COVID-19: How Will This End and How Will It Change Us?

The COVID-19 outbreak is still peaking, and some models show the number of deaths per day rising for the next two weeks.

Even so, experts and writers are turning their attention to the conclusion of the epidemic  and the indelible marks it might - who knows for sure? - make on American healthcare, the country as a whole, and the world.

Ed Yong, a science writer for The Atlantic, has written a piece titled, “How the Pandemic Will End” that has been shared thousands of times. Bill Gates and Barack Obama have tweeted their praise. Full text of the article is available here. It is timed as a 22-minute read, but you won't find a wiser use of 22 minutes of your COVID-19 attention span. 

A summary really can’t do justice to Yong’s thoughtful, graceful prose, but…

First, Yong goes through what went wrong (“the testing fiasco was the original sin of America’s pandemic failure”) and what needs to happen next (PPE for healthcare workers, massive rollout of tests, social distancing, and “clear coordination” of the intervention).

But it his “endgame” and “aftermath” sections that are special because they get above the day-to-day to offer some insight and organized ways of thinking about the post-crisis period.

Yong maps out three endgames: a “vanishingly small” chance of worldwide synchronous control of the SARS-CoV-2; rapid spread that leaves enough immunes survivors to create herd immunity but leaves millions dead and healthcare systems devastated in its wake; or “a protracted game of whack-a-mole” that involves stamping out outbreaks where they occur. He says whack-a-mole is the best option, but it will be long, complicated, and will depend on the development of a successful vaccine. And there is nothing quick about vaccine development.

His aftermath section is especially difficult to summarize partly because it is more theoretical and contemplates the possibility of major societal changes. In the short term, Yong sees income inequalities widening, a secondary pandemic of mental health problems, and the possibility of some shunning of COVID-19 survivor.

But he also quotes people who think the COVID-19 outbreak - presuming that it is brought under some kind of control in a fairly reasonable time - bring about some positive changes: everything from smarter work and labor policies to more thorough handwashing (“a habit that has historically been hard to enshrine even in hospitals”) to some enduring political and economic will to prepare for such disasters. “After every crisis -anthrax, SARS, flu, Ebola - attention is paid and investments are made,” writers Yong. “But after short periods of peacetime, memories fade, and budgets dwindle. This trend transcends red and blue administrations.”

Yong says also expect to see funding pour into virology and vaccinology funding, and a surge of students applying to public health programs.