This year will be one of broad, gradual recovery, but there is a fierce gantlet yet to be run.

In the midst of an unprecedented third surge of COVID-19 across the globe, a highly contagious, mutant strain is running rampant through England and spreading to Europe. It hit Colorado and just now California, which has again surpassed its record for COVID-19 deaths.

Simultaneously, highly effective vaccines — pre-made and fully approved — are now rolling out, limited only by the logistics of distribution. The end of the pandemic is in sight, but a dark winter still lies ahead. We will see incremental improvement each quarter, but it will take up to two years for a global shift to the new normal.

The next three weeks in the run-up to the presidential inauguration represent an extraordinary window of vulnerability to threats both foreign and domestic as we continue to observe a transition that is both unprecedented and highly unsettling.

Hawaii has so far done better than most parts of the nation, but we cannot let our guard down as the case rates taper and the vaccine is delivered to the general population. 2021 will see the beginning of a resurgence in the visitor industry so important to Hawaii, but it will come nowhere near a return to our pre-pandemic base line. Not all of the lost jobs and shuttered businesses will return. Many will have to reimagine and re-create their livelihoods on the road ahead.

Another round of badly needed checks is already starting to hit bank accounts, and this will help, but the second-largest stimulus package in history is still big on rescue and small on investment. It will be another helpful but temporary fix, one that will add another $900 billion to our ballooning national debt. Control of the U.S. Senate hangs in the balance until Tuesday, and the election result will be an indication of how much taxes might be raised to fund long-stated priorities:

>> COVID: The pandemic must be managed with a combination of rapid dissemination of vaccines, continuing precautions and economic support for families, businesses and governments hardest hit. Once the case rate settles, the deep recovery will begin.

>> Health care: The pandemic has highlighted, more than ever, the devastation wrought by health and wealth disparities, and though costly, the moral imperative to cover all Americans has hit a crescendo. Whether it is a comprehensive expansion of the Affordable Care Act, Medicare for All or a government-sponsored public option, we will see a hard push for universal coverage this year — a massive undertaking.

>> Climate change: With a renewed American commitment to the Paris Agreement, there will be substantial investment in solving global warming and combating sea level rise, carbon emissions and pollution. Investment in renewable energy including solar, smart, efficient battery storage and a transition away from combustion engines to electric vehicles will see a major uptick in investment and production.

>> Infrastructure: Long- deferred infrastructure upgrades must be addressed, including highways, bridges, ports and railroads, large building upgrades and smart renewal of energy grids.

Two gripping sets of questions remain. First, where will the needed resources come from? Undoubtedly, some will come from a partial rollback of the 2016 tax cuts and a reconfiguration of inheritance tax. But more is needed. Federal debt will still grow and add to the existing burden that will fall on the next generation. For some the magnitude of resources brought to bear to rebuild our economy will seem excessive; for others it will be far too little. If successful, renewed gross domestic product growth will increase the tax base naturally and foster a bona fide recovery, but this will take time and is not a given.

If the broad strokes become a reality, the biggest question is, Who will benefit? The world’s billionaires collectively increased their wealth by an average of 20% during 2020 while an estimated 1 in 9 Americans experienced food insecurity in the past year. As the U.S. tackles climate change and infrastructure, we must be vigilant that, at long last, social justice becomes and remains a centerpiece of this work. It will be an imperfect process.

The new normal will begin to declare itself this year. We must stand together, take care of our health, prepare to take on new roles in a dynamic recovery and work to build resilience at every level.

Ira Zunin is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center. His column appears the first Saturday of every month. Please submit your questions to info@manakaiomalama.com.