The New Normal

by Jennifer Ashton, M. D.

  Dedication

  To all the essential workers, to everyone who has been personally affected by COVID-19, directly or indirectly, and to everyone everywhere working toward the prevention and treatment of this virus . . .

  And to Alex and Chloe: You continue to be my Universe.

  Contents

  Cover

  Title Page

  Dedication

  Introduction

  Chapter 1: Body

  Chapter 2: Mind

  Chapter 3: Healthcare

  Chapter 4: Food

  Chapter 5: Exercise

  Chapter 6: Sleep

  Chapter 7: Health Fears

  Chapter 8: Medical News

  Chapter 9: Family and Friends

  Chapter 10: Public Places

  Chapter 11: Silver Linings

  Epilogue

  Acknowledgments

  Notes

  About the Authors

  Also by Jennifer Ashton, M.D., M.S.

  Copyright

  About the Publisher

  Introduction

  Several months into the coronavirus pandemic, I was running through Central Park when it suddenly struck me that everything was different. Central Park looked largely the same—it’s one of the few immutable aspects in a city that never sleeps. But the people in the park were different—everyone in masks, far more joggers, and far fewer tourists. Then there was me: I was actually running in the park, which wasn’t typical. But since I don’t go to the gym anymore, running outside has become my new normal.

  Just as I was finishing my new workout, I nearly ran into several dozen people standing on the sidewalk at the end of the park. This was odd: New Yorkers don’t just stand idly on the street. This is a city that moves and moves quickly, but it now appeared that people seemed to have fewer places to go or less incentive to go anywhere in a rush.

  Then I realized what they were doing: They were standing in line to go inside a Whole Foods Market nearby. The line snaked around the block, with people standing six feet apart on bright green decals plastered on the pavement. Every time a shopper exited the store, a security guard let someone in, reminding them to follow the one-way aisle arrows around the store.

  This was hardly an unusual sight. Lines were forming outside stores all over the city and across the country. But it wasn’t until that moment that I realized what it meant: If everyday activities like how we exercise and shop for food have changed so significantly, nothing in our world will ever be the same again, even if or when we find a cure for COVID-19. The coronavirus crisis has been like an asteroid hitting Earth: Our world has been permanently impacted and indelibly reshaped. It was like someone had suddenly unfurled a big banner across the end of Central Park that read WELCOME TO THE NEW WORLD. Everything here is different. Take a good look around. And get used to it.

  Months later, the new world that I first witnessed outside Central Park is now our new normal. Lines at grocery stores have come and gone and regulations have inevitably changed, but the endpoint is the same: The asteroid has hit, and it’s ushered in a whole new era. And in the pandemic era, what we do, how we think, what we fear, and what we believe in are all drastically different and will be for years to come.

  I’ve never seen anything like it before—no one has. The coronavirus pandemic is the greatest single story of our lifetime. Nothing in my career as a doctor or medical correspondent has even remotely approached the COVID-19 narrative in terms of its social, medical, economic, political, physical, mental, and emotional fallout. During this fallout, I’ve had a front-row seat, watching the story unfold, interpreting its twists and turns, and then analyzing and retelling it for millions of viewers.

  I’ve been with ABC News since 2012 and the chief medical correspondent for the network since 2017. I’ve appeared regularly on Good Morning America, World News Tonight with David Muir, Nightline, and other national programming. But when the outbreak began, I started to go on air for up to thirteen-plus hours per day and started broadcasting the show GMA3: What You Need to Know with Amy Robach. Since then, I’ve lived, slept, and even dreamed COVID-19, reading all the research and speaking regularly with epidemiology experts, public health officials, infectious disease specialists, and Dr. Anthony Fauci, the country’s top infectious disease doctor. I’ve been to the CDC headquarters in Atlanta; the United States’ vaccine development lab in Bethesda, Maryland; and the West Wing of the White House.

  Through it all, I’ve been left with one major takeaway: We will never be the same again. Not you, not me, not your next-door neighbor, not the guy or gal halfway around the world. If you lived through 9/11, you know what a crisis can do to a country. September 11 opened our eyes to a previously inconceivable threat and permanently changed the lives of thousands of Americans, along with how we travel, what we fear, and the economic, political, social, and physical landscape of the biggest city in the United States.

  The pandemic has not only altered our everyday activities like where we exercise and how we shop but also upended basic human necessities like how we eat, sleep, work, and interact with others. What was normal about being in an office, going out to eat, or seeing friends and family in 2019 isn’t today. Just like 9/11, the pandemic has also opened our eyes to a new, previously inconceivable threat—a never-before-seen, high-impact respiratory pathogen—and transformed how we approach our health, what we perceive is important, and even what we perceive is possible.

  If you’ve flown on a plane in the last twenty years, you know that travel never went back to “normal” after 9/11. Similarly, the world won’t ever go back to what life was like B.C. (before coronavirus), even if we develop an effective vaccine and treatment protocol. When I hear people say “when things go back to normal,” my heart pains a bit: Things aren’t going back to normal because this is our new normal. That’s a really important concept to understand.

  As a doctor, I can say with assurance the coronavirus isn’t going anywhere anytime soon. Infectious illnesses like COVID-19 that are highly transmissible but not consistently deadly are the hardest to control, while diseases like Ebola that are more lethal but also more difficult to contract are generally easier to contain and eradicate. For proof, just look at the flu, which is highly transmissible and not as deadly—and something doctors are still trying to get under control.

  Instead of waiting for science to outsmart the virus—because we could be waiting a long time if the flu and common cold are any indicators—we have to figure out how to live with the virus and manage it so it doesn’t manage us. We’ll need different degrees of management at different times, of course, but this is our new normal. There likely won’t be a point in your lifetime when you will be able to say corona-what?

  There’s another reason our “old normal” is never coming back. Even if we attain herd immunity or find a cure for COVID-19, it’s likely the planet will face another viral outbreak of the same proportions, if not even worse than COVID-19. Emerging infectious disease specialists tell us that another pandemic isn’t a matter of if, but when. We now know this can happen because we’ve seen it happen. The latent threat of another pandemic has significant psychological implications and will impact the world in many ways, including some that are unforeseen to us right now.

  What you can expect, however, is for people to think twice for years to come about being inside crowded spaces. Many won’t be eager to hug, and the handshake, as Dr. Fauci already declared, is likely dead. Hand-sanitizing stations aren’t going to disappear from public places anytime soon. Some people will continue to wear masks inside public areas for the rest of their lives. Almost all of us will think at every cough or sneeze, Be careful, wash your hands, stay at least six feet away, don’t touch your face.

&
nbsp; If this sounds a little like post-traumatic stress disorder (PTSD), that’s because it is: The pandemic has been tragic, terrifying, and disruptive enough that all of us have a touch of PTSD in the new normal. The next time you hear about a bad flu strain or a new viral outbreak, you’ll likely cringe and prepare for the worst. You may have flashbacks to when lockdown orders were initiated across the country at the beginning of the outbreak or feel a sense of deep foreboding, dread, or even depression.

  While this is our new normal, it’s not a reality that has to be frightening—or even unfamiliar—and that’s exactly why I wrote this book. My goal is to help you recognize and adapt to our new normal, because the sooner and more seamlessly you do, the sooner our new normal won’t be new anymore, but just normal. I want to help you see that we have to acknowledge that everything is different now, because only by acknowledging this can we begin to accept and heal. This is, after all, the definition of resiliency: our ability to recover readily from adversity. The more resilient you can become—physically, mentally, and emotionally—the better able you’ll be to withstand any adversity, whether it’s another pandemic or a personal challenge, and see it as an opportunity rather than an alarming event.

  But how do you begin to find resiliency in the new normal when it feels like the rules, expectations, and risks are constantly changing? New studies contradict things that were conveyed as truth just weeks prior, while friends and family seem to have different opinions and behaviors about what constitutes actual risk. In the infodemic age—when accurate and inaccurate information is spread as rapidly as a virus itself—the amount of news and interpretations of that news is staggering. We’ve never had to consider so much when trying to decide whether to do something so simple as attend a friend’s outdoor birthday party or go to the gym. With the stakes so high, the new normal can feel paralyzing to the point of self-isolation—or on the other hand, so overwhelming that we want to throw caution to the wind, cross our fingers, and hope for the best.

  While I can understand and relate to both attitudes, I certainly don’t recommend either. Instead, there’s a better approach—and it starts by learning to think like a doctor. When medical decisions are complicated or involve high risk in the ER or the OR, physicians don’t get paralyzed by fear or hope for the best: They act calmly, coolly, and based on the best data or science on hand.

  Throughout this book, I will teach you how to think like a doctor in order to help you stay informed, make safe decisions about your health, and better navigate the new normal. You don’t need an M.D. after your name to think like one—you just need to know how to take a calm, analytical, and evidence-based view of any crisis. And with this book, I’ll show you exactly how.

  First, though, I’m not just a doctor on TV—I’m also a real doctor who sees real patients in real life, as I’ve done for the last twenty years. From Day One of the pandemic, I’ve approached the crisis like a doctor, prioritizing evidence, not emotions. I’ve looked at the virus as I do a patient: What are the vital signs? What do we know about the disease? And what don’t we know about the disease? But I’ve kept others’ emotions in mind as well, as I’ve viewed the lens of the TV camera like the eyes of my patients: curious, frightened, and confused.

  Similar to how a doctor would never diagnose you based on unknown vital signs, I’ve never drawn conclusions about COVID-19—or any other illness, for that matter—based on hypotheses, politics, opinion, or conjecture. As I’ve said on air multiple times, it’s really important to say what we know and what we don’t know. We need to rely on facts, not fear, to make the best decisions about our health in a crisis situation, just as doctors do for patients in the ER and in the OR. When you do this, you can stay calm and steady about an emotionally charged, ever-evolving situation.

  What’s more, a good doctor doesn’t just focus on one body part or a single symptom: We look at the entire patient and the interaction of different systems to effectively diagnose and treat. Similarly, I’ve always taken a big-picture perspective of this pandemic. And I’ve passed that perspective on to viewers so they can understand what’s going on without getting bogged down in specifics that can change on a day-to-day basis.

  This last caveat is super important: If we’ve learned anything from this pandemic, it’s that details of a disease can change on a dime. That’s why it’s critical to learn how to think like a doctor and take a big-picture perspective. It’s also vital to understand how science works.

  In medicine and science, doctors learn new things every day, no matter how long or intensely they’ve studied a specific illness or disease. A doctor can spend his or her entire lifetime researching a virus or other pathogen and still not come close to knowing everything about it. We’re still learning new things about the flu, for example, even though influenza-like illnesses have been around for hundreds of years.

  In the instance of a brand-new pathogen like this novel strain of the coronavirus, we haven’t even begun to scratch the surface of what there is to know. That’s why I think it’s vital that we focus on what we know now, which means what medicine and science have shown us to date, while also incorporating what we know about other coronaviruses to help inform our analysis. New risk factors for COVID-19 could always emerge and the virus could change, which means medical information and advice should change with it.

  At the same time, it’s important to trust the facts we have at hand: evidence over emotion, medicine over make-believe, and science over sham. No virus in the history of humankind has been studied so rapidly and intensely as the coronavirus, and the amount of knowledge we’ve amassed in a short period of time is breathtaking, impressive, and reassuring.

  I’m not tone deaf, though. I know there’s more mistrust about medicine and the media right now than ever. If you’re skeptical, cynical, or scared, that’s okay, understandable, and actually appropriate. I’ll be the first to admit I don’t have all the answers—no one does. And the thing is, no one ever will—which is why it’s never about having all the answers in the first place and instead about knowing the right questions to ask. If you can learn to do this, you’ll be able to get the information you need to better navigate our new normal or any challenging crisis you might find yourself in.

  I want to recognize, too, that everyone’s situation is unique. Maybe you lost a family member, friend, or colleague to COVID-19—that’s a tragic reality to face. Or maybe you lost your job, your home, or your business in the pandemic. My heart goes out to you. Or perhaps you got sick with COVID-19 and are still recovering. Maybe you’re figuring out how to work from home permanently and/or are juggling children or older relatives in your household 24/7. Or maybe you’re an essential worker who’s never had the luxury of working from home this entire time. No matter your new normal, my goal is to help you navigate it. You can read this book start to finish or cherry-pick the parts that to appeal you, but I promise everyone can find something in every chapter.

  Whether it’s prioritizing the urgency of our own health, learning how to decipher complicated medical news, or simply understanding how to make what we eat and how we sleep work better for our bodies in stressful times, there are takeaways from the pandemic that can lead us all to healthier, happier lives. The coronavirus outbreak has been brutal, but the changes it’s inspired don’t have to be. Our new normal is a different place, to be sure, but it can also be a good one. And if you follow the roadmap to resilience that you’ll find inside this book, you’ll discover many hidden gems inherent in the coronavirus crisis along the way.

  One of the biggest gems, in my opinion, is that the pandemic has given us all a stronger sense of solidarity. Today, it’s not just one person adapting to our new normal—it’s all of us. Every single person has lost something in the pandemic, whether it was a family member, friend, business, job, their health, or their freedom. Some of us may have lost something less crucial, like our ability to go to the gym, eat at restaurants, travel, or see family and friends with abandon, but we s
till lost something. This means we’re all grieving together—and getting over it together. The human spirit has never been stronger.

  One of the greatest gifts of the pandemic, if you can find it and choose to accept it, is gratitude. It can be difficult, but I want to remind you with this book that we have a choice: We can either dwell on what we’ve lost or remind ourselves of all the things we still have. Even more important, we can choose to see what we’ve gained through adversity. And I promise you that we’ve all gained something.

  Finally, while everything is different in our new normal, there are two things that haven’t changed: laughter and love. I take a lot of strength from this fact. Laughter and love have never disappeared in times of war, peace, pandemics, or great health and prosperity. No matter what happens in our world next, you can always find laughter and love. And choosing to look for both—now and always—will serve as your GPS on the ultimate road to resiliency.

  Chapter 1

  Body

  It happened on a public bus in Detroit.

  A woman coughed repetitively. She didn’t cover her mouth. She didn’t seem to have any concern for others.

  Jason Hargrove was driving that bus in March 2020. He was so angered by the incident that afterward he posted an eight-minute-long video on Facebook about what happened, pleading with people to take seriously what we were calling the novel coronavirus.

  Eleven days later, Jason was dead from COVID-19. The fifty-year-old father of six died alone in the hospital, without his wife or any of his children by his side.

  Days later, his widow, Desha Johnson Hargrove, appeared on Good Morning America to share his story, which had already made headlines around the world. Speaking exclusively with correspondent T. J. Holmes, she begged people to stay at home and take the recommended precautions so that her husband’s death wouldn’t be in vain.

  Months later, Desha told me that she still felt people weren’t taking the pandemic seriously. “This is not a norm that anyone thought we’d see, but this is where we are,” she told me by phone. “And I want to help anyone from being in the spot that I am right now.”