In the midst of all this, I produced my first Zoom memorial service on Sunday for my step grandmother. What started last Tuesday was a close encounter with this strange new world.  When the ambulance was dispatched for Helen, her memory care facility made sure we understood that they would be unable to readmit her after her visit to the Fairfax County Emergency Room given the COVID-19 threat. Once at the ER, the doctor informed us visitors were not permitted due to the lockdown at the hospital as they prepared for and prioritized COVID-19 cases. Helen’s ER doctor presented two options: emergency surgery, with low chance of recovery given the upcoming strain on the healthcare system, or palliative care. Helen passed away later that night with only hospital staff at her bedside and family saying prayers from afar.

The family gathered around laptop screens from various quarantined houses across Michigan and Virginia, and the service began, like many, with a slideshow and music. We smiled at each other, some through tears and with tissue boxes within the screen’s Brady Bunch-like picture tiles. Unlike most memorial services, Helen’s began with technical support questions and confusion about what would happen next. After psalms, poems, video of choir music, recordings of her grandson’s piano arrangement made especially for Helen, and many loving words, we “left the meeting” with a promise to post the recording on YouTube for those who didn’t have enough bandwidth and had to join by audio only. 

We are in fundamentally changing times. 

I see some very dark scenarios 18 months from now after life of rolling quarantines, waiting for a vaccination to be available to the mass market, or therapies to mitigate symptoms and reduce the death rate. The numbers lead us to bleak scenarios: 20% unemployment, 30% reduction in US economy, 1 million deaths, >$3Trillion in additional national debt. It highlights concerns about security, societal fear, cyber-attacks on the financial system or electrical grid, hurricane season, feeding the hungry and homeless, business and personal bankruptcies, deaths from other illness, and depression and anxiety from isolation.

However, past pandemics have produced economic boom times and we will try to also focus on finding the silver lining. From pessimistic scenarios comes optimism in how society, even while scared, comes together for each other. Humanistic and compassionate behaviors prevail. We are a resilient country. Innovation brings solutions where long-neglected problems existed. New forms of communication, caring, and socializing are already being initiated. 

We use our Flash Futures methodology to imagine how the future may evolve and what are plausible future implications. Our Imagine if… illustrates how a new and effective healthcare system could emerge from this pandemic with new policies and technologies, making it more efficient; below are some thoughts on potential changes:

• Patients adopt and trust telemedicine, and telemedicine reduces total cost of care
  • Decrease in medical facility-related infections
  • Increase in acceptance and trust in AI/Avatar-based medical care
  • Realtime language translation allowing medical specialists to advise patient care teams without geographical limitations
    • Nursing shortage in the U.S. is addressed by surplus nurses elsewhere
    • Recognition of international certifications in the U.S.
  • Hand sensors for vitals in every home worn at breakfast like winter gloves
  • Home lab testing kits and diagnostic labs operating as efficiently as Warby Parker or Zappos
  • Medical fax machine communications eliminated
• Preventative care becomes valued over reactive medicine
  • Hygiene becomes the new normal
  • Patient analytics improve patient outcomes
  • Sensors provide guidance for preventative care and mitigate medical events
  • Physical therapy through video becomes effective alternative and a way to reduce total cost of care.
• Increased pandemic and crisis preparedness
  • Increased investment in future crisis care capabilities and capacity
    • Increase in government and private sector funding in preparedness and resiliency
    • Scaled capacity plan for medical supply chain (e.g., medical devices, beds, supplies)
  • Drug therapies, antidotes, and vaccinations developed, trialed, and available to market more efficiently and with affordable pricing
• Increase in recognition and appreciation of medical and science experts
  • Restore trust in science and science-based institutions
    • Halo effect for scientists in non-medical fields
    • Greater incorporation of science in institutional decision making (e.g., corporate strategy, government policy)
  • Physicians, scientists and nurses become the astronauts and entrepreneurs (AKA “heroes”) for this generation
    • Physicians and nurses recognized as first responders
    • Growth in students enrolled in medical and science programs
  • Increase in recognition of vulnerabilities to infectious diseases/pandemics
    • Increase appreciation for proactive screening
      • Preventative screening extends to other diseases/conditions
      • Current “sick care” model moves to a true, holistic healthcare (wellness) model
    • Increase in preventive cleaning measures
      • Increase in use of facility-based cleaning methods (e.g., UV, air filtration, aerosols)
      • Change in societal norms around transmittable behavior (e.g. shaking hands, cheek kiss greetings)
      • Change in building designs to reduce hand contact (e.g., doorless, auto-open)
    • Continuous screening capabilities implemented in large group areas
      • “Contact tracing” infrastructure (e.g., cell phones, social media, facial recognition)
      • Growth and innovation in scanning and contact tracing technologies/companies
      • Facilities (e.g., medical, offices, entertainment, retail) equipped with monitoring capabilities (e.g., health vitals, facial recognition)
      • Privacy concerns about passive data collection and screening addressed
    • Advances in virus and disease detection using newly available personal health sensor data
      • Contactless body or eye scans detect vitals and illnesses
      • New privacy laws protect personal data

These are the types of Alternate Futures^® scenarios we think about at Toffler Associates. Given the pace of change and new information, the pandemic is enabling unique conversations about challenges we never expected and some that have been ignored for far too long. In the coming weeks, Toffler Associates will share our perspectives on the long-term implications of the COVID-19 pandemic in a new blog series.

Our goal is not to predict the future, but by looking for patterns and drivers of change, we want to spark imagination, identify important questions, and explore secondary and tertiary impacts. Thinking about the future helps prepare for potential scenarios, but also informs what you can do in the near-term to execute dynamic, resilient leadership and decision making. 

Please reach out to us with your questions and we will do our best to answer those, too. Wishing you and your family health and peace.

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