14 Jun Embrace the Next Normal

As I start writing this article, the news around is being headlined with the Omicron variant of COVID-19. Perhaps by the time this article reaches you, the context of COVID-19 might have changed – for better or for worse. But one thing is certain – we are living in uncertain times. Most nations and experts were sure of turning the bend, only to be disproved again multiple times over the last few months. As of today, ongoing uncertainty seems to be the new normal – Uncertainty that comes out of a new normal of living with the virus.

Epidemics can end in two ways – One: transmission is well controlled and new cases come down to zero, and the epidemic becomes history. Secondly is that the disease becomes an ongoing part of the infectious-disease landscape, or an endemic. The shift from pandemic to endemic entails a number of practical considerations for managing the epidemic and the way we live. But the shift is also psychological, as we will be deprived of the satisfaction that a clean pandemic end point would bring. Instead, societies will have to adapt to living alongside COVID-19 by making some deliberate choices about how to coexist. – 1

Pandemics and endemics, in the past, have forced communities to move to newer ways of living and engaging in the world. Other major disruptions of life have also created new normal ways of engaging. Biblical stories are interesting examples. Adam and Eve had to build a new life in a new normal world outside Eden. Noah, Daniel and friends are examples of people who had to pick up the pieces and chart a new course, post flood and in captivity.

The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I – at somewhere between 20 and 40 million people. More people died of influenza in a single year than in the four-years of the Black Death Bubonic Plague from 1347 to 1351. Nationalism pervaded as people accepted government authority. This allowed the public health departments to easily step in and implement their restrictive measures. The war also gave science greater importance as governments relied on scientists, now armed with new germ theory and the development of antiseptic surgery, to design vaccines and reduce mortalities of disease and battle wounds. The medical and scientific communities developed new theories and applied them to prevention, diagnostics and treatment of the influenza patients. 2 Similarly the black death saw the origin of hospices and later the hospitals that we know of now.

The current pandemic that we are going through, with all the devastation it has left, has been traumatic for most of us. The physical effects of the virus, with high mortality, morbidity and many families losing their loved ones is the most evident. The economic, and the broader social impacts, the job losses, the migrants who have lost their livelihood, the relational issues with increasing domestic violence, etc. have been in the news and some of us might have experienced them. Education related challenges and the impacts on the system, the children and parents, is yet another major issue. Cross cutting through all these is the mental wellbeing related issues.

A recent Lancet article reviews this well. The COVID-19 pandemic has taken a toll on people’s mental health. Yet, the global extent of this impact remains unknown. The authors estimated a significant increase in the prevalence of both major depressive disorder (with an estimated additional 53·2 million cases worldwide—i.e., a 27·6% increase) and anxiety disorders (76·2 million additional cases—i.e., a 25·6% increase) since before the pandemic. Increased prevalence was seen among both males and females across the lifespan. These findings are all the more concerning because depressive and anxiety disorders were already leading causes of disability worldwide – 3.

But at the same time, if you look around there has been many positive changes and trends emerging around us. The challenges that we as individuals, communities and humanity at large have faced, have been opportunities to engage in a new way. New Normal was a well-known terminology in business circles but has become the current buzz word. 4- Most large organizations have ongoing research and strategy development teams looking at, sector by sector, what the new normal would look like. They engage in defining and understanding the new normal and coming up with strategies to limit the spread of disease at the same time mitigate the impact on other sectors. Some of them have gone ahead and coined terms like “Next Normal” or “Next Possible” as buzz words, to drive a new direction for tomorrow.- 5

A few trends are highlighted here. This is not a comprehensive list, but just a glimpse into the massive changes that are happening around us.

Faced with uncertainty and facing our mortality, the core issues of our life, existence and meaning, are in the minds of many, though not publicly discussed. Questions like, if life is so uncertain and I do not have control of my life, how should I live, who am I, what am I in the world for, how can I find significance, have never been asked the way they are being asked this season.

Such questions are leading to many looking at job, career and work in diverse ways. Large numbers of people are leaving formal work sector and are exploring more flexible ways of engaging. A Microsoft study discovered that 41% of workers worldwide are considering quitting their jobs described as the ‘Great Resignation’. The study shows that Gen Z is struggling more than other generations6, 7 Work life balance, being valued by managers, sense of belonging, a trusting and caring community at workplace, meaningful advancement of careers, flexibility and autonomy are what people are looking for. If this is not there, they are moving out to set up startups on their own.

For organizations and companies COVID-19 has brought on an even higher awareness that you cannot have healthy people on an unhealthy planet or workplace. So, companies are looking at climate change, healthy work environments recognizing that if they do not address these, that they may not have a competitive advantage in the market.

With social and physical distancing becoming a norm, Technology has become the driver of all engagements whether at personal, community -6 , 7-work or social levels. Digital systems and AI based algorithms helping in decision making and work has taken over many fields, including health care. Digital natives, children and young people find this easy, but digital immigrants, and the seniors struggle with this.

But what is assuring is, we are not alone in this – there is a collective vulnerability of our world. The most macho leaders, the most high-tech scientific establishments, and the economic prowess have all met their match in this lowly virus. It should make us humble — think about what we need to do differently; how we need to act and behave differently.- 8

So how should we face and live in such a world? It was Darwin, who said, it is not the strongest of the species that survives, nor the most intelligent; it is the one most adaptable to change.
If we need to live lives as salt and light in this world, we need to cultivate some mindsets and lifestyles. Daniel and his friends in Babylon are a good case study to reflect on. Faced with a new normal they did a few things. They did not shy away from embracing the changes around them. They learnt the new language, immersed themselves in the new context and culture and lived lives of influence. They built their knowledge and expertise in new ways of engaging and excelled themselves in the spheres of engagement. They built their lives with a long-term perspective, Daniel serving three empires and four emperors over 70 years. But they held on to the core values and their faith as foundations. They supported each other, as they faced challenging contexts and situations.

A changing context of the world and new normal emerging around us, is a call for us to live such lives. Return and renew our commitment to the core foundations of our faith and values that should undergird our lives. At the same time, accept and embrace change and excel in new ways of engaging. We need to live our lives with a long-term life perspective – a long obedience in the same direction. Rooted in our relationship to God build our dependence on the faith community that we are part of, to support and be supported in our journeys. Remember, God is still on the throne and in control. Such people and communities will continue to be salt and light in a world that is changing and losing its saltiness and light.

1. Pandemic to endemic: How the world can learn to live with COVID 19 Pandemic to endemic: How the world can learn to live with COVID-19 | McKinsey 2021
2. The Influenza Pandemic of 1918; https://virus.stanford.edu/uda/
3. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic, Lancet. 2021 Nov 6;398(10312):1700-1712. doi: 10.1016/S0140-6736(21)02143-7. Epub 2021 Oct 8.
4. The new normal, https://www.mckinsey.com/business-functions/strategy-and-corporate-finance/our-insights/the-new-normal 2009.
5. Beyond coronavirus: The path to the next normal, https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/beyond-coronavirus-the-path-to-the-next-normal 2020
6. The Next Great Disruption Is Hybrid Work—Are We Ready? https://www.microsoft.com/en-us/worklab/work-trend-index/hybrid-work 2021
7. The Great Resignation: Microsoft Predicts 41% Attrition https://www.forbes.com/sites/lucianapaulise/2021/07/21/the-great-resignation-microsoft-predicts-41-attrition/?sh=5b829fe42d4d 2021
8. COVID-19: What will be the new normal https://www.downtoearth.org.in/blog/lifestyle/covid-19-what-will-be-the-new-normal-70458

Dr. Santhosh Mathew is trained as a Physician and works part time in a Mission Hospital at New Delhi. He is the training coordinator of ICMDA and Regional Secretary for South Asia, ICMDA. He did his MBBS from Medical College Kottayam, and MD Medicine from CMC Ludhiana. He was involved in various hospital leadership roles across North India as part of Emmanuel Hospital Association from 1992. He was a lecturer in Nephrology and Medicine at CMC Ludhiana prior to joining EHA. He is married to Saira, an Anaesthetist, who currently heads Emmanuel Hospital Association. They have two grown up children.