said.
“If people and businesses start adopting this workstyle more readily, we could see longer-lasting air pollution reductions resulting in fewer respiratory and cardiovascular complications,” she said.
But overall, McIntosh-Kastrinsky said, the benefits of cleaner air won’t outweigh the pandemic’s wrath on society.
“These minor reductions are not worth the utter devastation to our health and society that we’re living through,” she said. “The COVID-19 pandemic is a global health disaster. People’s lives are being ruined by this.”