Dr Mary Black, public health doctor and trustee of Paintings in Hospitals, gives us a dose of reality on coronovirus and calls for courage and kindness...

And so we enter a new world of social distancing, people stocking their larders, and limitations on how we can gather. Borders are closing, airports are shutting down, and in some countries, police and armed forces are mobilising. It is all new and strange—but not for me.

Having grown up in Northern Ireland during Troubles, worked through a war in Bosnia, lived with a baby under UN Sanctions in Serbia, worked as a clinician during the early days of HIV, and been involved in various outbreak investigations, I have been here before. What I have learned is this.

1. Nothing concentrates the mind more than an existential threat. At our core, human beings want to survive. We will check we have the fundamentals in place and learn to live without the non-essentials we used to rely on. Ask the WW2 generation, refugees, and those who have lived through extreme situations for advice, they know a lot and will tell you that it can be done.

2. Nudge theory (positive reinforcement and indirect suggestions used to alter individual or group behaviour), does not encompass what will happen next. Social norms will shift primarily because we will look to those around us and change our behaviour accordingly.

3. We will see the best of human behaviour. We will see extreme acts of kindness as our streets connect up and we look after the elderly. Volunteer networks will spring up across the country. We will witness the selflessness of our health workers who will continue to turn up, day after day, exhausted and exposed. We will owe them our lives.

4. We will see the worst of human behaviour. Absolute greed as families stock up on 3 months supplies of nappies while others can’t find any. Profiteering, pilfering, and petty theft. Price gouging. Thankfully, in the UK, we do not live in a lawless society, so this will be damped down, there are other countries where it will not.

5. The media will suck up news—everything from sensible advice to shock stories. Expect tragic death stories to rise, alongside narratives of hope and recovery. If you can, contribute helpful, fact-based stories.

6. There will be misinformation and rumours, because these things thrive in a time of crisis. Social media exacerbates this and gives oxygen to quacks, cranks, and conspiracy theorists. If you can, counteract the nonsense that is already spreading, and report the worst to get it shut down.

7. Cabin fever. The government is concerned about lockdown for more than 10 – 12 weeks. Sarajevo, and other cities under siege, did it for four years, and countries like Yemen live with this constantly. Sales of jigsaws and Jenga will rise, but domestic violence will flare up and children at risk will be less visible. For some, cabin fever will be deadly, so keep a caring eye out for your neighbours.

8. Those marginalised in society are most at risk. They are always the first to suffer and die in a crisis, and this is no different. Anything we can do to protect the homeless, asylum seekers, the very poor, the socially isolated, the frail and elderly, we must do now.

9. The Great British Queue will stretch, not only getting longer, but also more spaced out. Expect cartoons and editorials that poke fun at this. Laughing at doom is a way to build community resilience. There is a point to black humour, but let’s not make it cruel.

10. When it is all over expect an explosion of life and colour. Once again, we will marvel at live theatre, holler for our favourite team in a stadium, and share intergenerational Sunday lunches in restaurants. And we will enjoy these things even more, knowing what it is like to do without.

In times of crisis, we all get to decide. Courage and kindness or looking out for yourself? The first will be what sustains us, individually and collectively. Choose decency as I know The BMJ‘s readers will. Then add a large dose of medicine and science, mix it up with a heavy dollop of common sense and garnish with courage.

Dr Mary E Black is a public health doctor, entrepreneur, non-exec for the National Centre for Atmospheric Science, and a trustee of Paintings in Hospitals. You can find her on Twitter: @DrMaryBlack.

(This article was originally published on the BMJ, 18/03/2020.)