William Cayley: The new normal

It is beginning to sink in that this societal upheaval is not just a temporary “time out,” writes William Cayley

bill_cayley_2“So how are you adjusting to the new normal?” 

I heard some variation of this question countless times over the first days and weeks of the societal shutdown that was implemented in an effort to contain the spread of covid-19. As sports were suspended, schools closed, and businesses shuttered, we collectively mourned the loss of our old “normal” and contemplated something different. 

At times, I was reminded of the world changing events portrayed in the recent Avengers film saga. In the final moments of the movie Infinity War, the cosmic bad guy Thanos snaps his fingers and erases half of all life. The movie Endgame then opens with a portrayal of the “new normal,” where half of humanity is gone—streets and sports arenas are empty and forlorn survivors are left to mourn the past. In late March, I commented in my journal that the roads on my morning commute were “so empty it was as though Thanos really had snapped his fingers!” 

Over the past month, the strangeness has just intensified. My clinic is nearly always quiet, shops are closed or are enforcing social distancing and infection control (I had to get my temperature taken to enter the hardware store yesterday!), infection and mortality rates feature heavily in the daily news, and the economic damage from our (entirely appropriate) preventive measures continues to pile up. 

And yet, amid all of these changes, I don’t think we really thought of this as a new “normal.” Rather, I think most of us thought (or hoped?) that this societal upheaval was just a temporary “time out.” Surely, we’d take some drastic steps, we’d face some challenges and some genuine social stress and discomfort, but this “new” state of affairs would not last forever? Surely, we’d reach a point at which we could go back to “the way it was?” 

I think it is beginning to sink in that this is not so. I wrote in my journal last week that, “we really are starting to look at a ‘new normal’ which will not be the rapid response to covid-19 as a new threat, but long term readjustments to managing it as an ongoing threat.” 

A new “normal” is starting to emerge, but it is something clearly new. While it seems that death rates from covid-19 may be plateauing in the hardest hit areas of the US, there is so much of the population still potentially at risk that we must plan for likely future “waves” of infection. It may be that social distancing, limitations on large gatherings, and even restrictions on hospital visitation may be vital for the long term prevention of future covid-19 surges. 

Daily work life has been drastically altered. Many are out of work, many are working from home, and our approach to travel and meetings for work has been radically reshaped. Will we resume our previous ways, or will remote meetings become the new standard?

Education has moved from taking place in schools and universities, to being almost entirely at home or online. While we accommodated this as a necessary adjustment this spring, it is now becoming more apparent that some (if not all) institutions need to plan for remote education for a much longer duration. Will students return to school and university in the fall as they have in other years? Or will remote education be with us for the foreseeable future? 

Retail business has been dramatically affected. Online shopping has boomed, but many local small businesses have either been forced to close, or have had to rapidly adapt to web based shopping and curbside pickup.

Not all of the changes we’ve encountered in recent months are bad. There are reports that global pollution is down, families are finding they have more time together, and some changes to retail practices may have simply expedited inevitable changes needed for flourishing in a 21st century economy. 

It is nearly impossible to quantify comparisons between society changing upheavals. There are valid concerns that the economic devastation due to covid-19 may be on par with the Great Depression, yet the scale of loss and change engendered by this crisis seems to pale in comparison to either of the world wars. Nevertheless, no matter how one tries to measure the impact of the covid-19 crisis, it seems clear that the “normal” at which we will sooner or later arrive, really will be something new.

The movie Endgame goes on to tell the thrilling story of how, through teamwork and sacrifice, the Avengers set things “right” and (more or less) restore life to the way it used to be. It is a happy ending, but the reality is that it is one fit only for the movies. 

No one I am aware of has any infinity stones, nor a time travelling Delorean, or even a Tardis. 

Our path to our new normal will not be straightforward, most likely will not be easy, and most certainly will involve a normal that really is a change from beforeit really will be a “new” normal.

And yet, we can hope that the new normal will eventually also involve a happy ending.

William E Cayley Jr is a clinical professor at the University of Wisconsin, Department of Family Medicine and Community Health. Twitter @bcayley

Competing interests: I declare that I have read and understood BMJ policy on declaration of interests and I have no relevant interests to declare.