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Pandemic effects on daily life may persist long after it’s over

Life After COVID

The pandemic that disrupted the world in 2020 has upended Terrence Hughes’ life more than most. One of Colorado’s earliest COVID-19 patients, the Denver minister and civic leader fought for survival in the hospital for nearly two months in the spring. He’s spent the months since then slowly recovering.

While hoping for a return to full health, he suspects that once the pandemic is over, daily life will never feel quite normal again. The precautions taken by the entire Hughes family — his wife, Rachel, also weathered COVID-19 early on, with a less severe case — have become ingrained.

“I’m sure the mask-wearing will stick with me. And maybe even gloves,” said Hughes, 57, a co-pastor at Five Points’ New Covenant Christian Church and Alpha Omega Ministries Disciples of Christ. “I don’t believe that we’ve seen the last of these types of outbreaks.”

As the first shots of COVID-19 vaccines went into the arms of Coloradans this month, experts in public health and a range of other fields told The Denver Post that Hughes’ caution is likely to be commonly shared once the pandemic has subsided.

Past epidemics, disasters and other society-wide shocks from history suggest that people will retain remnants of the far-reaching changes that have taken hold in their daily lives. Some will be subtle, perhaps including attentive hand-washing or a reluctance to resume hand-shaking or casual hugs with strangers.

Others legacies, such as reaching for a mask when you’re sick, might be more overt.

Hughes imagines a “new normal” in which people like him who have health conditions that make them vulnerable will just continue their routine when they go out: “As you grab your jacket, you grab your mask. As you grab your purse, you grab your mask.”

Though the pandemic’s end is still frustratingly far away — potentially well into 2021, depending on the vaccine roll-out — the horizon is now coming more clearly into view.

And the long-lasting effects are likely to go beyond individual behaviors.

“This has obviously been a once-in-a-generation — once-in-a-multiple-generation — event that has touched every part of society and the economy,” said Glen Mays, who chairs the Colorado School of Public Health’s Department of Health Systems, Management and Policy. “I’m confident there are going to be persistent effects. When you think about just the extent to which the pandemic has shaped people’s geographic location decisions, their economic decisions, their job opportunities, their housing options — people have shifted where they live or shifted what they do.”

Exactly which changes will take hold may be hard to pin down this early, but Mays predicted major currents would “take certain segments of society and the economy in different directions than they were going before the pandemic.”

Mays and other researchers said the markers left behind are likely to include emotional and psychological scars among those whose lives were most disrupted. Early research has keyed in on anxiety, depression, social isolation, substance abuse and obsessive-compulsive disorders as among the mental health conditions affected as people have coped with the collective stress of the pandemic, suggesting lasting consequences are possible.

The pandemic also accelerated the adoption of technological advances, such as video conferencing and online ordering, that are likely to stick with us, at least in some fashion. Nowhere is that more true than in education, even as schools and universities plan to revert primarily to in-person learning, and in health care, which has embraced telehealth in lieu of many doctor’s visits.

And yet there are obvious yearnings among the public for a return to many aspects of pre-pandemic life — the palpable excitement in the stands of a Rockies game at Coors Field, the warm communal glow of a wedding attended by hundreds of guests, a carefree couples’ night out at a restaurant, without anxiety.

Hughes feels that pull most strongly for a return to the fellowship of his church, which has stuck to remote services to keep its many older members safe.

“That’s what so insidious about this virus. Even a place like a church, with people singing — if somebody’s infected and they’re singing their hearts out,” he said, the virus can spread easily. “Especially in the Black church, the choirs and the singing are so much a part of our church worship experience. I miss that. I miss hearing those voices.

“I long for those times, and I’m not giving up hope.”

Pandemics have “an extraordinary impact”

The Spanish flu that engulfed the world in 1918 offers signals of how COVID-19 may affect our lives for years to come.

Tens of millions of people died worldwide as doctors and local officials struggled to understand how the infectious virus worked. There was little hope of a vaccine then, as medicine and science were far less advanced. The pandemic also took hold while World War I was underway. Historians have suggested it influenced both the end of the war as well as the course of the peace conference, since some leaders in attendance, including U.S. President Woodrow Wilson, were sidelined by the flu.

“Some of the long-term effects of the influenza pandemic literally didn’t show up for decades” in people, said Susan Kent, a history professor at the University of Colorado Boulder who has studied the Spanish flu. Among them, she said, were lower education rates and psychological illnesses found in some people whose mothers had been infected with the 1918 flu while pregnant with them.

But overall, despite a drive to improve medical care and a greater focus on public health, there was a contradictory impulse that played out post-pandemic — a willful choice among many to forget that terrible time. The resulting “historical amnesia” of the pandemic lasted until researchers dug into it in the 1970s and 1980s, Kent said.

In the United States, the coinciding ends of the Great War and the pandemic were followed by the Roaring ’20s, a long run not only of economic growth but a more carefree urban culture. Some historians see a link, a society-wide seeking of release after several crushing years of war and disease.

The current pandemic has been less catastrophic, thanks to modern medicine, but it’s still been deeply disruptive, making unexpected consequences possible.

“We don’t tend to pay attention to these epidemics because they seem just maybe a part of the natural world, but they can have such an extraordinary impact,” Kent said.

Hughes’ impulse to continue using a mask in crowded places reflects a phenomenon he’s seen himself in the cities of Japan, China and southeast Asia in the wake of modern epidemics. A year before the coronavirus pandemic, it was still common to see smatterings of people in Tokyo wearing masks on trains, in grocery aisles and on crowded streets, long after the last regional epidemic was raging.

“I think it’s quite likely that some of these protective behaviors are going to stick with us,” Mays said. “Society’s sort of been through a master class in infectious disease and public health protections.”

Mays is among public health researchers who point to Australia’s mild winter flu season this year as a hopeful sign that precautions taken for COVID-19 will help prevent many seasonal infections, too.

“I’m probably most excited about the fact that it may get planted in people’s heads that infectious disease is not something we actually have to live with every winter,” said Daniel Larremore, an assistant professor at CU Boulder. He combines expertise in computer science and public health to study how diseases spread within networks.

The pandemic is already spurring changes in public buildings and entire industries when it comes to how bathrooms are kept clean and how spaces are ventilated. Kim Day, the CEO of Denver International Airport, and Richard Scharf, the president and CEO of Visit Denver, said in interviews this fall that airlines, airports, hotels, restaurants and convention centers were already rethinking their approaches in many ways that were likely to be permanent, including installing more “touchless” technology.

“We’re never going to turn hand-dryers back on” in DIA’s bathrooms, Day predicted, noting that travelers appeared more comfortable with using compostable paper towels in the pandemic age.

Waiting for the pandemic’s end

Some Coloradans have gone to extraordinary lengths to avoid COVID-19.

In March, a week after the coronavirus was detected in the state, The Post wrote about Laura Cary and Michael Ancel’s decision to preemptively isolate in their southeast Denver home to avoid the potentially deadly risk for Ancel, 72, who has a chronic lung disease.

For more than nine months, the couple has kept it up. They’ve rarely strayed from their house or its porch, save for trips to the doctor’s office and distanced appointments at the veterinarian for their cats. During the summer they each took walks, though a misstep by Ancel during one predawn walk at Washington Park resulted in a broken leg.

Groceries and other supplies arrive on their porch after they order them online.

“Thank God for Amazon,” Ancel said in an interview last week.

Cary, 66, didn’t realize at the beginning just how long their isolation would last. But she has grown comfortable with the “quieter, calmer life” they’ve been living. She’s lost weight, she said, and they’ve grown closer.

“I kept realizing it was going to be longer and longer,” she said. “Maybe that’s a trick your mind plays on you. By the time I embraced the fact that we could be in here for a year or more, I was OK with it.”

During their isolation, a couple people they know have been hospitalized with COVID-19. Cary’s brother in Florida caught it, too. All have recovered.

They said they look forward to getting meals at nearby restaurants once again and traveling to visit their children out of state. But both activities will have to wait — potentially until the second half of 2021, Ancel figures.

“We’re looking forward to getting the vaccines, but we don’t want to get ahead of our friends who work at King Soopers and are getting exposed,” he said.

Cary and Ancel’s patience is unusual, but their eagerness to move beyond the pandemic is shared beyond their four walls.

Sociologists say the ways public health restrictions have challenged most people’s lives — spurring backlashes and even making mask-wearing a political fault line — highlight basic elements of human nature.

“That’s why it’s been hard to get people not just in our country but in countries around the world to abide by public health orders,” said Lori Peek, the director of CU’s Natural Hazards Center. “We are human beings, and we need connection — we need each other to survive. Being told to stay apart from our fellow human beings has been hard. And of course, that’s been exacerbated by all kinds of other behaviors, political and otherwise.”

Peek studies how disasters affect people, particularly those who are most vulnerable on the margins of society. Viewed as a disaster, she said, the pandemic has carried similar disproportionate effects on people — think of the different burdens carried by those who have been able to shift their work to home and lower-income service workers who, if they’re still employed, are still at risk of exposure to the virus every day at work.

As the likely end of the pandemic comes into view sometime next year, Peek hopes it spurs a greater effort to reckon with the long-term effects for people who have fewer means to simply snap back to normal.

Unlike the 1918 pandemic, which was nearly forgotten once it was over, she hopes the United States and the world take account of the deaths and the pain this one has caused.

“What is the story that’s going to be told about this pandemic, and how is it going to shape us as a society moving forward?” Peek said. “Or is it just going to be one more page in our history books? That will be our 2021 conversation.”

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