How will it be? Life after or life with Covid-19?

By Dr. B. J. C. Perera-May 25, 2020
Specialist Consultant Paediatrician

Whatever we do, it is not likely to just go away in a hurry; this little coronavirus that causes COVID-19. Little it may be but it certainly packs a punch. The experts are convinced that it will be around for at least a couple of years. The potential presence of this pestilence, especially with that well-recognised spectacle of its proven enhanced infectivity, will make it a perennial and even a ubiquitous threat for quite some time in the future. From a purely medical and epidemiological frame, even if significant ‘herd immunity’ develops as a result of large scale natural infection with the virus or because of the use of an effective vaccine, one has to keep in mind the tendency and capability of any type of virus to mutate. This little blight too might be quite capable of transforming itself into a slightly different type which might even negate the effects of ‘herd immunity’. Even if we are able to secure sufficient ‘herd immunity’, it will be needed for at least 80 per cent of the population to be immune, before it would be an effective weapon against this coronavirus. The animal llama, a furry smaller sized domesticated camel-like animal found mainly in South America, is thought to be quite resistant to this coronavirus. They produce antibodies known as nanobodies; the name being derived from the fact that these are much smaller than the conventional antibodies, which can effectively fight the virus. Once analysed and genetically sequenced, these nanobodies could be produced in the laboratory by genetic engineering and tested in humans. If found to be effective, these would be a powerful weapon against the virus that causes COVID-19. Scientific researchers are working tirelessly and diligently to find some way of dealing with the virus as well as the formulations of effective vaccines that could deal telling blows to the virus. If we are able to overcome this pandemic by some means, it will be life after COVID-19. If we cannot, then it will be a case of living with COVID-19. From all available indicators, it is more likely to be the latter.

If such a threat remains and we have to live with this nasty little pest, life will then never be the same again. Social distancing and personal hygiene will necessarily have to be an everyday part of life. Wearing of protective facial masks would become as common as wearing clothes. Canisters and dispensers of chemical sanitizers will be found everywhere, even along our roads. There will be no major social gatherings and no major lavish celebrations of significant life events such as weddings and anniversaries. The dead would need to be buried or cremated with the attendance of rather minimum numbers of loved ones. There will not be a place for major political rallies where thousands gather, which many are likely to welcome as a much longed-for development. The entire passenger transport systems of vehicles of all types will have to be completely changed with a modular paradigm shift towards an entirely different functionality with drastic changes in operational details. Transportation to and from schools and universities will remain as an inexplicable Achilles heel in educational pursuits. Inland travel will necessarily need to be curtailed and the customary and friendly visiting to the abodes of relatives and friends, especially to the residencies of the elderly, will need to be significantly reduced. Out-of-home travelling of the elderly or those with other coexistent diseases that make them more susceptible to attacks by the virus will have to be necessarily limited. International travel for holidays and conventions will probably even be a thing of the past or at least be severely curtailed by necessity in the immediate future. Air travel will take an entirely new dimension and as a result expenses incurred in air travel would go through the roof. International tourism will take a near-lethal body blow and impose terrible hardships on those who make a living out of it. Going out of home for celebratory meals or just for enjoyment would need to be carefully assessed as to their real need. The entire education system; primary, secondary, tertiary and postgraduate components of the hierarchical structure of teaching and learning, will need a near complete transformation and revamping of their current status. On-line and distance learning will become a part and parcel of the entire education process. Virtual on-line or telecommunication based shopping may become the order of the day but some obvious changes in the logistics and packaging of home-delivered articles would become a dire necessity as well. Major sporting events will need to be very carefully organised and it may not even be possible to showcase them in the same formats that we were used to, right up to even as recent times as the end of 2019.

To complicate matters further, the coronavirus disease may begin to manifest certain unexpected complications like the multisystem inflammatory disorders or the likes of it, presently causing a lot of concerns in children with COVID-19 of the United Kingdom, Europe and the United States of America. Such complications, which may be totally unexpected, could strike quite unpredictably; changing the façades, aspects and the outcomes of the disease drastically. In the distant past there were Diphtheria Wards, Tetanus Wards, Polio Wards etc., in hospitals for specific ghastly and much-dreaded diseases. We may need to have COVID WARDS in our hospitals in the future. If the virus gets the upper hand and causes further mayhem, intensive care facilities could become inundated with COVID-19 sufferers who desperately need their facilities. Non-communicable diseases may even take a greater toll because resources may need to be diverted to look after cases of coronavirus infections. A time may come, if and when an effective vaccine becomes available, where mass vaccination initiatives against the virus would be the order of the day, even up to one’s old age.

The economic fallout will be tremendous and singularly mind-boggling. The adverse pecuniary implications are totally overwhelming. By virtue of the implementation by the state or through self-imposition of some of the restrictions mentioned above, many features of the economy of all nations will show up a topsy-turvy type of an entirely new and unpredictable outlook. Transnational investments will be severely truncated because of the uncertainties associated with the global economy. Migration out of the native country for better economic prospects will not be all that attractive to a lot of people in the not too distant future. Many jobs will simply disappear, as evidenced by the developing scenarios of the economies of many countries even now. This is especially so in services connected to tourism. These jobs and employment opportunities that have either disappeared or gone underground at the present time are not likely to reappear for quite a while, possibly for a couple of years. Money in the wallets will become quite scarce. It would be prudent to save what little money that one has got rather than to give in to the temptation to splurge it on non-essential commodities and ventures. Various types of industries will be severely hit by the economic recession that would invariably result as an inevitable cascading effect of the impact of the pandemic. The rich might somehow get richer but at the same time, the poor are likely to get poorer. The gap between the rich and the poor would widen quite significantly. Many countries, including Sri Lanka would be inclined to enforce an embargo on non-essential imports. That of course would be a thing that all of us should look forward to. Even now, the little virus has begun to sound the final death-knell for the so-called ‘open economy’.

Many countries would need to look seriously at agricultural pursuits in an effort towards being self-sufficient in foods. That of course, would be a most welcome development and the farmer would suddenly and most certainly become an indispensible cog in the wheel of sustenance of nations. It must be reiterated that self-reliance on foods that are grown in plenty in a country would be an invaluable step in a quest towards mitigating the harmful effects of any catastrophe. This applies even more so to a country like Sri Lanka, blessed with the most fertile soil imaginable. The many aspects of agriculture for our country has been so graphically pointed out by that doyen of conservation of flora, Emeritus Professor of Botany of the University of Peradeniya, Nimal Gunatilleke, in an article titled ‘Post-COVID land development agenda: Lessons from the past’, in The Island of 22nd May 2020. He has written, "Agriculture is in the vanguard of this development drive in order to be self-sufficient in a number of crops that can be grown in Sri Lanka. This initiative is expected to ensure local food security while at the same time, saving on valuable foreign exchange that would have to be spent on importing these food items as we had done in the recent past. We now have the potential and an excellent opportunity to develop our agriculture in an ecologically and socio-economically sustainable way learning from our past rich agro-ecological heritage while meeting the challenges of the post-COVID era". All these are words of wisdom indeed; most suited for the future of living with COVID-19. Even at a household level, home gardens of vegetables and fruits would be a most welcome initiative, from many perspectives.

Education in all its forms will certainly need to undergo many changes, not only in the forms of delivery but also in a perceptible change in the dimensions of the availability of certain targeted areas and disciplines. Most forms of training for vocations would be determined by the ‘new world’ and the need for them in the future. The ultimate goals of all forms of callings, aptitudes and employment opportunities would be to put money back into wallets. Medicine and healthcare would always remain popular as well as essential disciplines, because of their inherent relationship to life, sickness and even contentment in human existence. The world would always need doctors, nurses and laboratory technicians. However, other fields that have hitherto remained in the shadow of disciplines that were considered popular and indispensible would quite fortuitously become the things for the future. All forms of Information Technology such as computer work, telecommunication fields, web-based on-line techniques, virtual designing, artificial intelligence, robotics and nanotechnology, just to name a few, would suddenly become the things for the ‘new world’. Even teaching music through the web and freelancing in the on-line environment would become most attractive and lucrative pursuits. In the medical field, telemedicine would become a very significant portal of providing healthcare. Many of these have the added advantage, a considerably important one, of the real possibility of working from home.

True enough, it will definitely be a different world; a world that we need to cotton on to with resolve, commitment and dedication. It would be an absolute necessity for the survival of the species. Our planet earth, the world as we know it today, and the human race that consists of the major inhabitants of it, have shown repeatedly that all of them are unbelievably resilient in the face of disasters which are man-made or natural in their origins. History has recorded that this has indeed been the case over many millennia. Like the proverbial and enigmatic phoenix, we have repeatedly shown our ability to even rise up from the ashes. That is an attribute that has ensured the very survival of the genus Homo sapiens. This time too, we will emerge from this catastrophe; stronger, smarter and more powerful. We will need to think differently and out of the box, carefully assess our capabilities, weigh the chances and act resolutely on them. In such a perspective, COVID-19 is most definitely not the end of the world. All it would need is a trek in a different direction on our part, forgetting all other petty differences of colour, caste, creed, ethnicity, religion and even politics. As for Sri Lanka, the future would be in unity in the face of diversity. We need to rise up in unison and harmony against this blight that is the novel coronavirus.