‘Optimism tinged with anxiety’: What to expect from the next 100 days of COVID-19, according to experts – Mayerthorpe Freelancer

Whats keeping you awake at night? Thats the question we put to doctors, scientists, philosophers, psychologists, futurists, microbiologists and bioethicists, 100 days after theWorld Health Organization officially declared COVID-19 a global pandemic. We asked the experts what theyre 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, its difficult to predict what the next 100 days will yield, said McGill Universitys Samuel Veissire. Below, Veissire 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:

Im worried about future waves being imminent, maybe not even waves, but just this steady, persistent (viral activity).How do we sustain what were doing? Its so important for mental health to have livelihoods. To continue to function. I dont know what the answer is. That kind of keeps me awake. Dr. Samira Mubareka, virologist and infectious diseases doctor at Sunnybrook Health Sciences Centre in Toronto

As summer arrives, lockdown-weary 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). Unlike the 1918 flu pandemic, in which the sight of coffins was an everyday occurrence, 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 and clinical psychologist at the University of British Columbia

Politics and social polarization is what worries 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 couldnt 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 didnt 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 Veissire, co-director, Culture, Mind and Brain Program at McGill University

On bringing patients back:

I worry about all the triaging of non-COVID activity that weve 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 at Torontos University Health Network

On a dreaded second wave:

I worry about big, rebounding second waves if all these physical distancing things are taken less seriously, orwhen kids go back to daycare or school. Nobody knows how important a vector they might be. Ferguson

I look at the next 100 days with optimism tinged with anxiety. What keeps me up at night is that, as the memory of the catastrophic events in Spain, Italy and N.Y.C. fades, people will take this disease lightly. We are seeing resurgences of the virus in places like Beijing and some U.S. states, and Canada is not immune from that. But until we have a vaccine we have to be vigilant as a population. Dr. Wael Haddara, chair/chief of critical care medicine at London Health Sciences Centre

On long-term care homes:

Im looking ahead to how institutional custodial care will change for the better. But that wont happen in the next 100 days. What is happening is reintroducing family visits in Ontarios LTCs after 100 days of isolation. 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 two-metre 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. Our elderly have been through a lot and deserve the comfort of family. Maya Goldenberg, associate professor of philosophy at the University of Guelph

On the anxiety of the unknown:

I can tell you exactly what keeps me up at night: Neurology resident Dr. Chris Freehan and I have been talking and writing about pre-traumatic 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 growing 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 and Canada Research Chair in Neuroethics at UBC

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 ... is inseparable

On the likelihood of reverse zoonosis:

The other thing that keeps me awake now is, 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 government-ordered 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. Were not really doing much in the way of surveillance of wildlife or protection of wildlife to make sure that doesnt happen. 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 cooperation 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 for efficacy, and ensure that the vaccine will then be distributed across the globe. We cannot give up this time like we have with SARS and MERS in the past. This virus will be with us for a long time. Eric Arts, professor of microbiology and immunology at 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:

Im not a public health doctor, but Im certainly supportive of everyone wearing a mask when theyre out in public, especially in a closed indoor environment. Universal masking would be very helpful. Ventilators and drugs and PPE, and lack therefore, are other things that keep me up at night. Hopefully well have all those things somewhat better sorted out if things get worse again in the coming months. The burn rate through (PPE) is constant. Ferguson

The next 100 days will bring us up to the start of the school year. While (Ontario Education Minister Stephen) Lecce has signalled that Ontario kids will be back in the classroom in September, school boards have not been given direction on how to prepare, teachers have not been consulted. Lecce has promised for a late June update, but this is not giving school boards enough time to plan for challenges. Goldenberg

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

Its difficult to predict what the next 100 days will yield. While we need to remain cautious and take cues from our public health authorities, we have reason to believe that the worst days of the pandemic are over in Canada, and that a brighter summer than previously anticipated lies ahead. At the same time, social, economic and psychological sequela from the lockdowns are also likely to endure for a while. 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. Veissire

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'Optimism tinged with anxiety': What to expect from the next 100 days of COVID-19, according to experts - Mayerthorpe Freelancer