COVID - have we learnt anything?

Do we have short memories or long memories? How often is it pointed out, especially with advancing age, that we can remember in exquisite detail what happened when we were at primary school but haven't a clue what we did yesterday morning? Is the same going to be true of the COVID-19 pandemic, and if so, what have we learnt that might be of value if, or more probably when, such a future microbiological tragedy strikes?

It is difficult to believe that just four years ago very few of us had read or heard of COVID-19. We were probably planning then, as now, where we were going to spend the holiday break, who to buy presents for and how soon we needed to send out Christmas cards. If we are to believe what information the world has been able to glean, somewhere in a fish market in Wuhan, China, something rather more than cash and haddock were being traded. A contact that was to change the world. Personally, I sometimes pinch myself to believe that which we have all been through. What will we tell our children and grandchildren who didn't experience it? Did the government really tell us we all had to stay at home? Were we all actually frightened that we might get seriously ill and possibly lose our lives? Was it true that there was no vaccine? Yes, remarkably all this came to pass, together with the overwhelming distress for the morbidity and mortality that ensued.

In an editorial in April 2020, written during the first UK lockdown, I alluded to the skew that the pandemic would cause to all manner of experience, data and epidemiology, likening it to the environmental effects modifying annular rings on trees.¹ The words proved to be accurate, if not necessarily supremely insightful, and there are many ways in which changes have happened. These reflect both short- and long-term reflection from the upswing in webinars and teledentistry to the echoes of social distancing (remember that?) now still immortalised as scuffed squares of black and yellow warning tape left on the floors of corner shops where apathy abides. It is in clinical delivery and care where the effects are most significant. The impacts of the backlog of patient attendance caused by the hiatus in practice opening are going to be felt for many years to come. These include the inevitable deterioration of health due to untended disease progressing, from the potentially life-threatening consequences of failure to screen and diagnose oral cancers to the certain life-long consequences of untreated and progressive caries and periodontal diseases.

How many of us have actually included contingency planning in our future thinking and financial projections?

The gap in provision, while relatively short-lived, has affected the balance of supply and demand across all countries but has especially exacerbated the NHS versus private divide. A controversy before lockdowns, this particular debate shows no signs of withering, or of solutions. In economic terms, we had to cope with furloughs, significantly increased costs for personal protective equipment and cross-infection control to mention but two factors. But have we built reserves as a result? How many of us have actually included contingency planning in our future thinking and financial projections?

While the pandemic prompted the adoption of technologies, techniques and processes that might otherwise have languished unimplemented for want of impetus, it has had extreme and extensive reverberations in dental education. This in turn is feeding into future recruitment and expectation from new graduates because, quite simply, the world is not as it was. We felt the effects on journal and publishing processes too with a huge upsurge of submission during lockdowns as authors suddenly with time on their hands turned to the unfinished manuscripts in their bottom drawers. A subsequent dip has now been overtaken with a gradual return to a calmer flow, but the blip endures.

In looking back over the coverage in the BDJ Portfolio, another aspect that strikes me is the use of bold optimistic language describing aspirations for when it was all over. ‘Building back better' and ‘the new normal' are examples but just as with the pragmatic rush to get on with our lives, these tattered banners seem to be at best forgotten and at worst trampled in the mud of wishful thinking. What happened to the bandwagon ideas that now people will appreciate prevention more? Has that really transpired? Call me cynical but I don't see any evidence.

In summary, in the short- and long-term memory stakes, I am not sure how well we equip ourselves in general for future survival based on our lived experience. ‘Keep calm and carry on' still surfaces as ‘what we are best at'. Perhaps in the final analysis, that is what we have learnt from the pandemic and therefore exactly what we will do again next time; but, honestly, it seems an opportunity missed.