What will 2021 bring? Promising vaccines and ‘the darkest days of our war on COVID-19’ – USA TODAY

Experts say side effects from the COVID-19 vaccine range from soreness to fatigue. USA TODAY

A trio of promising coronavirus vaccines promises to plunge a stake through the dark pandemic-riddled heart of 2020.

Thats the good news. Less encouraging is the reality that our national resolve will continue to be tested well into 2021 as a comprehensive inoculation rollout is likely only by summer.

In the meantime, winter is coming.

COVID-19 cases and deaths are skyrocketing nationwide, taxing hospital staff and facilities. More school disruptions seem inevitable, vexing students and frustrating parents. The recession has plunged millions into unemployment, challenging the incoming administration of President-elect Joe Biden to provide relief.

And partisan politics linger, undermining the kind of united front necessary to stem the tide of death and economic disruption.

The only way to face this is one day at a time, said Nina Lewellen, 30, of Detroit, whose birthday present last June was five days in intensive care with COVID-19. She is upset many of her Michigan peers continue to take the virus lightly as she continues to deal with repercussions including headaches and hair loss.

Nina Lewellen, 30, center, with her two children, Grace Lewellen, 10, left, and Grady Riney, 4. Lewellen was in the hospital for five days last June with COVID-19, and has been vocal about tell friends and neighbors in Detroit that the virus is not only real, but it is important to stay safe this winter as the case numbers climb.(Photo: Courtesy of Nina Lewellen)

The next few months promise to bring the worst of this pandemic to our door, so I can only hope that by sharing my own serious experience maybe I can get even one person to be careful, said Lewellen. The vaccines will help. But were a long way away.

Conversations with historians, futurists, doctors and business leaders around the country paint the coming year as both a challenge and opportunity, one that sees us all shouldering continued disruptions to the way we live and work but also, one day next year, newly appreciating the joys of attending a wedding or a throwing a Little League post-game barbecue.

The journey from here to there is a simple one, experts say. The more resolute we are in collectively facing the hardships 2021 brings us, the faster will we reap the freedom-filled rewards promised by the vaccines. And vice versa.

We are heading into the darkest days of our war on COVID-19, said Douglas Brinkley, historian at Rice University in Houston whose books have chronicled everything from the space race to World War II.

Our efforts to beat back the COVID-19 siege has revealed both the best and worst of American character.

On the one hand, this pandemic has shown we have short attention spans, dont trust science and believe in the survival of the fittest, Brinkley said. On the other, you see the tireless compassion of doctors and nurses working overtime to save lives. That deep community spirit is what we need now.

Or else that phrase seems to hang off the end of every observation made about 2021. The stakes, officials warn, are that high.

Plenty of people are sounding the alarm. Robert Redfield, the head of the Centers for Disease Control and Prevention, recently warned that the next three months will be the most difficult time in the public health history of this nation, with upwards of 450,000 deaths possible by February, up from around 280,000 currently.

World Food Program executive director David Beasley said Friday that2021 is literally going to be catastrophic," and the various humanitarian crises could be exacerbated as poorer nations waitlonger for the COVID-19 vaccine.

Philanthropist Melinda Gates, who along with her husband Bill has been working for decades to curb infectious diseases, said in a recent interview that vaccine skepticism in the United States threatens not only to undermine a COVID-19recovery but also extend the "stretch of very dark months ahead of us."

In Michigan, where increased testing has resulted in a 13% jump in positivity rates and rising 7-day death toll figures, Gov. Gretchen Whitmer pleaded for a rethinking of travel and holiday plans.

Medical staff members check on a patient in the COVID-19 intensive care unit at the United Memorial Medical Center in Houston, Texas. Healthcare leaders are warning that this winter could push hospitals and their staff to the breaking point as virus cases surge nationally.(Photo: Go Nakamura, Getty Images)

Los Angeles Mayor Eric Garcetti said Wednesday the areas mushrooming COVID-19 cases means residents should hunker down cancel everything." Sunday a stay-at-home order went into effect for 33 million Californians, including those in Southern California, the Bay Area and Central California to help stop the spread of a virus that is filling the state's ICUs.

Those warnings are powerful and even dire, and theyfallon fatigued ears.

Everyone is tired but unfortunately viruses dont care, they just replicate, said Timothy Brewer, professor of medicine and epidemiology at the University of California, Los Angeles. As long as its circulating, we need to be vigilant.

With a majority the nations hospitals at stretched capacity, the tipping point is here.

We are far from out of the woods just because there are vaccines that have good results, he said of products from Moderna and Pfizer that promise 95% effectiveness. Trial results from a third vaccine, from AstraZeneca, remain under review.

The vaccines themselves come with their own issues. Some require sub-Arctic temperatures up until the moment of injection, which presents a transportation and storage challenge. And then theres the fact that most require two shots, which in a nation of 330 million will be some undertaking.

Joel Zivot, an Emory University professor and ICU doctor, speaks with Hailey Wetta, a critical care physician. Both work with COVID-19 patients at Atlanta's Emory Decatur Hospital.(Photo: Courtesy of Joel Zivot)

People need to brace themselves from the cold reality of whats in front of us, and not stop any of the preventive measures meant to keep COVID-19 in check, said Joel Zivot, associate professor of anesthesiology and surgery at Emory University in Atlanta. He also works at Emory Decatur Hospitals intensive care unit, where he treats COVID-19 patients. He had the virus last summer.

In a recent article, Zivot posited that basic math which takes into account an 80% uptake of the vaccine that is 95% effective could yield between 500,000 and 2 million American deaths in 2021. Thatcalculation, whose wide death margin reflects whether the nation heeds heath community recommendations, excludes both how long it will take to make and distribute doses for all Americans,and how many will say yes.

The vaccine is not a panacea, he said. Itll take a year or more before some real material changes appear to the way we live. But, as I like to remind people, a year in a long life is a short time. We just have to be patient and think of the collective.

Health officials say they will continue to use media campaigns to influence often skeptical public opinions about both masks and the vaccine.

Liz Sharlot, director of communications at the Mississippi State Department of Health, said she aims to raise money to create a series of ads and public service announcements featuring testimonials from the first healthcare workers to receive the vaccine. Recent polls show that around 60% of Americans say they will take the vaccine when it becomes available.

"At first, health care workers will get these vaccines, soI want to use them in ads saying, 'I got it, it had few effects,'" says Sharlot. "If you hear it from people, it means something."

A Michigan group of business and health leaders spent $5 million on a coronavirus awareness campaigned aimed at younger Michiganders. A cartoon virus figure with dark sunglasses, dubbed "Rona," is seen here, on this digital outdoor ad, being pushed backwards as the words roll out: "Not here Rona." The campaign, leaders say, was successful in making some more aware of the need to social distance and wear masks, actions that have become politicized in Michigan and other states.(Photo: Courtesy of DTE Energy)

Last summer, Sharlot helped lead the departments ItIs Real campaign, featuring video interviewsof COVID-19 survivors.

In Detroit, a $5 million Rona 4 Real campaignis credited with changing the habits of younger Michiganders, who this summer were among those responsible for spreading the virus as they sought to mingle as cases fell. That campaign may get a twistas local leaders grow concerned that the existence of a vaccine may lead to a winter case spike.

"With the vaccine here, there's that same risk of younger people getting euphoric and reviving bad behavior," saidGerry Anderson, executive director of DTE Energy and co-chair of the Michigan Economic Recovery Council, which advised Whitmer on COVID-19 and spearheaded the Rona 4 Real campaign. "But well need discipline to hang in there.

Skepticism about COVID-19 may have contributed to prolonging the nations suffering well beyond what the United States had to endure during the last big viral conflagration, the 1918 Spanish Flu outbreak, said John Barry, author of The Great Influenza: The Epic Story of the Deadliest Plague in History.

A handout picture provided by National Guard Bureau shows soldiers in quarantine while recovering from the Spanish flu, at Camp Funston, Kansas, in 1918. That pandemic killed more than 600,000 Americans, back when the nation only have around 100 million citizens. But the Spanish Flu didn't last nearly as long, and the wearing nature of this COVID-19 pandemic is trying the patience of citizens as officials urge caution going into a possibly deadly winter.(Photo: US NATIONAL GUARD BUREAU HANDOUT, EPA-EFE)

While that event killed 675,000 Americans, or 0.5% of the 103 million population, and some 50 million worldwide, it took its biggest toll in only a 15-week period and passed through any given community in six to 10 weeks.

Theres really no comparison to the last plague, this one is much longer period of stress and were not done yet, Barry said. Wed all be better off if early on leaders had said what should have been said, This is going to a be long fight and we need to be prepared to fight it for the extended duration.

Economists looking ahead to 2021 see a mixed bag.

On the one hand, many spy the promise of a surge in discretionary spending as the vaccine gets widely distributed globally, bringing back everything from leisure travel to concerts and other group gatherings. Recently, the Organization for Economic Cooperation and Development projected global gross domestic product would rise next year by 4.2% after falling by the same percentage in 2020.

A Thanksgiving holiday traveler is directed as they pass through Los Angeles international Airport. State officials nationally worry such journeys may soon lead to a spike in COVID-19 cases and deaths, leading some, such as California Gov. Gavin Newsom, to warn that severe lockdowns could be imminent.(Photo: David McNew, Getty Images)

However, there will be no simple reset to the fall of 2019 as the virus batters the economy in the first quarter of 2021 JPMorgan economists have forecast a 1% contraction for the period and countless industries endure permanent change.

We wont return to pre-pandemic levels until the end of 2021, so in a way weve lost two years, said Andrew Butters, assistant professor at the Kelley School of Business at Indiana University in Bloomington.

In a recent report, Butters and his colleagues at the Kelley School predicted that employment is not likely to hit a pre-shut down peak until well into 2022, and while consumer spending ultimately may recover, it will be aimed at goods and not services as people remain wary of interaction for the foreseeable future.

After all of these changes weve seen in the economy in terms of businesses that have closed and jobs that no longer are viable, it would be nave to think none of these are going to stick, he said. Post-vaccine, there will be winners and losers in the new economy. Some sectors, firms and households will say, The economys back. And others will say, Not for me.

Other lasting changes despite the prevalence of a vaccine are likely to be behavioral, experts say.

These include a growing awareness of contagion and a corresponding aversion to big crowds, which in turn can, very sadly, dampen the natural curiosity we humans have about one another, said Maria Bothwell, CEO of Toffler Associates, a future-focused strategic advisory firm founded by Future Shock authors Alvin and Adelaide Toffler.

A waiter wears a mask and face covering at a restaurant with outdoor seating in Pasadena, California. The U.S. services sector, where most Americans work, has been hit hard by the COVID-19 pandemic as restaurant has been limited in an effort to curve the spread of the virus.(Photo: Marcio Jose Sanchez, AP)

But, Bothwell adds, it would be inaccurate to say that the pandemic has not brought positive changes to American society.

In her plus column: the ability of entrepreneurs to help society create new ways of doing business (the recent sale of messaging site Slack to Salesforce for $27 billion is bet on the permanent shift to remote working); a renewed appreciation for science and data-driven decision making (77% of Americans have at least some trust in scientists, according to a Pew Research Center poll); and a growing spotlight on healthcare inequity (the result of the poor and people of color suffering disproportionately from COVID-19).

On top of all that, youve also got a sense of elation, optimism and freedom that will surge over us as the vaccine helps us beat back the virus, Bothwell said. There will be more hugging and laughter. Thats something to look forward to.

Until then, its a matter of staying alive. Detroit resident Lewellen continues to tell anyone who will listen, whether on social media or in socially distanced meet-ups, about how serious this moment of national reckoning is.

I mean, what will it take for people to listen, losing someone? she said.

Lewellen, who caught the virus last summer from her asymptomatic 3-year-old, had a hellish experience at the hospital. Her breathing was so shallow doctors worriedthey would have to restart her heart. Once home, she was out of work for two months suffering from brain fog and insomnia.

Sal Lando, left, holds up signs during a protest against mandatory flu vaccinations, outside the Massachusetts State House, in Boston, last summer. Spurred by the pandemic, vaccine opponents have worked to reinvent their image around a rallying cry of civil liberties and medical freedom. Such a stance, health officials worry, could lead to a large percentage of Americans opting out of promising COVID-19 vaccines.(Photo: Nancy Lane, AP)

And that paled when compared to her mothers 10-day stay for COVID-19, which Lewellen says left her with cataracts in her eyes that only recently were removed.

While Lewellen is hopeful the vaccines will bring welcome relief at some point in 2021, for the moment she is girding for a battle to keep those around her safe.

Ill just keep doing everything I can to get the word out that people need to be very careful, said Lewellen. I know people are really fatigued by the masks and the restrictions, but this is not over.

Follow USA TODAY national correspondent Marco della Cava: @marcodellacava

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What will 2021 bring? Promising vaccines and 'the darkest days of our war on COVID-19' - USA TODAY