The Quest For A New Normal

Reflections on the COVID-19 Pandemic of 2020

It was late November or early December when Associate Professor and Chair of Biology William Cody, Ph.D., UD’s resident infectious disease expert, first heard about the novel coronavirus outbreak in China, but he admits that at the time, he wasn’t paying any particular attention to it.

“As a microbiologist, I’m always interested in emerging diseases, and unfortunately there have been a significant number of outbreaks in recent years,” he said. “There is always a chance of an epidemic becoming a pandemic, but it’s not a typical occurrence. In late January or early February, I realized I needed to start taking more notice. The reports from Italy were when I first started getting worried.”

When students in his Disease and Society class asked him about the coronavirus, he explained that annually about 1.5 million children die of vaccine-preventable diseases worldwide, but due to the success of our vaccination program, Americans see relatively few deaths and have stopped believing in the dangers of infectious diseases.

“I told them that yes, this is going to get serious, but no one will care because we don’t pay attention; we see infectious disease as something that happens in other countries or to the poor,” he said. “I did not think we’d see shelter-in-place orders. I’m not shocked at the number of deaths, but I am shocked at the extent of the response, because the U.S. does not typically coordinate large-scale efforts to mitigate threats from infectious disease.”

Cody believes that the atypical response was due to the danger to the health care system and the fear that the COVID-19 pandemic could actually collapse it. People who normally do not have to worry about access to health care suddenly felt threatened. In reality, Cody emphasized, millions of Americans have always been without access to health care, but these are the people on the margins, not usually the middle and upper classes.

“And we’re still not taking the deaths seriously,” he said. “It’s still an abstract concept to many. You don’t know someone personally who’s died, so you don’t realize the severity of the threat.”

What does Cody think about reopening?

“I don’t know that Americans have the taste for what we’ve been doing,” he said. “Sheltering, social distancing and in general being told what to do. There is also the very real economic problem. In some cases, too, not only are people out of work, but their insurance was tied to work, so their access to health care has also been compromised.”

As far as how long we should keep up some degree of sheltering and distancing, Cody says we just don’t have the data to know. We haven’t been doing enough testing. The tests haven’t been available enough; first, we weren’t able to get the tests, and even now, people are being told they don’t qualify to get one because they are not in a highrisk category.

“We won’t have the data until we can test those who are asymptomatic,” he explained. “I’d be shocked if we made it through the summer still sheltering and distancing, though, whether because of the social isolation, the economy or not wanting to be told what to do. Still, we don’t have the data to support businesses reopening right now.”

At the same time, politicizing everything is not productive, Cody feels. “Most of us are just trying to figure out how to get our families safely through this,” he said.

Cody admits that he has been disappointed in our public health agencies, namely the CDC: “We have not seen much leadership from them during this pandemic.” Due to the belated governmental response to COVID-19, all of us, regardless of political affiliation, have somewhat lost confidence in the institutions we should be trusting to protect us. Further, Cody feels that it’s truly scary when politics becomes involved with infectious disease.

“We have these daily press conferences, but reporters who cover politics are asking political questions,” he said. “We need live coverage of press conferences at the CDC.

We need more interviews with science and health reporters asking scientific questions. Take the confusion over whether we were supposed to wear masks or not. We need scientists to address these questions directly, to explain how we are supposed to be applying information and behaving in our daily lives, such as how small is our social circle supposed to be? How concerned do we need to be about workers coming into our homes? Do we need to wash our groceries? More of that type of question and answer would remove some of the fear.”

“The first reading assignment in my Disease and Society course is an article by Dr. Anthony Fauci, who was completely unknown to students at the time,” he added. “In it Fauci reflects on his infectious disease residency and the number of people who told him he was wasting his time because all infectious disease would be eradicated. Post-smallpox eradication, and pre-HIV and drug-resistant tuberculosis, this was a popular sentiment.”

Clearly, this is not the case. In 2009, there was the H1N1, or swine flu, pandemic; the difference there was that this strain of influenza wasn’t entirely new. It was referred to as “swine flu” because humans gave it to pigs in the 1970s. All pandemic strains of flu since 1918 have been directly related to the strain that caused the Spanish flu, including H1N1 in 2009. In 2009, scientists were able to develop a vaccine fairly quickly because,

As a microbiologist, I’m always interested in emerging diseases, and unfortunately there have been a significant number of outbreaks in recent years.

unlike the virus that causes COVID-19, this strain was not brand new, and there had been a previous vaccine for it; they were not starting from scratch. Now, the H1N1 vaccine is part of the annual flu shot.

“Flu is a vaccine-preventable disease,” said Cody. “And the flu is horrifying, so any comparison of the flu to COVID-19 is not comforting. One potential good outcome is that people start taking the flu more seriously and getting vaccinated against it, or that those who weren’t vaccinating in general might start doing so.”

A vaccine for COVID-19, however, won’t be ready anytime soon — not if it undergoes all the proper testing. It would be very difficult to develop one in less than 18 months.

“Any sooner would be cutting corners we don’t want to cut,” he said. “And it’s hard to test when you don’t know if having had the disease provides immunity.”

Of course, Cody acknowledges that the infec- tious disease aspects of the pandemic are not the only ones to consider. Economic impact as well as the population of any particular area and where that population stands on return- ing to business as usual are also key factors. Indeed, the economic impact of the pandem- ic has been tremendous and devastating. Families and businesses small and large are in grave peril; this includes, of course, univer- sities. In this sense, it might actually work in UD’s favor, Cody speculates, that we are not a sports school; while it would always be good for UD to have more donors, it may be that other schools depend on income streams that UD already did not have. Truthfully, we cannot yet know what the fall will look like. UD, like most other schools, is considering a variety of options for how classes might proceed as we face a combination flu/coronavirus season.

“Scientists and physicians are just now identifying risk factors and atypical signs and symptoms of COVID-19,” explained Cody. “The initial reports of long-term complication and sequelae, including lung scarring, heart damage and neurological symptoms, are just starting to come in.”

Indeed, this virus has repeatedly proven itself perplexing in its behavior and manifestations, making us all long for a normal that is probably already lost; our lives have already changed in likely irrevocable ways.

“Everyone wants to get back to normal as soon as feels possible,” said Cody, and truly, we do — but what will the new normal look like?