Why do we need a new normal?

[ShadowBloom]

This is a genuine question--I'm trying to understand, not argue that we don't. Many of the discussions about exit strategies say that we won't be going back to normal; there'll be some kind of new normal.


My question, why do we need a new normal? Did the 1918 epidemic dramatically change society? If it didn't (and I'll admit I didn't research this deeply), why/how is the current virus so different that its impact on society has to be long-lasting? I'm talking about long-lasting changes in how ordinary citizens do things, not in how states prepare for epidemics.

 

[Ready]

This is a genuine question--I'm trying to understand, not argue that we don't. Many of the discussions about exit strategies say that we won't be going back to normal; there'll be some kind of new normal.


My question, why do we need a new normal? Did the 1918 epidemic dramatically change society? If it didn't (and I'll admit I didn't research this deeply), why/how is the current virus so different that its impact on society has to be long-lasting? I'm talking about long-lasting changes in how ordinary citizens do things, not in how states prepare for epidemics.

The Spanish flu killed somewhere between 30-50 million people worldwide, so it clearly had a big impact on society.

As for long lasting changes for us? It depends what your definition of long is. If we develop a vaccine and get the entire country immunized it is likely that life will be going back to “normal” shortly after that.

So when will that happen? 12 months? 18 months? Nobody knows for sure. But until it happens life is going to be different. You are not going to see mass gatherings like sporting events and concerts without a vaccine or a highly effective treatment.

Other activities will resume, but in graduated steps. Restaurants may reopen but at reduced capacity. But eventually businesses will reopen to some extent.

 

[DenverGuy42]

My question, why do we need a new normal? Did the 1918 epidemic dramatically change society?

In 1918, and 1919, and 1920 - there were multiple waves of the epidemic. And it killed between 20,000,000 and 50,000,000 people. The world population was about 1.8 billion at the beginning of 1918.

The death toll today - if allowed to run virtually unchecked - would numerically be much higher. We have a lot more people and are infinitely more effective at allowing things to spread quickly.

But back to 1918 - the biggest wave of death was the 2nd wave. The pandemic started in March 1918, but it was in late 1918 with the second wave were the most deaths were observed. Remember also, there was a world war going on - the soldiers moving around was a great way to spread it all.

But we made it even better with air travel. We can spread stuff infinitely more efficiently than troops being moved on the ground.

Until we have a vaccine, or enough people have natural immunity having lived through the disease, and have a sufficiently large, immune population to achieve herd immunity - our choices are:

1) go back to the old normal. The second wave comes and we either shut it down all over again or we lose a lot of people. Rinse and repeat for the 3rd wave and so on.

2) go to a new normal that says baseball will be played in empty stadiums and watched on TV. That says restaurants can open for some in house dining but observing greater spread among the tables. That says gatherings over a certain size must be prevented (no concerts for example). That says we'll be testing like crazy and if a hotspot happens - we'll shut it down and we'll actively isolate anyone that is positive until they aren't. That says other things that are actively different from the way we were 3 months ago.


and only after a vaccine or enough people are immune would it be safe to resume the old normal.

 

[ShadowBloom]

2) go to a new normal that says baseball will be played in empty stadiums and watched on TV. That says restaurants can open for some in house dining but observing greater spread among the tables. That says gatherings over a certain size must be prevented (no concerts for example). That says we'll be testing like crazy and if a hotspot happens - we'll shut it down and we'll actively isolate anyone that is positive until they aren't. That says other things that are actively different from the way we were 3 months ago.

and only after a vaccine or enough people are immune would it be safe to resume the old normal.

So in 1918-20, was it a deliberate choice NOT to make these changes? Or did they, and I'm just not aware? Or did they not know enough about epidemics and how the disease spread to consider those options?


Just to add: I understand about flattening the curve to avoid overloading hospitals. But I'm still having trouble grasping the need for long-term changes in behavior and how society organizes and operates, which some seem to be suggesting. I read an article today suggesting that schools can't reopen for 2 years; that's the kind of change I'm trying to see and appreciate the need for. Did they manage to keep schools open during the Spanish flu?

 

[DenverGuy42]

So in 1918-20, was it a deliberate choice NOT to make these changes? Or did they, and I'm just not aware? Or did they not know enough about epidemics and how the disease spread to consider those options?


Just to add: I understand about flattening the curve to avoid overloading hospitals. But I'm still having trouble grasping the need for long-term changes in behavior and how society organizes and operates, which some seem to be suggesting. I read an article today suggesting that schools can't reopen for 2 years; that's the kind of change I'm trying to see and appreciate the need for. Did they manage to keep schools open during the Spanish flu?

they didn't do anywhere near what we are doing today.

Here is an article discussing it:

https://www.history.com/news/spanish-flu-pandemic-response-cities

some places did nothing - Philadelphia for example. And suffered hugely.

other places, St Louis for example, shut down in a manner similar to what we've been doing. They flattened their curve and suffered significantly less than places that did business as normal.

But, even St Louis got hit again - and suffered in the third wave, likely because they went back to normal.

Every place attacked it a little differently - and gave the people that study these things lots of case studies from which to derive the "best practices" from.

We know with 100% certainty that if we just go back to normal after flattening the curve - the 2nd wave is going to nail us hard and fast.

 

[ShadowBloom]

Thanks for that link. Seeing more details about the history is helpful.

 

[Dtail]

If this new drug from Gilead leads to effectively shutting down the deaths, but there is still a 2nd/3rd wave with hospitalizations, then I wonder would that be acceptable enough for many folks until the actual vaccine comes out?

 

[Aerides]

Obviously 1918 was a very different world. Medicine was not remotely where it is today - heck people believed smoking was GOOD for you until decades after that.

So the idea that they were even told to avoid shaking hands or wash their hands or close institutions in that society - which also had far more poverty, child labor, etc., doesn't make sense to me. Did the average person even know how it was spread? There is no way to equate the types of changes proposed now, vs. then. apples oranges.

But why we need a new normal for some behaviors now? Because - in the best case, if we assume Covid-19 dies off shortly - this will happen again, and we'd hopefully want a different outcome.

I'm not sure which article you are referring to, but there was a study yesterday re schools and 2 years, etc., but that was not an article, and was saying that would only be the path should we not mitigate the virus with other means, ie., cure, therapies, vaccine. It was published basically as a means to spur innovation vs. the worst case scenario, not a proposal of what can and can't be done.

 

[DenverGuy42]

If this new drug from Gilead leads to effectively shutting down the deaths, but there is still a 2nd/3rd wave with hospitalizations, then I wonder would that be acceptable enough for many folks until the actual vaccine comes out?

depends, if the treatment is done like this:

- you feel sick, call doctor and get tested that afternoon.

- results are back right away. you are positive.

- you get prescription and pick it up on your way home

- taking the medication solves most everyones problem

then sure - that would likely be good enough. However, if it is more like:

- you feel sick, call doctor but doctor cannot get you tested for a few days

no, that won't work - you might be really sick in a few days.

or if the medication has to be done in a hospital setting, that won't work (need to keep the curve very flat).

It depends. Do we have the testing capabilities. Can the medication be produced fast enough. Is it safe enough to self medicate with (the [mod edit] drug suggested by the president is not, you need to monitor the heart for many many people).

 

[Just_Steve]

depends, if the treatment is done like this:

- you feel sick, call doctor and get tested that afternoon.

- results are back right away. you are positive.

- you get prescription and pick it up on your way home

- taking the medication solves most everyones problem

then sure - that would likely be good enough. However, if it is more like:

- you feel sick, call doctor but doctor cannot get you tested for a few days

no, that won't work - you might be really sick in a few days.

or if the medication has to be done in a hospital setting, that won't work (need to keep the curve very flat).

It depends. Do we have the testing capabilities. Can the medication be produced fast enough. Is it safe enough to self medicate with (the [mod edit] drug suggested by the president is not, you need to monitor the heart for many many people).

1) Thats political BS.
2) People use Hydroxychloroquine at home as prescribed all the time just like any other medication.

 

[travelover]

One point to remember is that Covid19 only kills a small percentage of those that catch it. A more deadly virus like Hantavirus kills 2/3rds of those that catch it. If we continue as before and a really deadly, fast spreading virus occurs, we'd be in much, much worse shape.

 

[DenverGuy42]

1) Thats political BS.
2) People use Hydroxychloroquine at home as prescribed all the time just like any other medication.

it is not BS . studies using this medication for covid-19 have been halted in more than one case due to the 'cure' being worse than the disease. Heart arrhythmia are known to be caused by this - especially at the higher than normal dose being tried to treat covid-19.

As someone with elongated qT numbers - i would never be able to take this, as would many people. Even people without elongated qt numbers, the higher dose they are trying is causing issues.

https://www.sciencealert.com/clinic...oroquine-stopped-early-due-to-safety-concerns

"The antimalarial is known to cause dangerous side-effects; even its relatively 'safer' cousin, hydroxychloroquine, doesn't have a great track record. Of particular concern is the risk for patients to develop serious heart problems."

I wasn't saying anything political, just stating a fact. sorry if it didn't fit into your worldview.

 

[walkinwood]

I'm talking about long-lasting changes in how ordinary citizens do things...

Will you be caught without sufficient toilet paper for a month again? Canned & dried foods?

People are cooking at home more - will they frequent restaurants as often as they used to?

Will demand for crowded venues change?

Will demand for ocean cruises return?

Will people be more inclined to have an emergency fund? I thought that 2008/09 would inculcate that habit, but I was apparently wrong.

I'm convinced that we'll only know the changes in hind-sight. Everything & everyone is inter-connected in such complex networks, that forecasting is fraught with problems. You can only ask the questions & assign probabilities.

We had a neighbor who was a child during the great depression. That event colored her whole outlook on life. She didn't waste anything; was frugal & was always prepared for deprivation. She was in her mid-70s when we got to know her and was still working as a pediatric nurse even though they had sufficient funds for their simple lifestyle.

 

[target2019]

We get a new normal not because we need it, but because society is continuously adapting to threats. Walkinwood's post is insightful.

 

[Just_Steve]

it is not bullshit. studies using this medication for covid-19 have been halted in more than one case due to the 'cure' being worse than the disease. Heart arrhythmia are known to be caused by this - especially at the higher than normal dose being tried to treat covid-19.

As someone with elongated qT numbers - i would never be able to take this, as would many people. Even people without elongated qt numbers, the higher dose they are trying is causing issues.

https://www.sciencealert.com/clinic...oroquine-stopped-early-due-to-safety-concerns

"The antimalarial is known to cause dangerous side-effects; even its relatively 'safer' cousin, hydroxychloroquine, doesn't have a great track record. Of particular concern is the risk for patients to develop serious heart problems."

I wasn't saying anything political, just stating a fact. sorry if it didn't fit into your worldview.

So much for stopping.

:US clinical trials of hydroxychloroquine hit ‘warp speed,’ could show in weeks whether it works on coronavirus"

https://www.cnbc.com/2020/04/15/cor...als-of-hydroxychloroquine-hit-warp-speed.html

 

[DenverGuy42]

So much for stopping.

:US clinical trials of hydroxychloroquine hit ‘warp speed,’ could show in weeks whether it works on coronavirus"

https://www.cnbc.com/2020/04/15/cor...als-of-hydroxychloroquine-hit-warp-speed.html

I said halted in more than one case?

and this says "could show" - as in maybe. The science is out on this so far. We'll see. But it is all being done under very controlled (eg: hospital) settings right now - because without monitoring, it can, will, does affect the heart. They know this from history. They are trying higher levels then people normally take and it is taking a harder toll on the heart itself.

why is that hard to get? I gave you an article that describes the issues they are running into?

I hope it is a viable treatment - for some people. It won't be one for me and for many people like me with elongated qt numbers and afib from the get go. It is not as simple as you are trying to make it out.

(and an article that uses "warp speed" - really,

"On March 24, researchers at NYU Langone launched one of the nation’s largest hydroxychloroquine studies and enrolled their first patient 10 days later. "

that's faster than a normal clinical trial would have been in the past, but really - to call it warp speed. And then to reference an utterly discredited french result as well. come on. let's see where it gets us.)

 

[Just_Steve]

I said halted in more than one case?

and this says "could show" - as in maybe. The science is out on this so far. We'll see. But it is all being done under very controlled (eg: hospital) settings right now - because without monitoring, it can, will, does affect the heart. They know this from history. They are trying higher levels then people normally take and it is taking a harder toll on the heart itself.

why is that hard to get? I gave you an article that describes the issues they are running into?

I hope it is a viable treatment - for some people. It won't be one for me and for many people like me with elongated qt numbers and afib from the get go. It is not as simple as you are trying to make it out.

(and an article that uses "warp speed" - really,

"On March 24, researchers at NYU Langone launched one of the nation’s largest hydroxychloroquine studies and enrolled their first patient 10 days later. "

that's faster than a normal clinical trial would have been in the past, but really - to call it warp speed. And then to reference an utterly discredited french result as well. come on. let's see where it gets us.)

Well, it is a quote from one of the investigators.

“We’re trying to move at warp speed,” Dr. Anna Bershteyn, an assistant professor at NYU Langone and the study’s co-principal investigator, said in an interview with CNBC. “The fastest an answer can possibly come we think is in two months.”

By the way it sounds like you have an agenda because it won't help you. Guess we all have axes to grind.

 

[48Fire]

My question, why do we need a new normal? Did the 1918 epidemic dramatically change society? If it didn't (and I'll admit I didn't research this deeply), why/how is the current virus so different that its impact on society has to be long-lasting? I'm talking about long-lasting changes in how ordinary citizens do things, not in how states prepare for epidemics.

Yes, we do need a new normal. Here's just one example on the micro level. I observed a conversation with a couple co-workers.

"I thought you were taking the day off and going golfing?"

"I was, but I wasn't feeling well, so I came in to work."

Imagine if that person brings COVID-19 to work. Sick people need to be encouraged/forced to stay home. I think you might see things like unlimited sick time from employers, at least until a vaccine.

And on a macro level, we have all of this death and illness, and the virus still lingers on. Without a new normal, it will roar back for sure, just like in 1918. I can't change everyone's behavior, but we will definitely have a new normal in our happy home

 

[brewer12345]

I have a question about restaurants reopening. I keep hearing that it will require greater spacing between tables for seated dining when it happens (leaving aside takeout). Given that this destroys the economics of high turnover, modestly priced places, does this mean that restaurants will be pretty much very expensive upscale affairs/.

 

[Aus_E_Expat]

I think the new normal will be different - but maybe not radically different.

Cruise ship holidays will disappear for a long time (5 - 10 years?).

Budget international travel will take a long time to come back (many airlines will not reopen and who will go on a budget holiday if you have to spend a further 14 days in self isolation upon return).

Restaurants and cafes will have less tables, more spaced out. That will increase costs (unless rents remain down).

Bars will not be the crowded heaving venues they were (maybe a good thing).

Domestic manufacturing capacity will increase - we cannot rely on long supply chains, particularly from China.

Foreign investment will be scrutinized (particularly Chinese investment which may be seen as profiteering from low asset prices).

Taxes will increase to pay for the stimulus and rescue packages.

Many people will be more willing to accept more government monitoring for better tracing (afterall, we let Google and Facebook do it already).

 

[DenverGuy42]

Well, it is a quote from one of the investigators.

“We’re trying to move at warp speed,” Dr. Anna Bershteyn, an assistant professor at NYU Langone and the study’s co-principal investigator, said in an interview with CNBC. “The fastest an answer can possibly come we think is in two months.”

By the way it sounds like you have an agenda because it won't help you. Guess we all have axes to grind.

no, i don't have an axe to grind. someone says "political BS “ to me about something I said that was not political in the least.

I said I hope this is a good treatment, however the jury is still out on that. Just because as lower doses this is safe for most people in an out patient setting doesn't mean that it will be for covid 19. We just don't know.

nuff said.

 

[48Fire]

I have a question about restaurants reopening. I keep hearing that it will require greater spacing between tables for seated dining when it happens (leaving aside takeout). Given that this destroys the economics of high turnover, modestly priced places, does this mean that restaurants will be pretty much very expensive upscale affairs/.

Should be interesting. One of our favorite restaurants is 120 yards from our place, and they have family style, picnic table seating. So you often get seated next to perfect strangers. Guess that will be changing, but at some costs, both non-recurring and recurring. Many are unlikely to survive. Those that do will probably increase costs due to higher demand, lower supply to make it all work.

 

[brewer12345]

Should be interesting. One of our favorite restaurants is 120 yards from our place, and they have family style, picnic table seating. So you often get seated next to perfect strangers. Guess that will be changing, but at some costs, both non-recurring and recurring. Many are unlikely to survive. Those that do will probably increase costs due to higher demand, lower supply to make it all work.

Restaurants go in and out of business all the time. I expect this will be a big flush out and when the dust settles you will see new restaurants pop up like mushrooms after the rain. But I think that will not happen until the pandemic is clearly behind us. I was thinking about in the meantime, what kind of restaurant would be viable on an economic basis.

 

[DenverGuy42]

I was thinking about in the meantime, what kind of restaurant would be viable on an economic basis.

https://www.sonicdrivein.com/

they've got it made for a while.

 

[MissMolly]

Why do we need a new normal? Because this time it's different.