What happens when the global pandemic gets forgotten, and our organizations, communities and bodies still remember? How might we design institutions that help us recover from what’s happened and thrive in what’s to come?
The World Health Organization is meeting this week to discuss whether the emergency phase of the global COVID-19 pandemic response is over. The decision, whenever it is made, will have enormous consequences for how people see, think about, and act upon pandemic-related policies. There’s a widespread science-based belief that COVID-19 is not going anywhere and that it will be part of our lives for years to come.
Working with health organizations at the front line of the pandemic response, I’ve heard of a consistent desire among professionals to return to work beyond the pandemic response. Among the public? Many have already moved on in their minds. While we aren’t back to beforetimes, things look and feel much closer to our earlier normal than ever.
Except, the pandemic’s effects are still here. In many ways, we’ve not fully felt them.
It takes little foresight to see that the recovery period will take time, care, and attention and require a design strategy if we are to address what it will require of us.
How do we design for something that simultaneously sits in the past, present, and future, with remarkably different qualities at each stage?
First, let’s talk about our past and present situation.
- The Past. We know the story, but maybe we need to remember. Three years ago this week, the city (and country) I live in (Canada) had its first active case of COVID-19. We were one of the earlier nations to detect it, but far from the first or worst in being affected by it. Over six weeks, the numbers started to rise until the dramatic and near-global lockdown in mid-March 2020. Since it was first uncovered in 2019, COVID-19 has mutated, spread, and killed millions worldwide. These mutations have led to new waves of infections, countered by a series of public health measures and vaccinations to varying degrees of effect. During this timeline, the public’s knowledge and attitudes have changed, public health responses evolved, and policies adapted and changed. It’s been a mess. All the while, health workers have been operating in an emergency response and sometimes have been overwhelmed by the numbers of people sick, infected, or affected by COVID-related issues.
- The Present. Health system staff are exhausted. It’s not only been COVID-19 but other issues like influenza and more traditional respiratory diseases. Add to that the presence of what’s known as ‘long-COVID‘; a constellation of symptoms that have affected as many as 20% of those who contracted COVID at all ages. Meanwhile, the backlog of care, treatment, and prevention efforts that were slowed or suspended during the pandemic is producing its own health problems. Did I mention that this backlog requires considerable effort from an exhausted, depleted, overworked health workforce to clear?
The Pandemic Futures
We once spoke of a post-pandemic plan, and now it’s COVID-19’s endemic future.
However, in design, we look to futures (plural). While we don’t know what’s coming, there are things we have more confidence in than others. Five things jump out as being worthy of consideration:
- Workforce. The workforce will continue to be strained by demands and will not be adequately reinforced soon. This is due to ongoing fatigue, current demands, and reinforcements and replacements that will take time to develop. In healthcare, nurses, doctors, and other care staff require years of education and experience to deliver quality care. Further, the workforce is aging, and many of those in it are likely to retire in the coming years, adding to the number of qualified staff needed to support the system.
- Worklife. We know that remote and hybrid work has transformed entire industries and communities as transportation patterns change with it, but it’s uncertain how much of this change will hold.
- Health. The distress of COVID induced by isolation, illness, primary (direct) and secondary (indirect, witnessing) trauma, and the mourning for lost opportunities, cultural events, habits, and norms will linger. The myriad of untreated, poorly treated, and undiagnosed health conditions left from the last three years will be felt. This is also assuming that a new harsh strain of COVID-19 or some other infectious disease doesn’t emerge.
- Social Well-being. Educational, economic, community, cultural, family, and recreational disruptions are not easily fixed. Many social and community institutions won’t return. Some new ones will emerge. The sense of loss and discontinuity from this will still be felt as our system seeks to gain some stability.
- Psychosocial Issues. Our interactions are different, we developed differently as children and parents, and our sense of space, self, and relationship with others and our community has changed. Our sense of risk, social norms, and values have been affected in ways that few other events have done to us. We are different is subtle and profound ways. We’ve already seen a sharp rise in mental health issues over the pandemic, and many of these are likely to continue in different forms. Burnout has become widespread.
With these assumptions in place, let’s figure out what we might do to support recovery.
Design Considerations for Recovery
If we assume that the five points listed above are correct, each with some variation in scope and intensity, we can use those as our starting constraints. The idea is that we work with these as given rather than design for a situation that’s unrealistic. For example, I’m going to design things differently if I am assuming people aren’t likely to be at their pre-pandemic best.
The first point of consideration is tied to the models we use to guide our design. Using pre-pandemic models of community, workplaces, work structures, and organization are insufficient references. They were designed using different assumptions, which are likely not correct anymore.
With that in mind, consider let’s how we might approach recovery. Let’s ask some different questions:
- 1. Energy. What are the energy levels of people? Do we have the same energy for work, play, relationships and social life? Where are people spending their energy, and where are they drawing energy from? When we design, we are going to want to account for where people’s energy levels are. People may need more attentional resources to engage in events that require a lot of energy. “Low and slow” programs, services, and supports might be needed. Conversely, we should seek ways to amplify those things that give energy to people gently.
- 2. Work. What does work mean in 2023? Reconceptualizing what it means to expend effort to accomplish something is what work design is all about in 2023. People need jobs to live but also to serve a purpose. Work can be a positive part of our lives if it allows us to connect to people and purpose, realize skills and talents, help others, and gain income, status, and personal success. Many jobs offer opportunities for some of these. Job redesign is worth considering to support workers’ positive benefits while supporting an organization’s purpose. In light of tools like AI and a changing economy, now is an ideal time to work on redesigning jobs to suit new purposes and the people doing the work. It all can be done to support recovery. Motivation is low, burnout is high – what would a supportive workplace look like that recognized these two things while still enabling people to get what’s needed to be done, done.
- 3. Health. Rather than assume health is static, recognize it’s dynamic. How might we create an ability for people to engage in their lives and responsibilities while recognizing burnout? How might we change our language of health to one that promotes well-being (e.g, mental wellness) rather than speaks of deficits (e.g. illness)? How might we design spaces in our community, workplaces, or houses of worship for people to bring their whole selves in whatever state without the pressure to do things? If health allows us to connect or separate us from the world, how might we put health at the centre of that world? That means creating a culture of health within our institutions.
It might be ideal for many of us to stop and take a break for a few weeks or months. That will do some good, but it’s only practical for some of us. For things like healthcare, we can’t close up shop. But we can’t continue as we have, either. Recovery includes rehabilitation, which, like the physical form of rehab, is best done while active. That means that rather than have us stop, let’s slow down a little, be intentional, precise, and keep moving. Trauma is an active psychological process and treating it requires activity, not just trying to forget.
This is designing with a healing orientation, just as we would any other form of physical or psychological issue.
Could you ask yourself some of these questions? Rather than go forward as we have in beforetimes when it’s no longer relevant but all we know, try something different. As I tell my clients: if you don’t deal with the issues of trauma, stress, burnout and fatigue now, you will later, and it will not be at the time and situation of your choosing.
We owe this to ourselves.
If this is an issue you’re struggling with in your organization, let’s talk. I’ve been helping some of those on the front lines of this pandemic design and redesign themselves for recovery. Those that ask the big questions and design answers for them do the best.