COVID-19 can offer some silver linings

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Finding the positives during a worldwide pandemic.



The COVID-19 Pandemic continues to dominate our lives as cases are again on the rise both in the US and in many other countries world-wide. Over 66 million global infections have been documented at the time of this writing and over 1.5 million deaths have occurred, suggesting around a 2-2.5% fatality rate among documented cases.

A certain percentage of survivors have developed ongoing, chronic, disabling symptoms (“long haulers”) that have prevented them from return to their previous more normal state.

The pandemic has profoundly disrupted economic and financial systems causing governments to spend billions on economic “bailouts” to attempt to stabilize economies. It has also profoundly affected the human social order and the way we interact, leaving many of us isolated, and contributing to secondary issues/diseases accelerated by such isolation.


COVID-19 has overwhelmed many hospitals and health care systems, in some cases leading to a rationing of health care assets. It has divided government decision-makers and pitted groups with opposing views on every aspect of the disease process against each other, leading to a fractionated response to intervention and containment.

Even if this disease were to eventually disappear, such as the 1918 Spanish Flu or SARS-CoV-1, the impact on our society will be felt for many years or even decades to come.

However, now we seem to be entering a “second wave” of this pandemic process, as the disease continues to accelerate with no signs currently suggesting this virus will fade away any time soon without the intervention of broadly available target therapies such as successful vaccination programs.

There are opinion/viewpoint pieces now appearing discussing the possibility of various “silver linings” evolving from this current COVID-19 pandemic. In the face of the current escalation of this disease process prior to the general availability of a vaccine or targeted therapy, can there possibly be any “silver linings?”


I do believe that some factors about the virus and disease process itself potentially offers to us some potential downstream benefits. But only if we, from both the medical and the governmental/decision-maker sides, actively “step up” and take advantage of some options that this disease has offered us, as next time we may not be recipients of these relative benefits!”

The Upside?

The first potential “benefit” of this pandemic is that — as hard as it might seem to believe right now — it could be much, much worse in several ways. Number one is that the death rate could be profoundly higher as during other pandemics or other viral outbreaks. The 1918 influenza pandemic had an alarmingly higher death rate with roughly 50 million deaths estimated. Other viruses such as smallpox produced death rates of around 30% before vaccines became available. The death rate from Ebola Zaire during outbreaks has classically been listed as around 70%.

This pandemic could also be worse if the virus was even more contagious. For example, rubeola (measles) can infect 9 out of 10 non-vaccinated persons that come within any proximity of an active measles case, making it one of the most contagious diseases known.

Also, this virus is zoonotic. Its effect could be potentially much worse if this virus finds a zoonotic intermediate host reservoir (such as MERS has done). But so far, it has not been documented to do so.

Thus, if this newly-appearing novel virus had evolved to produce a much higher death rate, such as Ebola or smallpox initially did, and/or a greater (pre-vaccination) transmission rate like measles, and/or found a zoonotic reservoir in which to become endemic and promote further transmission, the level of disruption to our society would be almost unimaginably worse than it is right now, one from which we might not recover as an organized society.

A second, related “benefit” may be even more profound. That benefit is that COVID-19 has and continues to make us painfully aware of our almost total lack of true overall preparedness for such pandemics. And while as of yet, it is not totally disrupting our society and governmental and health systems beyond some capability to respond.

We have been provided a chance now to do better in the future. With the accelerating worldwide population and with increasing global temperatures, pandemic infections are on the rise and will probably become an accelerating reality in our 21st century world. Since 2002, we have seen increasing disease appearances and accelerating outbreaks, such as SARS-CoV-1, West Nile, Dengue, Ebola, MERS, Zika, Chikungunya and now COVID-19.


COVID-19 has given us a chance and hopefully motivated us to evolve our response systems, to more aggressively investigate and learn more about diseases such as these viruses, and how to better combat them, to develop better systems to protect our society, governmental and health care systems from the devastating effects of future pandemics that may be fast approaching.

The question now becomes, will we learn from this event and produce a better response to such events in the future? I firmly hope that we do so, as I strongly suspect that the next appearing pandemic may be even more severe than COVID-19.


Dr. Severance is an adjunct assistant professor in the Department of Medicine at Duke University School of Medicine. His clinical practice includes a position as an attending physician in the Division of Hyperbaric Medicine, Erlanger Baroness Medical Center, UT College of Medicine/Health Science Center in Chattanooga, TN.

He frequently speaks to various issues in clinical healthcare and consults on questions of healthcare workplace dissatisfaction/burnout and related issues.  He can be followed on LinkedIn.

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