Even after a large swath of the U.S. population is vaccinated, the challenge of reducing viral transmission will remain, and so will the need to wear face masks, which like airport screening will be inconvenient but worthwhile. One open question is whether mandates to wear them will be necessary. Some social distancing will also be needed, and lockdowns to cope with fresh outbreaks, although hopefully not nearly as severe as over the past year.
In the new normal, the virus will not be eliminated. It likely will continue to circulate, mutating into new variants with different capabilities. This means vaccination may need to be regular, more like influenza than measles.
Diagnostic testing will become a routine part of everyday life. Perhaps home diagnostic tests will be as ubiquitous as the toothbrush. The test result may affect each individual’s choices about what to do at work, travel and play. But it also may become a necessary gateway to other venues, such as an office or movie theater. Some hard thinking must be applied to whether a negative test can or should be required.
The testing question goes to the heart of a larger debate just over the horizon: What does immunity, whether from a vaccine or previous sickness, entitle a person to do? The current vaccines appear to be highly effective in preventing serious disease outcomes, hospitalization and death. But it isn’t yet known whether a vaccinated person can transmit the virus. Nor is it clear precisely what immunity is conferred by previous illness, or for how long. Should there be a required certification, some kind of immunity passport? Would this lead to privacy questions, stigmatization or discrimination? While school districts have in the past successfully insisted that all students be inoculated for measles, will the principle apply to the coronavirus more generally? Can offices, transit and leisure venues limit access to those with an immunity passport?
The new normal will also mean a willingness to adapt to new science, getting used to shifts and new discoveries, such as the virus variants now circulating. It must include a recommitment to government public health agencies, long starved for resources. Building a national and global viral genomic surveillance system is a must. The impressive work done in research, development and manufacturing of vaccines should inspire more attempts to create rapid medical countermeasures.
The burden of loss of the past year is enormous. But after the pandemic can be a time of promise, with lessons learned, lives saved and restarted.