Coronavirus could be an opportunity to change our health behaviours for the better

We all talk about the new normal, but what does that mean in terms of behaviour? Will changes we’ve made to fight coronavirus stick with us permanently and might this be good? Martin Michaelis, Mark Wass and Michael Calnan report

People gather inside painted circles on the grass encouraging social distancing at Dolores Park in San Francisco (AFP/Getty)

A return to pre-pandemic normal life seems impossible for the foreseeable future. In the absence of control measures, it would result in the rapid spread of coronavirus and many deaths.

About 70 per cent of a population needs to be immune to establish herd immunity, a level of immunity in the population that stops coronavirus transmission. For the UK, with its 66 million inhabitants, this would require the infection of about 46 million people. At an estimated death rate of 0.5 per cent, this would result in nearly a quarter of a million deaths.

This best-case scenario doesn’t consider the daily introduction of newborn babies, not yet immune to the novel coronavirus, nor that it appears unlikely that large proportions of the population will develop long-term immunity in response to a mild case of Covid-19. If immunity is short-lived, natural herd immunity will never be reached and the coronavirus will continue to circulate. The virus may also mutate and new variants may reinfect people immune to the original virus variant.

Only a small percentage of the population has been in contact with the coronavirus, so we remain as vulnerable to further waves of the disease as we were before the pandemic. Further peaks are inevitable as long as the virus is still spreading, making a return to normal out of reach. But perhaps the measures we have put in place to control the virus are not so bad. Indeed, we might want to consider keeping them.

Social distancing and thorough hygiene are the main measures that stop the coronavirus from spreading. Social distancing stops virus transmission through the air via exhaled droplets and is a very effective measure, although it does have negative effects on some people’s wellbeing and mental health.

Hygiene measures, such as hand washing and disinfection, prevent virus transmission via contaminated surfaces. Both social distancing and improved hygiene prevent the spread of Covid-19 and other infectious diseases.

If we can maintain these measures, there will also be fewer cases of flu and the common cold. The spread of germs that cause diarrhoea, nausea and vomiting will also be reduced. More importantly, these measures could prevent the next pandemic, which could be much more deadly than Covid-19 or seasonal flu.

Different influenza virus strains circulate in birds, which have killed 30 per cent to 60 per cent of infected humans and that are only a few mutations away from becoming easily transmissible between humans. And Mers, which is also caused by a coronavirus and is transmitted from camels to humans, kills around a third of those infected.

Dromedary camels are a major reservoir host for Mers (Getty/iStock)

If these much more deadly viruses gain the capacity to spread as effectively from human to human as the novel coronavirus, the situation will be much worse than the current pandemic. Lifestyle adaptation now will help to protect us from future pandemics.

Given the acute threat of Covid-19, people may permanently change their behaviour, if circumstances enable them to. Habits that used to be socially acceptable may no longer be tolerated.

Since we can be infected when we are close to others and when we touch contaminated surfaces, people may change their attitudes towards all aspects of social contact associated with the spread of disease.

Based on their experience of the Covid-19 pandemic, people may avoid activities and places or demand and accept more thorough hygiene practices

Working life may change and involve more working from home, reducing personal contact where possible (more online meetings), abolishing hot-desking and reducing shared equipment.

People may be less prepared to join crowds and crowded places and develop a new perception of a safe distance. Public transport, lifts and venues, such as sports stadiums, convention centres, theme parks and fairgrounds, may need to be adapted to this. And travelling may be reduced and more carefully planned.

There may also be less body contact, including shaking hands and hugging, and increased preparedness to wear face coverings and accept other protective measures in a wider range of situations.

More emphasis may be permanently placed on personal hygiene measures, such as hand washing, combined with a higher awareness of the infection risk associated with objects that are touched by many, such as door handles, shopping baskets, handrails and filling nozzles, as well as shared equipment from gyms and sports halls, public toilets and rental services.

Based on their experience of the Covid-19 pandemic, people may avoid activities and places or demand and accept more thorough hygiene practices that would have been previously unacceptable.

Increased awareness of infection risks and hygiene may result in a society that is much better prepared to deal with the threats posed by infectious diseases. Similar changes have happened in the past. For example, the realisation that cholera is transmitted in contaminated water resulted in a permanent change of attitude towards sanitation.

However, if these changes in behaviours are to be attained and sustained, public policies need to recognise and address the precarious living and working circumstances that some poorer people experience and that will stand in the way of everyone adopting this new normal.

Martin Michaelis is a professor of molecular medicine at the University of Kent. Mark Wass is a reader in computational biology at the University of Kent. Michael Calnan is a professor of medical sociology at the University of Kent. This article first appeared on The Conversation