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Should we have a universal one-week lockdown every year?

There is certainly no doubt in anyone’s mind that our recent COVID-19 pandemic resulted in a heavy universal dose of misery and death. But recently, at a Zoom meeting, the participants were challenged to come up with one positive effect that resulted in their lives from the enforced lockdown. A variety of responses were given such as having dinner every night with the family and the clearing of polluted air in big cities. Another suggestion was the lack of commuter traffic congestion so that individuals performing essential services were able to get to work quicker and safer than was the case in earlier times. Some of the participants in this meeting noted that they had more time to read, to play music, to catch up on household repairs and chores, or to engage in hobbies and/or leisure time activities. One individual stated that “Since neither myself nor any of my family members or friends contracted a serious case of COVID pneumonia, the time spent at home was actually quite pleasant, except, of course, for the constant news media reports of ever increasing morbidity and mortality throughout the country and the world.”

Although I have been working at the hospital and clinic during this time, the workload so far has been lighter than usual, and I get home earlier every day than I would have during pre-COVID times. In addition, my family and friends meet on a number of occasions through Zoom, Skype, Facebook, Wechat, and other computer enabled venues. This past week, a group of 6 friends from medical school days met one Saturday morning to talk and reminisce. Although there had been individual contact between us over the years, we had not met all together as a group since graduation. This social event was a complete success, and we are planning to repeat it every month from now on.

Following our e-reunion, the thought occurred to me that perhaps, when the pandemic is over, such a profound worldwide event and its equally profound response, deserves some commemoration—or even something more. It occurred to us that only remembering the event might not be enough. Perhaps we might also need some time to consider the lessons this pandemic has taught us.

And what might those lessons be? We thought of many. Perhaps the most important one is existential: The world we live in is far more fragile than we thought. A simple virus, first cousin to the common cold has, by virtue of both its communicability and its unpredictable lethality, been able to infect four million people worldwide, and kill approximately 5% of those admitted to hospital.

But it is not merely the infection rate itself that is so unnerving; it is the utter randomness in the COVID’s selection of victims. True, people with health problems, some ethnic and social groups, and older individuals are more likely to die – but the coronavirus has killed thousands of people in the prime of life. Indeed, what makes it particularly frightening is that the virus might cause mild or no symptoms in one family member and yet be lethal to another. Children, even the very young, have been known to die from it. And so, with COVID-19 we lack the sense of invulnerability that many more predictable illnesses grant.

Moreover, the virus can kill rapidly and even overwhelmingly. People who did not know they were sick have died within a day of the discovery of the disease. And many of those who did die frequently succumbed over several days hospitalized in intensive care units, tied to ventilators and with multiple intravenous lines. Perhaps, the saddest element of these deaths is that patients die alone without the presence of their loved ones to hold, touch, or even see them. If we have learned nothing more from this plague, we have all discovered that it does not take a meteor striking the earth to decimate our society. A tiny bundle of nuclear material does quite well.

We have also learned that both preparation and discipline matter. When we compare the variable responses to this plague, from the highly organized and universal response in such countries as South Korea, to the often chaotic conditions in the US, we can only hope that the next time—and there will surely be a next time—we will have learned how to respond here at home.

But perhaps most important, we have learned that saving the world cannot be left to government alone. Many of the successes and failures of our COVID responses have been dependent on the willingness of each of us individually to do what needed to be done: obey social distancing, wash our hands frequently, wear personal protection masks, and stay at home unless it was absolutely necessary to go out. We discovered that what is also required are heroes of all kinds. Throughout the world, COVID heroes come in many sizes and shapes: not just physicians, nurses, and healthcare technicians, but also those who clean the hospitals, staff the ambulances, maintain the food supply, and preserve societal order and discipline during these staggeringly disruptive times. Each of those heroes is a person who is willing to leave his or her family and place themselves in danger in order that the rest of us might be a little safer. Truly, we learned a most important lesson: That the whole world is in the hands of each of us.

But we have discovered one more thing as well, that the condition of the planet we live on is also our responsibility. During these days of markedly reduced production of atmospheric pollution, we have been able to look at the sky each night and see the stars and notice during the day that the air above our largest cities is clear and free of smog. Following the current pandemic, our next challenge will be dealing with climate change. If we do not recognize and change the potentially destructive factors in our current global environment, then the resulting alterations in our climate will produce effects that will make the damage caused by this virus seem trivial.

But what does this have to do with setting aside a time for remembrance? It seems to us that such a commemoration should not be a simple holiday; instead, it should take the form of an annual exercise. For a week, once a year, we could put on face masks in public, wash our hands frequently, keep the kids at home, perform our work at home as much as possible, and try not to drive, or fly. Perhaps during one designated week each year we should repeat the current lockdown both to remember and practice the lessons learned. Each of us could then use the time to “unwind” and to think about what was most important in our lives. Special virtual programs could be developed for school and university students, and special entertainment events could be sent by radio, television, the web, and social media.

If, for example this week of remembrance and lockdown were to be held at the height of the flu season, it might interrupt the infection cycle enough to produce an important reduction in new cases of influenza or corona virus pneumonia for a few weeks following the lockdown. And, if it were accompanied by widespread instruction in hand washing, social distancing, avoiding touching the face, and the wearing of masks that offer some self-protection, then lives would be saved, absenteeism from work  reduced, and hopefully the universal state of happiness might be increased.

Possibly, the lockdown week of remembrance could be held the week after New Year’s day which marks the end of a month long period of massive social movement and exposure to new vectors, and, unsurprisingly, the height of the flu season. The lockdown week would honor all those First Responders from the COVID era and those who had suffered or died during the pandemic. School opening could easily be delayed for this first week in January with emphasis placed on families coming together at home for a week—another potentially beneficial element. If such an event were to become a reality throughout the world, it would also be a way to fully remember and acknowledge that “we are all in this together”.

As always, I would be happy to hear from readers concerning this unusual idea at [email protected] or on our blog at amjmed.org.

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