As the nation struggles to respond to the COVID-19 pandemic, watch for these three trends in the U.S. health conversation over the coming months:

1. Medical mysteries and advances:

The novel coronavirus is like none we’ve ever seen, with symptoms ranging from the expected, such as fever and shortness of breath, to the bizarre, including skin rashes and strokes. 

A few of the questions and advances to watch for in the coming months as scientists rush to find answers:

  • How can COVID-19 ravage the lungs of some people, while leaving them feeling completely healthy and symptom-free?
  • Why are people in their 30s and 40s having strokes?
  • What is behind the uneven recovery of some people, including those who continue to test positive for the disease weeks after recovery?
  • Do antibodies actually confer immunity, and for how long?
  • How many people have actually been infected? (Hint: we’ll know when widespread diagnostic and antibody testing become available, and reliable)
  • When will we have a cure or a vaccine? Keep an eye out for the results of dozens of clinical trials around the world.

2. Free-for-all experimentation:

Most decision-making about pandemic recovery and reopening is happening at the state level, with governors making much-debated calls balancing lives and livelihoods.

Some like Georgia are reopening their economies against public health advice; some like New York are standing firm in the city, but looking to relax restrictions in rural areas. Some states are banding together to develop regional strategies for acquiring protective and medical equipment, much of it from China, and for opening up their economies to protect the greatest number of people in interconnected, highly mobile areas. 

Time and expanded testing will tell who’s getting it right, and how long we’ll have to battle waves of new infections and deaths as states experiment. Meanwhile, internal CDC documents predict the daily caseload will increase dramatically over the coming month, suggesting relaxing restrictive policies may be premature. And prominent forecasters now predict substantially more deaths than previous estimates, as social mobility increases.

3. Inequity

In city after city, state after state, we hear about the inequitable burden of COVID-19 on African American and Latinx communities. In Chicago, for example, 70% of deaths are among African Americans, yet they represent just 30% of the population.  The reasons are familiar and historic: lack of access to health care; higher rates of underlying health conditions; lower-paid, higher-risk jobs; poverty; systemic racism; and crowded or group living situations. 

Many of the solutions being implemented nationwide to ease the pain of this epidemic are also the solutions to the long-term disparities faced in many communities of color:  laptops, broadband, financial aid, small business loans, health insurance, and more.  Look for advocates to seek a new deal to build on those emergency solutions to address the underlying causes of disparities for good.

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