Reflections on how COVID has changed the world

COVID changed the world - empty train carriage

By Terry Slevin, CEO of the Public Health Association of Australia.

The world has changed. Few people on the planet could have remained unaffected by the events of the first three months of 2020.  At the time of writing, more than two million people have been diagnosed and almost 130,000 people have died as a result of the COVID virus. And we all watch the daily count as the numbers climb.

 So what have we learned so far?

People have changed and adapt quickly

Never in my 58 years (36 of which have been spent in public health) watching the way people think and behave on health issues, have I seen such a fundamental, rapid and wide spread change in the behaviour of Australians. 

While we hear about people not making the recommended changes, the vast majority of us have turned our lives upside down.  In many cases this is driven by the imperative to reduce the impact of the virus on the elderly and most vulnerable. Most of us understand that the virus will be a mild disease in four out of five of those who have it. But the other 20 percent will be really sick and perhaps one or two percent will die. That still turns into horrendous numbers as the toll mounts, but most people who have made these big changes have a sense that it is others who will most likely benefit.

We have relinquished liberties that two months ago would have been unthinkable, largely to benefit other people. It seems to me worth acknowledging and celebrating that fact.

People look to governments and to experts – but is there trust?

The trend of the past 10 years to mistrust and dismiss “experts” and to be sceptical of the beneficial role of government has switched in the face of a worldwide crisis. It is clear that people look to government to lead on the big issues.  There appears to be a greater credence given to people with genuine expertise.  We have “turned to the trusted voice”, in a way that as a nation we have spectacularly failed to do on other issues.

Yet roughly half of us did not vote for the governments in power. Whether it is at a state or territory level, or nationally, many people spend most of the time suspicious of the decisions and motives of the governments that we now need to rely upon. Be they Liberal or Labor, it is hard (and probably unwise) to entirely set aside that scepticism. 

But in times of genuine crisis, the question worth asking is – can we dial down the party political filter (even a little?) and invest some trust that ALL governments in Australia are doing their very best in the most difficult of times?   Of course there are notable examples elsewhere in the world where such trust has NOT been earned.

The best of people emerges

As this pandemic unfolds, we are watching people show their best. One wonderful example is the hotels with a heart initiative to provide safe accommodation to homeless people during the pandemic.  PHAA member Associate Professor Lisa Wood from UWA played an important role in adapting this initiative which commenced in the UK.  Like much of the COVID19 responses, an important question will be – what happens to the people who benefit from this initiative when the crisis is over?

There will be countless examples as this pandemic unfolds.  But the main point is there are many many wonderful people doing outstanding things in frightening and trying times.

We come to learn what is important to us

As we remain isolated in our homes, we learn what parts of normal daily life is important to us. Simple things like interactions with family, friend and colleagues.  The importance of face to face communication is highlighted when the best we can do is via a computer screen. 

We are finding out exactly what is means to be “social animals”.  The simple joys and pleasures of our lives once removed become better appreciated, reinforcing what we know about the importance of being socially CONNECTED. But in the short term we must follow the advice to stay physically distant.

And what of public health?

In a public health crisis it is easy to focus on the urgent and immediate while losing sight of the big drivers that contributes to good or poor health.  All the things that were important in 2019 and before will be important in 2020 and beyond. Our friends in the tobacco, alcohol, gun, unhealthy food and gambling industries continue to find ways to promote their products to anyone they can, with a focus on the most vulnerable. They will not be taking a break during this crisis.  We have already seen the alcohol industry successfully lobby to forestall perfectly reasonable pregnancy warning labels on alcohol containers. Efforts to push back against this tide remain extremely important.

Now seems a good time to also highlight what might otherwise be considered mundane. The vital importance of sound and accurate health related monitoring and surveillance.  We need to be supremely confident in our data capture of key health “inputs and outcomes”.  Regardless of your area of interest in public health, a key question will soon be “what was the impact of the COVID19 pandemic on that ?  It seems few will be uninfluenced – in one direction or another.

Inequity, the social, commercial, cultural and ecological factors that play such a big role in the health and wellbeing of Australians will continue to do so.  We must focus our efforts on the people who need the greatest support: refugees, prisoners, people with mental health problems, Aboriginal and Torres Strait Islander people, the homeless, people with addictions, and others. Perhaps now even more so.

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