Wow, who could have imagined that a 120-nanometer particle would jolt financial markets by trillions of dollars, or bring a country and the world to a shutdown, or even humble the most powerful of political leaders to declare a national emergency.

No longer are we in denial that our lives will go on as usual. We are learning to conform to an eerie new normal: not shaking hands, not going to large social gatherings, and not going to work in-person, unless it’s essential.

So what will the new normal look like?

First, it’s important to know how we got here by understanding the life cycle of an epidemic. It begins with an index case entering the community undetected. Then there is community transmission, forming a cluster of local cases. The cluster, if undetected over days and weeks, becomes a local outbreak and is only recognized when testing is done, and the patient and his or her contacts are placed in stringent quarantine.

With delay in testing, the outbreak becomes an epidemic and, if enough epidemics occur across the globe from a novel infectious agent, it is a pandemic. That  is where we are now, with coronavirus, formally known as the SARS-CoV-2 virus, which causes the disease of COVID-19.

Italy, Seattle, and New Rochelle, New York, were unfortunate recipients of an index patient, likely from China. Now these regions are beyond the outbreak stage in the life-cycle of the epidemic. 

At present, we do not know if there is community transmission in our area. Rapid, sustained testing will answer this question, yet the new normal has begun for all of America and it will profoundly affect our personal life, family life, professional life and social life.

In the new normal, initially there will be scarcity of testing kits, personal protection equipment like face masks and hand sanitizers. We hope that we will have sufficient  hospital beds, and ventilators in regions where a surge of cases occur.

A Flourish map

In the new normal, travel plans will never be definitive. If an outbreak occurs in the destination city, our travel will need to be canceled. Many will prefer to drive than to risk exposure to national and international travelers at airports.

In the new normal, a cough will not be just a cough, it could be harbinger of a potentially infectious virus. This virus may be transmitted from us to others or from others to us. 

In the new normal, our health departments will be better funded and will play the game of “whack-a-mole” as the virus pops up in persons who may have come from another city or country. The government will get all of their contacts’ names and notify them of the exposure and ask them to self-quarantine for 14 days.

Coronavirus in Tennessee

In the new normal, we may not be able to find our favorite food in the shopping aisle, like a breakfast cereal, but we will have sufficient supply of food and essential goods.

In the new normal, we may not have the choice of leisure activity like a concert, a sports event or a Broadway show. Rather, we will find pleasure in movies through streaming or a board game with the family.

In the new normal, the elderly will think judiciously before venturing out for shopping or an event if there is local community transmission of the virus, because the virus discriminates in causing severe illness among them.

In the new normal, wearing a face mask in public may be a sign that you are ill and care about the safety and well being of others. It may be a  sign of abundance of precaution.

But some things will not change.

In the new normal, like the old normal, we will still have each other. We will be together. We will be there to still care for each other. Humans are incredibly resilient and adaptable, and we will move forward.