‘Optimism tinged with anxiety’
What to expect in the coming days for COVID-19
TORONTO — “What’s keeping you awake at night?” That’s the question we put to doctors, scientists, philosophers, psychologists, futurists, microbiologists and bioethicists, as 100 days had passed after the World Health Organization officially declared COVID-19 a global pandemic. We asked the experts what they’re anticipating for the next 100 days, what we should do differently, what worries them most.
“Things have changed at such manic speed in the past three months, it’s difficult to predict what the next 100 days will yield,” said McGill University’s Samuel Veissière. Below, Veissière and others reflect on the challenges ahead. Their responses have been edited for clarity and length.
ON COMPLIANCE FATIGUE, SOCIAL ISOLATION AND THE POLITICS OF A PANDEMIC:
“I’m worried about future waves being imminent, maybe not even waves, but just this steady, persistent (viral activity). How do we sustain what we’re doing? It’s so important for mental health to have livelihoods. To continue to function. I don’t know what the answer is. That kind of keeps me awake.” Dr. Samira Mubareka, virologist, infectious diseases, Sunnybrook Health Sciences Centre in Toronto
“As summer arrives, lockdownweary people will increasingly flock to parks, beaches. Protest rallies and, south of the border, political rallies will bring people together in large numbers. This could prolong the current wave of infection or even spur a second wave. Paradoxically, efforts to combat one social problem (protest rallies to combat racism) could exacerbate another social problem (the spread of COVID-19 … COVID-19 is largely a hidden pandemic, where the sick and dying are sequestered in hospitals, and coffins are nowhere to be seen. This can lead people to underestimate the seriousness of the current pandemic.” Dr. Steven Taylor, professor, clinical psychologist, University of British Columbia
“Politics and social polarization worry me the most. Before the pandemic some of us had predicted that 2020 would be the year of reason and reconciliation in the culture wars. We couldn’t have been more wrong. For a few weeks, as the world ground to a halt, trying to make sense of the new threat posed by the virus, people everywhere appeared to be uniting in ways never seen before. This sadly didn’t last. As everything from epidemiology, mathematical modelling, mask wearing, treatment options and whether or not to lock down became politicized, the already-polarized left-right divide took a sharper turn toward irreconcilable divisions. The recent wave of protests condemning racism and police brutality gave millions of young people worldwide a much-needed sense of purpose and justice after months of terrifying isolation, but it also reinforced the tribalization of politics that had been underway since the Trump election.” Samuel Veissière, co-director, Culture, Mind and Brain Program, McGill University
ON BRINGING PATIENTS BACK:
“I worry about all the triaging of non-COVID activity that we’ve done, shutting down all sorts of cardiac and cancer and transplant care in order to potentially look after COVID patients, and the adverse effects patients have suffered because of that. I worry about this balance of trying to ramp up and catch up with all the non-emergency activity that we shut down, with the ongoing burden of COVID disease in our ICU.” Dr. Niall Ferguson, head of critical care,Toronto’s University Health Network
ON LONG-TERM CARE HOMES:
“I’m looking ahead to how institutional custodial care will change for the better. But that won’t happen in the next 100 days. … This hard lockdown on already isolated people has had a devastating impact — even in homes where basic care needs were still provided adequately. Many residents have declined significantly. New family visits will require face masks and keeping a twometre distance. Many elderly residents cannot see their family at two metres away, cannot hear what they are saying through a mask, and often have dementia, making the strange meetings very distressing. There is evidence of successful closer encounters with screening and testing in place coming from the Netherlands. I hope our government will explore kinder options.” Maya Goldenberg, associate professor of philosophy, University of Guelph
ON THE ANXIETY OF THE UNKNOWN:
“Neurology resident Dr. Chris Freehan and I have been talking and writing about ‘pretraumatic’ stress disorder, the stress of waiting for the next surge in the pandemic, preparing for the unknown, anticipating the morally challenging decisions that will accompany a resurgence, where it will be, why, how do we keep frontline healthcare workers mentally healthy when they are already fragile … how do we keep individual and societal anxiety under control, while tensions and frustrations about the continued need to distance ourselves from loved ones and others continue.” Judy Illes, professor of neurology, Canada Research Chair in Neuroethics at UBC
ON THE LIKELIHOOD OF REVERSE ZOONOSIS:
“Humans are the most abundant species on the planet. This virus is circulating broadly amongst us. The likelihood of a reverse zoonosis, or spill over back into wildlife is a concern. (In June, Dutch mink farms began a governmentordered cull over concerns minks infected with coronavirus could transmit it to humans.) If the virus establishes itself in a wildlife reservoir, it can change enough that if it spills back over into humans, we can have resurgent disease. We’re not really doing much in the way of surveillance of wildlife or protection of wildlife to make sure that doesn’t happen.” Dr. Samira Mubareka
ON THE HUNT FOR A VACCINE:
“My biggest concern relates to our collective ability in the coming months to a year to determine what is the most effective vaccine, how will we be able to produce sufficient quantities for Canada and across the world, and how we can push corporate and government interests aside for collaboration and co-operation for testing and production
… As the numbers of cases decrease around most of the high-income countries, we will need to turn for support to the lower-income countries to test these vaccines in a safe and ethical manner … and ensure that the vaccine will then be distributed across the globe … We cannot give up this time … This virus will be with us for a long time.” Eric Arts, professor of microbiology and immunology, Western University in London
“There is a growing anti-vaccination sentiment in Canada and the U.S. Our most recent research indicates 20 per cent of Canadians, and 25 per cent of Americans would not get vaccinated. If those numbers continue to grow, that will seriously undermine the effects of vaccination for battling the coronavirus.” — Taylor
ON WHAT WE NEED TO DO NOW:
“What we will or should do differently is start waking up to the fact that we are all connected to the point that our individual and collective fate — pandemics, global warming, nuclear weapons, artificial intelligence — is inseparable from that of those living on the other end of the world. And this is where we can find an opportunity to start developing what the Dalai Lama calls ‘a sense of oneness.’ Because the major 21st century problems cannot be solved within borders with the traditional me vs. you, or us vs. them mindset, but require a unified global approach that can come only after we stop seeing ourselves as different.” Futurist Nikola Danaylov
“The biggest challenge for the next 100 days will be to take conversations offline, depoliticize everyday life and rediscover the shared humanity and solidarity that seemed to have been awoken in the pandemic early days.” Veissière