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The New Normal

The parking lot at Benjamin Rose is mostly empty these days. A handful of people are in the building, but there are no classes, no team meetings. The Rose Centers are closed. It’s…quiet.  

In March, Benjamin Rose Institute on Aging, following the guidance from Governor Mike DeWine and Dr. Amy Acton, Director of the Ohio Department of Health, temporarily closed our community-based programs and services as part of the statewide effort to “flatten the curve” in Ohio. Staff members began working from home. We encouraged our consumers and clients to take precautions against COVID-19:  practice social distancing; stay home. 

One of the things I am proudest of about our staff is their commitment to our mission, and the creativity and flexibility they have demonstrated in finding ways to meet the needs of older adults and family caregivers when “normal” became “impossible.” We quickly added people to home meal delivery routes. We implemented wellness checks and regular phone calls to folks we usually saw each day at a Rose Center or our Adult Day Program. Face-to-face therapy sessions became phone conversations. Committee meetings and team projects became conference calls or Zoom meetings. More than 1,300 phone calls to clients were completed over the past two weeks. We increased our presence on social media and made frequent updates to our website. We rented extra vans to deliver the larger numbers of home-delivered meals. We worked with our partners at the Greater Cleveland Food Bank and Western Reserve Area Agency on Aging to source an additional 200,000 shelf-stable meals. It was truly a team effort. 

Since the middle of March, we have grappled with how to get our work done, while also keeping our people, staff, volunteers, consumers and community partners safe. The conversation now turns toward trying to get back to “normal.” How do we move forward in the face of COVID-19?
It’s always a bit risky to predict the future in print, but the new “normal” may seem much different than where we were in February. Think of how air travel changed following 9/11. Similar, sweeping changes may be in store for us: changes made in response to a pandemic that has already taken thousands of lives and sickened many thousands more. But, will those changes be the right ones? Will they be effective? And will they prepare us for the next great health emergency?

LESSONS LEARNED

Public health: The first lesson of the pandemic is to accept the inadequacy of our public health infrastructure. Hospitals and nursing homes scrambled to find basic personal protective equipment.  Gloves, gowns and masks, critical to “universal precautions,” are in short supply. And even basic, community responses are impacted: Meals on Wheels, senior centers and day care facilities. A generation of cuts in funding for public health departments at the local, state and federal level left us poorly prepared for population surveillance. Public health is not medical treatment, it is prevention and education and awareness. High touch is as important as high tech. It deserves a higher priority in the new normal.

The “essential” workforce: One of the early challenges for Ohio and other states was to determine, quickly, the work (and the workers) who were essential in maintaining basic needs: food, health care, transportation, housing. Many people could work from home, but for many in service sectors, the reality was either losing a job, or assuming the risk of exposure to the novel coronavirus. Healthcare workers providing direct care to patients, at home or in hospital or nursing facilities, did so with limited protective equipment. Other service sector workers (laborers, bartenders, cooks, wait staff) lost their jobs. Across the country, unemployment offices were overwhelmed by the surge in jobless claims. Ironically, during a pandemic more than 3.5 million Americans lost their health care coverage, because most households rely on employer-sponsored health care plans.  Health care is a major industry, and a major employer, in the US, but many direct care workers are paid well below the average wage and many do not have benefits or full-time work. What lessons will we learn about the importance of working people in the new normal?

The value of vulnerable populations: COVID-19 is caused by a “novel coronavirus,” and we are still learning about the disease and how it spreads, but it is evident that vulnerable populations are more at risk. Older adults and others with weakened immune systems are more likely to experience serious illness or death. COVID-19 spread rapidly, in part, because people who carried the disease, but were asymptomatic, moved among populations that became ill. Some pundits viewed the illness a “just a flu,” or one that only affected “old people,” suggesting that social distancing and other efforts weren’t worth the effort.  

Mahatma Gandhi said, “The true measure of any society can be found in how it treats its most vulnerable members.” The simple truth is that funding for senior programs and other vulnerable populations have been declining since the 1990s. Modest increases in funding for the Older Americans Act have not kept pace with inflation or the growing number of older adults. The greater Cleveland area gets less federal and state support for programs like senior transportation, home meal delivery or community access programs than it did 20 years ago, even though the senior population has increased.   Frail, homebound older adults, people with disabilities and their family caregivers struggled with social isolation before the pandemic. Will they continue to be invisible in the new normal? Or will we learn to value the contribution these people have made, and continue to make, in or society? 

I am optimistic about the future, and hopeful that we will rise to the occasion. America has done it before. The 1918 Spanish Flu, as well as cholera, typhoid fever and typhus epidemics led to implementation of public health departments, water and sanitation districts, and advances in medicine to treat and prevent future outbreaks. Polio shattered millions of lives in the US, until the development of a vaccine, and a national campaign of inoculation. It begins with a commitment to the common good and the willingness to learn from our current situation. The new normal can be better for all of us.