Physician anesthesiologist at Stanford at Associated Anesthesiologists Medical Group
Richard Novak, MD is a Stanford physician board certified in anesthesiology and internal medicine.Dr. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California.

Eventually the peak of the COVID pandemic will ease off and the number of cases and death rates will plateau. What about life after the pandemic? Will everyone go back to living like they did in February 2020 before the crisis arrived?


Remember how airline travel was forever changed after 9/11? We adapted to the TSA screening. We adjusted to taking off our shoes, belts, and removing toiletries and electronics before every flight. In a similar way, this COVID-19 event in American history will change the way we live.

I’m a busy anesthesiologist and internist. I’ve been reading opinions and data from infectious disease experts regarding the COVID crisis for weeks. I foresee 14 medically-related trends on life and medical care in America occurring after the pandemic, but before the vaccine is available. Pondering these issues will help us prepare to find solutions. Here they are:

Testing, testing, testing. As soon as COVID testing is widely available, you’ll see skyrocketing numbers of individuals being tested. A test for COVID infection is necessary to discern who actually has the disease and is contagious. When we do not have adequate diagnostics we are forced to social distance everyone blindly. We don’t know which febrile patients with a cough to quarantine. We don’t know which asymptomatic patients are carrying the COVID virus and are contagious. The availability of a COVID test which is a) accurate, b) mass-produced, and c) inexpensive, will be the first game changer. Scientists have also developed a test for COVID antibody, which diagnoses which individuals have previously had the infection. We don’t know for certain that these individuals are immune to reinfection, but scientists are hopeful that is the case. Once we know who has had the disease already (positive antibody test), or those who are currently not contagious for the virus (negative COVID virus test), we can divide our workforce into safe employees and quarantined employees. Then people can come out of shelter and trickle back to work. But because you could test negative for the virus and then become infected the next day, testing would have to be cheap enough and available enough to be repeated frequently.

Gathering of large numbers of people will continue to be discouraged or banned. That means music concerts, sporting events, movies, cruise ships, casinos, or churches full of hundreds or thousands of individuals will be an ongoing bad idea. Until you know that person next to you is COVID negative, you won’t want to be sitting two feet away from them. This issue will plague the entertainment and sporting industries until there is a vaccine which eliminates the disease.

Scant air travel. Do you really want to sit two feet away from multiple strangers for several hours without knowing they are COVID negative? The airline industries and the travel/vacation/resort industries will be severely curtailed until there is a vaccine, widespread testing, or a cure.

Continued high usage of videoconferencing, including telemedicine clinic visits and remote schooling. Most physicians never used Zoom or WebEx prior to the COVID shutdown. Now we’re all using some form of videoconferencing every day. It’s an excellent way to interact and conduct lectures, meetings, or patient interviews, although it limits the ability to perform physical examination of the patient. Most teachers never taught using videoconferencing prior to the COVID shutdown. Now many are using it every day. Zoom and its brethren will be a major part of American life for years to come.

Ongoing delays in elective medical care. The majority of my anesthetic practice deals with elective, non-emergency surgery. All elective surgery has stopped with the COVID crisis. When will it begin anew? See #1 above. When we know a surgical patient is COVID negative and the patients know that all the medical staff is COVID negative, we can proceed with non-urgent cases. What about in-person medical office visits? Physicians will want to know that patients are COVID negative or antibody positive. I see a model where a patient must either have a certificate that documents a positive COVID antibody test, or have a negative COVID test (done one day prior to surgery) before their non-urgent surgery can be done. Likewise for in-person clinic visits.

Concerns that COVID will resurge in the fall of 2020 and/or in the spring of 2021. This fear will keep our country’s leadership on edge until there is a vaccine which eliminates the disease. Social distancing edicts may be withdrawn this summer, but the fear of another surge in the autumn will keep the specter of shelter-in-place on every politician’s mind until they are assured it is not needed.

14-day quarantining for anyone who enters the U.S. from abroad should disappear once available COVID testing is available. Accurate testing before an individual boards an international flight will reveal the whether that incoming individual is contagious.

Voting by absentee ballot will be mandated, or at least be very prevalent. Why would America choose to convene thousands of individuals at voting booths or voting sites on November 3rd 2020, thereby increasing the risk of respiratory disease spread? I’ve voted absentee ballot for decades. I’m usually too busy at work to get to the polling location before it closes. Absentee voting is easy, takes far less time, and will be medically safer than traveling to polling locations.

Lawsuits will abound. American is a litigious country. Expect families who experienced a COVID death to look for someone to sue—someone who didn’t close their gym, didn’t close their music festival, or didn’t order shelter-in-place soon enough—because that delayed decision caused their family member to contract COVID and die.

Finger pointing like you’ve never seen. Every politician will look toward politicians in the other party and blame them for not acting quickly enough. We’re seeing some of this already, but it’s drowned out by the mortality going on. After the smoke settles look for amplified criticism directed towards China for not telling the world the crisis was coming, federal political leadership for not being prepared for the pandemic, governors for not shutting down their state soon enough, legislators for not sending enough money to all the unemployed citizens, etc.

Eventually we’ll all pay higher taxes to replace the money given away by the CARES (Coronavirus Aid, Relief, and Economic Security) Act, which is funding two trillion dollars to Americans who are not working due to the COVID medical crisis. It’s also possible there will be a CARES II and CARES III at some point in the future depending on the duration of the economic crisis. The aid is necessary and wise. We’ll all have to pay for it someday.

Ongoing financial problems for workers in the depressed industries of airlines, vacation/resorts, cruise ships, theme parks, hotels, entertainment, and arena/stadium based sporting leagues.

On a positive note, adequate federal stockpiles of both ventilators and personal protective equipment (PPE) will be readied for any future pandemics.

Again on a positive note, there will be increased federal funding regarding vigilance and preparation for future viral outbreaks.

If the present crisis was a Hollywood movie (e.g. Outbreak, Contagion, or The Andromeda Strain), scientists would find a cure just when things were looking most dire. Will the COVID-19 crisis end happily like a Hollywood screenplay? Will COVID just fade away as the weather gets warm again? Nobody knows. Many intelligent researchers around the world are working on medical therapies against the COVID-19 virus. I’m hopeful that a cure will come. 

Many intelligent researchers around the world are working on a vaccine against the COVID-19 virus. Dr. Anthony Fauci of the National Institutes of Health (NIH) estimates it will be 12-18 months before experts develop the ultimate game changer, a vaccine.  I’m hopeful and optimistic that a vaccine will come. 

President Trump expects the United States to reopen its economy “sooner than people think.” Experts disagree. See The New York Times story, U.S. is Nowhere Close to Reopening the Economy, Experts SayDr. Fauci states that “the United States might never get entirely back to where it was before the novel coronavirus outbreak, especially without a vaccine.” Until that time, I foresee the changes listed above. Don’t be surprised to see them arrive after the peak of the current pandemic is in our rear view mirror.

I welcome discussion from my readers as to their viewpoints and predictions on life in America after the pandemic.