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Unintended Positive Consequences of COVID-19

“If everyone is moving forward together then success takes care of itself.” - Henry Ford


“Ac-Cent-Tchu-Ate the Positive”

- 1944 Song, Music by Harold Arlen, Lyrics by Johnny Mercer



On March 11, 2020, the World Health Organization (WHO) finally declared that COVID-19 is a pandemic, that is, an infectious disease that is rapidly spreading globally. In the ensuing year, the number of cases, hospitalizations, and deaths caused by COVID-19 has been staggering. The ongoing suffering and grief remain overwhelming for some and painful for all. We are finally, however, glimpsing the light at the end of the seemingly endless COVID-19 tunnel. And although the journey through this pandemic has been brutal, some very encouraging things have emerged from this crisis. Bearing in mind the sobering losses we have experienced and the disparate impacts the pandemic has had on different communities across the country (and world), this Germ Gems post provides my assessment of such “unintended positive consequences” of the COVID-19 pandemic.

Positive things have emerged from past crises. In his 2018 book, Factfulness: Ten Reasons We're Wrong about the World--And Why Things Are Better Than You Think, global health leader Hans Rosling claimed that humans have a negativity impulse, that is, we’d rather hear bad news than good. Nonetheless, Rosling provides convincing evidence that almost every aspect of our existence from global poverty to death due to violence and wars has improved dramatically in the recent past.


Perhaps because of our negativity impulse, we tend to forget the positive things that have emerged from past worldwide crises including pandemics. For example, it is said that Isaac Newton did his most prolific work while in quarantine from Cambridge University during the Great Plague of London. It was while he was “social distancing” at home that his ideas about gravitation, sparked by the famous apple falling from a tree in his garden, were formulated.


We also know that many technological and medical advances were accelerated by wars. Penicillin is a case in point. Sir Alexander Fleming is credited with the discovery of penicillin in 1928. In 1938-39, Ernst Chain, a German-born biochemist, and Sir Howard W. Florey, a pathologist, with a group of colleagues at Oxford University started their research on the purification and therapeutic use of penicillin. But it took World War II to encourage companies to develop a way of producing this highly effective antibiotic on an industrial scale. It is estimated that this “miracle drug” saved 100,000 lives in the European Theater between D-Day, June 6, 1944, and the final German surrender. During the war its effectiveness was touted on a war poster that read: “Thanks to PENICILLIN...He Will Come Home!”


The unprecedented development and distribution of safe and effective COVID-19 vaccines. In his recent book Panic! 2: Chronicles of a Lost Time, philosopher Slavoj Zizek stated: “[E]ven horrible events can have unpredictable positive consequences.” He cites the development of the COVID-19 vaccines as an example.


The development of vaccines against SARS-CoV-2, the coronavirus that causes COVID-19, was absolutely astounding. On May 15, 2020, “Operation Warp Speed,” a public-private partnership initiated by the U.S. government to facilitate and accelerate the development, manufacturing, and distribution of COVID-19 vaccines, therapeutics, and diagnostics, was announced. By mid-December two mRNA vaccines, produced by the pharmaceutical giant Pfizer/BioNTech and the biotechnology start-up company Moderna, received Emergency Use Authorization (EUA) by the U.S. Federal Drug Administration (FDA). (Keep in mind that it takes on average 10 years to develop a vaccine.) On February 27, 2021 the FDA granted Johnson & Johnson (J&J) an EUA for its adenovirus-vectored vaccine. And currently, at least five additional vaccines are in late-stage development in the U.S. Innovations in the development of COVID-19 vaccines, such as the first successful mRNA and adenovirus-vectored vaccines, represent a real triumph for Science. And they will set the stage for development of vaccines needed in future pandemics.


Almost as amazing as the development of the vaccines, are partnerships that have sprung up between pharmaceutical companies that are ordinarily rivals: Merck and J&J, Sanofi and Pfizer, and CureVac and Novartis.


The development of an efficient vaccine delivery system does, however, remain a challenge. Prior to COVID-19, the U.S. had not faced a massive vaccination program since the polio epidemic in the 1950s. Initially, we were ill-prepared to administer the COVID-19 vaccines on a massive, nationwide basis. Nonetheless, every day improvements are occurring. By early March it appeared that the U.S. was finally getting its act together when the number of vaccine doses being administered per day across the U.S. topped two million! Mastering how to deliver vaccines efficiently and quickly to millions of people will serve this nation well in responding to future pandemics.

Impact on other infectious diseases. The seasonal influenza kills on average 50,000 Americans per year. This year the seasonal flu essentially disappeared. On January 30, 2021, the Center for Disease Control and Prevention (CDC) recorded 1,316 cases of flu in the U.S. (by this time last year, the number of cases was 129,997). And on March 2, 2021, an article appeared in The Washington Post entitled “The flu killed nearly 200 children last season. This time, 1 has died.” This is another positive consequence of the COVID-19 pandemic.


We have not been able to stop the COVID-19 pandemic through our mask wearing, hand washing, social distancing, business closures, etc. Nonetheless, these precautions, imperfect as they may be in preventing COVID-19, have been enough to virtually wipe out the flu this year. Moreover, similar drops in the incidence of other seasonal viral respiratory tract infections, like respiratory syncytial virus, are also being observed. The CDC is now faced with determining exactly how this “no flu season” will affect planning for next year’s flu season.


There’s also been a positive impact of the behavioral measures to thwart COVID-19, referred to as “non-pharmaceutical interventions” (NPIs), on infections outside of the respiratory tract. For example, NPIs appear to explain a reduced incidence of diarrhea outbreaks caused by norovirus (reported in the Journal of Infectious Diseases in February, 2021). Norovirus is the single most common cause of gastroenteritis (diarrhea) in the developed world (estimated 685 million cases annually). Although outbreaks on cruise ships have captured media attention in the past, and the cruise ship industry has been all but decimated by COVID-19, a vast majority of norovirus infections aren’t linked to travel on cruise ships. Rather than reduced travel on cruise ships, it appears that attention to another of the NPIs, in this case frequent handwashing, is responsible for the precipitous decline in cases of norovirus infection.


The impact of NPIs on sexually transmitted infections is currently unknown. The COVID-19 pandemic did reduce in-person visits to HIV care facilities. But according to a recent report in the Journal of Infectious Diseases, it also accelerated growth of alternative, innovative options, such as, telemedicine and medication delivery to homes. It is thought that these alternative options for seeking and obtaining medical care for HIV may actually contribute to the goal of “Ending the HIV Epidemic Initiative,” that is, to reduce new HIV infections in the U.S. by 90% by 2030.


Positive impacts on the environment. Another unintended positive consequence of the COVID-19 pandemic is its effect on the environment. Early on in the pandemic, many cities went into lockdown, factories were shuttered, and transportation by vehicles and planes was markedly curtailed. (Advocates for a healthy climate had been asking for essentially these changes for years.) As a result, levels of CO2 and other greenhouse gases in the atmosphere fell precipitously. In January of this year, it was reported that the pandemic resulted in a 10.3% drop in greenhouse gas emissions, and that the U.S. had witnessed the largest drop in annual emissions since the World War II era.


The benefit to human health of cleaning up the air was most obvious by the reductions of air pollution in cities in India and China. But cities throughout the world became more livable. The change was so swift and striking, scientists came up with a new name for the phenomenon—the “anthropause”—denoting a stop in the manmade extinctions occurring in the Anthropocene epoch.

Positive impacts on lifestyle and relationships. Many people have experienced the benefits of working from home, avoiding traffic and crowds, participating in the resurgence of community spirit, and taking advantage of digitized continuing education courses, all of which are positive consequences of COVID-19. Moreover, this pandemic has driven more people outdoors, where experiencing nature can both reduce stress and lift spirits. It has been suggested that enhancing these positive developments could help build community resilience enabling us to cope with future pandemics.


A national survey by researchers in Sydney, Australia in June 2020 revealed that 960 (70%) of participants experienced at least one positive effect resulting from changes to daily life during the COVID-19 pandemic. For me, speaking more often then ever to my children, even if it has been by phone or via the internet, has been the positive effect of this pandemic that I “ac-cent-tchu-ate.”

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Main Page images courtesy of Shuxian Hu, MD. Dr. Hu is a scientist in the Neuroimmunology Research Laboratory at the University of Minnesota.

 

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