POVID, or a “post-covid” world may still seem like a distant dream. Peter Brindley and Matt Morgan imagine what life might be like as we learn to live with covid in the long term
A portmanteau is an old word to describe a novel idea. In short, it is a collision of words, sounds, and meanings. Examples abound, but we now understand what is meant by “motel,” “brunch,” “smog,” “email,” and let’s not forget “Brexit.” As a result, portmanteaus are a way to understand new realities and future directions. Fast forward to our current crisis and even the previously mysterious covid-19 started out as a portmanteau: coronavirus disease 2019. In fact, this pandemic (“pan” meaning “all” and “demos” for “people”), can barely be understood without resorting to some form of word-mash.
It was actually ever thus whenever a new idea came along. “Aerosol” came from the ancient Greek combination of “solution” and “air”; “droplet” was a Shakespearean neologism, and “vaccine” combined cow (vacca) plus variolae (i.e. the pustules in smallpox). Centuries on we deploy the word-combo “covidiot” as dismissive shorthand for those who—in our exalted opinion—refute or mangle science. We worry about an entire affected generation, namely the “coronnials.” We also fret about drinking too many “quarantinis” on “staycation.” With so many useful examples already, we wish to audition the portmanteau “povid” (post-covid). It may still seem some way off, but we offer six “guestimates” about the post-viral world.
1. Masks forever?
How much Human influenza did you see this year? How about Respiratory Syncytial Virus? Well, we saw none in either of our ICUs, and the Centre for Disease Control reported less than 1%.  Accordingly, we think it’s an easy, albeit perhaps depressing, prediction that masks are here to stay.
It’s one thing to wear a mask for minutes, quite another to do so for years. We predict that, over time, more people will take less delight in uttering the “face, hands, space” mantra, but most will, nonetheless, carry on. This is because most people are decent and always will be, and that is worth remembering. It is also because the restrictions are backed by current science, and so they should be followed, even if wearily. However, because science can mature, these ideas may too. As such, we also predict—in fact we implore—more research concerning where and how humans can safely congregate and when we can safely drop our masks. After all, isolation, even if well intentioned, is hardly risk-free.
2. More working to live, less living to work
We predict plenty of people will be cured of their “workaholism” (another portmanteau) whereas others will go back to failing to practice what they earnestly previously preached. Take, for example, us: please! Despite both of us working in ICU, and already having witnessed a huge amount of premature death, this pandemic was an especially powerful reminder to never put off that trip, or skip that celebration. The hippies were right all along: the only certainty is the here and now, so embrace it. While work can be meaningful, the last year highlighted how it pales compared to nature and friendship. Similarly, when it comes to time away from work, the last year highlighted that an evening of Netflix can be heaven, and a month can be hell.
If the world reverts to its work focus then it’s because the drive for security breeds insecurity, because we hairless apes love shiny stuff, because it helps to be distracted…and let’s not forget those pesky bills. On a more positive note, humans also need to be needed, and we actually do want to serve. Regardless, to-date, employment has been the most obvious way to fulfill many human needs. While work will always be a big thing, covid is a stark reminder that work is not the only thing.
3. Online consultations, and conferences: zoom zoom!
With a market cap of 130 billion US dollars, Zoom is now worth more than IBM and ExxonMobile.  Therefore, we confidently predict that communication and congregation will continue to become the new oil. Before covid-19, it was not uncommon to drive hours to see a medical specialist only to be told what you already knew: “sorry, but you’re not a candidate for surgery.” We predict that zoom consultations will continue to grow apace. Interestingly, we have heard lots from doctors about the brave new world of 2-D communication, and many were pleasantly surprised. It’s now time to hear what patients think. In fact, it’s always time to hear what patients think.
It’s tougher to predict the future of online medical conferences. This is because covid-19 has underscored how many still crave interactions in 3-D. For example, we used to love going away to a good conference. Truth be told, we loved going away to a bad conference, if it was in a nice place. We appreciate the simplicity of Zoom (and Microsoft Teams and whatever bandwagon products are yet to come), but are not mad keen about lecturing into a feedbackless cybervoid. Because audiences can now log-in without engaging, we fear that is exactly what many will do.
4. Vaccines are back!
Vaccines are firmly in the spotlight, so expect more to be produced and promoted. The covid vaccine has been free to date, but expect plenty of debate when the conversation pivots to pneumococcus, herpes zoster, or clostridum difficle. In other words, will the bucks stop with the public purse or private wallet. Despite immense gratitude owed to the covid-19 vaccine brigade, we predict few will take time to thank those who did the sequencing and manufacturing, ditto those who volunteered for experimental shots. As such, we will do so now and loudly.
Regardless of your political stripe, vaccine funders also deserve a shout-out. This includes government departments (well, tax payers really), scientific institutes, and charities. [3,4] Less than 2% of the money for the Oxford/Astra-Zeneca vaccine was private, but Pfizer and Moderna raised hundreds of millions from financial markets and suit pockets. Debate will continue about whether manufacturers and distributors should make hefty profits, and how long gratitude will last without years of bountiful, affordable, supply.
Do you know many people with polio? No, well that’s because vaccines work. We predict more will accept that truth, even if they don’t go as far as the Italian virologist, Roberto Burioni, when he told the Italian public in 2016: “the earth is round, gasoline is flammable, vaccines are safe and effective”. (ref 5) We predict more border guards will want to ask for proof of covid immunity, in the same way that some already do for yellow fever. We expect more employers will want “no jab, no job” policies, in the same way that some hospitals in North America already demand proof of immunity to measles, mumps, and rubella before granting hospital privileges. We do not, however, predict any of this will happen squabble free.
5. But then again, maybe it never ends
Making povid predictions is difficult because coronavirus’s spike proteins mutate, populations hesitate, and those in power complicate. Regardless, virologists believe that covid-19 will remain in low level circulation for decades. After all, the 1918 influenza strain persisted into the 1950s.
While many are focused on the race between vaccines and variants, it doesn’t take a genius to foresee endless dissertations into what went right and wrong. This is because covid-19 not only ravaged personal health, but our shared economy, our cherished freedoms, and oft-neglected community responsibilities. In short, it deserves a proper debrief
As the old quote goes, “predictions are notoriously difficult, especially about the future.” Accordingly, it’s often wisest just to hope for the best while bracing for the worst. Once again there is a portmanteau, namely “antici-pointment,” and we expect plenty of it. We cannot know if the word “povid” will enter common parlance, but it offers a useful shorthand for contrasting the world before covid and after. Therefore, even while covid still rages, let’s start the povid discussions now. After all, who would have predicted that corona would become so much more than an innocent patio beer.
Peter Brindley, Department of Critical Care Medicine, Department of Anesthesiology and Pain Medicine, and the Dosseter Ethics Centre, University of Alberta, Edmonton, Canada. Scholar, Peter Wall Institute for Advanced Studies. Twitter @docpgb
Matt Morgan, honorary senior research fellow at Cardiff University, consultant in intensive care medicine, research and development lead in critical care at University Hospital of Wales, and an editor of BMJ OnExamination. Twitter: @dr_mattmorgan