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Pandemic aftermath: Navigating a new normal in health, education, and social dynamics

Susan Levenstein, MD
Policy
January 25, 2024
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Psychological distress. In 2021, 40% of high school students felt sad and hopeless, 20% seriously considered suicide, and 10% attempted it, with suicides among young people hitting their highest rates ever, though they fell in 2022. Since the greatest increase was before 2017, we can’t really blame the pandemic. And some “innovative” approaches for combatting depression may actually make kids worse. But it’s people over 35 – especially men over 75 – who have raised U.S. suicides to the most ever recorded. Women attempt suicide more often, but men are four times as likely to succeed, largely because they choose highly lethal means, such as firearms.

Academic performance. test scores plummeted during the pandemic and haven’t rebounded. A BMJ article makes a fairly convincing case against the school closings and distance learning that led untold millions of children to fall behind educationally. Why would anyone think you could teach first-graders to read over Zoom? But more could have been done to protect teachers and staff, who were at higher risk for severe illness: improving ventilation, installing HEPA filters in classrooms, and holding classes outdoors.

Cancer screening. New diagnoses of many types of cancer plunged early in the pandemic when people were avoiding all medical care. The dip only lasted a few months but was deep enough that there were fewer new diagnoses overall in 2020 than in 2019 of all the major cancers eligible for screening (colorectal, breast, lung, cervical, melanoma, and prostate).

Sexually transmitted infections. In New York City, at least, they rose substantially between 2020 and 2021, especially among African Americans. Particularly worrisome, the rates of syphilis among women and congenital syphilis among newborns have nearly doubled since 2019. To some extent, this is a continuation of STD rates already soaring before COVID-19, but was surely worsened by inadequate prenatal care, testing, and treatment during the pandemic.

Recovery from cardiac arrests. A study by Seattle-based researchers found that out-of-hospital cardiac arrests rose by 19% during the pandemic, but treatment success fell. In 2018-2019, 17.2% of patients survived with decent brain function; in 2020-2021, only 13.7%. The poor outcomes were related less to patients having COVID-19 than to factors such as slower response to 911 calls and fewer bystander-witnessed events due to lockdowns.

Birth defects. COVID-19 during pregnancy might cause situs inversus, where internal organs such as the heart are on the wrong side of the body, according to Chinese researchers who noted a fourfold jump in this rare condition during the unspeakable surge that infected an estimated 82% of China’s population after the zero-COVID policy was abruptly scrapped in December 2022.

Criminality. Murders in the U.S. fell by 6% in 2022, but the huge surge in the first year of the pandemic left a lasting mark, with 25% more homicides in 2022 than in 2019. And the number of children shot to death increased by 12%. U.S. shootings that killed four or more people fell from 34 in 2019 to 21 in 2020, when movements were restricted, but in 2021, they bounced back to 31; in 2022 to 36, and on December 3rd, 2023, well before the end of the year, they hit a record high of 38, with an additional six by December 28th. Crimes against property have been sky-high, too, with a million cars stolen in 2022, and that figure is expected to go still higher in 2023. And shoplifting is booming, with rates 60% above pre-pandemic levels, bringing empty shelves in cities like LA and New York.

Subway etiquette. The four million New Yorkers who now take the subway every weekday (five million before the pandemic, 300,000 at its peak) seem to have lost the polite habits that used to make the ride tolerable, such as not blocking doors and not hogging seats.

Disheartened medical students. Nobody used to drop out of medical school. Now 25% of American medical students are considering it. More than half worry about their mental health and 76% about their finances, and – most shockingly – 63% plan to enter health care careers that do not involve directly treating patients.

Distrust of science. Americans’ faith that scientists work for the public good has fallen drastically. In a new Pew poll, nearly four in ten Republicans had “not too much” confidence in scientists or “none at all.” Only 13% of Democrats share that deep skepticism, though their confidence, too, has eroded some. Fortunately, 78% of all Americans still think it’s worthwhile to invest in scientific research.

Hooky. In poorer neighborhoods, where daily attendance used to be the norm, a third of kids are missing at least 10% of school days. In Oakland, that’s a whopping 61%, and it’s happening in affluent areas too.

Economic delusions. Americans tell pollsters the economy sucks. In reality, not only is inflation down, real wages up, and unemployment at a 50-year low, but even people’s own behavior doesn’t match. As New York Times articles point out, they’re spending, vacationing, and job-switching the way they do when they believe the economy is good. Why the false impression of a poor economy? Maybe because gas and food prices are still higher than they were pre-pandemic.

Gender gaps. Women live longer than men. In the United States, that difference has been growing, especially during the pandemic. According to data through 2021, that’s mainly because COVID-19 kills more men than women because men have more comorbidities and are more likely to have jobs entailing workplace exposures. Other major contributors are drug overdoses, unintentional injuries, and homicide; minor ones include suicide and heart disease.

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Undervaccination. We’ve nearly eliminated polio worldwide and prevented deaths from measles and sterilization from mumps by making preschool vaccinations obligatory. Now, the no-vax movement that flourished with COVID-19 has been challenging that requirement, largely on “religious” grounds, even though no major religion objects to vaccination. The number of kindergarteners given a vaccine exemption countrywide has gone from 1.6% to 3% since 2011 – worst off is Idaho, at 12.1%. Recent decades have seen measles epidemics in under-vaccinated communities, notably ultraorthodox Jews.

Susan Levenstein is an internal medicine physician and author of Dottoressa: An American Doctor in Rome.

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Pandemic aftermath: Navigating a new normal in health, education, and social dynamics
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