Her grandmother died in the worst of the 1918 flu pandemic, among the thousands of losses that overwhelmed Philadelphia hospitals, morgues, and funeral homes.

She left behind three children, all under 10.

“They were pretty traumatized through their whole lives,” said granddaughter Karen Zeitz.

Her mother seemed to live in mourning as an adult. And Zeitz grew up to understand that an invisible germ could sweep away a healthy 31-year-old woman and irreparably alter the future of a loving family. This year the coronavirus seriously sickened one friend and killed another.

“Am I ever not going to be paranoid about this stuff?” said Zeitz, 72, a semiretired lawyer who lives in South Philadelphia. “It really did a number on our heads.”

Pennsylvania will lift all coronavirus restrictions on Memorial Day, with Philadelphia scheduled to lift most of its restrictions on June 2. New Jersey ended social distancing on Friday.

But as people edge back toward normal, or try to figure out what normal means, the future will inevitably be complicated, with pandemic scars and losses running deep and the efforts to reconnect to others — some wrecked, some untouched — more challenging than just tossing aside a medical mask.

“We’re never going back to normal,” said the Rev. Joe Nock, pastor of the Second Antioch Baptist Church in Mantua, who was nearly hospitalized with the virus. “Like after 9/11 it was never the same? … It may be subtle, but people are going to have a hard time reintegrating.”

He fears some families will be hit by delayed grief, as they finally exhale and fully contemplate their losses. Others who escaped physical illness suffered emotionally and financially, losing jobs and careers and the worlds of people and friendships they encompassed.

Counselor and scholar George James expects to see blooms of social anxiety as people relearn and renegotiate everyday social behaviors as simple as shaking hands.

“Some people have had life-altering experiences,” said James, a licensed marriage and family therapist at the Council for Relationships in Philadelphia. “COVID made some disparities larger.”

How do people trust one another again? Those who took every precaution to protect themselves and others, and those who scorned even simple masks to make a political point?

The impact of nearly 600,000 dead Americans — the equivalent of wiping out the city of Baltimore — may not be fully realized for years or decades.

“I’m a very different person than I was last year,” said Rachel Hanes, 17, a senior at Cheltenham High School in Wyncote. “I’m more independent. I’m more nervous than I used to be, about large crowds. It’s just been ingrained in my head that there’s a possibility for COVID spread there, even though I’m totally vaccinated.”

It’s becoming safer every day as more Americans get shots — half of all adults now are fully vaccinated.

But people struggle with the turmoil of the last 14 months, the nation rocked not only by a once-in-a-century pandemic but the widespread social protests against racism and police abuse, and by the insurrection where supporters of former President Donald Trump violently sought to overturn the results of the presidential election.

The pandemic exposed racial and class inequalities in health care, education, and jobs, and helped provoke a rising tide of violence against Asian Americans.

Reopening will bring new pressures. Evictions will restart. Pennsylvania’s 7.4% unemployment rate is half the pandemic highs, but double that of March 2019. More people need mental health treatment that has become harder to find.

“It’s easy for people to say that now that business restrictions have lifted, everyone can go back, life is back to normal,” said Anna Perng, a Chinatown resident who advocates for immigrants and for people with disabilities.

But many Asian Americans are afraid to return to schools, jobs, and transportation systems, because of the exposure to potential assailants. When Perng and her colleagues walk through Philadelphia, they don’t risk distraction by checking their phones or answering calls.

“We’re always looking around us at our surroundings,” Perng said.

The pandemic cost people marriages and friendships and sanity. Dentists who earned their livings inside people’s mouths saw their work upended, and teachers faced viral threats merely by walking into their classrooms. Ride-share drivers got greater danger and fewer fares.

It was a steamy 88 degrees earlier this month when Bernadette Gaymon, an N95 mask tight on her face, arrived at a community-resource fair at Mitchell Elementary at 55th and Kingsessing, where her great-grandchildren attend school.

She has COPD, a lung disease, and intends to keep wearing a mask, no matter the loosening pandemic restrictions or the rising summer heat. And that spa gift card she received from her family at Christmas?

“I told them to give it away,” Gaymon said. “I’m not ready to let anyone get that close to me.”

As people come back together, they wonder: How could they ever stand to watch someone blow out their birthday candles — and then eat the cake? When will they stop silently holding their breath in elevators? At what point does the thought of squeezing onto a crowded train not make them nervous?

“You build it back one relationship at a time,” said Terrill Haigler, 31, of North Philadelphia. “I need to feel the compassion of another human being, just like another human being needs to feel it from me.”

The pandemic changed everyone, and him in two big ways:

One, he became famous. The Instagram account he created to plead for masks and gloves for fellow sanitation workers as “Ya Fav Trashman” brought him awards, donations, and appearances on Good Morning America and ABC’s World News Tonight.

Two, he endured desolating loss. His mother died. Not from the coronavirus. A heart attack, at 53.

Haigler left the Sanitation Department to pursue full-time advocacy of a cleaner, better Philadelphia, and it’s his mother’s loving, forward-thinking spirit that inspires his plans for food drives and jobs programs.

“The pandemic really helped me realize my purpose,” he said. “COVID has taught me I have to live every day to the fullest.”

Physicist Paul Halpern tried to do the same, while strictly following Centers for Disease Control and Prevention safety guidelines whenever he ventured to work at the University of the Sciences.

But even as cases drop dramatically, he’s found people cautious. Halpern reached to shake hands with an acquaintance — who pulled back, even though both were vaccinated, masked, and outdoors.

“I’m wondering if people will ever be comfortable shaking hands, hugging, things like that, that used to be signs of friendliness,” he said. “My worry is people are developing a general anxiety, without facts.”

Fear of the virus caused some to leave the Millennium Baptist Church, even though almost all the members have been vaccinated and the building is disinfected from top to bottom, pew to hymnal, twice a week, said the Rev. Tracy Mallory.

“Many of the seniors, they think this is apocalyptic, and it’s the end of the world,” Mallory said. “They don’t want to come back.”

He regularly phones to remind them that the West Philadelphia church is still there, still welcoming, still supporting them, and keeping the faith as society reopens.

It’s been so long. And it’s seemed even longer.

In late September 2019, Zeitz gathered with 200 others in South Philadelphia, marching up Broad Street to honor the dead of the 1918 flu pandemic.

Three months later, the World Health Organization announced the discovery of a mysterious pneumonia in China, and two weeks after that the first case of coronavirus appeared in the United States.

The march retraced the steps of a World War I parade that infamously drew 200,000 people together. As she walked, Zeitz carried a copy of her grandmother’s death certificate.

Her name was Molly Clara Rosenfeld. Gone for a hundred years, and still mourned today, her loss exerting its impact on generations.

“These things,” Zeitz said, “die hard.”

Staff writers Kristen A. Graham and Dylan Purcell contributed to this article.