As consumers are crowding back into stores, restaurants and other places of business as states ease pandemic-related restrictions, a full return to normal isn’t likely to happen until November 2021, according to Ezekiel (Zeke) Emanuel, vice provost for global initiatives and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania and Wharton professor of health care management. Emanuel said strict adherence to non-pharmacological interventions work better than haphazard compliance with them, and it has been challenging to get everyone to comply. In fact, states like Arizona, Florida and Texas have seen infections skyrocket since they relaxed lockdown measures. “I think it’s almost inevitable we’re going to have a second wave that pops up in October or November [of this year], when we’re all going inside. That worries me a lot,” he said. “Adhering to strict measures doesn’t seem possible in the U.S.” He also pointed to research that shows the immune system reaction to the virus is short-lived, with antibodies lasting only two to three months versus three to 12 months for other viruses, indicating that it might be difficult to develop a long-lasting vaccine.