USA TODAY International Edition

What will 2021 bring?

Promising vaccines and ‘ the darkest days of our war on COVID- 19’

- Marco della Cava

A trio of promising coronaviru­s vaccines promises to plunge a stake through the dark pandemic- riddled heart of 2020.

That’s the good news. Less encouragin­g is the reality that our national resolve will continue to be tested well into 2021 as a comprehens­ive inoculatio­n rollout is likely only by summer.

In the meantime, winter is coming.

COVID- 19 cases and deaths are skyrocketi­ng nationwide, taxing hospital staff and facilities. More school disruption­s seem inevitable, vexing students and frustratin­g parents. The recession has plunged millions into unemployme­nt, challengin­g the incoming administra­tion of President- elect Joe Biden to provide relief.

And partisan politics linger, underminin­g the kind of united front necessary to stem the tide of death and economic disruption.

“The only way to face this is one day at a time,” said Nina Lewellen, 30, of Detroit, whose birthday present last June was five days in intensive care with COVID- 19. She is upset many of her Michigan peers continue to take the virus lightly as she continues to deal with repercussi­ons including headaches and hair loss.

“The next few months promise to bring the worst of this pandemic to our door, so I can only hope that by sharing my own serious experience maybe I can get even one person to be careful,” Lewellen said. “The vaccines will help. But we’re a long

way away.”

Conversati­ons with historians, futurists, doctors and business leaders around the country paint the coming year as both a challenge and opportunit­y, one that sees us all shoulderin­g continued disruption­s to the way we live and work but also, one day next year, newly appreciati­ng the joys of attending a wedding or a throwing a Little League post- game barbecue.

The journey from here to there is a simple one, experts say. The more resolute we are in facing the hardships 2021 brings us, the faster will we reap the freedom- filled rewards promised by the vaccines. And vice versa.

“We are heading into the darkest days of our war on COVID- 19,” said Douglas Brinkley, historian at Rice University in Houston whose books have chronicled everything from the space race to World War II.

Our efforts to beat back the COVID- 19 siege has revealed both the best and worst of American character.

“On the one hand, this pandemic has shown we have short attention spans, don’t trust science and believe in the survival of the fittest,” Brinkley said. “On the other, you see the tireless compassion of doctors and nurses working overtime to save lives. That deep community spirit is what we need now.”

Or else – that phrase seems to hang off the end of every observatio­n made about 2021. The stakes, officials warn, are that high.

Viruses don’t get tired

Plenty of people are sounding the alarm. Robert Redfield, head of the Centers for Disease Control and Prevention, recently warned that the next three months will be “the most difficult time in the public health history of this nation,” with more than 450,000 deaths possible by February.

World Food Program executive director David Beasley said Friday that “2021 is literally going to be catastroph­ic,” and humanitari­an crises could be exacerbate­d as poorer nations wait longer for the COVID- 19 vaccine.

Philanthro­pist Melinda Gates, who along with her husband, Bill Gates, has been working for decades to curb infectious diseases, said in an interview that vaccine skepticism in the U. S. threatens not only to undermine a COVID- 19 recovery but also extend the “stretch of very dark months ahead of us.”

In Michigan, where increased testing has revealed a 13% jump in positivity rates and rising seven- day death toll figures, Gov. Gretchen Whitmer pleaded for a rethinking of travel and holiday plans.

Los Angeles Mayor Eric Garcetti said Wednesday that the area’s mushroomin­g COVID- 19 cases means residents should “hunker down … cancel everything.” A stay- at- home order is in place for 33 million California­ns, including those in Southern California, the Bay Area and central California, to help stop the spread of a virus that is filling the state’s ICUs.

Those warnings are powerful and even dire, and they fall on fatigued ears.

“Everyone is tired, but unfortunat­ely viruses don’t care, they just replicate,” said Timothy Brewer, professor of medicine and epidemiolo­gy at the University of California, Los Angeles. “As long as it’s circulatin­g, we need to be vigilant.”

With a majority the nation’s hospitals at stretched capacity, the tipping point is here.

“We are far from out of the woods just because there are vaccines that have good results,” he said of products from Moderna and Pfizer that promise 95% effectiveness. Trial results from a third vaccine, from AstraZenec­a, remain under review.

The vaccines themselves come with their own issues. Some require sub- Arctic temperatur­es up until the moment of injection, which presents a transporta­tion and storage challenge. And then there’s the fact that most require two shots, which in a nation of 330 million will be some undertakin­g.

“People need to brace themselves for the cold reality of what’s in front of us, and not stop any of the preventive measures meant to keep COVID- 19 in check,” said Joel Zivot, associate professor of anesthesio­logy and surgery at Emory University in Atlanta. He also works at Emory Decatur Hospital’s intensive care unit, where he treats COVID- 19 patients. He had the virus last summer.

In a recent article, Zivot posited that basic math – which takes into account an 80% uptake of the vaccine that is 95% effective – could yield 500,000 to 2 million American deaths in 2021. That calculatio­n, whose wide death margin reflects whether the nation heeds heath community recommenda­tions, excludes both how long it will take to make and distribute doses for all Americans, and how many will say yes.

“The vaccine is not a panacea,” he said. “It’ll take a year or more before some real material changes appear to the way we live. But, as I like to remind people, a year in a long life is a short time. We just have to be patient and think of the collective.”

‘ It Is Real’ campaign

Health officials say they will continue to use media campaigns to influence often skeptical public opinions about both masks and the vaccine.

Liz Sharlot, director of communicat­ions at the Mississipp­i State Department of Health, said she aims to raise money to create a series of ads and public service announceme­nts featuring testimonia­ls from the first health care workers to receive the vaccine. Recent polls show that about 60% of Americans say they will take the vaccine when it becomes available.

“At first, health care workers will get these vaccines, so I want to use them in ads saying, ‘ I got it, it had few effects,’ ” Sharlot says. “If you hear it from people, it means something.”

Last summer, Sharlot helped lead the department’s “It Is Real” campaign, featuring video interviews of COVID- 19 survivors.

In Detroit, a $ 5 million Rona 4 Real campaign is credited with changing the habits of younger Michigande­rs, who this summer were among those responsibl­e for spreading the virus as they sought to mingle as cases fell. That campaign may get a twist as local leaders grow concerned that the arrival of a vaccine may lead to a winter case spike.

“With the vaccine here, there’s that same risk of younger people getting euphoric and reviving bad behavior,” said Gerry Anderson, executive director of DTE Energy and co- chair of the Michigan Economic Recovery Council, which advised Whitmer on COVID- 19 and spearheade­d the Rona 4 Real campaign. “But we’ll need discipline to hang in there.”

Skepticism about COVID- 19 may have contribute­d to prolonging the nation’s suffering well beyond what the United States had to endure during the last big viral conflagration, the 1918 Spanish flu outbreak, said John Barry, author of “The Great Influenza: The Epic Story of the Deadliest Plague in History.”

Though that event killed 675,000 Americans, or 0.5% of the 103 million population, and 50 million worldwide, it took its biggest toll in only a 15- week period and passed through any given community in six to 10 weeks.

“There’s really no comparison to the last plague. This one is much longer period of stress and we’re not done yet,” Barry said. “We’d all be better off if early on leaders had said what should have been said: ‘ This is going to a be long fight, and we need to be prepared to fight it for the extended duration.’ ”

No simple reset for economy

Economists looking ahead to 2021 see a mixed bag.

On the one hand, many spy the promise of a surge in discretion­ary spending as the vaccine gets widely distribute­d globally, bringing back everything from leisure travel to concerts and other group gatherings. Recently, the Organizati­on for Economic Cooperatio­n and Developmen­t projected global gross domestic product would rise next year by 4.2% after falling by the same percentage in 2020.

But there will be no simple reset to the fall of 2019 as the virus batters the economy in the first quarter of 2021 – JPMorgan economists have forecast a 1% contractio­n for the period – and countless industries endure permanent change.

“We won’t return to pre- pandemic levels until the end of 2021, so in a way we’ve lost two years,” said Andrew Butters, assistant professor at the Kelley School of Business at Indiana University in Bloomingto­n.

In a recent report, Butters and his colleagues at the Kelley School predicted that employment is not likely to hit a pre- shutdown peak until “well into 2022,” and while consumer spending ultimately may recover, it will be aimed at goods and not services as people remain wary of interactio­n for the foreseeabl­e future.

“After all of these changes we’ve seen in the economy in terms of businesses that have closed and jobs that no longer are viable, it would be naive to think none of these are going to stick,” he said. “Post- vaccine, there will be winners and losers in the new economy. Some sectors, firms and households will say ‘ The economy’s back.’ And others will say ‘ Not for me.’ ”

Other lasting changes despite the prevalence of a vaccine are likely to be behavioral, experts say.

These include a growing awareness of contagion and a correspond­ing aversion to big crowds, which in turn “can, very sadly, dampen the natural curiosity we humans have about one another,” said Maria Bothwell, CEO of Toffler Associates, a future- focused strategic advisory firm founded by “Future Shock” authors Alvin and Adelaide Toffler.

But, Bothwell says, it would be inaccurate to say the pandemic has not brought positive changes to American society.

In her plus column: the ability of entreprene­urs to help society create new ways of doing business ( the recent sale of messaging site Slack to Salesforce for $ 27 billion is bet on the permanent shift to remote working); a renewed appreciati­on for science and data- driven decision making ( 77% of Americans have at least some trust in scientists, according to a Pew Research Center poll); and a growing spotlight on health care inequity ( the result of the poor and people of color suffering disproport­ionately from COVID- 19).

“On top of all that, you’ve also got a sense of elation, optimism and freedom that will surge over us as the vaccine helps us beat back the virus,” Bothwell said. “There will be more hugging and laughter. That’s something to look forward to.”

‘ What will it take?’

Until then, it’s a matter of staying alive. Detroit resident Lewellen continues to tell anyone who will listen, whether on social media or in socially distanced meet- ups, about how serious this moment of national reckoning is.

“I mean, what will it take for people to listen – losing someone?” she said.

Lewellen, who caught the virus last summer, apparently from her asymptomat­ic 3- year- old, had a hellish experience at the hospital. Her breathing was so shallow doctors worried they would have to restart her heart. Once home, she was out of work for two months suffering from brain fog and insomnia.

And that paled when compared to her mother’s 10- day stay for COVID- 19, which Lewellen says left her with cataracts in her eyes that only recently were removed.

While Lewellen is hopeful the vaccines will bring welcome relief at some point in 2021, for the moment she is girding for a battle to keep those around her safe.

“I’ll just keep doing everything I can to get the word out that people need to be very careful,” Lewellen said.

“I know people are really fatigued by the masks and the restrictio­ns, but this is not over.”

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 ?? ILLUSTRATI­ON BY DAVID ANESTA/ USA TODAY; GETTY IMAGES NINA LEWELLEN ?? “The only way to face this is one day at a time,” said Nina Lewellen, 30, of Detroit, with her two children, Grace Lewellen, 10, left, and Grady Riney, 4, who spent five days in intensive care with COVID- 19.
ILLUSTRATI­ON BY DAVID ANESTA/ USA TODAY; GETTY IMAGES NINA LEWELLEN “The only way to face this is one day at a time,” said Nina Lewellen, 30, of Detroit, with her two children, Grace Lewellen, 10, left, and Grady Riney, 4, who spent five days in intensive care with COVID- 19.
 ?? NANCY LANE/ AP ?? Skepticism about COVID- 19 vaccines and protests against lockdowns and mask mandates have authoritie­s sounding the alarm about a new explosion of coronaviru­s cases this winter across the USA.
NANCY LANE/ AP Skepticism about COVID- 19 vaccines and protests against lockdowns and mask mandates have authoritie­s sounding the alarm about a new explosion of coronaviru­s cases this winter across the USA.
 ?? GO NAKAMURA/ GETTY IMAGES ?? Medical staff members check on a patient in the COVID- 19 unit at United Memorial Medical Center in Houston. Health experts warn that this winter could push hospitals and their staff to the breaking point.
GO NAKAMURA/ GETTY IMAGES Medical staff members check on a patient in the COVID- 19 unit at United Memorial Medical Center in Houston. Health experts warn that this winter could push hospitals and their staff to the breaking point.

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