LULU GARCIA-NAVARRO, HOST:
* Dr. Jacob Appel is a psychiatrist and bioethicist at the Icahn School of Medicine at Mount Sinai Hospital in New York. We asked him to tell us when he realized that things were going to be different.
JACOB APPEL: As someone who studies infectious disease and knows a lot about pandemics, I thought this was a possible risk but didn't really think this was going to transform our lives. And then one day, I went to the medical school, and I was in my psychiatry department doing my work. And I realized there was nobody else there because everybody else who was not an employee engaged in emergency care had been sent home. And I realized things had changed.
GARCIA-NAVARRO: Dr. Appel is the director of ethics education at Mount Sinai. And after this long, painful year, he's been thinking a lot about what happens next.
APPEL: The questions I'm often asked when I give lectures as a bioethicist and as a psychiatrist are, how has COVID changed the future of society? Will people go back to cruise ships? Will they continue having Zoom meetings? But I think the more important question, the long-term question, is how this will change the people who lived through a year of lockdown, what the generational implications will be. And the question is, will it make us more altruistic? Will we come together and be the kind of people who are more likely to donate blood or become organ donors or check up on an elderly neighbor, or will we become more tribal and retreat into ourselves and become the kind of people who are hermetically sealed in our apartments or homes and periodically emerge to fight over toilet tissue?
GARCIA-NAVARRO: I mean, we're nearly a year into this pandemic and understanding that, obviously, tragedy has changed many of us. Beyond that, have we changed already, in your view?
APPEL: Oh, I'm sure we have. How exactly we have is much harder to predict. But when you look at other large-scale events in the past, whether it's the flu of 1918, 1919 or the Great Depression or World War II, it has a significant impact on the generation, on the way the cohort views themselves, their society. So of course we're changing. There are suggestions that we're changing for the better and suggestions that we're changing for the worse. But it's hard to know how it plays out in the short term.
GARCIA-NAVARRO: Talk me through that. I mean, let's start with the positive. What suggestions do you see that we're changing for the better?
APPEL: So I think there's a lot of suggestion that - or a lot of indication that people are really coming together to appreciate friends and family more. I've had people I haven't heard from in years reach out to me to check on my welfare. And I know friends and family have had the same experience. So I think at some level, we are more interested in the welfare of our neighbors.
GARCIA-NAVARRO: And then the flip side - what danger signs or warning signs do you see?
APPEL: I think the most glaring flip side is a year ago when many state governors and many authorities asked us to follow public health rules, stay inside, socially distance, wear masks. Initially, people were very willing to do so. And the poll data showed most people were supportive. If you compare that to the vaccine rollout, where now people have sort of thrown up their hands and said, the system is unfair. People with influence and power get more benefit. I'm going to game the system any way I can - I think we've lost a lot of that solidarity. And it really scares me because there will be another tragedy someday, whether a pandemic or another public health threat. And I'm not sure this generation will be willing to come together in the same way that we did back in March.
GARCIA-NAVARRO: You note that because not everyone experienced the pandemic in the same way, you know, equitably, not everyone will come out of this changed in the same way.
APPEL: Yeah, I think that is a significant concern. We talk about people as uniform or monolithic, but historically, that is far from the case, I think. How well-off Caucasian Americans and how lower-income African Americans have experienced the pandemic, for example, is very different. And if I were - and I am not. I am Caucasian. But if I were an African American and I saw how decisions made during the pandemic reinforced existing health inequalities and a history being shortchanged by the society and by the health care system, I might be more willing to help those who were similar to me and less willing to help those who were different than me.
GARCIA-NAVARRO: There's also, of course, the more personal experiences that people have had, apart from the systemic questions - you know, if you were alone during this pandemic, if you were a parent during this pandemic, if you lost someone during this pandemic.
APPEL: Oh, absolutely. Many people have come out of the pandemic largely unscathed. And the data shows that these are particularly people who are well-off and in a good position to begin with, economically, socially. And others have lost everything. They've lost economically. They've lost loved ones. Their lives have been entirely disrupted. And it will be hard for them to put the pieces back together again. I think as we go forward, we may see increased polarization between those two groups of people. For some, this will be an unfortunate event that they get past fairly quickly. And for others, it will be the defining moment of their lives.
GARCIA-NAVARRO: What should we be doing as individuals to make post-pandemic life better for us all?
APPEL: I think people should actually ask themselves, how has the pandemic changed me? What do I want out of life now that I never reflected about before? And then people should also reflect on those around them and ask themselves, how do I think this pandemic has affected the people I care about, my community? How can I change my own behavior to meet the needs of those around me that I may not even have recognized before the pandemic occurred?
GARCIA-NAVARRO: That's Dr. Jacob Appel, an associate professor of psychiatry and medical education at the Icahn School of Medicine.
Thank you so much.
APPEL: Thank you. Transcript provided by NPR, Copyright NPR.