key: cord-0953515-bmy22pxl authors: Arora, A title: Life after COVID-19: a better normal? date: 2020-08-23 journal: Perspect Public Health DOI: 10.1177/1757913920951591 sha: 5584dbec26008bedc113cea62dedef42bec572ce doc_id: 953515 cord_uid: bmy22pxl nan In the 1940s, Kurt Lewin, often referred to as 'the father of social psychology', proposed a model for understanding behavioural change within organisations, which has since become a key theory in the study of behaviour. His 'Unfreeze-Change-Refreeze' model formed part of an integrated approach to analyse change at group, organisational and even societal levels. 1 Lewin was especially keen that his work be used to bring about societal change, which could resolve forms of social conflict. 1 The model consists of three stages: The COVID-19 pandemic has elicited a clear sense of dissatisfaction with the status quo, as evidenced by the fact that society has experienced transformational change in a very narrow time frame. From a public health perspective, the dissatisfaction with the status quo appeared quickly at the onset of the pandemic, with an immediate recognition that vaccination efforts and drug trials must be expedited. 3 From a medical perspective, the dissatisfaction with the status quo facilitated a rapid rise in telehealth and increased collaboration between primary and secondary care. 4 From a societal perspective, the dissatisfaction with the status quo was based on universal understanding that remote working would reduce spread of infection and that community efforts were needed to help those in need. 5 While the pandemic has caused disruption to lifestyles, it has also brought about changes such as, reduced environmental impacts, revitalised community spirit and enhanced focus on funding for healthcare systems, which we should now aim to sustain. Public health principles and research are garnering widespread media attention as we begin to see issues of vaccination, controlled trials, infectious diseases and protective behaviours battling for front pages in newspapers. A plethora of behavioural changes to improve outcomes in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged, with varying evidence bases. These suggestions range from decreasing alcohol intake to increasing vitamin D intake. 6, 7 If the behavioural changes from this pandemic can be 'refrozen', there is potential to accelerate years of public health-directed change within the space of a few months. Nadler and Tushman 8 describe two dimensions with which change can be analysed: whether it is reactive or anticipatory, and whether it is incremental or transformational. The scope for change available through the pandemic is both reactive and transformational, which leads to what Nadier and Tushman describe as a 'recreation'. This change is rare and involves a response to a crisis which threatens the status quo unless radical deviations from that status quo are quickly made. These changes are substantial in size and scope, but they are also difficult to maintain since they must be enacted quickly with little room for error. This recreational change fits with what is referred to as the 'punctuated model of equilibrium', a framework for political change in the context of complex social systems. The framework, as described by Baumgartner and Jones, 9 posits that policymaking consists of long periods of While the pandemic has caused disruption to lifestyles, it has also brought about changes such as, reduced environmental impacts, revitalised community spirit and enhanced focus on funding for healthcare systems, which we should now aim to sustain Policymaking consists of long periods of stability, punctuated by sporadic periods of intense and rapid change stability, punctuated by sporadic periods of intense and rapid change. The revolutionary periods that punctuate the model act as an opportunity to disrupt pre-existing activities and replace them with a new equilibrium. 10 On that basis, it could be argued that the COVID-19 pandemic may act as a punctuation mark for this model and an opportunity for change. We can conceptualise societal behaviour as a constantly evolving entity, moving slowly in no defined direction. Occasionally, perhaps only once in a generation, there is an event which may cause a seismic change and redirect its course. Subscribers to Lewin's theory of change may accept that we are currently in the early stages of a behavioural change process. The ongoing COVID-19 pandemic has continued to inflict strain on healthcare providers, while also bringing political bodies under unprecedented scrutiny. In some areas, there is clear dissatisfaction with existing systems as healthcare, politics, social behaviours and public health itself are all facing unprecedented scrutiny. These necessitate change and some degree of effort to maintain that change if it is to continue into a new equilibrium. With societal structures facing extreme tension, our attention must eventually shift towards how we can build and maintain an idealistic post-COVID-19 society once that tension is released. The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. The author(s) received no financial support for the research, authorship and/or publication of this article. Anmol Arora https://orcid.org/0000-0003-4881-8293 Managing change: a strategic approach to organisational dynamics Organizational change theory: implications for health promotion practice Developing COVID-19 vaccines at pandemic speed COVID-19: a remote assessment in primary care The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study Evidence that Vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths Alcohol does not protect against COVID-19; access should be restricted during lockdown. World Health Organization Organizational frame bending: principles for managing reorientation Agendas and instability in American Politics Organizational transformation as punctuated equilibrium: an empirical test Our new e-learning programme offers a flexible, simple approach to studying food hygiene and is designed to fit around professional schedules.The aim of this programme is to equip you with a knowledge and understanding of:• The need for food hygiene • The importance of food poisoning bacteria • Hygiene procedures and food safety management systems Suitable for food handlers in catering, retail, child care and residential care and also for training centres as part of their blended learning programme.Twitter: @R_S_P_H Facebook: Royal Society for Public Health LinkedIn: Royal Society for Public Health For more infor mati on or to disc uss tailor ing and bran ding the prog ramm e, plea se cont act elea rnin g@r sph .org .uk or call 020 7 265 738 3Please note that this is an e-learning programme only. 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