Looking Beyond Tomorrow for Health Care and Society

Jul 15, 2020, 11:00 AM

Just 6 months ago, the novel coronavirus now known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19, the severe disease it causes, were unheard of.

Today, this highly contagious and dangerous virus and the widespread virulent disease it causes have resulted in major disruptions of business, education, and transportation, and have permeated and interrupted virtually every aspect of daily life. Millions of people have been affected by COVID-19, hundreds of thousands have experienced critical illness, and tens of thousands have died. Physicians, other health care professionals, and health care systems around the world have been challenged like never before in recent history.

Since one of the first publications in JAMA, titled “Coronavirus Infections—More Than Just the Common Cold,” by Fauci and colleagues on January 23, 2020, it was clear that the scope and ultimate effects of this outbreak were unclear and would evolve rapidly. However, at some point the acute phase of the pandemic will end, and it will be necessary to understand what the future may look like in health care and in society. Various forecasts have suggested possible timelines for when peaks in disease activity, intensity, and severity of COVID-19 may begin to gradually subside. There are major concerns and uncertainty not only regarding when a return to some semblance of “normal” activities might occur, but also regarding what that “new normal” will be like, in terms of the implications related to the lingering risk of ongoing COVID-19 disease. These implications may be profound and most likely will have important consequences for daily life and for the health care system. At least in the short term, as severe disease and the current pandemic begin to subside, some of the significant and fundamental changes that have occurred in health care and in society will remain in place, and many of these may become permanent.

It is impossible to know exactly what the future pattern of COVID-19 disease activity might be, because it seems that the only predictable aspect of this pandemic is that it has been unpredictable. It is clear that the US and countries around the world must be better prepared for what may emerge in the coming months than they were for the initial pandemic, and they may need to implement bold and creative responses. Accordingly, in a series of upcoming Viewpoints, JAMA will attempt to look beyond tomorrow—to the postacute phase—to describe and understand various issues in health care that may need to be considered and addressed. Among these may be clinical issues, such as development of effective therapies and a safe vaccine; public health issues, such as continued surveillance, risk mitigation, and containment; infectious disease–specific issues, such as appropriate therapeutic interventions, serologic testing, and prevention of transmission; financial issues and personnel to mount an effective response to COVID-19 resurgence or perhaps another severe disease outbreak.

While acknowledging that there will be uncertainty in addressing the topics in the “COVID-19: Beyond Tomorrow” series, the insights from these Viewpoints should serve to help inform physicians, other health care professionals, administrators, and policy makers about what the future may hold with COVID-19 for health care and society. Perhaps these Viewpoints could also serve to provide suggestions to galvanize efforts about what will need to be done beyond tomorrow.

A Guest Editorial