COVID-19 pandemic: Behavioral, medical experts look back on 2020, 2021 and predict 2022

LOS ANGELES - "Fifteen days to slow the spread."

That was the slogan Americans repeatedly heard from U.S. health leaders as COVID-19 cases started to emerge in various countries in the early months of 2020. The hope was that if the country enacted a temporary lockdown, where people would shelter at home and only go out for emergencies, the virus would eventually subside in less than three weeks.

But it didn’t as the World Health Organization declared COVID-19 a pandemic in March 2020.

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Soon, an unprecedented global lockdown started and ushered in an unforeseen and nightmarish era that would reshape human behavior, medicine and everyday life, possibly forever in some aspects.

Nearly two years into the pandemic with more than 261 million cases and five million deaths, countries are still trying to stop the spread. Some are still enacting lockdowns as more than seven billion people worldwide have received at least one dose of a COVID-19 vaccine. 

U.S. health officials cannot predict how much longer the pandemic will last, but some scientists are taking a look back on how far the world has come and what’s possibly in store for the future.

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2020: COVID-19 pandemic impacts hospitals as people adopt new behaviors

Duke University Hospital's infectious disease specialist Dr. Cameron Wolfe started hearing rumblings about the coronavirus in December 2019. 

"My first e-mail was Dec. 29.," Wolfe told FOX Television Stations. "I distinctly remember reading it and thinking ‘Oh, I wonder what these four people are doing in an ICU’ in Wuhan [China]."

At the time, a mysterious respiratory illness was on the rise in China. Wolfe said he spent the next few months at his hospital in Durham, North Carolina, keeping tabs on the developments. He said he had hoped the coronavirus would go the way of previous viruses where they’re contained to pockets of the population and eventually subside. 

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But the coronavirus didn’t, and soon COVID-19 cases touched virtually every part of the world. As doctors scrambled to find treatments and cures for the virus, they also had to contend with an influx of COVID-19 patients by building pop-up ICU wards to handle the surge. They also had to deal with lockdowns, forcing them to postpone non-COVID procedures and streamlining their daily duties. 

"Operationally, it was really significant through the early phases of lockdown in 2020 where we just had to stop all elective activities," Wolfe said. "We largely stopped all non-emergency surgeries for a period of time."

Hospitals quickly adapted in order to balance serving the medical needs of the community while at the same time preventing a COVID-19 outbreak. 

"I think when we talk about the mortality of COVID, we struggle to really factor in all the extra deaths and extra illness that occurred because people didn’t have access to healthcare and we weren’t in a position to offer it to them," he continued. 

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But the pandemic did lead to some changes within the medical community. 

"Hospitals have learned, in a good way, how to adapt and how to use more virtual techniques, how to prioritize patients in different ways," Wolfe added. "That’s been a positive adaption in the end."

Later in 2020, doctors also started to get their first weapon against COVID-19. In October, U.S. regulators approved the first drug to treat COVID-19: remdesivir, an antiviral medicine given to hospitalized patients through an IV. The drug can cut the time to recovery by five days — from 15 days to 10 on average. 

Then the COVID-19 vaccine started to roll out in December, preventing many serious cases and deaths of the illness. 

But as hospitals adjusted, so did Americans. Behavioral scientist Chris Segrin, who works at Arizona State University, said people developed unusual behavioral patterns before WHO officially declared a pandemic. 

"The hoarding of paper goods would probably be the most memorable example," he told FOX Television Stations. "But there was also a lot of avoidance of others, a lot of not wanting to touch other people or touch doorknobs."

Some were stockpiling in advance of city and state lockdown orders. It’s a common reaction in times of a crisis, when consumers feel a need for control and security, said David Garfield, global leader of the consumer products practice at AlixPartners, a consulting firm.

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NCSolutions, a data and consulting firm, said online and in-store U.S. toilet paper sales rose 51% between Feb. 24 and March 10, as buyers started getting uneasy about the growing number of virus cases. But sales rocketed a whopping 845% on March 11 and 12 as states announced lockdowns.

"I was worried that people were sort of degenerating a little bit and fending for themselves," Segrin continued. 

Segrin noted that after the pandemic started, the country entered the "Zoom era" with businesses, schools and other organizations opting for virtual meetings over in-person attendance. 

Segrin said he became concerned that many of the preventative behaviors people took during the start of the pandemic could tear the fabric of what holds a society together. This, especially after health officials had recommended people stay at least six feet away from others and avoid physical contact, such as hand-shaking. 

"We as human beings are social animals," he said. 

As the pandemic progressed, Segrin said around September 2020, he noticed many Americans were suffering from COVID fatigue while some had a sense of optimism as cases started to drop ahead of the big winter surge.

"People were starting to have gatherings and go back to ‘normal’," he said, adding humans are creatures of habit and it was only a matter of time before people resumed pre-pandemic activities. 

Despite the hardships, Segrin said 2020 proved that people are resilient and can get through difficult times. 

2021: Hospitals settle into new long-lasting protocols, COVID-19 vaccine

Wolfe said despite the tragedy of the COVID-19 pandemic and lockdown, it did shine a light on areas that needed improvement such as communication within the hospital industry. 

Wolfe said in some ways, hospital operations have become decentralized. Some in-person office visits can be replaced with zoom calls, for example.

"Previously, that would’ve never happened," he continued

At Duke hospital, Wolfe said administrators changed the way they conduct monoclonal antibody infusions, which was an early pre-hospital treatment for people who contracted COVID-19. Instead of having numerous patients flood the emergency rooms, the hospital set up independent clinics to conduct the treatment. 

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"So, in fact, we’ve set up different infusions clinics in ways to process patients and move them through the system in ways that we've never really thought about before," he said. 

Wolfe also said the pandemic highlighted how the public healthcare industry is underfunded. For instance, he felt that contact tracing was much better in other developed countries such as Singapore and Australia. 

But in 2021, the medical field started to gain strength in the war on the pandemic with the vaccine rollout increasing, causing a major drop in hospitalizations and deaths for people who have been inoculated.

Meanwhile, in terms of how people adapted to the continuing pandemic, Segrin believes human behaviors didn’t fluctuate as much throughout 2021 compared to 2020 as vaccines were readily available throughout the year, bringing down the collective fear of the virus. He noted that sporting events, concerts and other activities started to resume. 

"In general, I think 2021 went better so far than 2020," he said. 

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In retrospect, Segrin said even with his 35 years of experience as a behavioral scientist, he learned a lesson about human interaction throughout the course of the pandemic. 

He pointed out, with social media, the ability to spread misinformation was much easier during the COVID-19 pandemic compared to previous global pandemics.

Over the summer, U.S. Surgeon General Vivek Murthy called for a national effort to fight misinformation about COVID-19 and vaccines, urging tech companies, health care workers, journalists and everyday Americans to do more to address an "urgent threat" to public health.

In a 22-page advisory, his first as President Joe Biden’s surgeon general, Murthy wrote that bogus claims have led people to reject vaccines and public health advice on masks and social distancing, undermining efforts to end the coronavirus pandemic and putting lives at risk.

2022: Doctors remain hopeful to reach the tipping point in pandemic, future of human interaction in question

Wolfe said he’s constantly asked when will the U.S. reach a tipping point and the worst days of the pandemic are solidly in the past.

He said two things have to happen: children must get vaccinated and hospitals must reach a place where they don’t have to divert attention from other healthcare issues to handle with COVID-19 cases. According to the U.S. Centers for Disease and Control Prevention, more than 271 million Americans over the age of five have received at least one shot of the COVID-19 vaccine, representing more than 77% of the total demographic. 

Wolfe also said the tipping point will be reached when the number of COVID-19 cases and deaths are not staggering as with flu cases. The CDC said the 7-day moving average of COVID-19 deaths hovers around 1,200. 

"We kind of nationally accept that 30,000 people will die from the flu every year," he explained, saying despite the tragic deaths, the country doesn't go into lockdown and most Americans resume their normal, daily activities. 

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"When we’re down to an annualized [COVID-19] death rate similar to the flu then I feel like people will feel like they’ve won," he said "We’re a long way away from that."

Wolfe is hesitant to say when hospitals will go back to pre-pandemic operations, wanting to see how the winter plays out and if there’s another massive wave of COVID-19 cases and deaths. It also depends if another variant appears on the horizon. 

COVID-19 cases are sharply on the rise in the U.S. According to the CDC, the 7-day moving average of cases stands above 176, 000. That’s up from more than 67,000 in late October. 

The omicron has raced ahead of other variants and accounted for 73% of new infections earlier this month.

It remains clear the U.S. has an uphill battle before the pandemic ends. 

Wolfe also remains concerned that a large portion of the country remains unvaccinated. He also said if COVID-19 vaccine boosters hold up, hospitals could really maintain the upper strength on the COVID-19 pandemic. 

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"At the moment, we’re getting back to closer to where we used to be," Wolfe said of the hospital industry. "But we’re still not on full operations"

But some health experts have come to the conclusion that COVID-19 is going to be an issue for years to come.

"It is going to be endemic. It is going to exist in our population for a long period of time," said Deborah Fuller, a professor of microbiology at the University of Washington. "You saw what looked like an inflection point coming and, boom, here came the delta variant."

The country’s top infections disease expert, Dr. Anthony Fauci, previously said that 

COVID-19 is not yet at the level of being reduced to an endemic illness, despite increased efforts to vaccinate as many people as possible. Speaking at a White House briefing in November, Fauci said he doesn’t believe COVID-19 will ultimately be eradicated, but he feels confident that vaccination is the best tool to eliminate the disease from a particular region. 

Meanwhile, Segrin said he’ll pay particular attention to human behavior in 2022 and whether people adopt new behaviors, revert to pre-pandemic behaviors or end some behaviors altogether. 

He wonders if the COVID-19 pandemic ended human hand-shaking. 

"If I had to look into a crystal ball, I would predict that we will continue to return to pre-pandemic types of behaviors," he said. 

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But he said some anxious or immunocompromised people may never go back to physical touching. 

"They may never get back to hugging or shaking hands as a form of greeting people," he said. 

He also believes more people will be aware of their physical space, even with social distancing rules being relaxed. 

But he hopes society doesn’t become too distant. 

"We are at our very best and our very strongest when we take care of each other," he said. 

The Associated Press contributed to this report. This story was reported from Los Angeles.