“I know not with what weapons World War III will be fought, but World War IV will be fought with sticks and stones.” This quote allegedly belongs to A. Einstein who imagined a grim day in the aftermath of a world war among nations who carried nuclear arms. 

It is part of human curiosity to imagine beyond the current as to let the mind to wonder on the aftermath of this unique international lockdown!  Thoughts wonder on some prosaic elements of the lockdown and to wonder the side effects on our psyche.  Obviously as I do not have a vast epidemiological knowledge, I can only consider what I know from previous health scares.    

The previous large-scale health scare was in the 1980s.  I still remember the horrible ad with the carved headstone that read AIDS.  One word that scared so many people then.  People were told to practice safe sex and to avoid sharing needles.  People became worried and at the time an HIV diagnoses was a death sentence.  Images of people suffering Kaposi’s sarcoma began to surface in what became more than a global epidemic; it became a test in our compassion.  Early on, gay people reported discrimination, victimisation and eventual, vilification.  It took some mobilisation from the gay community and the death of some famous people to turn the tide of misconceptions, before we turned the tide of the disease.  At this stage, HIV is not a death sentence and people who are in receipt of medical attention can live full and long lives. 

It is interesting to consider how we will react to the easing of the restrictions and the ushering on a new age.  In some Asian countries, since SARS in 2003 some people wear face masks and gloves.  Will that become part of our attire and will it be part of professional wear beyond the health care professions?  If this becomes a condition, how many people will comply, and what will happen to those who will defy them. 

We currently talk about resilience and the war spirit (a very British motif) but is this the same for all?  This is not a lockdown on equal terms.  There are people in isolation in mansions, whilst some others share rooms or even beds with people, they would rather they did not.  At the same time, we talk about resilience, all domestic violence charities speak of a surge in calls that have reached crisis levels.  “Social distancing” has entered the lexicon of our everyday, but there are people who simply cannot cope.  One of the effects the day after, will be several people who will be left quite traumatised.  Some may develop an aversion to people and large crowds so it will be interesting to investigate if agoraphobia will surge in years to come. 

In one of my exercise walks. I was observing the following scene. Grandparents waving at their children and grandchildren from a distance.  The little ones have been told not to approach the others.  You could see the uneasiness of contactless interaction.  It was like a rehearsal from an Ibsen play; distant and emotionally frigid.  If this takes a few more months, will the little ones behave differently when these restrictions are lifted?  We forget that we are social animals and although we do not consciously sniff each other like dogs, we find the scent of each other quite affirming for our interactions.  Smell is one of the senses that has the longest memory and our proximity to a person is to reinforce that closeness. 

People can talk on social media, use webcams and their phones to be together.  This is an important lifeline for those fortunate to use technology, but no one can reach the level of intimacy that comes from a hug, the touch on the skin, the warmth of the body that reassures.  This was what I missed when my grandparents died, the ability to touch them, even for the last time. 

If we are to come out of social distancing, only to go into social isolation, then the disease will have managed something that previous epidemics did not; to alter the way we socialise, the way we express our humanity.  If fear of the contagion makes us withdrawn and depressed, then we will suffer a different kind of death; that of what makes us human. 

During the early stages of the austerity we saw the recurrence of xenophobia and nationalism across Europe.  This was expected and sociologically seemed to move the general discussions about migration in rather negative terms. In the days before the lockdown people from the Asian community already reported instances of abusive behaviour. It will be very interesting to see how people will react to one another once the restrictions are lifted.  Will we be prepared to accept or reject people different from ourselves? 

In the meantime, whilst doctors will be reassessing the global data the pandemic will leave behind, the rest of us will be left to wonder.  Ultimately for every country the strength of healthcare and social systems will inevitably be evaluated.  Countries will be judged, and questions will be asked and rightfully so.  Once we burry our dead, we must hold people to account.  This however should not be driven by finding a scapegoat but so we can make the most of it for the future. Only if we prepare to see the disease globally, we can make good use of knowledge and advance our understanding of the medicine.

So maybe, instead of recriminations, when we come outside from our confinement, we connect with our empathy and address the social inequalities that made so many people around us, vulnerable to this and many other diseases.