Just yesterday, it was Wednesday, March 18, 2020, the last full day of Winter in Richmond, Virginia. It was also my last day physically working in my office at the university, trying to get all the loose ends tied up before heading home for who knows how long. The sun was out. It was 60°F (15.5°C) and the air was fresh and clear. Yet, the feeling was the same as if a foot of snow were accumulating and the city were closing down. The streets were quiet except for a few passing cars and the world seemed to be slowing as I watched. The snow was invisible but was now intruding on us here in the US. We had plenty of warning that this was coming, two months' notice, more than for any snowstorm in the past. Yet, it still came on suddenly as if no one expected it would really arrive.

The COVID-19 pandemic is a jolting and catastrophic, generation-defining event, one that could easily be the most disruptive occurrence to human society (and orthodontic practice) in a century. It has already reshaped the way we live, think, and communicate. There have been devastating social and financial consequences. We have seen how different countries and different individuals have approached the challenge differently. Some have shut the world off around them, some have willingly or reluctantly (either quickly or slowly) joined along with the prevailing tide, and others persisted to ignore the warning signs and attempted to live as they had before. The tragedy of the lives lost and those that will be lost is certainly heartbreaking.

Communicating with friends and colleagues in China, Korea, Italy, and other countries around the world, I got a sense for how universities, dentists, and orthodontists were dealing with this crisis as it developed and spread. They shared their institutional and personal experiences, advice, and emotions. Just a couple of weeks ago I was in Thailand and I saw their vigilance screening every person entering the university, shopping malls, and airports. Yet, when I returned home to the US in early March, I was surprised to see that no such measures were in place here. It is hard to fully appreciate the impact until it hits you at your own doorstep.

As the situation unfolded hastily here at home after my return, in our university practice we first adopted stricter protection and disinfection techniques working with patients. We attempted to practice social distancing as much as possible among ourselves and our staff. We tested internet communication software and teleconferencing as a means of continuing daily classes and seminars with the students and residents. Similarly, it became apparent quickly that telemonitoring technology was going to become critical for managing continued patient care and to resolve patient emergencies. It was a crash course to develop new skill sets. It all happened so fast and it will continue to keep evolving rapidly with time.

One memory that haunts me is from that last day I spent working at the university. The school was practically deserted, and the atmosphere was eerily quiet and dark. I was standing in our business office talking to the manager and commending our staff, who had worked tirelessly for 3 days rescheduling patients and telling them we would be closed for an uncertain period of time. A patient came in to pick up her new retainers, having completed her orthodontic treatment just the previous week. The patient was beaming, flashing her new smile and calling to us from the hallway, nearly dancing with joy. She pointed excitedly toward her mouth and held up her new retainer case for us to see. She stepped into the office to show me how happy she was to have come so far…and my reaction was to back away.

Since that day, knowing this will be published in the May issue of The Angle Orthodontist, we will no doubt have accommodated somewhat better (I hope) to the new world in which we are living. Today, March 19, with the temperature outside at 85°F (almost 30C) and the sun still shining, I wonder if the snow will have melted by the time this is published or whether it will still be piling up.