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  Although I hesitate to write another coronavirus-related article, what else is there to talk about? My children are furloughed from school, store shelves are depleted of toilet paper and sanitizer, and social events of every stripe have been canceled. Nonetheless, Americans will get past this crisis. But what will the world look like when the pandemic is resolved? The following are a few predictions. Whereas I try to base my column on scientific evidence, these thoughts are partially conjectural. Hand-washing. Hand-washing is really a habit, ingrained in one’s youth. I notice that medical students, for example, are quite attuned to hand hygiene. Mature persons who forego regular use of hand sanitizer, or ignore hand-washing, represent a greater challenge. To be sure, it depends on the person. I am encouraged by the greater ubiquity of hand-sanitizing agents. We are moving in the right direction. I hope this trend will continue. Future vaccines. About half of Americans forego the flu shot. Yet influenza kills tens of thousands of our citizens, in most years. A coronavirus vaccine would likely face hurdles, due to similar levels of opting out. Anti-vaccination enthusiasts typically rely on “herd immunity,” while putting others at risk.

I see this experience as being potentially seismic, as some among us investigate online education, or even home schooling.

Education. My two children are furloughed from school, due to concerns with regard to coronavirus transmission. Neither my daughter’s college tuition nor my son’s high school tuition is likely to be in any way partially refunded. Many parents with young children will need to balance work with child care. I see this experience as being potentially seismic, as some among us investigate online education, or even home schooling, rather than sticking with existing brick-and-mortar schools. People vote with their feet. Competition is good. Telecommuting. My medical practice takes me to dozens of statewide locations. Yet minimally invasive robot-assisted surgical procedures allow surgeons to operate on patients from a distance. Telemedicine, which I practiced in the prison system years ago, is also garnering more attention. I see telecommuting and working from home as a future trend. Greeting behavior. Shaking hands has been competing with alternative greetings for a while. The elbow bump and fist bump, as alternatives, are nothing new. When I was in the Air Force, I recall learning that elbow bumps were common among tool-holding mechanics. Years ago, I mentioned to a hospital co-worker that the Eastern tradition of bowing was less conducive to contagion than was our Western hand-shaking custom. Her response was, “So, now you want us to bow down to you?” Times change. Fist bumping and elbow bumping is the norm at the gym I habitually attend. I have seen foot bumping, also. Stay tuned. Shipboard cruises. Social isolation, as may occur in solitary confinement, is a form of punishment. Social and sensory deprivation may beget confusion, disorientation or even suicidal ideation. Yet the recent quarantines on cruise ships seem to have emerged with little public discussion of the obvious medical consequences. Can you imagine being stuck in an inner cabin, without a porthole, for two weeks? Was there no alternative to this mandatory confinement of paying passengers? As a former cruise customer, who once sailed onboard the very Grand Princess vessel that ended up in the Port of Oakland, I would be reluctant to consider another voyage. That concern goes double for my elderly patients. Chronic medical conditions tend to worsen in settings that involve disrupted exercise, emotional stress, social isolation, poor access to medication, dietary change and possible viral exposures. In order to recover, the cruise industry must make some changes. The late Gen. George Patton said, “Accept the challenges, so you may feel the exhilaration of victory.” The challenges of the coronavirus may lead us to future accomplishments.   Scott Anderson, M.D., Ph.D., is a clinical professor at the �ٺ���Ƶ School of Medicine. This column is informational and does not constitute medical advice. •�Ģ�Ģ This article was provided by the author and originally appeared in The Daily Republic on March 22, 2020.