lessons from the pandemic essay

I Thought We’d Learned Nothing From the Pandemic. I Wasn’t Seeing the Full Picture

M y first home had a back door that opened to a concrete patio with a giant crack down the middle. When my sister and I played, I made sure to stay on the same side of the divide as her, just in case. The 1988 film The Land Before Time was one of the first movies I ever saw, and the image of the earth splintering into pieces planted its roots in my brain. I believed that, even in my own backyard, I could easily become the tiny Triceratops separated from her family, on the other side of the chasm, as everything crumbled into chaos.

Some 30 years later, I marvel at the eerie, unexpected ways that cartoonish nightmare came to life – not just for me and my family, but for all of us. The landscape was already covered in fissures well before COVID-19 made its way across the planet, but the pandemic applied pressure, and the cracks broke wide open, separating us from each other physically and ideologically. Under the weight of the crisis, we scattered and landed on such different patches of earth we could barely see each other’s faces, even when we squinted. We disagreed viciously with each other, about how to respond, but also about what was true.

Recently, someone asked me if we’ve learned anything from the pandemic, and my first thought was a flat no. Nothing. There was a time when I thought it would be the very thing to draw us together and catapult us – as a capital “S” Society – into a kinder future. It’s surreal to remember those early days when people rallied together, sewing masks for health care workers during critical shortages and gathering on balconies in cities from Dallas to New York City to clap and sing songs like “Yellow Submarine.” It felt like a giant lightning bolt shot across the sky, and for one breath, we all saw something that had been hidden in the dark – the inherent vulnerability in being human or maybe our inescapable connectedness .

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But it turns out, it was just a flash. The goodwill vanished as quickly as it appeared. A couple of years later, people feel lied to, abandoned, and all on their own. I’ve felt my own curiosity shrinking, my willingness to reach out waning , my ability to keep my hands open dwindling. I look out across the landscape and see selfishness and rage, burnt earth and so many dead bodies. Game over. We lost. And if we’ve already lost, why try?

Still, the question kept nagging me. I wondered, am I seeing the full picture? What happens when we focus not on the collective society but at one face, one story at a time? I’m not asking for a bow to minimize the suffering – a pretty flourish to put on top and make the whole thing “worth it.” Yuck. That’s not what we need. But I wondered about deep, quiet growth. The kind we feel in our bodies, relationships, homes, places of work, neighborhoods.

Like a walkie-talkie message sent to my allies on the ground, I posted a call on my Instagram. What do you see? What do you hear? What feels possible? Is there life out here? Sprouting up among the rubble? I heard human voices calling back – reports of life, personal and specific. I heard one story at a time – stories of grief and distrust, fury and disappointment. Also gratitude. Discovery. Determination.

Among the most prevalent were the stories of self-revelation. Almost as if machines were given the chance to live as humans, people described blossoming into fuller selves. They listened to their bodies’ cues, recognized their desires and comforts, tuned into their gut instincts, and honored the intuition they hadn’t realized belonged to them. Alex, a writer and fellow disabled parent, found the freedom to explore a fuller version of herself in the privacy the pandemic provided. “The way I dress, the way I love, and the way I carry myself have both shrunk and expanded,” she shared. “I don’t love myself very well with an audience.” Without the daily ritual of trying to pass as “normal” in public, Tamar, a queer mom in the Netherlands, realized she’s autistic. “I think the pandemic helped me to recognize the mask,” she wrote. “Not that unmasking is easy now. But at least I know it’s there.” In a time of widespread suffering that none of us could solve on our own, many tended to our internal wounds and misalignments, large and small, and found clarity.

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I wonder if this flourishing of self-awareness is at least partially responsible for the life alterations people pursued. The pandemic broke open our personal notions of work and pushed us to reevaluate things like time and money. Lucy, a disabled writer in the U.K., made the hard decision to leave her job as a journalist covering Westminster to write freelance about her beloved disability community. “This work feels important in a way nothing else has ever felt,” she wrote. “I don’t think I’d have realized this was what I should be doing without the pandemic.” And she wasn’t alone – many people changed jobs , moved, learned new skills and hobbies, became politically engaged.

Perhaps more than any other shifts, people described a significant reassessment of their relationships. They set boundaries, said no, had challenging conversations. They also reconnected, fell in love, and learned to trust. Jeanne, a quilter in Indiana, got to know relatives she wouldn’t have connected with if lockdowns hadn’t prompted weekly family Zooms. “We are all over the map as regards to our belief systems,” she emphasized, “but it is possible to love people you don’t see eye to eye with on every issue.” Anna, an anti-violence advocate in Maine, learned she could trust her new marriage: “Life was not a honeymoon. But we still chose to turn to each other with kindness and curiosity.” So many bonds forged and broken, strengthened and strained.

Instead of relying on default relationships or institutional structures, widespread recalibrations allowed for going off script and fortifying smaller communities. Mara from Idyllwild, Calif., described the tangible plan for care enacted in her town. “We started a mutual-aid group at the beginning of the pandemic,” she wrote, “and it grew so quickly before we knew it we were feeding 400 of the 4000 residents.” She didn’t pretend the conditions were ideal. In fact, she expressed immense frustration with our collective response to the pandemic. Even so, the local group rallied and continues to offer assistance to their community with help from donations and volunteers (many of whom were originally on the receiving end of support). “I’ve learned that people thrive when they feel their connection to others,” she wrote. Clare, a teacher from the U.K., voiced similar conviction as she described a giant scarf she’s woven out of ribbons, each representing a single person. The scarf is “a collection of stories, moments and wisdom we are sharing with each other,” she wrote. It now stretches well over 1,000 feet.

A few hours into reading the comments, I lay back on my bed, phone held against my chest. The room was quiet, but my internal world was lighting up with firefly flickers. What felt different? Surely part of it was receiving personal accounts of deep-rooted growth. And also, there was something to the mere act of asking and listening. Maybe it connected me to humans before battle cries. Maybe it was the chance to be in conversation with others who were also trying to understand – what is happening to us? Underneath it all, an undeniable thread remained; I saw people peering into the mess and narrating their findings onto the shared frequency. Every comment was like a flare into the sky. I’m here! And if the sky is full of flares, we aren’t alone.

I recognized my own pandemic discoveries – some minor, others massive. Like washing off thick eyeliner and mascara every night is more effort than it’s worth; I can transform the mundane into the magical with a bedsheet, a movie projector, and twinkle lights; my paralyzed body can mother an infant in ways I’d never seen modeled for me. I remembered disappointing, bewildering conversations within my own family of origin and our imperfect attempts to remain close while also seeing things so differently. I realized that every time I get the weekly invite to my virtual “Find the Mumsies” call, with a tiny group of moms living hundreds of miles apart, I’m being welcomed into a pocket of unexpected community. Even though we’ve never been in one room all together, I’ve felt an uncommon kind of solace in their now-familiar faces.

Hope is a slippery thing. I desperately want to hold onto it, but everywhere I look there are real, weighty reasons to despair. The pandemic marks a stretch on the timeline that tangles with a teetering democracy, a deteriorating planet , the loss of human rights that once felt unshakable . When the world is falling apart Land Before Time style, it can feel trite, sniffing out the beauty – useless, firing off flares to anyone looking for signs of life. But, while I’m under no delusions that if we just keep trudging forward we’ll find our own oasis of waterfalls and grassy meadows glistening in the sunshine beneath a heavenly chorus, I wonder if trivializing small acts of beauty, connection, and hope actually cuts us off from resources essential to our survival. The group of abandoned dinosaurs were keeping each other alive and making each other laugh well before they made it to their fantasy ending.

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After the monarch butterfly went on the endangered-species list, my friend and fellow writer Hannah Soyer sent me wildflower seeds to plant in my yard. A simple act of big hope – that I will actually plant them, that they will grow, that a monarch butterfly will receive nourishment from whatever blossoms are able to push their way through the dirt. There are so many ways that could fail. But maybe the outcome wasn’t exactly the point. Maybe hope is the dogged insistence – the stubborn defiance – to continue cultivating moments of beauty regardless. There is value in the planting apart from the harvest.

I can’t point out a single collective lesson from the pandemic. It’s hard to see any great “we.” Still, I see the faces in my moms’ group, making pancakes for their kids and popping on between strings of meetings while we try to figure out how to raise these small people in this chaotic world. I think of my friends on Instagram tending to the selves they discovered when no one was watching and the scarf of ribbons stretching the length of more than three football fields. I remember my family of three, holding hands on the way up the ramp to the library. These bits of growth and rings of support might not be loud or right on the surface, but that’s not the same thing as nothing. If we only cared about the bottom-line defeats or sweeping successes of the big picture, we’d never plant flowers at all.

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8 Lessons We Can Learn From the COVID-19 Pandemic

BY KATHY KATELLA May 14, 2021

Rear view of a family standing on a hill in autumn day, symbolizing hope for the end of the COVID-19 pandemic

Note: Information in this article was accurate at the time of original publication. Because information about COVID-19 changes rapidly, we encourage you to visit the websites of the Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), and your state and local government for the latest information.

The COVID-19 pandemic changed life as we know it—and it may have changed us individually as well, from our morning routines to our life goals and priorities. Many say the world has changed forever. But this coming year, if the vaccines drive down infections and variants are kept at bay, life could return to some form of normal. At that point, what will we glean from the past year? Are there silver linings or lessons learned?

“Humanity's memory is short, and what is not ever-present fades quickly,” says Manisha Juthani, MD , a Yale Medicine infectious diseases specialist. The bubonic plague, for example, ravaged Europe in the Middle Ages—resurfacing again and again—but once it was under control, people started to forget about it, she says. “So, I would say one major lesson from a public health or infectious disease perspective is that it’s important to remember and recognize our history. This is a period we must remember.”

We asked our Yale Medicine experts to weigh in on what they think are lessons worth remembering, including those that might help us survive a future virus or nurture a resilience that could help with life in general.

Lesson 1: Masks are useful tools

What happened: The Centers for Disease Control and Prevention (CDC) relaxed its masking guidance for those who have been fully vaccinated. But when the pandemic began, it necessitated a global effort to ensure that everyone practiced behaviors to keep themselves healthy and safe—and keep others healthy as well. This included the widespread wearing of masks indoors and outside.

What we’ve learned: Not everyone practiced preventive measures such as mask wearing, maintaining a 6-foot distance, and washing hands frequently. But, Dr. Juthani says, “I do think many people have learned a whole lot about respiratory pathogens and viruses, and how they spread from one person to another, and that sort of old-school common sense—you know, if you don’t feel well—whether it’s COVID-19 or not—you don’t go to the party. You stay home.”

Masks are a case in point. They are a key COVID-19 prevention strategy because they provide a barrier that can keep respiratory droplets from spreading. Mask-wearing became more common across East Asia after the 2003 SARS outbreak in that part of the world. “There are many East Asian cultures where the practice is still that if you have a cold or a runny nose, you put on a mask,” Dr. Juthani says.

She hopes attitudes in the U.S. will shift in that direction after COVID-19. “I have heard from a number of people who are amazed that we've had no flu this year—and they know masks are one of the reasons,” she says. “They’ve told me, ‘When the winter comes around, if I'm going out to the grocery store, I may just put on a mask.’”

Lesson 2: Telehealth might become the new normal

What happened: Doctors and patients who have used telehealth (technology that allows them to conduct medical care remotely), found it can work well for certain appointments, ranging from cardiology check-ups to therapy for a mental health condition. Many patients who needed a medical test have also discovered it may be possible to substitute a home version.

What we’ve learned: While there are still problems for which you need to see a doctor in person, the pandemic introduced a new urgency to what had been a gradual switchover to platforms like Zoom for remote patient visits.

More doctors also encouraged patients to track their blood pressure at home , and to use at-home equipment for such purposes as diagnosing sleep apnea and even testing for colon cancer . Doctors also can fine-tune cochlear implants remotely .

“It happened very quickly,” says Sharon Stoll, DO, a neurologist. One group that has benefitted is patients who live far away, sometimes in other parts of the country—or even the world, she says. “I always like to see my patients at least twice a year. Now, we can see each other in person once a year, and if issues come up, we can schedule a telehealth visit in-between,” Dr. Stoll says. “This way I may hear about an issue before it becomes a problem, because my patients have easier access to me, and I have easier access to them.”

Meanwhile, insurers are becoming more likely to cover telehealth, Dr. Stoll adds. “That is a silver lining that will hopefully continue.”

Lesson 3: Vaccines are powerful tools

What happened: Given the recent positive results from vaccine trials, once again vaccines are proving to be powerful for preventing disease.

What we’ve learned: Vaccines really are worth getting, says Dr. Stoll, who had COVID-19 and experienced lingering symptoms, including chronic headaches . “I have lots of conversations—and sometimes arguments—with people about vaccines,” she says. Some don’t like the idea of side effects. “I had vaccine side effects and I’ve had COVID-19 side effects, and I say nothing compares to the actual illness. Unfortunately, I speak from experience.”

Dr. Juthani hopes the COVID-19 vaccine spotlight will motivate people to keep up with all of their vaccines, including childhood and adult vaccines for such diseases as measles , chicken pox, shingles , and other viruses. She says people have told her they got the flu vaccine this year after skipping it in previous years. (The CDC has reported distributing an exceptionally high number of doses this past season.)

But, she cautions that a vaccine is not a magic bullet—and points out that scientists can’t always produce one that works. “As advanced as science is, there have been multiple failed efforts to develop a vaccine against the HIV virus,” she says. “This time, we were lucky that we were able build on the strengths that we've learned from many other vaccine development strategies to develop multiple vaccines for COVID-19 .”

Lesson 4: Everyone is not treated equally, especially in a pandemic

What happened: COVID-19 magnified disparities that have long been an issue for a variety of people.

What we’ve learned: Racial and ethnic minority groups especially have had disproportionately higher rates of hospitalization for COVID-19 than non-Hispanic white people in every age group, and many other groups faced higher levels of risk or stress. These groups ranged from working mothers who also have primary responsibility for children, to people who have essential jobs, to those who live in rural areas where there is less access to health care.

“One thing that has been recognized is that when people were told to work from home, you needed to have a job that you could do in your house on a computer,” says Dr. Juthani. “Many people who were well off were able do that, but they still needed to have food, which requires grocery store workers and truck drivers. Nursing home residents still needed certified nursing assistants coming to work every day to care for them and to bathe them.”

As far as racial inequities, Dr. Juthani cites President Biden’s appointment of Yale Medicine’s Marcella Nunez-Smith, MD, MHS , as inaugural chair of a federal COVID-19 Health Equity Task Force. “Hopefully the new focus is a first step,” Dr. Juthani says.

Lesson 5: We need to take mental health seriously

What happened: There was a rise in reported mental health problems that have been described as “a second pandemic,” highlighting mental health as an issue that needs to be addressed.

What we’ve learned: Arman Fesharaki-Zadeh, MD, PhD , a behavioral neurologist and neuropsychiatrist, believes the number of mental health disorders that were on the rise before the pandemic is surging as people grapple with such matters as juggling work and childcare, job loss, isolation, and losing a loved one to COVID-19.

The CDC reports that the percentage of adults who reported symptoms of anxiety of depression in the past 7 days increased from 36.4 to 41.5 % from August 2020 to February 2021. Other reports show that having COVID-19 may contribute, too, with its lingering or long COVID symptoms, which can include “foggy mind,” anxiety , depression, and post-traumatic stress disorder .

“We’re seeing these problems in our clinical setting very, very often,” Dr. Fesharaki-Zadeh says. “By virtue of necessity, we can no longer ignore this. We're seeing these folks, and we have to take them seriously.”

Lesson 6: We have the capacity for resilience

What happened: While everyone’s situation is different (and some people have experienced tremendous difficulties), many have seen that it’s possible to be resilient in a crisis.

What we’ve learned: People have practiced self-care in a multitude of ways during the pandemic as they were forced to adjust to new work schedules, change their gym routines, and cut back on socializing. Many started seeking out new strategies to counter the stress.

“I absolutely believe in the concept of resilience, because we have this effective reservoir inherent in all of us—be it the product of evolution, or our ancestors going through catastrophes, including wars, famines, and plagues,” Dr. Fesharaki-Zadeh says. “I think inherently, we have the means to deal with crisis. The fact that you and I are speaking right now is the result of our ancestors surviving hardship. I think resilience is part of our psyche. It's part of our DNA, essentially.”

Dr. Fesharaki-Zadeh believes that even small changes are highly effective tools for creating resilience. The changes he suggests may sound like the same old advice: exercise more, eat healthy food, cut back on alcohol, start a meditation practice, keep up with friends and family. “But this is evidence-based advice—there has been research behind every one of these measures,” he says.

But we have to also be practical, he notes. “If you feel overwhelmed by doing too many things, you can set a modest goal with one new habit—it could be getting organized around your sleep. Once you’ve succeeded, move on to another one. Then you’re building momentum.”

Lesson 7: Community is essential—and technology is too

What happened: People who were part of a community during the pandemic realized the importance of human connection, and those who didn’t have that kind of support realized they need it.

What we’ve learned: Many of us have become aware of how much we need other people—many have managed to maintain their social connections, even if they had to use technology to keep in touch, Dr. Juthani says. “There's no doubt that it's not enough, but even that type of community has helped people.”

Even people who aren’t necessarily friends or family are important. Dr. Juthani recalled how she encouraged her mail carrier to sign up for the vaccine, soon learning that the woman’s mother and husband hadn’t gotten it either. “They are all vaccinated now,” Dr. Juthani says. “So, even by word of mouth, community is a way to make things happen.”

It’s important to note that some people are naturally introverted and may have enjoyed having more solitude when they were forced to stay at home—and they should feel comfortable with that, Dr. Fesharaki-Zadeh says. “I think one has to keep temperamental tendencies like this in mind.”

But loneliness has been found to suppress the immune system and be a precursor to some diseases, he adds. “Even for introverted folks, the smallest circle is preferable to no circle at all,” he says.

Lesson 8: Sometimes you need a dose of humility

What happened: Scientists and nonscientists alike learned that a virus can be more powerful than they are. This was evident in the way knowledge about the virus changed over time in the past year as scientific investigation of it evolved.

What we’ve learned: “As infectious disease doctors, we were resident experts at the beginning of the pandemic because we understand pathogens in general, and based on what we’ve seen in the past, we might say there are certain things that are likely to be true,” Dr. Juthani says. “But we’ve seen that we have to take these pathogens seriously. We know that COVID-19 is not the flu. All these strokes and clots, and the loss of smell and taste that have gone on for months are things that we could have never known or predicted. So, you have to have respect for the unknown and respect science, but also try to give scientists the benefit of the doubt,” she says.

“We have been doing the best we can with the knowledge we have, in the time that we have it,” Dr. Juthani says. “I think most of us have had to have the humility to sometimes say, ‘I don't know. We're learning as we go.’"

Information provided in Yale Medicine articles is for general informational purposes only. No content in the articles should ever be used as a substitute for medical advice from your doctor or other qualified clinician. Always seek the individual advice of your health care provider with any questions you have regarding a medical condition.

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For the past year, our country has been mired in not one deep crisis but three: a pandemic , an economic meltdown and one of the most fraught political transitions in our history. Interwoven in all three have been challenging issues of racial disparity and fairness. Dealing with all of this has dominated much of our energy, attention and, for many Americans, even our emotions.

But spring is nearly here, and we are, by and large, moving past the worst moments as a nation — which makes it a good time to take a deep breath and assess the changes that have occurred. While no one would be displeased if we could magically erase this whole pandemic experience, it's been the crucible of our lives for a year, and we have much to learn from it — and even much to gain.

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AARP asked dozens of experts to go beyond the headlines and to share the deeper lessons of the past year that have had a particular impact on older Americans. More importantly, we asked them to share how we can use these learnings to make life better for us as we recover and move forward. Here is what they told us.

Lesson 1: Family Matters More Than We Realized

"The indelible image of the older person living alone and having to struggle — we need to change that. You're going to see more older people home-sharing within families and cohousing across communities to avoid future situations of tragedy."

—Marc Freedman, CEO and president of Encore.org and author of How to Live Forever: The Enduring Power of Connecting the Generations

Norman Rockwell would have needed miles of canvas to portray the American family this past year. You can imagine the titles: The Family That Zooms Together. Generations Under One Roof. Grandkids Outside My Window. The Shared Office . “Beneath the warts and complexities of all that went wrong, we rediscovered the interdependence of generations and how much we need each other,” Freedman says. Among the lessons:

Adult kids are OK. A Pew Research Center survey last summer found that 52 percent of the American population between ages 18 and 29 were living with parents, a figure unmatched since the Great Depression. From February to July 2020, 2.6 million young adults moved back with one or both parents. That's a lot of shared Netflix accounts. It's also a culture shift, says Karen Fingerman, director of the Texas Aging & Longevity Center at the University of Texas at Austin. “After the family dinners together, grandparents filling in for childcare, and the wise economic sense, it's going to be acceptable for adult family members to co-reside,” Fingerman says. “At least for a while.”

What We've Learned From the Pandemic

• Lesson 1: Family Matters • Lesson 2: Medical Breakthroughs • Lesson 3: Self-Care Matters • Lesson 4: Be Financially Prepared • Lesson 5: Age Is Just a Number • Lesson 6: Getting Online for Good • Lesson 7: Working Anywhere • Lesson 8: Restoring Trust • Lesson 9: Gathering Carefully • Lesson 10: Isolation's Health Toll • Lesson 11: Getting Outside • Lesson 12: Wealth Disparities’ Toll • Lesson 13: Preparing for the Future • Lesson 14: Tapping Telemedicine • Lesson 15: Cities Are Changing

Spouses and partners are critical to well-being . “The ones who've done exceptionally well are couples in long-term relationships who felt renewed intimacy and reconnection to each other,” says social psychologist Richard Slatcher, who runs the Close Relationships Laboratory at the University of Georgia.

Difficult caregiving can morph into good-for-all home-sharing. To get older Americans out of nursing homes and into a loved one's home — a priority that has gained in importance and urgency due to the pandemic — will take more than just a willing child or grandchild. New resources could help, like expanding Medicaid programs to pay family caregivers, such as an adult child, or initiatives like the Program of All-Inclusive Care for the Elderly, a Medicare-backed benefit currently helping 50,000 “community dwelling” seniors with medical services, home care and transportation.

"A positive piece this year has been the pause to reflect on how we can help people stay in their homes as they age, which is what everyone wants,” says Nancy LeaMond, AARP's chief advocacy and engagement officer. “If you're taking care of a parent, grandparent, aging partner or yourself, you see more than ever the need for community and government support, of having technology to communicate with your doctor and of getting paid leave for family caregivers. The pandemic has forced us to think about all these things, and that's very positive.”

Family may be the best medicine of all . “Now we know if you can't hug your 18-month-old granddaughter in person, you can read to her on FaceTime,” says Jane Isay, author of several books about family relationships. “You can send your adult kids snail mail. You can share your life's wisdom even from a distance. These coping skills may be the greatest gifts of COVID” — to an older generation that deeply and rightly fears isolation.

a healthcare technician unfrosts vials of a covid vaccine in a lab

Lesson 2: We Have Unleashed a Revolution in Medicine

" One of the biggest lessons we've learned from COVID is that the scientific community working together can do some pretty amazing things."

—John Cooke, M.D., medical director of the RNA Therapeutics Program at Houston Methodist Hospital's DeBakey Heart and Vascular Center

In the past it's taken four to 20 years to create conventional vaccines. For the new messenger RNA (mRNA) vaccines from Pfizer-BioNTech and Moderna, it was a record-setting 11 months. The process may have changed forever the way drugs are developed.

"Breakthroughs” come after years of research . Supporting the development of the COVID-19 vaccines was more than a decade of research into mRNA vaccines, which teach human cells how to make a protein that triggers a specific immune response. The research had already overcome many challenging hurdles, such as making sure that mRNA wouldn't provoke inflammation in the body, says Lynne E. Maquat, director of the University of Rochester's Center for RNA Biology: From Genome to Therapeutics.

Vaccines may one day treat heart disease and more. In the near future, mRNA technology could lead to better flu vaccines that could be updated quickly as flu viruses mutate with the season, Maquat says, or the development of a “universal” flu shot that might be effective for several years. Drug developers are looking at vaccines for rabies, Zika virus and HIV. “I expect to see the approval of more mRNA-based vaccines in the next several years,” says mRNA researcher Norbert Pardi, a research assistant professor of medicine at the University of Pennsylvania.

"We could use mRNA for diseases and conditions that can't be treated with drugs,” Cooke explains.

It may also target our biggest killers . Future mRNA therapies could help regenerate muscle in failing hearts and target the unique genetics of individual cancers with personalized cancer vaccines. “Every case of cancer is unique, with its own genetics,” Cooke says. “Doctors will be able to sequence your tumor and use it to make a vaccine that awakens your immune system to fight it.” Such mRNA vaccines will also prepare us for future pandemics, Maquat says.

In the meantime, use the vaccines we have available. Don't skip recommended conventional vaccines now available to older adults for the flu, pneumonia, shingles and more, Pardi says. The flu vaccine alone, which 1 in 3 older adults skipped in the winter 2019 season, saves up to tens of thousands of lives a year and lowers your risk for hospitalization with the flu by 28 percent and for needing a ventilator to breathe by 46 percent.

Lesson 3: Self Care Is Not Self-Indulgence

"Not only does self-care have positive outcomes for you, but it also sets an example to younger generations as something to establish and maintain for your entire life."

—Richelle Concepcion, clinical psychologist and president of the Asian American Psychological Association

As the virus upended life last spring, America became hibernation nation. Canned, dry and instant soup sales have risen 37 percent since last April. Premium chocolate sales grew by 21 percent in the first six months of the pandemic. The athleisure market that includes sweatpants and yoga wear saw its 2020 U.S. revenue push past an estimated $105 billion.

With 7 in 10 American workers doing their jobs from home, “COVID turned the focus, for all ages, on the small, simple pleasures that soothe and give us meaning,” says Isabel Gillies, author of Cozy: The Art of Arranging Yourself in the World.

Why care about self-care? Pampering is vital to well-being — for yourself and for those around you. Activities that once felt indulgent became essential to our health and equilibrium, and that self-care mindset is likely to endure. Whether it is permission to take long bubble baths, tinkering in the backyard “she shed,” enjoying herbal tea or seeing noon come while still in your robe, “being good to yourself offers a necessary reprieve from whatever horrors threaten us from out there,” Gillies says. Being good to yourself is good for others, too. A recent European survey found that 77 percent of British respondents 75 and younger consider it important to take their health into their own hands in order not to burden the health care system.

Nostalgia TV, daytime PJs. It's OK to use comfort as a crutch. Comfort will help us ease back to life. Some companies are already hawking pajamas you can wear in public. Old-fashioned drive-ins and virtual cast reunions for shows like Taxi, Seinfeld and Happy Days will likely continue as long as the craving is there. (More than half the consumers in a 2020 survey reported finding comfort in revisiting TV and music from their childhood.) Even the iconic “Got Milk?” ads are back, after dairy sales started to show some big upticks.

So, cut yourself some slack. Learn a new skill; adopt a pet; limit your news diet; ask for help if you need it. You've lived long enough to see the value of prioritizing number one. “Not only does self-care have positive outcomes for you,” Concepcion says, “but it also sets an example to younger generations as something to establish and maintain for your entire life."

Lesson 4: Have a Stash Ready for the Next Crisis

"The need to augment our retirement savings system to help people put away emergency savings is crucial."

—J. Mark Iwry, a senior fellow at the Brookings Institution and former senior adviser to the U.S. secretary of the Treasury

Before the pandemic, nearly 4 in 10 households did not have the cash on hand to cover an unexpected $400 expense, according to a Federal Reserve report. Then the economic downturn hit. By last October, 52 percent of workers were reporting reduced hours, lower pay, a layoff or other hits to their employment situation. A third had taken a loan or early withdrawal from a retirement plan , or intended to. “Alarm bells were already ringing, but many workers were caught off guard without emergency savings,” says Catherine Collinson, CEO and president of the Transamerica Institute. “The pandemic has laid bare so many weaknesses in our safety net."

Companies can help . One solution could be a workplace innovation that's just beginning to catch on: an employee-sponsored rainy-day savings account funded with payroll deductions. By creating a dedicated pot of savings, the thinking goes, workers are less likely to tap retirement accounts in an emergency. “It's much better from a behavioral standpoint to separate short-term savings from long-term savings,” Iwry says. (AARP has been working to make these accounts easier to create and use and is already offering them to its employees.)

Funding that emergency savings account with automatic payroll deductions is a key to the program's success. “Sometimes you think you don't have the money to save, but if a little is put away for you each pay period, you don't feel the pinch,” Iwry notes.

We're off to a good start . Thanks to quarantines and forced frugality, Americans’ savings rate — the average percentage of people's income left over after taxes and personal spending — skyrocketed last spring, peaking at an unprecedented 33.7 percent. On the decline since then, most recently at 13.7 percent, it's still above the single-digit rates characterizing much of the past 35 years. Where it will ultimately settle is unclear; currently, it's in league with high-saving countries Mexico and Sweden. The real model of thriftiness: China, where, according to the latest available figures, the household savings rate averaged at least 30 percent for 14 years straight.

Lesson 5: The Adage ‘Age Is Just a Number’ Has New Meaning

"This isn't just about the pandemic. Your health is directly related to lifestyle — nutrition, physical activity, a healthy weight and restorative sleep."

—Jacob Mirsky, M.D., primary care physician at the Massachusetts General Hospital Revere HealthCare Center and an instructor at Harvard Medical School

Just a few months ago, researchers at Scotland's University of Glasgow asked a big question: If you're healthy, how much does older age matter for risk of death from COVID? The health records of 470,034 women and men revealed some intriguing answers.

Age accounted for a higher risk, but comorbidities (essentially, having two or more health issues simultaneously) mattered much more. Specifically, risk for a fatal infection was four times higher for healthy people 75 and older than for all participants younger than 65. But if you compared all those 75 and older — including those with chronic health condition s like high blood pressure, obesity or lung problems — that shoved the grim odds up thirteenfold.

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Live healthfully, live long . More insights from the study: A healthy 75-year-old was one-third as likely to die from the coronavirus as a 65-year-old with multiple chronic health issues. The bottom line: Age affects your risk of severe illness with COVID, but you should be far more focused on avoiding chronic health conditions. “Coronavirus highlighted yet another reason it's so important to attend to health factors like poor diet and lack of exercise that cause so much preventable illness and death,” says Massachusetts General's Mirsky. “Lifestyle changes can improve your overall health, which will likely directly reduce your risk of developing severe COVID or dying of COVID."

Exercise remains critical . In May 2020 a British study of 387,109 adults in their 40s through 60s found a 38 percent higher risk for severe COVID in people who avoided physical activity. “Mobility should be considered one of the vital signs of health,” concludes exercise psychologist David Marquez, a professor in the department of kinesiology and nutrition at the University of Illinois at Chicago.

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a remote controlled delivery robot on a sidewalk amongst pedestrians

Lesson 6: We Befriended Technology, and There's No Going Back

"Folks who have tried online banking will stay with it. It won't mean they won't go back to branches, but they might go back for a different purpose."

—Theodora Lau, founder of financial technology consulting firm Unconventional Ventures

Of course, the world has long been going digital . But before the pandemic, standard operating procedure for most older Americans was to buy apples at the grocery, try the shoes on first before buying, have your doctor measure your blood pressure and see that hot new movie at the theater.

Arguably the biggest long-term societal effect of the pandemic will be a grand flipping of the switch that makes the digital solution the first choice of many Americans for handling life's tasks. We still may cling to a few IRL (in real life) experiences, but it is increasingly apparent that easy-to-use modern virtual tools are the new default.

"If nothing else, COVID has shown us how resilient and adaptable humans are as a society when forced to change,” says Joseph Huang, CEO of StartX, a nonprofit that helps tech companies get off the ground. “We've been forced to learn new technologies that, in many cases, have been the only safe way to continue to live our lives and stay connected to our loved ones during the pandemic.”

The tech boom wasn't just video calls and streaming TV. Popular food delivery apps more than doubled their earnings last year. Weddings and memorial services were held over videoconferences (yes, we'll go back to in-person ones but probably with cameras and live feeds now to include remote participants). In the financial sector, PayPal reported that its fastest-growing user group was people over 50; Chase said about half of its new online users were 50-plus. In telehealth, more doctors conducted routine exams via webcam than ever before — and, in response, insurance coverage expanded for these remote appointments. “It quickly became the only way to operate at scale in today's world,” Huang says, “both for us as patients and for the doctors and nurses who treat us. Telemedicine will turn out to be a better and more effective experience in many cases, even after COVID ends."

Tech is for all . To financial technology expert Lau, the tech adoption rate by older people is no surprise. She never believed the myth that older people lack such knowledge. “There's a difference between knowing how to use something versus preferring to use it,” Lau says. “Sometimes we know how, but we prefer face-to-face interaction.” And now those preferences are shifting.

man at his home computer on a telemedicine call

Lesson 7: Work Is Anywhere Now — a Shift That Bodes Well for Older Americans

"One of the major impacts of the new working-from-home focus is that more jobs are becoming non-location-specific."

—Carol Fishman Cohen, cofounder of iRelaunch, which works with employers to create mid-career return-to-work programs for older workers

Necessity is the mother of reinvention : Forced to work remotely since the onset of the pandemic, millions of workers — and their managers — have learned they could be just as productive as they were at the office, thanks to videoconferencing, high-speed internet and other technologies. “This has opened a lot of corporate eyes,” says Steven Allen, professor of economics at North Carolina State University's Poole College of Management. Twitter, outdoor-goods retailer REI and insurer Lincoln Financial Group are a few of the companies that have announced plans to shift toward more remote work on a permanent basis.

Face-lift your Face-Time . Yes, many workers are tied to a location: We will always need nurses, police, roofers, machine operators, farmers and countless other workers to show up. But if you are among the people who are now able to work remotely, you may be able to live in a less expensive area than where your employer is based — or work right away from the home you were planning to retire to later on, Cohen says. As remote hiring takes hold, how you project yourself on-screen becomes more of a factor. “This puts more pressure on you to make sure you show up well in a virtual setting,” Cohen notes. And don't assume being comfortable with Zoom is a feather in your cap; mentioning it is akin to listing “proficient in Microsoft Word” on your résumé.

Self-employed workers have suffered during the pandemic — nearly two-thirds report being hurt financially, according to the “State of Independence in America 2020” report from MBO Partners — but remote work could fuel their comeback. Before the pandemic, notes Steve King, partner at Emergent Research, businesses with a high percentage of remote workers used a high percentage of independent contractors. “Now that companies are used to workers not being as strongly attached physically to a workplace, they'll be more amenable to hiring independent workers,” he says.

Travel less, stay longer . Tired of sitting in traffic to and from work? Can't stand flying across country for a single meeting? Ridding yourself of these hassles with an internet connection and Zoom calls may be the incentive you need to work longer. People often quit jobs because of little frustrations, Allen says. But now, he adds, “the things that wear you down may be going by the wayside."

Ageism remains a threat . Older workers — who before the coronavirus enjoyed lower unemployment rates than mid-career workers — have been hit especially hard by the pandemic. In December, 45.5 percent of unemployed workers 55 and older had been out of work for 27 weeks or more, compared with 35.1 percent of younger job seekers. Some employers, according to reports this fall, are replacing laid-off older workers with younger, lower-cost ones, instead of recalling those older employees. Psychological studies, Allen says, indicate that older workers have better communication and interpersonal skills — both of which are critical for successful remote work. But whether those strengths can offset age discrimination in the workplace is unknown.

Lesson 8: Our Trust in One Another Has Frayed, but It Can Be Slowly Restored

"Truth matters, but it requires messaging and patience.”

—Historian John M. Barry, author of The Great Influenza

Even before our views perforated along lines dotted by pandemic politics, race, class and whether Bill Gates is trying to save us or track us, we were losing faith in society. In 1997, 64 percent of Americans put a “very great or good deal of trust” in the political competence of their fellow citizens; today only a third of us feel that way. A 2019 Pew survey found that the majority of Americans say most people can't be trusted. It's even tougher to trust in the future. Only 13 percent of millennials say America is the greatest country in the world, compared with 45 percent of members of the silent generation. No wonder that by June of last year, “national pride” was lower than at any point since Gallup began measuring. To trust again:

As life returns, look beyond your familiar pod. “Distrust breeds distrust, but hope isn't lost for finding common ground, especially for older people,” says Encore.org's Freedman. “Even in the era of ‘OK, boomer’ and ‘OK, millennial’ — memes that dismiss entire generations with an eye roll — divides are bridgeable with what Freedman calls “proximity and purpose.” Rebuilding trust together, across generations, under shared priorities and common humanity.” He points to pandemic efforts like Good Neighbors from the home-sharing platform Nesterly, which pairs older and younger people to provide cross-generational support, and UCLA's Generation Xchange, which connects Gen X mentors with children in grades K-3 in South Los Angeles, where educational achievement is notoriously poor. “Engaging with people for a common goal makes you trust them,” he says.

Be patient but verify facts. History also provides a guide. In the wake of the 1918 influenza pandemic that killed between 50 million and 100 million people, trust in authority withered after local and national government officials played down the disease's threats in order to maintain wartime morale. Historian Barry points out that the head of the Army's’ division of communicable diseases was so worried about the collective failure of trust that he warned that “civilization could easily disappear ... from the face of the earth.” It didn't then, and it won't now, Barry says.

Verify facts and then decide. Check reliable, balanced news sources (such as Reuters and the Associated Press) and unbiased fact-checking sites (such as PolitiFact) before clamping down on an opinion.

Perhaps most important, be open to changing conditions and viewpoints. “As we see vaccines and therapeutic drugs slowly gain widespread success in fighting this virus, I think we'll start to overcome some of our siloed ways of thinking and find relief — together as one — that this public health menace is ending,” Barry adds. “We have to put our faith in other people to get through this together.”

aerial photo of people in a grassy park staying within social distancing circles painted on the grass

Lesson 9: The Crowds Will Return, but We'll Gather Carefully

"Masks and sanitizers will be part of the norm for years, the way airport and transportation security measures are still in place from 9/11."

— Christopher McKnight Nichols, associate professor of history at Oregon State University and founder of the Citizenship and Crisis Initiative

The COVID-19 pandemic won't end with bells tolling or a ticker-tape parade . Instead, we'll slowly, cautiously ease back to familiar activities. For all our fears of the coronavirus, many of us can't wait to resume a public life: When 1,000 people 65 and older were asked which pursuits they were most eager to start anew post-pandemic, 78 percent said going out to dinner, 76 percent picked getting together with family and friends, 71 percent chose travel, and 30 percent cited going to the movies.

Seeing art , attending concerts, cheering in a stadium — even going to class reunions we might have once dreaded — we'll do them again. But how will we return to feeling comfortable in groups of tens, hundreds and thousands? And will these gatherings be different? How we come together:

Don't expect the same old, same old . Just as the rationing, isolation and economic crisis caused by World War I and the Spanish flu epidemic “led to a kind of awakening of how we assembled,” Nichols says, expect COVID to shake up the nature and personality of our public spaces. Back in the 1920s, it was the rise of jazz clubs, organized athletics, fraternal organizations and the golden age of the movie cinema. As the pandemic subsides, we'll probably see more temperature-controlled outdoor event and dining spaces, more pedestrian and bicycling options, more city parks and more hybrid events that give you the option to attend virtually.

Retrain your brain . Psychologists say the techniques of cognitive behavioral therapy can help people at any age regain the certainty and confidence they need to venture into the public space post-pandemic. “Visualizing good outcomes and repeating a stated goal can help overcome whatever obstacles are holding you back,” says Gabriele Oettingen, a professor of psychology at New York University, who suggests making an “if-then plan” to reacclimate to public life. If eating indoors at a restaurant is too agitating, even if you've been vaccinated, then try a table outside first. If a bucket-list family vacation to Italy feels too daunting, then book a stateside trip together first. “There's always an alternative if something stands in the way of you fulfilling your wish,” she says. “Eventually, you'll get there.”

Lesson 10: Loneliness Hurts Health More Than We Thought

"What we've learned from COVID is that isolation is everyone's problem. It doesn't just happen to older adults; it happens to us all."

— Julianne Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University

How deadly is the condition of loneliness? During the first five months of the pandemic, nursing home lockdowns intended to safeguard older and vulnerable adults with dementia contributed to the deaths of an additional 13,200 people compared with previous years, according to a shocking Washington Post investigation published last September. “People with dementia are dying,” the article notes, “not just from the virus but from the very strategy of isolation that's supposed to protect them.”

Isolation may be the new normal . Fifty-six percent of adults age 50-plus said they felt isolated in June 2020, double the number who felt lonely in 2018, a University of Michigan poll found. Rates of psychological distress rose for all adults as the pandemic deepened — increasing sixfold for young adults and quadrupling for those ages 30 to 54, according to a Johns Hopkins University survey published in JAMA in June. And it's hard to tell whether the workplace culture many of us relied on for social support will fully return anytime soon.

Those 50-plus have a leg up. “Older adults with higher levels of empathy, compassion, decisiveness and self-reflection score lowest for loneliness,” says Dilip Jeste, M.D., director of the Sam and Rose Stein Institute for Research on Aging at the University of California, San Diego. “Research shows that many older adults have handled COVID psychologically better than younger adults. With age comes experience and wisdom. You've lived through difficult times before and survived.”

Help yourself by helping others. Jeste says that when older adults share their wisdom with younger people, everyone benefits. “Young people are reassured about the future,” he adds. “Older adults feel even more confident. They're role models. Their contributions matter."

a couple poses for a photograph at a scenic overlook at yosemite national park in california

Lesson 11: When Your World Gets Small, Nature Lets Us Live Large

"For older people in particular, nature provided a way to shake off the weight and hardships associated with stay-at-home orders, of social isolation and of the stress of being the most vulnerable population in the pandemic."

— Kathleen Wolf, a research social scientist in the School of Environmental and Forest Sciences at the University of Washington

One silver lining to COVID-19's dark cloud : Clouds themselves became more familiar to all of us. So did birds, trees, bees, shooting stars and window gardens. Nearly 6 in 10 Americans have a new appreciation for nature because of the pandemic, according to one survey that also found three-quarters of respondents reported a boost in their mood while spending time outside.

By nearly every measure, the planet got more love during COVI D. And wouldn't it be nice if that continued going forward? The ins and outs on our new outdoor life:

Move somewhere greener (or at least move around more outside). How you access nature is up to you, but consider the options. Nearly a third of Americans were considering moving to less populated areas, according to a Harris Poll taken last year during the pandemic. Walking, running and hiking became national pastimes. One day last September, Boston's BlueBikes bike-share system saw its highest-ever single-day ridership, with 14,400 trips recorded. Stargazers and bird-watchers helped push binocular sales up 22 percent.

Once known mainly as a retirement activity, pickleball has been the fastest-growing sport in America, with almost 3.5 million U.S. players of all ages participating in the contact-free outdoor net game designed for players of any athletic ability. The return of the pandemic “victory garden” reflects research that finds 79 percent of patients feel more relaxed and calm after spending time in a garden.

Make the city less gritty . The University of Washington's Wolf thinks that our collective nature kick will go beyond a run on backyard petunias. Her research brief on the benefits of nearby nature in cities for older adults suggests we may rethink the design of neighborhood environments to facilitate older people's outdoor activities. That means more places to sit, more green spaces associated with the health status of older people, safer routes and paths, and more allotment for community gardens. “It's impossible to overestimate the value these outdoor spaces have on reducing stressful life events, improving working memory and adding meaning and happiness in older people's lives,” Wolf says.

If you can't get out, bring nature in . Even video and sounds of nature can provide health gains to those shut indoors, says Marc Berman of the University of Chicago's Environmental Neuroscience Lab. “Listening to recordings of crickets chirping or waves crashing improved how our subjects performed on cognitive tests,” he says.

Above all, the environment is in your hands, so take action to protect it . “We've seen a lot of older folks stepping up their activity in trail conservation, stream cleaning, being forest guides and things like that this year, which indicates a shift in how that age group interacts with nature,” says Cornell University gerontologist Karl Pillemer.

"There's an old saw that older people care less than younger people about the environment. But given this year's nature boom, I'm expecting that to change. As the generation that gave birth to the environmental movement enters retirement, we're likely to see a wave of interest in conservation among those 60 and up."

Lesson 12: You Can Hope for Stability — but Best Be Prepared for the Opposite

"COVID-19, perhaps more than any other disaster, demonstrated that we need to continue ensuring response plans are flexible and scalable. You can't predict exactly what a disaster will bring, but if you know what tools you have in your tool kit, you can pull out the right one you need when you need it."

— Linda Mastandrea, director of the Office of Disability Integration and Coordination for the Federal Emergency Management Agency (FEMA)

The pandemic was among the toughest slap-in-the-face moments in recent history to remind us that everything — everything — in our lives can change in a moment. While older Americans may have a deep-seated desire for stability and security after all it took to get to an advanced age, we certainly cannot bank on it. Which is why the word of the year, and perhaps the coming century, is “resilience.” Not just at the individual level but at every social tier, from family to community to the nation as a whole.

Banish fear . “We don't have to live in fear” of some looming disaster, says former director of the Centers for Disease Control and Prevention Tom Frieden, now president and CEO of global public health initiative Resolve to Save Lives. “By strengthening our defenses and investing in preparedness, we can live easier knowing that communities have what they need to better respond in moments of crisis."

Preparation must start at the top . For government, that means a new commitment to plans that allow, not so much for stockpiles but for the ability to ramp up production of crucial equipment when needed. “We need increased, sustained, predictable base funding for public health security defense programs that prevent, detect and respond to outbreaks such as COVID-19 or pandemic influenza,” Frieden says.

Being creative and even entrepreneurial helps , says Jeff Schlegelmilch, director of the National Center for Disaster Preparedness at Columbia University's Earth Institute. Warehouses full of masks could have helped us initially, he says, but stockpiles of equipment aren't the answer on their own. In a free market there is pressure to sell off surpluses, so he suggests we reimagine our manufacturing capacities for times of emergency. When whiskey distillers stepped up to make hand sanitizer, and auto manufacturers switched gears to build ventilators, we saw “glimmers of solutions,” Schlegelmilch says, the sort of responses we may need to tee up in the future.

Focus on health care . Prime among the areas that need to be addressed, crisis management consultant Luiz Hargreaves says, are overwhelmed health care systems. “They were living a disaster before the pandemic. When the pandemic came, it was a catastrophe.” But Hargreaves hopes we will use this wake-up call to produce new solutions, rather than to return to old ways. “Extraordinary times,” he says, “call for extraordinary measures."

Lesson 13: Wealth Inequality Is Growing, and It Affects Us All

"It's outrageous that somebody could work full-time and not even be able to pay rent, let alone food and clothing. There's a recognition that there's a problem on both the left and right. "

— Joseph Stiglitz, Nobel Prize–winning economist, Columbia University professor and author of The Price of Inequality

"The data is pretty dramatic,” says Stiglitz, one of America's most-esteemed economists. Government economists estimate that unemployment rates in this pandemic are less than 5 percent for the highest earners but as high as 20 percent for the lowest-paid ones. “People at the bottom have disproportionately experienced the disease, and those at the bottom have lost jobs in enormous disproportion, too."

As white-collar professionals work from home and stay socially distant, frontline workers in government, transportation and health care — as well as retail, dining and other service sectors — face far greater health risks and unemployment. “We try to minimize interactions as we try to protect ourselves,” he says, “yet we realize that minimizing those interactions is also taking away jobs.” The disparate effects of the pandemic are particularly evident along racial lines, points out Jean Accius, AARP senior vice president for global thought leadership. “Job losses have hit communities of color disproportionately,” he says. And there's a health gap, too, with people of color — who have a greater likelihood than white Americans to be frontline workers — experiencing higher rates of COVID-19 infection, hospitalizations and mortality, and lower rates of vaccinations. “What we're seeing is a double whammy for communities of color,” Accius says. “It is hitting them in their wallets. And it's hitting them with regard to their health."

Those economic and health crises, along with protests over racial injustice over the past year, says Accius, “have really sparked major conversations around what do we need to do in order to advance equity in this country."

A rising gap between rich and poor in any society, Stiglitz argues, increases economic instability, reduces opportunities and results in less investment in public goods such as education and public transportation. But the country appears primed to make some changes that could help narrow the wealth gap, he says. Among them are President Biden's proposals to raise the federal minimum wage to $15 an hour, increase the earned income tax credit for low-income workers and provide paid sick leave. Stiglitz also proposes raising taxes on gains from sales of stocks and other securities not held in retirement accounts. “The notion that people who work for a living shouldn't pay higher taxes than those who speculate for a living seems not to be a hard idea to get across,” Stiglitz says.

"Many people continue to say, ‘It's time for us to get back to normal,'” Accius says. “Well, going back to normal means that we're in a society where those that have the least continue to be impacted the most — a society where older adults are marginalized and communities of color are devalued. We have to be honest with what we are going through as a collective nation. And then we have to be bold and courageous, to really build a society where race and other social demographic factors do not determine your ability to live a longer, healthier and more productive life.”

Who Owns America's Wealth?

For some, hard times bring opportunity.

Want a positive reminder of the American way? When the going got tough this past summer, many people responded by planning a new business. In the second half of 2020, there was a 40 percent jump over the prior year's figures in applications to form businesses highly likely to hire employees, according to the U.S. Census Bureau.

Significantly, no such spike occurred during the Great Recession, points out Alexander Bartik, assistant professor of economics at the University of Illinois at Urbana-Champaign. “That's cause for some optimism — that there are people who are trying to start new things,” he says. One possible reason this time is different: Unlike during that recession, the stock market and home values have held on, and those sources of personal wealth are often what people draw upon to fund small-business start-ups.

High-propensity* Business Applications in the U.S.

*Businesses likely to have employees

the number of applications to form businesses likely to hire employees greatly increased during the pandemic

Lesson 14: The Benefits of Telemedicine Have Become Indisputable

"The processes we developed to avoid face-to-face care have transformed the way we approach diabetes care management.”

— John P. Martin, M.D., codirector of Diabetes Complete Care for Kaiser Permanente Southern California

If there was ever any truth to the stereotype of the older person whose life revolved around a constant calendar of in-person doctor appointments, it's certainly been tossed out the window this past year due to the strains of the pandemic on our health care system. The timing was fortuitous in one way: Telemedicine was ready for prime time and has proved to be a godsend, particularly for those with chronic health conditions.

Say goodbye to routine doctor visits . Patients who sign up for remote blood sugar monitoring at Kaiser Permanente in Southern California use Bluetooth-enabled meters to transmit results via a smartphone app directly to their health records. “ Remote monitoring allows us to recognize early when there should be adjustments to treatment,” Martin says.

We need to push for more access . The pandemic underlines the need for more home-based medical help with chronic conditions. But that takes both willingness and a lot of gear, such as Bluetooth-enabled blood pressure monitors and, on the doctor side, systems to store and analyze the data. “People need access to the equipment, and health care systems have to be ready to handle all that data,” says Mirsky of Massachusetts General Hospital.

Group doctor visits may be a way forward . Mirsky is conducting virtual group visits and remote monitoring of blood sugar for his patients with type 2 diabetes. “Instead of having a few minutes with each person to talk about important issues — like blood sugar testing, diet and exercise — we get an hour or more to go over it,” he says. “At every meeting somebody in the group has a great tip I've never heard of, like a new YouTube exercise channel or fitness app. There's group support, too. I see group visits like this continuing into the future, becoming part of routine chronic disease care for all patients who want it."

Bottom line: The doctor is in (your house) . Managing chronic health conditions like diabetes “can't just be about getting in your car and driving to your doctor's office,” Martin says. Taking care of your health conditions yourself is the path forward.

Lesson 15: Our Cities Won't Ever Be the Same

"This is obviously a very big watershed moment in how we live, how we organize our cities and our communities. There are going to be long-lasting changes."

— Chris Jones, chief planner at Regional Plan Association, a New York–based urban planning organization

"When you're alone and life is making you lonely, you can always go downtown,” Petula Clark sang in her 1964 chart-topping ode to city life. Well, things change. Suddenly, crowds are the enemy, public buses and subways a health risk, packed office towers out of favor, and a roomy suburban home seems just where you want to be. But don't write off downtowns just yet.

The office and business district will look different. Many workers have little interest in returning to a 9-to-5 life. For those who do make the commute, they may find cubicles replaced with more flexible work spaces focused on common areas, with ample outdoor seating space for meetings and working lunches. And some now-empty offices will likely be converted into apartments and condos, making downtowns more vibrant. “Now you have an opportunity to remake a central business district into an actual neighborhood,” says Richard Florida, author of The Rise of the Creative Class and a cofounder of CityLab, an online publication about urbanism.

Public spaces will serve more of the public. Those areas set up for outdoor restaurant dining — some of those will likely remain. Streets and parking lots have been turned into plazas and promenades. Many cities have already opened miles of bike lanes; in 2020, Americans bought bikes, including electric bikes, in record numbers. “This idea of social space, where you can get outside and enjoy that active public realm, is going to become increasingly important,” says Lynn Richards, the president and CEO of Congress for the New Urbanism, which champions walkable cities.

Contributors to this report: Sari Harrar, David Hochman, Ronda Kaysen, Lexi Pandell, Jessica Ravitz and Ellen Stark

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We have reached the end of the beginning of the COVID-19 pandemic with more problems on the horizon.
Covid-19 lessons can be drawn from the previous two years about how to handle future and long-standing challenges.
Early assumptions about future trends should be made with caution as uncertainty and unpredictability are still present.
Leadership has proven important across the board.

Whatever happens next in this unprecedented COVID-19 pandemic, we have reached the “end of the beginning.” We paused to reflect on Ipsos’ experience over the last couple of years, with the thought that it might provide lessons for the future, addressing long-standing challenges like ageing populations, a fragile planet and growing inequalities.

So, what are these lessons?

COVID-19 Lesson #1: People proved adaptable

By the end of March 2020, more than 100 countries were in a full or partial lockdown. Two years on, life has continued, but often in an altered state. The resilience and optimistic economic performance seen in many countries come with limits, though, as many admitted to picking and choosing post-lockdown rules to follow . There were also hot takes on what the “new normal” would look like. Commentators predicted that some behaviour would stick, such as accelerated online shopping, even though there were more reports of increased difficulties making online purchases than a year ago, suggesting the path to the new normal is likely more incremental than suggested.

COVID-19 Lesson #2: Mental health is as important as physical health

Through one global public health crisis, another was revealed, as many say their personal health situation worsened, experiencing mental health challenges for the first time. Levels of reported anxiety are higher than ever, with women hit hardest and young people more likely to “ languish .” Now, 79% of people worldwide say their mental health is as important as their physical health . As investment in mental health services is only a fraction of overall health spending, a more serious conversation to address this crisis is due.

Mental health is one of the top health problems

COVID-19 Lesson #3: Consumer desires are unpredictable

After initial panic buying, observers noted that the void caused by social restrictions was being filled with premium brand experiences. Enduring consumer habits are yet to become clearer, but for now, there is still uncertainty and inequality: unemployment and inflation among people’s top priorities. If we are about to go through a period of restricted purchasing power, brands may need to adjust and consider that consumer behaviour changes during a crisis, with some of those changes only later becoming permanent.

Respondents reflect on consumption habits

COVID-19 Lesson #4: Inequalities are widening

The pandemic, rather than erasing old problems, added new ones and exacerbated existing inequalities across age, gender, ethnicities and geography. One survey indicated that people believe the pandemic has been worse for older people than for younger people and research shows that the burden of childcare is falling on women disproportionately, consequently widening other aspects of the gender gap. More positively, there has been a narrowing of the “digital divide,” with older people’s increasing technology adoption to keep in touch with friends and family. Such digital acceleration and increasing home working acceptance will likely have lasting implications, including a potential reorientation of how our cities, suburbs and surrounding areas all interact.

COVID-19 Lesson #5: The “empty planet” scenario is now more likely

The pandemic has modified birth rates but not with the tongue-in-cheek expectation of a boom. Instead, looming uncertainty caused many to delay having children, accelerating pre-existing population decline. The empty planet scenario , or 'population bust,' expected by 2050, may come sooner. Brands and governments will need more nuanced approaches to older generations who simultaneously have more spending power and rely more on public services. Companies may also need to restructure their workforce to plug gaps created by ageing and non-replenishing manpower.

COVID-19 Lesson #6: We're getting more insular

Previous surveys have continuously shown huge disparities in outlook by country, including close neighbours, pointing to cultural considerations, differing legal systems and government points of view combining and varying people’s experiences. There is also evidence of “ de-globalisation ,” with many retreating to familiar territories and less dependence on foreign countries sought for goods and materials. Borders have become less porous during the pandemic, and there is apparent reluctance for their reopening.

Have you read?

Majority of consumers willing to pay more for goods which use scarce natural resources - ipsos survey, ending hunger and poverty are the top priorities for global public: forum, ipsos poll, confidence in covid-19 vaccines continues to rise, ipsos-forum poll shows, covid-19 lesson #7: maintaining public trust is difficult.

Doctors have become the world’s most trusted profession , while scientists took second place. Politicians and advertising executives, however, remain at the bottom of the league table in terms of public trust. “Behaving responsibly” is the key driver of such sentiment, with a greater tendency to challenge authority than before. During the pandemic, governments had a special challenge, as they've needed to quickly make decisions that impacted thousands of lives and livelihoods with limited, shifting data. The ability to set new rules and guidelines requires the trust of the public which can wear thin over the course of a multi-year crisis.

COVID-19 Lesson #8: Expectations of the state have changed

As the COVID-19 crisis unfolded, people turned to governments to protect the economy and society and mobilise a healthcare response, including vaccine rollout. While they demonstrated their power, their limitations also became apparent, needing the help of international pharmaceutical companies, which have since enjoyed a boost to their image. There is some evidence for support of further strengthening of state intervention but whether that will continue once the pandemic ends or will carry to other crises like climate change is yet to be seen.

COVID-19 Lesson #9: Fear and risk are being redefined

Concerns about personal health and safety and financial and health worries created a crisis where people felt a loss of control with perceptions that governing institutions also did not have a good grasp on the pandemic. Fear and inconvenience still present serious hurdles in different areas of life, international travel being a prime example. This feeling extends across borders with more than two in three people in the US, Russia, Brazil and Germany stating : “I feel things in my country are out of control right now.” As the pandemic has moved and changed, people around the world have needed to adapt to constantly shifting contexts and weigh what risks they are and are not comfortable taking on.

COVID-19 Lesson #10: A sustainable future requires leadership

Despite initial lower emissions at the start of the pandemic, climate concern has not diminished and there is near-consensus an environmental disaster is likely without drastic changes. The same leadership sought from the pandemic is sought in the fight against climate change, giving governments and businesses a clear mandate to act . However, according to the research, people are far from aware of how their lifestyles should adapt to save the planet, which could mean this environmental feat is the biggest leadership challenge to come.

Environmental disaster is feared by 83% of people

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Our most valuable lessons from 2 pandemic years

Andee Tagle

It's been two years since the world as we knew it was forever changed by the coronavirus pandemic .

We know you probably don't need that reminder, and there are probably a lot of people out there who don't want one.

This essay first appeared in NPR's Life Kit newsletter. Subscribe to the newsletter so you don't miss the next one, plus weekly tips that can help make life a little easier.

But if you're reading this, it means you've been through a lot:

Through unemployment and essential work; lockdowns and empty grocery store shelves and social distancing or even isolation; Zoom rooms and tiger kings and sourdough starters and all the sweatpants ; mask mandates and police brutality; a presidential election and an insurrection ; vaccines and boosters and masks off and on and off and on again .

It's been a revolving door of fear and fatigue and anger and uncertainty and suffering and loss . But we've also experienced a surprising amount of joy , and kindness, and new discovery, and delight , even.

Mental Health

Feeling blah take a joy break.

All of this to say: it feels all but impossible to qualify two years of pandemic living in any one way, but one thing is certain: we're still here – and we're changed.

The Life Kit team looked back on some of the most valuable lessons from the last two years that can help you look forward. Here are moments that helped change our mindsets and kept us moving through the past two years:

How to let more joy into your life

Producer Janet W. Lee grew to appreciate the small things:

While recent years have made it harder for me to look at the world with a more positive outlook, poet Ross Gay taught me to let more joy into my life . Gay is the author of The Book of Delights , where he shares the practice of calling out the delights in his everyday. This practice of taking a second to say the smell of coffee is lovely or to smile at the sound of my cat purring has brightened up my life.

Laziness does not exist

Managing producer Meghan Keane thanks Dumptruck for finding worth beyond productivity:

Dumptruck the chinchilla Devon Price hide caption

Dumptruck the chinchilla

Before the pandemic, I was all about hustle culture: get to work early, leave late, ignore any signs that I might need to slow down. But then a chinchilla named Dumptruck changed everything. We interviewed social psychologist (and owner of Dumptruck) Devon Price about his book Laziness Does Not Exist . Price says he never questions Dumptruck's worth because he lies around all day, but we're extra hard on ourselves when we aren't being productive. He says what we often see as laziness is actually a signal from our bodies to rest – we all still have worth when we are simply breathing on the couch.

Time is the building block of life

Producer Clare Marie Schneider learned the value of time:

Four Thousand Weeks author Oliver Burkeman says he's in recovery from productivity. Now, he thinks of time as a precious resource – the building block of our lives. When we interviewed him, he said, "The sum total of all the things you paid attention to will have been your life." To me, this way of looking at time leaves a little more room to embrace taking out the trash, over and over again, and to move towards what feels most exciting in life.

Finding passion outside of work

Producer Audrey Nguyen shifted her energy to find what she loves outside of her work:

A Field Guide for Fledgling Birders

I've struggled with pouring too much of myself into my work, and not leaving enough gas in the tank for my life outside of the 9-to-5. One of the most useful lessons I learned came from our interview with sociology professor Erin Cech , author of The Trouble With Passion: How Searching For Fulfillment At Work Fosters Inequality . She recommends finding ways to "diversify your meaning-making portfolio." Taking a step back and figuring out how to make room for passion outside of work has been really helpful for my mental health. I've been birding , and I'm currently taking a pottery class with my partner at our local community college!

Find your "resilience circle"

Visual and digital editor Beck Harlan built community in a time of isolation:

The last two years have felt particularly uncertain. That makes it hard to plan, hard to dream and hard to cope. Author Elizabeth White faced some uncertainty of her own during the Great Recession, and she has a piece of advice: don't go it alone. White found support in a "resilience circle" – essentially, "a few people that I could tell the truth to." Having those folks who'll be a sounding board and a cheer squad in your corner, can get you through a lot. It doesn't matter how you connect — Whatsapp, Marco Polo, postcards, a weekly walk — just that you DO.

From all of us to you: we're grateful for the time you've spent with us today and throughout the pandemic. We're still here.

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Lessons we will learn from this pandemic, unicef young reporters shed light on the lessons they have learned during the covid-19 pandemic.

There is no rainbow without rain

Eva Hadzipetrova (15), UNICEF Young Reporter

I’ve been thinking a lot - what is it that will come out of all this? Equality! This situation has shown us that we are all the same regardless of our religion, culture, customs, whether we are poor or rich. The virus simply does not choose. It connected us in a way, it showed us that we should all stick together. During this chaos, while many of us in a panic, it showed us the weight of humanity. It reminded us who we are. Maybe the world will finally change.

We humans are fragile by ourselves. Our strength lies in being part of a community.

We do not live without relationships and we should never forget that. We have a very caring and shared connection between us and it’s amazing to see how we stick together at times. Sharing is caring. Sometimes we need to remember how important kindness is. We need to remember that we have been given a gift called life and that we should appreciate it.

Everything can end tomorrow. Focus on what is important to us. When all this is over, Earth will continue to spin, and life will flow again. The question is whether by then we will have learned our lesson. Let us be mindful of our Earth and it will be kind to us. There is no rainbow without rain. Remember that.

There is good in every evil

Maria Mitrikeska (15), UNICEF Young Reporter

There is an old saying ‘there is good in every evil’ that I will now use as a tiny consolation in this difficult, unexpected time. As a young teenager, believe me it is hard dealing with this situation, and to everyone who is reading this and feeling helpless, I just want to tell you that you are not alone, and it will be better!

I am aware of everything that has been taken away from us due to this situation, of all the unrealized plans, be it birthdays, travels, weddings ... and sadly, we cannot do anything about it. But we are not powerless! On the contrary, it is all of us together that can make the world a better place. If each of us respects the measures imposed by authorities, the situation will get better and it will pass much faster than expected.

I can single out isolation - staying at home – as one of the most important measures. I know it sounds difficult and believe me, at first this sounded impossible to me, just unfeasible. I found it hard and boring, I wasn’t used to sitting in the same closed place for so long. But over time, I started to find hobbies. I tried things I had never tried before. I spent a lot more time with my parents than before, and even though I didn’t go out, I exercised at home. I found I had the time to watch the TV series and read books I never had the time for! Also, I have to admit that for me, online learning is much easier, more flexible and stress-free.

One of the most important things I’ve learned while we’re in isolation is to take care of myself and to devote more time to myself.

Taking care of yourself is something so underestimated nowadays. Whether due to a lack of time or due to too much stress in everyday life or for a whatever reason, people don’t devote enough time to themselves. While in isolation, I’ve had a lot of time to think and realize that actually taking care of myself is one of the things that makes me happy. I mean little things that I believe are available to everyone. These little things are actually the ones that help me find myself.

Let’s go back to the sentence “There is good in every evil”. A simple short sentence, but still so powerful! This is just one perspective of a young girl who is going through the same thing as many others. So don’t forget, you’re never alone!

A pandemic that taught me to love

Branislav Maksimovski (15), UNICEF Young Reporter

It’ll take just a little patience and support for us to master this crisis, but together can we do it. We only need to respect the recommendations and measures issued by the state, to protect ourselves, the people closest to us, and others who live in our community. We all know that it is not easy to stay at home but taking a break to stop and reflect has its own virtues.

If someone asks me how I’m dealing with the pandemic and how it influences me I would say:

I know that is not easy for us, I know it’s not easy for those lying in the hospitals, I know it’s not easy for those who lost someone. Life takes us in different directions. That’s why it’s important to live the moment, without thinking of the past or the future. I sit at home, do my school assignments, go out on the balcony, have a tee or coffee, listen to good music. I can’t count all the activities I do to stay positive. It matters to me that my brother, my parents and grandparents are safe and for them I do my best. I write essays, I paint, I read. This situation has taught me many things.

It taught me to love, to listen, to care, to respect and to help.

Help - that’s the word I’m looking for. What does it mean “to help someone”? Help someone to teach them something. Help someone by having a conversation with them. We should use this word in our vocabulary more often, so we can see a smile on people’s faces more often. This situation taught me to love. Not only to love a person, but also to love the little things in life.

Life is a lesson, we learn and continue to learn every day

Andrijana Kamcheva (25), UNICEF Young Reporter

Humans are very complex beings; they spend their whole life learning. But why wait for something bad to happen so that we learn how to appreciate the good? Why can’t we appreciate the little things that actually make us happy?

I never had a chance to think about the things that have happened to me. I wasn’t appreciating many things and I have given importance to so many things, which weren’t important at all. I didn’t know that the rain makes me happy or that the coffee I have on the balcony is tastier than the coffee in a coffee shop. I realize that reading books makes me happy. Playing cards and monopoly at home wasn’t that bad at all and working out at home is better that at a gym. I realized that I’m a philanthropist and have a great sense of empathy, which makes me very happy.

We learn how to live every day. We choose the path we will take.

Just think about everything you dream of? It is good that we dream and work towards achieving a goal. Don’t be afraid to work miracles on yourself, don’t be afraid to live as you deserve. Its normal to come across obstacles, that’s how we learn when we overcome challenges.

Life is a lesson; we learn every day and we will continue learning every day. Everything doesn’t have to be perfect in life for us to be happy and to appreciate ourselves and everything around us. We just have to be greatful. Remember that the best life lesson is learned during hard times and when we make mistakes.

Enjoy your life and appreciate what you have. Just think about the fact that there are people in the world with less. Be happy and positive for everything around you and you will become a stonger person.

Blogs written by UNICEF Young Reporters are part of a UNICEF volunteer initiative to give young people the space to share their own views on topics important to them. The work of the Young Reporters during COVID-19 pandemic is partly funded by USAID.

New online platform offers networking and learning

u-platform.by is the only youth platform in Belarus that brings together training, volunteering, fighting online bullying and more

Forward to dream

In Uzbekistan UNICEF Skills4Girls programme equips women and girls with much-needed digital skills

Preparing for the next pandemic: Early lessons from COVID-19

Subscribe to the economic studies bulletin, dante disparte dante disparte chief strategy officer and head of global policy - circle, executive vice president, policy and social impact - diem association, member - fema national advisory council @ddisparte.

February 16, 2021

15 min read

COVID-19 has caused more than 109 million confirmed cases , claimed more than 2.4 million lives, and even brought prosperous nations and well-run healthcare systems to their knees. Few countries have been spared. Even in the economically powerful U.S., the tension between maintaining social freedoms and engaging in efforts of collective defense against the virus has led to politicization (e.g., mask wearing, social distancing and vaccine refusal). Sadly, the U.S. is bearing the heaviest human toll from the virus with 25.4 percent of total confirmed cases and more than 486,000 deaths. Fortunately, even in our darkest hour in the fight against COVID-19 – amid a predictable winter surge – there is a light at the end of the tunnel. Pfizer and Moderna have each produced vaccine breakthroughs with 90 percent or greater efficacy, while Johnson & Johnson seeks approval of a single dose vaccine that may be available over the summer. With over 70 million doses delivered across the country, close to 53 million doses have been administered of which 14 million people have received their second shot, breaking the logistical and supply chain log jam that plagued early vaccine efforts.

Even though pandemic preparedness and biodefense have had ardent and clarion supporters, namely Bill Gates and the first Secretary for Homeland Security Tom Ridge , COVID-19 proved how ill-prepared we were to combat a 100-year pandemic. It is not too early to draw lessons from this lack of preparation and global coordination. Not only will doing so aid current recovery efforts, but it would also increase readiness for the next communicable or vector-borne disease to threaten the world. Below are seven areas of opportunity to learn from our COVID-19 response and improve readiness for future pandemic shocks.

Restore institutional trust

Public health always depends on public trust. This is especially true during a global health emergency in which the first line of defense is public adherence to health directives, including to quarantine, observe social distancing, wear masks, and, eventually, receive a vaccine. It is notable that during the 21st century’s pandemics, the most effective remedies borrow from a playbook that is hundreds of years old. Unfortunately, the fight against COVID-19, like past outbreaks and pandemics, has suffered from various perverse, insidious, and conspiratorial setbacks, including the specter of cyber-attacks attempting to thwart the lucrative and geopolitically prized race for a cure or vaccine. Indeed, cyber ne’er-do-wells are also targeting cold supply chains as the mobilization of vaccines gets underway.

The eroding public trust in the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), World Health Organization (WHO), and pharmaceutical companies more generally has already signaled the need for reform. In the U.S., the CEOs of major pharmaceutical firms , along with industry bodies, have made public pledges that their race for a cure will not succumb to political pressure nor will their companies cut corners on public safety and scientific soundness. Seeing a tension between public interest, shareholder value, and corporate reputation, the private pharmaceutical industry seems to have distanced itself from political interference and emphasized science in their decision making. The same temperament should hold true among political leaders who, in a crisis, must model the behavior they want to see in the public. Such leaders must also provide clear, fact-based information, even if— especially if—it is politically inconvenient.

Fortify early alert frameworks

Some countries, such as Singapore and South Korea , have a comparatively more effective disease outbreak early alert system. This is especially true in Southeast Asia, where people are accustomed to the perennial threat of communicable upper respiratory diseases. Many of these diseases have been identified and mitigated through preventative measures including airport and port of entry screening, temperature checks, and broader social acceptance of wearing masks. Partly due to such measures, countries with crowded urban environments such as Taiwan or Singapore have fared comparatively well in terms of COVID-19 infections even though social distancing (of six feet or greater) may be impossible in some settings such as public transport. These examples demonstrate that building a system for defense against infectious diseases, especially novel or emerging threats, requires an outermost perimeter that serves as a veritable early alert system. Central components of this early alert system include forward-deployed infectious disease specialists, as well as trusted relationships among scientists and epidemiologists. These specialists know the tell-tale signs that a novel virus is emerging and when to sound the alarm – in short, science and data should guide decision-making in response to potential outbreaks.

Sadly, in the case of COVID-19, many components of such early alert systems have been greatly strained, defunded, and politicized, both at the national and global levels. However, in the fight against a so-called “invisible threat,” global solidarity, trust, and real-time threat information sharing are a part of our collective defense. The U.S. is best positioned to lead and refortify these early alert frameworks, beginning with shoring up trust in public health authorities within the country and resourcing them adequately for the global fight against vector-borne and emerging infectious diseases. It was always a matter of time before a new pandemic would occur, and efforts to improve defenses post-COVID-19 should treat the prospect of communicable disease outbreaks like a mathematical certainty.

Threat-based resource allocation

One of the risk management conundrums in pandemic preparedness and biodefense is that the risk feels intangible. Additionally, experts who warn about the specter of contagion are frequently dismissed. Prominent voices from Bill Gates, who sounded a clear alarm at the 2017 Munich Security Conference , to Governor Tom Ridge and Senator Joe Lieberman, who co-chair the bipartisan commission on U.S. biodefense and pandemic preparedness , have largely gone unheeded. COVID-19 must serve as a global wake up call, lest the great human and economic sacrifices are in vain.

Hopefully, the aftermath of COVID-19—which may still be some ways off as the U.S. grapples with a growing third wave and the appearance of mutating variations , which may blunt the effectiveness of vaccines—will recalibrate resource allocation to match the global threat environment. Even in the lead up to the COVID-19 pandemic, U.S. resource allocation for combating infectious diseases and developing biodefense was woefully inadequate. In 2014, the U.S. allocated $6 billion in Federal funding to civilian biodefense, mostly in a diffused manner across a range of research and development programs. Similarly, despite the threat of novel infectious diseases making the “magic leap” and the ever-present specter of bioterrorism or lab-borne threats from malicious actors, this low defensive posture is largely the same around the world.

Comparatively speaking, as a share of global defense spending, the security industrial complex does not allocate nearly enough threat-based resources to mitigating pandemic risk, in the form of money, attention, or human capital. In aviation risk management, there is a process of capturing near misses. By this measure, when it comes to emerging zoonotic risks, scientists have identified 200 zoonoses and seen six registered as a Public Health Emergency of International Concern under the WHO’s emergency classification. Of these, three have been coronaviruses, suggesting that it was only a matter of time before one reached pandemic proportions. Considering the amount of money spent in shoring up the U.S. economy and providing direct relief to citizens (more than $5.7 trillion in economic interventions thus far), pre-investing in infectious disease prevention and meaningful ways of breaking the chain of transmission are clearly a better investment than ex-post efforts to deal with a novel zoonotic health crisis.

Science in the war room

There is an adage in management circles that if you do not measure something, you cannot manage it. In fighting the spread of COVID-19, data and science should be the most critical elements of decision making. Unfortunately, the void of reliable real-time information has been a global challenge during the COVID-19 crisis. This has been particularly true in the U.S., where different states have each pursued varying degrees of transparency, accuracy, accountability, and, critically, methodologies, with regards to reporting infection and casualty rates. In some instances, low-levels of technological processes like the limits of Excel spreadsheets or the specter of keystroke errors, have created misreporting and miscalculation on the number of confirmed cases, as well as the prevalence of community spread.

Another major challenge in the race for a vaccine has been the early, often erroneous signals surrounding the effectiveness of treatments and experimental drugs or vaccines. The world has embarked on nothing short of a vaccine space race to find an effective cure for COVID-19, with some countries, such as Russia, claiming victory early on even though clinical trials have been either scant or could not support efficacy and safety with data. Sadly, even in the face of a global threat, the tendency of economic nationalism and retrenchment stands in the way of global collaboration and solidarity in the race for a vaccine and its global availability. This is true for the vital task of building the type of integrated supply chains that are needed for the provision of lifesaving N95 masks and medical equipment, as well as the high-functioning cold supply chains required to distribute vaccines at global scale. Unless there is great coordination on cold supply chain management, likely led by the logistics prowess of the U.S., the advent of a vaccine may be a Hail Mary pass for many countries wherein poor countries that comprise the largest share of the world’s population may pay the heaviest price of vaccine nationalism.

Privacy preserving technology

Although we have many technological tools that could help control a public health crisis, those tools are only beneficial if the technologies are both trusted and readily deployable. The general lack of reliable, real-time threat information sharing, contact tracing, and community prevalence data during this pandemic has meant people and public health authorities have either been flying blind in the fight against COVID-19 or are relying on backward-looking reporting of confirmed cases. This type of reporting has been particularly plagued with issues: persistent testing bottlenecks, false positive tests, the asymptomatic nature of many cases, and lags in reporting testing outcomes have all presented challenges in mounting an effective and trusted response. The gap in population-scale technologies to facilitate open information sharing, including self-reporting COVID-19 symptoms in a privacy preserving way, is a clear national and global vulnerability. The lack of ubiquitous, trusted technologies in the hands of U.S. citizens confounded real-time risk-reward decision making at the household level.

Playing whack-a-mole with the moving target of a COVID-19 resurgence (including the specter of rapidly evolving variants) without a reliable national COVID-19 dashboard has hampered containment, mitigation, and public health information sharing. In the absence of reliable, real-time data on community prevalence of COVID-19, the assumption is that everyone is a potential threat, which is what makes the “nuclear” lockdown option necessary despite its economically detrimental effects, especially on the most vulnerable people and sectors. Herein lies the difference between risk and uncertainty: risk is measurable, uncertainty is not, which is why the latter is a driver of panic, paralysis, and fear. These are the very conditions that have gripped many parts of the country, as U.S. households have contended with the type of life-or-death decision making usually reserved for battlefields or hospitals.

Indeed, as vaccines are gradually approved, notwithstanding the deleterious effects of vaccine nationalism , containing COVID-19 will require the largest vaccination campaign in U.S. history. As with yellow fever vaccination cards required at ports of entry in a number of countries , the prospect of health passports being upgraded from risk-prone analog cards, which may be lost or forged, is another opportunity to leverage technology. Here, too, the advent of privacy preserving technology in the form of portable e-health passports can provide individual protections and community health assurances as we overcome our trepidations to return to normal. Five major airlines are adopting their own e-health passport as a potential precondition for boarding, along with rapid testing to augment potentially porous airport screening or traveler-provided assurances on pre-travel health. Until population-scale clearances are provided, restoring trust and business as usual may see two populations being served: one group that can provide high-assurance on COVID-19 immunity may be allowed to resume a semblance of normal activities, while the other may struggle with restrictions until the chain of transmission is broken.

Mass casualty surge capacity

There is a fundamental tension between public health emergencies—and their resulting need for collective defense against a pandemic—and privatized healthcare. The definition of a moral hazard is risk-taking behavior without bearing the consequences of the risk. The vulnerability of an unequal and ill-prepared U.S. public health system, where more than 26 million people are functionally out of the system (as uninsured or poorly covered), has been laid bare during the COVID-19 pandemic. Not only did the material scarcity of life-saving equipment like ventilators and personal protective equipment (PPE) – among other essential supplies – imperil frontline healthcare workers, but it also often consigned those with treatable conditions to their death.

There is a clear need for improved universally accessible emergency healthcare surge capacity to respond to mass casualty events. The national healthcare emergency perimeter should reach 100 percent of the U.S. population, particularly when combating the spread of an infectious disease or responding to a wide-scale bio-hazard event or other mass casualty threat. The medical and emergency management professionals on the frontlines, meanwhile, should never experience a shortfall of predictably necessary and life-saving supplies. Sending healthcare professionals to fight COVID-19 with ill-fitting, reused, or patchwork PPE, is tantamount to sending soldiers into battle without body armor or weapons. In keeping with this combat analogy, the nation’s healthcare and emergency response system must also draw lessons learned from the COVID-19 response and formulate tabletop exercises and preparedness drills that treat mass casualty events, communicable diseases, and bio-threats as ever present, rather than as so-called black swans or statistically rare events.

Public-private accelerator

If and when the world sounds the all clear on COVID-19 and the global economy returns to a new normal, a generational debt of gratitude will be owed to scientists and medical professionals. The pandemic, like prior global crises, has blurred the lines between public and private resources. In many countries, including the U.S., governmental powers usually reserved for times of war were used to compel the private sector’s balance sheet to make a down payment on the greater good. While some firms responded to this call to action affirmatively and on their own volition, others will be compelled by the Defense Production Act , not realizing that shielding their balance sheet amid total economic collapse would be a reputation tarnishing Pyrrhic victory. This is especially true considering the scale of the taxpayer backstop that has been deployed in the U.S. in an unprecedented mobilization of the government’s financial wherewithal to stave off massive layoffs, business closures, and economic ruin.

In all, the economic response to COVID-19 has tipped already perilous U.S. debt-to-GDP rates to stratospheric heights not seen since World War II. With national debt projected to be greater than the size of the U.S. economy, the down payment on COVID-19 response and recovery will require generational commitments to ensure national resilience in the face of future threats. A public-private approach to catalyzing national and global resilience to large-scale emerging threats such as climate change , pandemic preparedness, and biodefense, among others, would be a more effective use of resources than addressing a catastrophic event without a plan. Operation Warp Speed, the nom de guerre for the U.S. race for a cure, has mobilized what is ostensibly the fastest pursuit of a safe vaccine in history and has also shown the benefits of purposeful societal collaboration. The U.S. is not alone in this quest. If this type of innovation accelerator were not a zero-sum proposition for each country but rather a globally shared and pre-funded capability immune from corporate intellectual property restrictions and national interests, the potential for broad societal benefits would be unprecedented.

The dreadful human, economic and sociopolitical toll of the COVID-19 pandemic hearkens to a war time effort. Rather than combating this disease in global solidarity, many countries and regions have opted to go it alone, ignoring the reality that against a threat unseen like a novel zoonotic disease, porous national borders that depend on the arteries of trade, integration, and globalization, will offer little defense. Some of the capabilities established in response to COVID-19 should remain in place, including and especially reinforced early alert frameworks that can serve as a proverbial tripwire that a novel virus, vector-borne disease or other bio threat has surfaced. These early alert systems are a global tripwire framework that all countries must contribute to and believe in. Similarly, once the tendencies of vaccine and resource nationalism are overcome, countries must realize that in the face of pandemic and other global threats, we are in effect as strong as the weakest link. U.S. leadership in strengthening the chain of pandemic resilience will be a vital catalyst to ensuring the world is prepared for the next one and that the costly lessons from COVID-19 prepare future generations.

Science coupled with focused public spending or guaranteed demand for billions of vaccines has produced multiple breakthroughs in record time compared to the typical 12 to 18 months it takes to develop a new vaccine. This rapid vaccine development capability should not be disbanded once COVID-19 is contained, especially as many developing countries will rely on coordinated international assistance to contain domestic outbreaks and prevent mutations from leaping over national borders. COVID-19 bears many similarities to other global threats, such as climate change, severe income inequality and societal polarization. Like COVID-19, responding to these threats will require a societal approach, tradeoffs across the public and private lines and trusted public leadership that people will follow.

Dante Alighieri Disparte is Founder and Chairman of Risk Cooperative, a risk management and insurance advisory firm; a member of FEMA’s National Advisory Council; a member of the World Economic Forum Digital Currency Governance Consortium; and Executive Vice President of the Diem Association. The author did not receive financial support from any firm or person for this article or, other than the aforementioned, from any firm or person with a financial or political interest in this article. Other than the aforementioned, he is currently not an officer, director, or board member of any organization with an interest in this article.

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What Lessons Do Americans See for Humanity in the Pandemic?

This essay explores which lessons, if any, U.S. adults are taking away from the coronavirus outbreak. We surveyed 10,211 U.S. adults from July 13 to 19, 2020. All respondents were first asked whether they believe there is a lesson or set of lessons for humankind to learn from the coronavirus outbreak. Then, a random half of respondents who said “yes” to this question were asked to explain, in their own words, the lesson humankind should learn. More than 3,700 respondents wrote a response, a sampling of which are presented throughout this report.

All respondents to the survey are part of Pew Research Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. For more, see the ATP’s methodology and the methodology for this report.

The questions used in this essay can be found here .

W hen an event has as much impact as the coronavirus outbreak – disrupting billions of lives and leading to more than 1 million deaths around the world – it’s natural for people to ponder big questions. Is this just a random occurrence, or is there something more at play? Is it all part of God’s plan? Or, at a more worldly level, can this experience teach us any truths about humanity?

We sought to explore these questions in a recent Pew Research Center survey, conducted in mid-July on the Center’s American Trends Panel . First, we asked people: Do you believe there is a lesson or a set of lessons for humankind to learn from the coronavirus outbreak? And if so, do you think these lessons were sent by God, or not?

A large majority of U.S. adults (86%) say there is some kind of lesson or set of lessons for humankind to learn from the pandemic, and about a third of Americans (35%) say the lessons were sent by God. The remainder say the lessons were not sent by God (37%), they do not believe in God (13%), or there is no lesson to be learned (13%).

Then, we asked half the respondents who said yes to the first question to describe, in their own words, what lessons they think humankind should learn. This prompted more than 3,700 people to write their answers, which ranged from a few words to several sentences.

The rest of this essay looks at a sampling of responses – including many examples presented exactly as respondents wrote them. Some responses have been lightly edited for spelling and clarity. Due in part to the great variety of responses we received, we did not attempt to quantify what percentage of Americans believe there is a certain type of lesson to be learned.

There are, however, a few common themes. These include practical lessons, such as wearing a mask; personal lessons, like remembering the importance of spending time with family and loved ones; and societal lessons, such as the need for universal health care. Still other takeaways are political in nature, including criticisms of both political parties and concerns about the politicization of the pandemic.

Americans who say God is using the pandemic to send a lesson to humanity often highlight religious lessons. Those who do not think the lessons of the pandemic were sent by God mention a variety of topics – though rarely religious ones.

Lessons about God and religion: ‘The rapture is at hand’

Additional lessons about god and religion.

“We should humble ourselves before God. We should look to Him as God and repent of our arrogance, ignorance, and contempt of our Holy God. We should cry out to Him for our salvation.” – 54-year-old woman

“We need to pray more and pray harder.” – 19-year-old man

“We need to learn that every person’s life is a precious gift from God. We must learn to love one another period. If your belief in our Father in Heaven does not convict you to love all races, we are not following really serving Him … He loves all of us, and we are required to love Him and one another!!” – 66-year-old woman

“Use this time to know God better. Receive as a gift this time of less activity and immerse yourself in quiet contemplation for personal spiritual growth. Develop gratitude in the midst of the current situation. Pray for the sick and unemployed.” – 57-year-old man

Among those who say there is a lesson about religion within the pandemic, some respondents point to the role God has in humans’ lives. For instance, a 53-year-old woman writes that “whether you believe it or not, God is in control and we must have God at the center of our lives. He is our savior.”

Other respondents say the pandemic is a sign the end of the world is near. In the words of a 55-year-old woman, “it is biblical prophecy playing out. This pandemic as well as other world events are a wakeup call and confirmation that the rapture is at hand as prophesied in the Book of Revelation.”

A 58-year-old man feels God wants people to reflect on their lives: “God is telling us that we need to change our ways or he will send a virus that will make us be alone so that we have time to think about how we live our lives. We all need to live as one we are all children of God. God did not create mankind to live as we do. And he is not going to let this virus end until he knows that we have learned our lesson.”

Lessons about society: ‘Just who are the essential workers?’

Additional lessons about society.

“Capitalism has caused us to develop an unsustainable and inhumane system. We should take this opportunity to restructure our society so that people can spend more time with family and so that there are appropriate safety nets in place to protect people when disaster strikes.” – 30-year-old man

“The lesson that humankind should learn is how horribly we are treating our Earth. When countries were quarantined our Earth started to heal in so many ways, simply because people were not out abusing it every day.” – 26-year-old woman

“A single human life is worth more than rescuing the economy for a few. With universal health care, the millions of laid off Americans would be able to provide for their families most basic needs.” – 29-year-old man

“That public health affects economic health, for one thing. Also, it’s exposed all the flaws in our society: science denial, safety net for the working poor, health outcome disparities between rich and poor, white and POC. Lack of childcare options. How much work schools do that isn’t education (meals, childcare, reporting of abuse, etc.)” – 49-year-old woman

“While the working class supports, arguably runs, the economy, there is not adequate aid for them in this time of crisis. Whereas big businesses and the one percent are given aid, disproportionately large compared to their “need.” The government is not for all the people, it is for the well off and rich some. The working class keeps the economy growing, but in business and government eyes, they could not care less what happens to them so long as they are spending their money. However in these times, there is no money to spend for these working class citizens, but somehow big businesses and corporations are getting richer due to the financial aid they are receiving from the government.” – 22-year-old-woman

“What we do to the Earth has consequences – we can’t continue building cities and abusing resources and the climate for personal profit without expecting something to happen. As a species, we need to find a way to live in harmony with the planet and learn to be more content with what we have, as well as supporting our community members and ensuring that people are cared for and understood properly.” – 27-year-old man

Some respondents see lessons in society’s failure to face up to problems like racism, economic inequality and climate change. According to a 24-year-old woman, “the system that is in place currently needs to be dismantled. We need change, equity and true equality for all races, gender, religions, etc. The facade of America being a country of the free and of equal opportunity is being exposed.”

Another respondent, a 63-year-old man, emphasizes the need for universal health care: “Health care should be universal to maintain the population’s health. Having so many people without lifelong care promotes comorbidities that, as we see now, affect the death rate from this pandemic.”

Much of the public discourse this spring centered on whether lockdown orders were causing unnecessary harm to the economy. Americans see lessons on both sides of this debate. “The economy should be important, but grandparents and parents shouldn’t die because people are too antsy to stay home or try and accommodate for current events,” a woman in her mid-20s writes. “People should be the first concern in health and human rights over economic value and growth.”

Other respondents register anti-lockdown sentiments, saying the pandemic’s main lesson is that government officials and public health experts have overreacted. “Don’t believe everything you are told by experts,” a 65-year-old man concludes. “Shutting down the economy for a virus which kills less than 1% of the population is insane.”

Another respondent says the pandemic has taught us which workers are actually essential to the economy, a viewpoint shared by many. “Just who are essential workers? It’s not the financiers and money pushers or the 1%,” writes a 65-year-old woman. “It’s the plant and factory workers, the grocery clerks, the people producing our food, the caregivers in nursing homes and daycare centers, the janitors. The disparity and inequity in this country must be addressed. Our infrastructure and health care systems need fixing.”

Some respondents reflect concern for the environment and the severity of climate change when asked about the lessons humankind should learn from the coronavirus outbreak. For instance, according to a 53-year-old man, “the virus seems to have come about by humankind’s continued encroachment on the natural world. We need to be far better stewards of our planet than we have in the past.”

Another respondent, a woman in her 40s, is more explicit: “Mother Earth will prevail. We have done so much damage with overuse of land, destruction of ecosystems, and hunting of animals. The virus is a way to get us to stop or eliminate us completely. Pollution, global warming and building have destroyed the earth.”

Lessons about life and relationships: ‘An opportunity for people to rethink their priorities’

Additional lessons about life and relationships.

“We don’t need all the materialistic things. Value humankind and intimacy.” – 55-year-old woman

“To appreciate and love each other. To be thankful for our blessings.” – 71-year-old woman

“To empathize with each other, to be considerate of others, to appreciate all of those who serve and work with the public, treat them well and compensate them well.” – 52-year-old woman

“It’s important to occasionally take step back and focus on your well-being and your relationships with those you love. Working and spending your time and money isn’t what life is about.” – 24-year-old man

“Many of those who have died with coronavirus had underlying health issues, such as obesity and type 2 diabetes, two conditions that are preventable. The lesson is to take better care of yourself so that your healthy body has a much better chance of surviving the virus.” – 52-year-old woman

Many respondents mention lessons about changes people should make in their personal lives and relationships with others. One 46-year-old woman says people need to “think about what is REALLY important and how your time is REALLY spent … hopefully this is an opportunity for people to rethink their priorities.” Similarly, a man in his 40s writes, “Life moves too quickly and people don’t slow down long enough to see their lives pass by. The virus has shown us that life doesn’t need to fly by so quickly. We can enjoy the moment more.”

Spending time with loved ones is another key theme in the responses. According to a 44-year-old woman, “the importance of family and friend interactions should not be overlooked. Internet and electronic interactions cannot replace or fulfill human need for interactions face to face.”

Others reference the need for humankind more broadly to come together with a common purpose. One 42-year-old man notes that the pandemic has alerted us to the fact that “we need to work together since the world is more connected today than ever. One simple little virus in China has spread worldwide. You cannot defeat it on our own. We need allies and a government that cares for the people.” And a 68-year-old woman says that humankind should focus not on what divides us, but what unites us: “We need each other to survive and should be willing to set aside individual differences for the greater good.”

Many respondents also frame the coronavirus as a simple reminder to treat others well. A 54-year-old woman says that “we should always be kind to one another regardless of race, religion, or political belief. The virus does not discriminate, and neither should we.”

Lessons about government and politics: ‘Political polarization is detrimental to the public good’

Additional lessons about government and politics.

“Start voting for best interest and not on partisan lines.” – 47-year-old man

“Humankind absolutely cannot trust their government officials do the right thing. This virus is perpetrated by the left wing media and the Democrat Party to remove Trump from office.” – 46-year-old man

“Be careful about who you vote for or support.” – 84-year-old man

“We get the leadership we vote for.” – 27-year-old woman

Respondents provide a range of anti-government responses that criticize both Democrats and Republicans.

One woman in her 30s takes aim at the political left specifically: “The lesson is that our government is out of control. We elect officials to speak/act on our behalf, it is unacceptable that individuals see this as a career path. We need term limits for all. The left is 100% out of control and the level of corruption is going to bring the United States to its knees.” But another respondent, a woman in her 60s, is clear in her disapproval of the Trump administration’s response to the pandemic: “Trump is going to kill us if we don’t vote him out of office.”

Indeed, opinions about the pandemic have diverged along partisan lines in the U.S., and some respondents see a lesson in this fact: “Politicization of public health crises should be avoided,” a 49-year-old man says. “Science should be prioritized over political agendas when dealing with public health. Political polarization is detrimental to the public good.”

Others mention more general, and less partisan, lessons about the current state of U.S. politics. According to a 38-year-old man, “We humans have the wrong leaders in place and we need to replace them with kinder more compassionate leaders who will choose the right thing over what’s politically expedient.”

Respondents’ criticism of government is not limited to the U.S. In fact, many respondents condemn China for its response to the initial outbreak. “You can’t trust the Chinese government,” a 56-year-old woman writes. “They knew about this and did not communicate it to the world, allowed travel in and out of Wuhan, and other parts of China to all over the globe. They are responsible for the spread of this virus.”

Practical lessons: ‘Cleanliness is of extreme importance’

While many respondents share broad, sweeping ideas about the world, others give more narrow and practical answers. For one 76-year-old woman, the lesson is “that humankind should learn to abide by the govt. orders to stay home. As much as possible wear masks when out in the public, and social distancing. Also not to assume that the virus is nearing over when the cases are still going up, to still be cautious!!!!”

For another respondent, a man in his 60s, “cleanliness is of extreme importance. Handwashing and staying away from people when sick is crucial.”

Another theme is the idea that people need to do a better job anticipating future crises. According to a 54-year-old man, “We all need to be better prepared for any other pandemic, many people did not take it seriously. Government, medical authorities, specialists were not prepared and this is a chance to look and prepare.”

Finally, many respondents mention the importance of respecting expertise. As one man in his 30s sums up, the lesson humankind should learn is “to listen to scientists, professionals, and subject-matter experts that have spent most of their lives researching and studying topics such as climate change, health, social inequality, etc. It took a pandemic to highlight all of these issues and still there is significant part of the population that chooses to reject proven facts in favor of uneducated opinions of influencers and politicians. Doctors have no self-interest in providing medical advice to slow down the pandemic, politicians have significant self-interest in making choices that gets them reelected depending on the district or region they are in. Thus the consensus between the medical field and the disparity in the laws and ordinances to address the pandemic. We need to get back to listening to the experts and eradicate these opinions that everything is a conspiracy.”

Cover image: People gather in circles designed to encourage social distancing at a park in California. (Josh Edelson/AFP via Getty Images)

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POLICY BRIEF article

Lessons learnt from the covid-19 pandemic.

$\nNils Chr. Stenseth &#x;&#x;$

1 Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Oslo, Norway
2 Savannah River Ecology Laboratory, University of Georgia, Aiken, SC, United States
3 CAS Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
4 State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
5 CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
6 Chinese Center for Disease Control and Prevention, Beijing, China

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has been characterized by unprecedented rates of spatio-temporal spread. Here, we summarize the main events in the pandemic's timeline and evaluate what has been learnt by the public health community. We also discuss the implications for future public health policy and, specifically, the practice of epidemic control. We critically analyze this ongoing pandemic's timeline and contrast it with the 2002–2003 SARS outbreak. We identify specific areas (e.g., pathogen identification and initial reporting) wherein the international community learnt valuable lessons from the SARS outbreak. However, we also identify the key areas where international public health policy failed leading to the exponential spread of the pandemic. We outline a clear agenda for improved pandemic control in the future.

Introduction

In late-December 2019, pneumonia of unknown etiology (PUE) was reported from a cluster of patients who were initially linked epidemiologically to the Huanan Seafood Market in Wuhan, China ( 1 , 2 ). These cases of PUE were reported to the WHO China Country Office on December 31, 2019 ( 3 ), and the Chinese Center for Disease Control and Prevention (CCDC) sent an investigative team to Wuhan on the same day. The first batch of samples was dispatched to three organizations (China CDC, Wuhan Institute of Virology under Chinese Academy of Sciences and Chinese Academy of Medical Sciences) for virus genome sequencing and virus isolation. Parallel experiments from these organizations were carried out with coordination of the National Health Commission to make sure the results were comparable. The novel SARS-related coronavirus was identified when several PUE samples tested positive with a pan-coronavirus RT-PCR covering all SARS-related coronaviruses, and the pan-PCR product was sequenced. As of January 7, 2020, Chinese health officials had confirmed that the PUE was caused by a novel coronavirus ( 4 ). Hence, it took China just about a week to inform the world about the etiology of the PUE, which is indeed efficient for identifying a novel pathogen causing an emerging infectious disease, demonstrating China's improved ability to manage new outbreaks ( 5 ). Concurrent to the virus identification, NGS-sequencing was also carried out and on 10 January, 2020, the CCDC shared the whole genome sequences through the Global Initiative on Sharing All Influenza Data (GISAID; Accession numbers EPI_ISL_402119 and EPI_ISL_402121) ( 6 ), and reported these data to the WHO. Prior to the work in early January 2020, the Wuhan Institute of Virology had sequenced similar bat-derived coronaviruses, but did not have SARS-CoV-2 in the lab suggesting a laboratory-origin as being unlikely ( 7 ), a finding supported by a recent WHO report ( 8 ). Specifically, the Wuhan Institute of Virology got the partial sequences of the RdRp gene by pan-coronavirus RT-PCR from a bat fecal swab collected in 2013 (sample ID 4991) and later named RaTG13 following the bat species, samples location and year. The institute ignored this sequence when they found it is distantly related to SARS-CoV. In 2018, they decided to sequence as much as possible of the full-length genome from their stock samples which are positive for SARS-related coronavirus. They completed the nearly full-length genome sequence of RaTG13 but didn't publish it. In 2020, after they received the SARS-CoV-2 sequence, the institute compared it with all of their unpublished sequences and found its closest relative RaTG13 (96.2% nucleotide identity), and they then completed the whole genome sequence ( 9 ). As of current date, the RaTG13 strain has never been isolated and has not been the focus of further studies, except with regard to ACE2 interaction using pseudovirus and binding affinity assays. The current data indicate that the TG13 spike has low binding affinity to human ACE2 compared to SARS-CoV-1, SARS-CoV-2, Pangolin CoV and bat SARS-related CoV WIV1 ( 10 – 13 ).

Policy Options and Implications

Global response.

It is clear that both China and the WHO demonstrated dramatically improved responses to COVID-19 with the lessons learned from previous epidemics (see Figure 1 ). For example, in the case of the SARS-CoV epidemic (2002-2003), initial cases were identified in mid-November 2002 but it was only on 10 February 2003 that the developing epidemic was confirmed and the first report to WHO was made ( 14 ). In stark contrast, as highlighted above, Chinese officials informed WHO of a potential epidemic within a week of the first cases being identified in Wuhan. The WHO also acted quickly and formally alerted the world of a public health emergency of international concern (PHEIC) by end of January, well before pandemic spread had started. Indeed, at the time the PHEIC was declared only 25 countries/regions outside mainland China had reported any cases of the disease, and of these only 6 (i.e., Hong Kong, Japan, Singapore, South Korea, Taiwan, Thailand) had reported over 10 cases. Unfortunately, the rest of the world did not seem to pay too much attention to these alerts, and it was not until mid-March—when WHO Director-General announced COVID-19 as a global pandemic ( 25 )—that the rest of the world “woke up” and started to accept that a pandemic was developing.

Figure 1 . Comparative timelines of two coronavirus epidemics. The relative timelines for SARS-CoV epidemic of 2002–2003 (top row) ( 14 – 19 ) and SARS-CoV-2 pandemic of 2019 (bottom row) ( 20 – 22 ), specifically highlighting dramatic differences in duration to notification of the WHO, identification of the pathogen and sequencing of the pathogen genome after the identification of the first case. The maps show the spatial extent of SARS-CoV-2 infection at three critical time points ( 23 , 24 ).

Source Identification

While identifying the origin of COVID-19 is essential to prevent the next pandemic ( 26 ), the actual origin of SARS-CoV-2 remains enigmatic ( 8 ). Viruses that are phylogenetically related to SARS-CoV-2 have been identified in several wildlife species (e.g., horseshoe bats and pangolins), but as of now no wildlife species has tested positive SARS-CoV-2 across China ( 8 ). It is currently proposed that the entry of the virus into the human population could have been facilitated by cross-species transmission through one or multiple intermediate host species ( 9 , 27 , 28 ). However, this hypothesis is primarily based on our understanding of SARS MERS, and/or avian flu, and may need to be revisited and assessed as more data come to light. Initially it was also suspected that the coronavirus had entered the human population through the Huanan Seafood Market, a live animal market in Wuhan, China. However, the early report for COVID-19 did not find direct epidemiological links for many patients with the market ( 29 ). Thus, it is possible that the live animal markets might have served as an amplifier due to large numbers of people in close proximity to each other in the cold environment—just like the after-ski bar in Kitzloch, Austria ( 30 ).

Control Strategies

Different strategies have been implemented to combat the pandemic in different countries. Some countries (e.g., Sweden) initially tried so-called herd immunity by natural infections and some used mitigation or suppression, but in general these approaches had minimal effects on stopping the spread of the disease within and between countries. Generally, most countries across the globe tried to limit the spread of the pathogen through various non-pharmaceutical interventions (NPIs), including the implementation of lockdowns of varying intensity and geographic scope. However, it has been noted that the inadequate (e.g., United States and India) or delayed (e.g., Russia, United Kingdom, and France) implementation of lockdowns could have reduced their efficacy in impeding the spread of infections in many countries ( 31 ). Just as delays in implementing lockdowns have increased pathogen spread, the premature lifting of these restrictions can also cause a resurgence in case numbers as has been observed recently in India ( 32 , 33 ). One of the most effective implementations of NPIs was undertaken by China, which took immediate and stringent measures to prevent pathogen spread, including the lock-down of the city of Wuhan, where the virus was first identified, and suppression measures for the rest of the country ( 34 ). The WHO-China Joint Mission on COVID-19 ( 35 ) revealed that the immediate prevention and control measures that China took to curtail the epidemic were implemented in three main phases. The first stage focused primarily on preventing cases from being exported from Wuhan in conjunction with closing wet markets and enhanced surveillance to try to identify the zoonotic source. The second stage focused on controlling the impacts of the epidemic through medical intervention, improved diagnostics for rapid identification of infected individuals, and critically on reducing the rate of spread by curtailing the movement of people, restriction of mass gatherings, contact tracing, increased quarantine measures, and enhanced border security. Finally, in the third stage the focus shifted to controlling isolated and/or sporadic case clusters. In this stage there was a critical effort to strike a balance between effective disease control and sustainable economic/social development. The effective implementation of these policies made China one of the most successful countries in terms of COVID-19 control. The effectiveness of China's control measures is evidenced in terms of the per-capita cases reported. Thus, as of May 6, 2021, the global infection rate was about 20,022/million persons, with considerable variation amongst various countries (e.g., 98,503 and 15,573 cases/million persons in USA and India, respectively). However, China's cumulative infection rates remained one of the lowest globally (71 cases/million persons) ( 36 ). It is important to note that after Wuhan outbreak which was cleared on April 8, 2020 ( 37 – 39 ), China has experienced many small waves of outbreak with local transmission due to imported cases, but all the viruses are “stable” strains (with single imported case of both 501Y.V1 and 501Y.V2 but no local spread) and there are no new variants arising from China, indicating the successful suppression of virus circulation. For both containment and suppression strategies, lock-down of the city/region (the areas could be very small), lock-down of the household and isolation/quarantine are the three important factors for the success. Looking to the future, with no recurrent outbreaks in China even in the winter season (as of Feb 23, 2021), we might consider such a mitigation strategy to ensure meeting public health goals, while keeping the society socially active and economically strong. It is also important to recognize the need for better international coordination in terms of reducing transmission (e.g., restriction of social gatherings and mask ordinances) and the timely identification of potential spread (e.g., contact tracing). Early in the pandemic these measures, in conjunction with stricter limitations of international travel, would have helped reduce the initial global spread of the virus. However, in these late stages of the pandemic, localized lockdowns (e.g., at city or county scale) are likely to be more effective than large-scale lockdowns at national or regional levels ( 40 ).

Actionable Recommendations

We have learnt many critical lessons from the ongoing coronavirus pandemic with respect to the requirements for rapid response and large-scale surveillance, as well as the needs for effective and coordinated strategies to control novel pathogens. While there remain many unknowns and uncertainties relating to the control of future pandemics, based on what we learnt from SARS-CoV-2 we make the following recommendations:

1. While pandemics are unpredictable by nature, proper preparation and prior planning can help manage them better. For a long time, coronaviruses have been identified as pathogens with high pandemic potential, and have thus been high on the prioritized preparedness list. Yet the globe was still unprepared to effectively deal with COVID-19. There is no doubt that many of the science-based requirements for pandemic control—rapid identification of the causative agent, genome sequence and determination of the key epidemiological parameters related to transmission—were met, but the global management of the pandemic still failed in many respects. Clearly, science alone cannot control a pandemic. In the long run, active science outreach to the public and policy makers are fundamental to achieving a coordinated implementation of intervention across scales, sectors and population groups ( 41 ). There is no doubt that a unifying science-based strategy, public involvement, and informed decision-making are the three key steps to improve the control of such public health emergencies in the future.

2. Both China and international communities outside China have learnt the vital need for improved preparedness to rapidly identify and limit the spread of emerging pathogens. Stockpiling of emergency supplies and the logistics of meeting rapidly ramped-up demand was a major bottleneck in the response to COVID-19. From the very beginning medical and public health workers were faced with the shortage of many essential items, including equipment for oxygenation support (e.g., oxygen masks, respirators, and ECMO/extracorporeal membrane oxygenation) and even personal protection equipment (e.g., face masks and gloves). Despite the lesson learnt, there seems to be no practical way to address this issue because there is no easy way to store such supplies in bulk for logistic and economic reasons. Additionally, the next pandemic may be characterized by other symptomatology (e.g., hemorrhagic fever) rather than respiratory failure. Thus, there is a need to think of creative solutions to address our ability to meet such sudden supply-demand dynamics in the future, and we would like to leave this as an open question to the readers.

3. The WHO has to be given a much stronger role in the coordination of the implementation of the various control-measures. Given the exponential nature of pathogen spread it is imperative that we ensure the rapid mobilization of mitigation and control strategies at international scales before local epidemics can progress to pandemics. The authority of the WHO for global coordination of pandemic responses must be strengthened.

4. There is also an urgent need to address several open questions related to COVID-19, particularly the possible reservoir or intermediate host(s), the role of live-animal markets in introducing or maintaining the virus in the human population. China-WHO Joint Study Group recently spent a month (January-February, 2021) in Wuhan to investigate the origins of the virus, but with no definitive answers yet. For the whole year of 2020, scientists and public health professionals in China and across the globe have been trying to answer this critical question, but with limited success. For example, it still remains unclear if SARS-CoV-2 differs fundamentally from other coronaviruses (e.g., SARS-CoV and MERS-CoV) in terms of its epidemiology and entry into the human population ( 42 ). Given the lack of information there is a necessity to keep an open mind and follow an objective scientific agenda to address the outstanding questions.

5. It is encouraging that shortly after the genome was made publicly available identification of potential vaccine candidates was initiated, with NIH joining up with Moderna Inc. in mid-January ( 43 ). Potential vaccine candidates were rapidly screened, with Moderna publishing their preliminary report on the mRNA-based COVID-19 vaccine on 14 July 2020 ( 44 ), and BioNTech and Pfizer publishing safety and immunogenicity data from Phase 1 clinical trials of two RNA vaccine candidates on October 14, 2020 ( 45 ). Given that several vaccines have now been approved for human use, it is clear that vaccine development for COVID-19 has progressed at an extremely rapid rate, with less than a year elapsing from initial pathogen discovery to vaccine deployment. There is no doubt that the rapid development of the SARS-CoV-2 vaccine was only possible because it was able to leverage a large body of basic research on other coronaviruses, such as MERS-CoV ( 46 ). Such an approach to preparedness using prototype pathogens could also be started for the other 23 virus families known to infect humans (e.g., Flaviviridae and Filoviridae), thus dramatically improving our ability to manage future pandemics ( 43 ).

6. While vaccines are a key component of control, the recent pandemic has also highlighted the fundamental importance of NPIs given their efficacy in reducing viral spread ( 47 ). While the effectiveness of these NPIs is highly variable (e.g., depending on community-level infection rates), several specific NPIs have been shown to consistently reduce the transmission of SARS-CoV-2. These interventions include the closure of schools and workplaces, bans on public events and gatherings of more than 10 people, as well as limiting human movement ( 48 ). The continued use of such NPIs needs to be enforced especially at the very early stages of vaccination.

7. Most importantly, an international scientific conference should be convened, as soon as possible, to discuss not only the biomedical issues related to the pandemic, but also other issues related to pandemic control, such as the effectiveness of the various interventions adopted in different countries ( 47 ) and the need for improved policy coordination ( 49 ). Such large international conferences have been very effective in the past. A historic example includes the international sanitary conference held in February 1897 at Venice to discuss the spread of plague ( 50 ), and the international conference following the Manchurian plague of 1910-1911 in Shenyang (then Fengtian), China ( 50 – 53 ). These examples can serve as portfolios that can be effectively adopted to better evaluate the strengths and weaknesses of country-specific and international responses to the COVID-19 pandemic and to improve pandemic response in the future.

Conclusions

The ongoing COVID-19 pandemic caused by SARS-CoV-2 has brought to the fore the devastating societal and economic consequences associated with emerging infectious diseases. Human history has been punctuated by many such global pandemics including the bubonic plague (14th century), the flu (20th century) and HIV/AIDS (20th and 21st century), and it is unlikely that COVID-19 will be the last one. Indeed, the risk of emergence of novel diseases in human populations is increasing at an alarming rate due to numerous factors including the rapid range expansion of disease vectors, destabilization of natural ecosystems, as well as the rapid increase in agriculture and urbanization. By critically comparing the 2002–2003 SARS outbreak and COVID-19 pandemic, we identified that significant strides have been made in terms of rapid pathogen identification and expedited initial outbreak reporting by China, as well as the PHEIC declaration by WHO. However, one of the major failures was the delayed international response to the PHEIC declaration by the WHO, a delay which allowed for the exponential spread of the pandemic. We recommend that these are the critical areas that the international public health community must focus on to better control future pandemics in a highly connected global population. In the end we feel that the most essential lesson we can learn from COVID-19 is that pandemic control hinges on rapid, effective, coordinated and sustained pandemic response at local, national and international levels.

Author Contributions

NS developed the idea. GD and NS wrote the first draft of the manuscript. GD coordinated input from other authors. All other authors contributed to specific sections, discussed results, and edited the manuscript.

NS acknowledges support from the COVID-19 Seasonality Project (reference number 312740) from the Research Council of Norway. GD acknowledges support through the US Department of Energy Financial Assistance Award no. DE-EM0004391 to the University of Georgia Research Foundation. RL acknowledges support from Researcher Project for Young Talents (reference number 325041) from the Research Council of Norway. RY acknowledges support from Ministry of Science and Technology of China (no. 2020YFC0848900). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All data are available from the references cited, code for graphs is available from GD on request.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: pandemic, COVID-19, epidemiology, SARS-CoV, public health

Citation: Stenseth NC, Dharmarajan G, Li R, Shi Z-L, Yang R and Gao GF (2021) Lessons Learnt From the COVID-19 Pandemic. Front. Public Health 9:694705. doi: 10.3389/fpubh.2021.694705

Received: 13 April 2021; Accepted: 05 July 2021; Published: 02 August 2021.

Reviewed by:

Copyright © 2021 Stenseth, Dharmarajan, Li, Shi, Yang and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Nils Chr. Stenseth, n.c.stenseth@mn.uio.no ; Guha Dharmarajan, guha@srel.uga.edu

† These authors have contributed equally to this work

‡ ORCID: Nils Chr. Stenseth orcid.org/0000-0002-1591-5399 Guha Dharmarajan orcid.org/0000-0001-8500-0429 Ruiyun Li orcid.org/0000-0001-8927-9965 Ruifu Yang orcid.org/0000-0003-3219-7269 George F. Gao orcid.org/0000-0002-3869-615X

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

How to Write About Coronavirus in a College Essay

Students can share how they navigated life during the coronavirus pandemic in a full-length essay or an optional supplement.

Writing About COVID-19 in College Essays

Serious disabled woman concentrating on her work she sitting at her workplace and working on computer at office

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Experts say students should be honest and not limit themselves to merely their experiences with the pandemic.

The global impact of COVID-19, the disease caused by the novel coronavirus, means colleges and prospective students alike are in for an admissions cycle like no other. Both face unprecedented challenges and questions as they grapple with their respective futures amid the ongoing fallout of the pandemic.

Colleges must examine applicants without the aid of standardized test scores for many – a factor that prompted many schools to go test-optional for now . Even grades, a significant component of a college application, may be hard to interpret with some high schools adopting pass-fail classes last spring due to the pandemic. Major college admissions factors are suddenly skewed.

"I can't help but think other (admissions) factors are going to matter more," says Ethan Sawyer, founder of the College Essay Guy, a website that offers free and paid essay-writing resources.

College essays and letters of recommendation , Sawyer says, are likely to carry more weight than ever in this admissions cycle. And many essays will likely focus on how the pandemic shaped students' lives throughout an often tumultuous 2020.

But before writing a college essay focused on the coronavirus, students should explore whether it's the best topic for them.

Writing About COVID-19 for a College Application

Much of daily life has been colored by the coronavirus. Virtual learning is the norm at many colleges and high schools, many extracurriculars have vanished and social lives have stalled for students complying with measures to stop the spread of COVID-19.

"For some young people, the pandemic took away what they envisioned as their senior year," says Robert Alexander, dean of admissions, financial aid and enrollment management at the University of Rochester in New York. "Maybe that's a spot on a varsity athletic team or the lead role in the fall play. And it's OK for them to mourn what should have been and what they feel like they lost, but more important is how are they making the most of the opportunities they do have?"

That question, Alexander says, is what colleges want answered if students choose to address COVID-19 in their college essay.

But the question of whether a student should write about the coronavirus is tricky. The answer depends largely on the student.

"In general, I don't think students should write about COVID-19 in their main personal statement for their application," Robin Miller, master college admissions counselor at IvyWise, a college counseling company, wrote in an email.

"Certainly, there may be exceptions to this based on a student's individual experience, but since the personal essay is the main place in the application where the student can really allow their voice to be heard and share insight into who they are as an individual, there are likely many other topics they can choose to write about that are more distinctive and unique than COVID-19," Miller says.

Opinions among admissions experts vary on whether to write about the likely popular topic of the pandemic.

"If your essay communicates something positive, unique, and compelling about you in an interesting and eloquent way, go for it," Carolyn Pippen, principal college admissions counselor at IvyWise, wrote in an email. She adds that students shouldn't be dissuaded from writing about a topic merely because it's common, noting that "topics are bound to repeat, no matter how hard we try to avoid it."

Above all, she urges honesty.

"If your experience within the context of the pandemic has been truly unique, then write about that experience, and the standing out will take care of itself," Pippen says. "If your experience has been generally the same as most other students in your context, then trying to find a unique angle can easily cross the line into exploiting a tragedy, or at least appearing as though you have."

But focusing entirely on the pandemic can limit a student to a single story and narrow who they are in an application, Sawyer says. "There are so many wonderful possibilities for what you can say about yourself outside of your experience within the pandemic."

He notes that passions, strengths, career interests and personal identity are among the multitude of essay topic options available to applicants and encourages them to probe their values to help determine the topic that matters most to them – and write about it.

That doesn't mean the pandemic experience has to be ignored if applicants feel the need to write about it.

Writing About Coronavirus in Main and Supplemental Essays

Students can choose to write a full-length college essay on the coronavirus or summarize their experience in a shorter form.

To help students explain how the pandemic affected them, The Common App has added an optional section to address this topic. Applicants have 250 words to describe their pandemic experience and the personal and academic impact of COVID-19.

"That's not a trick question, and there's no right or wrong answer," Alexander says. Colleges want to know, he adds, how students navigated the pandemic, how they prioritized their time, what responsibilities they took on and what they learned along the way.

If students can distill all of the above information into 250 words, there's likely no need to write about it in a full-length college essay, experts say. And applicants whose lives were not heavily altered by the pandemic may even choose to skip the optional COVID-19 question.

"This space is best used to discuss hardship and/or significant challenges that the student and/or the student's family experienced as a result of COVID-19 and how they have responded to those difficulties," Miller notes. Using the section to acknowledge a lack of impact, she adds, "could be perceived as trite and lacking insight, despite the good intentions of the applicant."

To guard against this lack of awareness, Sawyer encourages students to tap someone they trust to review their writing , whether it's the 250-word Common App response or the full-length essay.

Experts tend to agree that the short-form approach to this as an essay topic works better, but there are exceptions. And if a student does have a coronavirus story that he or she feels must be told, Alexander encourages the writer to be authentic in the essay.

"My advice for an essay about COVID-19 is the same as my advice about an essay for any topic – and that is, don't write what you think we want to read or hear," Alexander says. "Write what really changed you and that story that now is yours and yours alone to tell."

Sawyer urges students to ask themselves, "What's the sentence that only I can write?" He also encourages students to remember that the pandemic is only a chapter of their lives and not the whole book.

Miller, who cautions against writing a full-length essay on the coronavirus, says that if students choose to do so they should have a conversation with their high school counselor about whether that's the right move. And if students choose to proceed with COVID-19 as a topic, she says they need to be clear, detailed and insightful about what they learned and how they adapted along the way.

"Approaching the essay in this manner will provide important balance while demonstrating personal growth and vulnerability," Miller says.

Pippen encourages students to remember that they are in an unprecedented time for college admissions.

"It is important to keep in mind with all of these (admission) factors that no colleges have ever had to consider them this way in the selection process, if at all," Pippen says. "They have had very little time to calibrate their evaluations of different application components within their offices, let alone across institutions. This means that colleges will all be handling the admissions process a little bit differently, and their approaches may even evolve over the course of the admissions cycle."

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Six Lessons We’ve Learned From Covid That Will Help Us Fight the Next Pandemic

Public health experts weigh in on the steps America needs to take to stem a future outbreak

Simar Bajaj

It has been three years since the first reported Covid-19 case in Wuhan, China, and more than 6.6 million people have died from this disease since. The United States has the highest number of Covid-19 deaths worldwide, with a sixth of the global toll. But despite this devastation, the U.S. may not be ready for the next pandemic: Experts say they can easily imagine a virus that is as infectious (if not more infectious) than the coronavirus but far more deadly. “If this was our test run, I think we mostly failed,” says Bob Wachter, chair of the Department of Medicine at the University of California, San Francisco.

So, what went wrong? No one answer can explain everything, and Amy Acton, former director of the Ohio Department of Health, thinks the U.S. needs to establish a 9/11-style commission to study the pandemic response and improve preparedness going forward. With the country seemingly ready to move on, though, nobody can say when this commission will happen , if ever.

In this absence, we reached out to public health experts to distill six lessons we’ve learned from Covid-19 that could help us fight the next pandemic.

We need to rapidly scale up testing

According to Eric Topol, director of the Scripps Research Translational Institute, the first failure of the pandemic was “not to have a test for almost two months.” As Covid-19 spread across the country between late January and early March 2020 , the U.S. was driving blind, unable to track transmission and get ahead of the disease. “That set us down a dark hole that never has been truly dug out,” Topol says.

On January 11, 2020, Chinese scientists uploaded the coronavirus’ genome online , and a week later, German scientists made the first diagnostic test. In the U.S., the Centers for Disease Control and Prevention (CDC) was developing its own test, but the first batch created was defective—and it took weeks to fix the issue. Meanwhile, the U.S. refused to use the World Health Organization (WHO) test, even as almost 60 other countries did, and federal regulations obstructed state, academic and commercial labs from developing their own versions. These regulations were lifted only at the end of February . “One of the biggest missteps we had was lost time,” says Monica Bharel, former commissioner of the Massachusetts Department of Public Health.

Looking around the world, many countries empowered commercial labs to produce Covid-19 tests so that early in the pandemic, they were able to test tens of thousands of people per day, even as the U.S. could test fewer than 100 . “One of the real lessons is that the CDC cannot, or—at least based on the way they were two years ago— should not have been trusted to be the only developer for testing,” says Wachter.

In the future, waiving some of the regulatory hurdles and using WHO tests as a temporary measure could help the U.S. rapidly scale up testing while still ensuring quality control and efficacy.

We need to leverage data more effectively

During the pandemic, “follow the science” was a common refrain, but the paucity of quality data made it almost impossible to adhere to this commitment. The initial delay in testing was part of the issue because it left public health officials with inadequate information to guide their state’s response. “If you don’t test, you don’t know what’s there,” Acton says.

That’s true from an equity lens as well. In late March, Bharel saw that Massachusetts wasn’t getting enough reporting of cases, hospitalizations and deaths by race and ethnicity, so she put out a public health executive order requiring this breakdown. And, in short course, race and ethnicity reporting shot up from 28 percent to 98 percent for Covid-19 deaths, Bharel says. That granularity in data allowed Massachusetts to identify health disparities early and proactively work to close them, even as many other states were working in the dark.

Beyond testing and data collection, one of the biggest challenges of the pandemic was that public health departments’ data systems were severely outdated. In Ohio, that meant that the department had to look elsewhere for its data analytics. “We don’t even have the money to afford that,” says Acton, “but we were able to go to Cleveland Clinic and scientists from amazing universities who could run the numbers for us.”

These collaborations were critically important but decentralized, so every state was reporting Covid-19 data in ways that weren’t always compatible nationally. “It was very difficult for me in Massachusetts to say, what can I learn from Illinois or Rhode Island or New York—and compare and contrast,” Bharel says. “There has to be a way for the CDC to obtain information from all states and territories in a standardized way.”

In future pandemics, the CDC should mandate that states collect granular, high-quality data and help build the digital infrastructure to standardize reporting across the U.S. Public health agencies could then share this data with Americans in daily briefings and weekly reports, as opposed to data snapshots that usually come too little, too late, Topol says.

We need to seek out a diversity of voices

Acton says, “when you’re a leader, truth doesn’t always get up to you.” That’s partially by design, because gatekeepers help prevent information overload. But it’s also partially politics: “Bureaucratic systems incentivize, at certain levels, not speaking up,” she adds.

That’s why Acton admires Ohio Governor Mike DeWine, who used to say that “the only decisions he regrets are when he didn’t work hard enough to get all the information he needed.” This relentless information-seeking helped Ohio build a kitchen cabinet of advisers from day one. “Ohio got ahead because we were able to get the information we needed,” Acton says.

The lesson for future pandemics is to seek out expertise from across the government and country, from theologians to communications experts to medical anthropologists and more. Acton points to Angela Merkel of Germany as a leader who “intentionally surrounded herself with a diversity of minds and thoughts” to make the most informed decisions she could. In a pandemic that cuts across all facets of society, leaders need to deliberately weigh all sides of the situation to make the most effective decisions, she says.

Deliberately seeking out this diversity of voices is also critical for fighting health disparities, Bharel emphasizes. Massachusetts, for instance, formed a health equity advisory group, so community members, health care workers and other experts could counsel the department on where and how to deploy limited resources. The state’s vaccination strategy, widely touted for its high uptake and reach , was probably the most notable example of this advisory group’s success.

Massachusetts started with mass vaccination sites, like most states, but quickly observed that these sites weren’t reaching all residents equally. So, in the state’s most vulnerable regions, the department pursued a hyperlocal strategy, hiring community members to serve as vaccine ambassadors. They would go door to door, answer people’s concerns and walk them over to get vaccinated—familiar faces engaging their communities. “In the United States, if you start to feel unwell, it is your responsibility to physically go to the health care facility,” Bharel says. “What if we flipped that and said we want to come to you in the community, and we want to help you be well?”

Of course, this engagement shouldn’t be transactional—getting shots in arms and then leaving. Public health departments should form interdisciplinary advisory committees that represent their community’s diversity and can help guide their work, whether the threat is lung cancer or the next pandemic. Prioritizing the community’s lived experiences and continuously investing in their success builds trust and equity.

We need to continue making big bets on vaccines

The Covid-19 vaccine was undoubtedly the big success story of the pandemic. “It proved that a concerted public-private partnership is capable of producing at scale a highly effective vaccine in eight to ten months,” Wachter says. This victory was a testament to the unprecedented commitment of federal resources, an expedited Food and Drug Administration approval process, previous research into mRNA vaccines and good fortune that the spike protein was an easy target.

But this success also offers an important lesson. “If you make a big bet, and you’re successful with a program, you should keep making big bets,” Topol says. By removing the risk for pharmaceutical companies, Operation Warp Speed got the U.S. first-generation vaccines, but the government didn’t kick-start a second or third operation to make nasal vaccines or pan-coronavirus vaccines, which could have protected against new variants. This was reportedly because of a lack of political interest and funding . “It’s stupid,” Topol adds. “If this is the best we can do, it’s not good enough.”

Indeed, a big part of the promise of mRNA vaccines is that they can be endlessly tweaked, providing a foundation to tackle all sorts of infectious, autoimmune and neurodegenerative diseases. For future pandemics, the U.S. should take advantage of this iterative nature to develop a series of new vaccines and not put all its eggs in one basket with first-generation vaccines, Topol emphasizes. Furthermore, Congress should be thinking of vaccine development as an instrument of national security , opening up its enormous defense budget to pandemic preparedness. After all, big public-private partnerships will always be needed to continue pushing technological boundaries and protecting American’s health.

We need to actively crowd out bad information

In 1984, HIV was discovered as the cause of AIDS, but almost 40 years later, scientists still haven’t been able to develop an effective vaccine for the virus. For Covid-19, however, “we learned that the biggest problem with vaccines is that people don’t take them,” Wachter says. Despite high-quality scientific evidence that they are essentially riskless, “the misinformation machine is able to elevate any tiny risk, either perceived or real, to feel almost equivalent to the benefit,” he adds.

Part of the challenge is that public health officials are not doing enough to compete for people’s attention. “The network that makes a conspiracy theory go viral is very well worked out and very strategic and intentional,” Wachter says, “whereas [public health] information networks tend to be like, ‘Well, we’re just putting out information. Why do we have to even think about spread?’”

For future pandemics, public health officials need to extensively engage their communities to drown out misinformation. “In Massachusetts, in the first 120 days of the pandemic, our governor had over 100 press events,” Bharel says. “What we really wanted to do was make our information the trusted source of information, because we knew there was a lot else out there.” Consequently, the department worked hard to put out information in different languages, create PSAs with physicians from local communities and creatively engage the public otherwise. In the Commonwealth Fund’s Scorecard , Massachusetts came eighth in the U.S. in its response and management of the Covid-19 pandemic.

But Topol thinks holding press conferences and engaging the public isn’t enough. “You have to take on the anti-science community, aggressively,” he says, “because if you don’t neutralize it, it just grows and gets more organized and sponsored and funded.” But what would this takedown actually look like? Topol envisions a fact-checking team at the White House or U.S. Department Health and Human Services (HHS) that would be responsible for publicly calling out public health lies spread on major media networks. “These bad actors, whoever they are, need to be identified so that the public knows that these people are making stuff up or lying—and they’re twisting and distorting things,” Topol says.

Whether or not this fact-checking crew could actually work is an open question, but Topol is emphatic that public health cannot take a hands-off approach to misinformation going forward. “It’s harmed millions of people, maybe cost hundreds of thousands of lives in this country already,” he says. “And we just let it happen.”

We need to infuse public health communication with vulnerability

Although misinformation was certainly deadly, the problems with pandemic communication were so much broader. With shifting guidance on issues such as isolation length and booster eligibility , public health agencies lost the American people’s credibility. “When the vaccines first came out and they began saying breakthrough infections are rare, everyone looked around and said, ‘No, they’re not. Half of my family has one,’” Wachter says. According to a poll published in May 2021 by the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, only half of the public reported a great deal of trust in the CDC, and only a third in HHS.

Some of these failures in communication were to be expected because, as Bharel put it, “we were flying the plane at the same time as were building it.” In the context of a novel virus, of course scientific understandings evolve, but communicating this shift to the public proved to be more difficult, with the federal government faltering again and again. For instance, the CDC’s masking recommendation in April 2020 was seen as arbitrary and capricious rather than reflecting greater evidence for airborne transmission and asymptomatic spread .

For future pandemics, the U.S. should consider taking a page out of Ohio’s playbook. In 2020, New York Times producers watched seven weeks of Acton’s press briefings and released an opinion documentary titled “The Leader We Wish We All Had,” focusing on her vulnerability, brutal honesty and empowerment. She acknowledged Ohioans’ pain and made them feel less alone. She openly projected her own uncertainty instead of providing static, irrevocable answers. When testing was in short supply in April 2020, she confessed that the Department of Health didn’t know how much Covid-19 had spread. “I have to be very clear and transparent with you. All of these numbers are a gross underestimation,” Acton said at the time, “and we have no real idea of the prevalence of this infection yet.”

Acton reflects back and says, “We would directly lay truth on the table, and once you do, more truth will spread.”

Bharel echoes similar points about transparency and flexible messaging. “This is what we know now. This is what we don’t know. And this is how we’re trying to find out more information,” she parcels out. Public health experts say that the public can handle—and in fact appreciates—difficult truths, as well as learning what specific work is being done to provide more clarity.

But perhaps one of the most important lessons for public health messaging is unity. During her wildly popular press briefings , Acton would share everything from Michael Stipe’s song “No Time for Love Like Now,” to the story of Bonnie Bowen, a 93-year-old Ohioan who’s made watercolor paintings every day since March 2020. When Bowen got Covid-19, she received 250,000 prayer messages—and ended up surviving. “We had to build a life raft where people were pulling one another up, and in Ohio, we ended up creating this movement of people helping people,” Acton says. “Kindness is an age-old, enduring principle. It’s about having the hard conversations but holding space and seeing the humanity in one another.”

Before the next pandemic, Wachter says “there should be a postmortem of the communication effort by the federal government about what the lessons learned were.” After cleaning house accordingly, HHS should establish an integrated system for public health communication, like the U.S. has for extreme weather and homeland security threats , and promulgate best practices for science communication to state and local leaders.

We need to question whether we’ve learned our lessons

We discussed the six biggest takeaways from Covid that will help us fight the next pandemic, but we could have mentioned so many other lessons, from improving ventilation to reforming contact tracing to depoliticizing public health. And that’s why Acton, Bharel, Topol and Wachter all emphasized the need to fully reckon with the failures of the Covid-19 pandemic and ensure that we are actually learning from our mistakes.

But Topol says there’s no guarantee that we will. And Wachter paints a similarly bleak picture about the future of public health: “We will underinvest in it because that’s what everybody always does when the acute threat passes. There’s always some other threat to take its place in the public attention and priorities.”

But experts stress that we can’t let this moment go by, especially after the past three years have brought unimaginable suffering, fear and loss to every pocket of the U.S. “We need to mourn, memorialize and then move forward,” Acton says. “We have to make meaning out of things we've endured.”

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Simar Bajaj | | READ MORE

Simar Bajaj is a student at Harvard University studying the history of science and a research fellow at Massachusetts General Hospital and Stanford University School of Medicine. He has previously written for the Washington Post , Guardian , TIME Magazine , and New England Journal of Medicine .

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Wake up with a Smile

9 valuable lessons we’ve learned during the pandemic.

1. Family is nonnegotiable.

For many of us, this year brought with it quality family time that we never expected and, honestly, might never have had otherwise. It’s reminded us just how much family matters. And I don’t just mean blood relatives, I mean chosen family, too.

We were encouraged to take a step out of the craziness of our former lives and deeply invest in those relationships again, whether it was face-to-face or not.

We’ve had the opportunity to not just catch up on life, but to also spend priceless time with our loved ones, asking personal questions, being there for the important moments, leaning on each other for support, and growing together. As a result, we remembered just how much we need each other!

2. Prioritize health and wellness .

When the pandemic first began, the world started paying attention to health, wellness, and hygiene like never before. We realized just how effective our handwashing wasn’t , how much we shouldn’t be touching our faces, and the beauty of both modern and natural medicine. These are all crucial practices and levels of care that will hopefully stick with us in the future.

Not only that, but without the usual benefits of daily activity, in-person workouts, and restaurant dining, a microscope was placed on just how willing we were to maintain our wellness all on our own.

With the pandemic came a myriad of free cooking and workout classes on social media and a realization that, particularly when we’re stuck inside, our bodies really do need nutrients and activity to survive.

3. We can get by on less. Much less.

The road to discovering how little we need was paved with uncertainty. With the overwhelming job loss that came with the pandemic, people had to learn how to pinch pennies, clip coupons, and trim excess like never before.

Even for those who kept their jobs, without indoor dining, salons, gyms, and a wealth of other standard social activities, saving money actually became easier to do. Even though we’ll all be lining the doors when things are back to normal, we realized in the process that we actually can live on a lot less and still be content.

4. Build that nest egg.

In addition to pinching those pennies, we learned the endless value of having a rainy day fund – or more appropriately, an emergency fund. An emergency fund is one that is set aside for the most essential of needs, including rent, medical expenses, childcare, and food.

As we’ve all heard over and over again, these are unprecedented times. The nature of unprecedented times is that we don’t see them coming, so we don’t plan for them.

If this year has taught us anything, it’s the importance of setting aside a little extra money and leaving it there until the day comes when we might need it.

5. Slow down.

We’ve realized that not only is it OK to slow down, but it’s actually essential.

When the pandemic hit, it was as if the whole world was running on overdrive and then, all at once, it crashed. We allowed it to get this way because we have a tendency to align our worth with our busyness. But luckily, this past year has shown us just how unbalanced that meter is.

There are a few key points to remember moving forward. First of all, self-care is not self-indulgent; it’s one way that we keep ourselves healthy, both physically and mentally. Second, slowing down is what helps us truly live in the present and find contentment in our circumstances.

6. We should be talking about mental health.

One of the best silver linings of this year is that we learned just how valuable mental health is. Studies show that ever since the pandemic hit, close to 40 percent of Americans now suffer from anxiety and depression. The causes are endless: financial stress, difficult home lives, boredom, loss, fear, and, perhaps the heaviest of all, loneliness.

These universal mental health issues truly are a “second wave” of this global crisis, and the greatest benefit has been the light shed on their gravity.

People are being more vocal than ever about the importance of honesty and vulnerability when it comes to our mental health, just like we would a physical ailment. By doing so, we can get the love and support we need.

7. Our thoughts on people have changed.

The more closed off we’ve had to become socially and the more we’ve noticed the deep need around us, the more we’ve realized whom we consider to be truly essential.

In our own lives, we’ve learned which friends we want close to us in times of trouble – and maybe even some relationships we’ve been needing freedom from.

In our communities, we’ve finally realized the overwhelming value of our essential workers: in health care, education, food service, and the most underappreciated segments of our workforce. May we never forget how brave and resilient they have been for all of us these past 12 months.

8. Becoming comfortable with uncertainty.

“The one thing that’s certain about this current crisis is the massive amount of uncertainty,” Paul Knopp, U.S. Chair and CEO of KPMG LLP, told Accounting Today . “In order to succeed, you must execute on the activities and behaviors that are within your control.”

We have definitely learned flexibility this year. From working and schooling from home, to rerouting our careers, to finding new ways to stay connected, to moving back in with our parents, our flexibility has been award-winning and record-breaking.

A benefit of this growing pain is that it’s made us more comfortable with uncertainty. There’s so much about the future that we can’t possibly know or predict right now, so ultimately all we can do is be OK with it – and choose to find the wonder and joy in our present circumstances.

9. We are deeply resilient.

We are capable of so much more than we ever knew. This year has been rife with chaos, unrest, injustice, loss, and pain – but we’ve survived. We’re still standing. Even in the darkest time, we’ve been able to look outside ourselves and pull through for those in need in remarkable ways. It’s helped us realize the stuff we’re made of .

More than that, we’ve done it together. We’ve all been in isolation together, and we’ve survived together. It’s reminded us that at the end of the day, we are all just human beings, and we need each other.

And now we know with certainty that we can handle anything!

After the levels of stress we’ve lived through this past year, the best we can do is make sure it wasn’t for nothing. We can search for the good, continue to grow, and allow our circumstances to change us for the better. Only then will we continue to come out on the other side stronger, more resilient, more compassionate, and more hopeful than ever!

Share this story to remind others how much they’ve grown this year.

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Ten lessons from the first two years of COVID-19

Two years ago today, the World Health Organization (WHO) declared that COVID-19 was a pandemic. Since then, more than six million lives around the world have been lost to the disease, and daily life has been upended in countless ways. Some countries are now regaining a degree of normality, though the threat of another variant-induced wave of disease remains. On this second anniversary, we reflect on ten things the world has learned through the course of the pandemic.

Infectious diseases are a whole-of-society issue. One in every 1,300 people alive in 2019 has died from infection with SARS-CoV-2, but when we look back on COVID-19 in the future, the direct health impact may not be what we remember most. Indirect effects on health, as a result of delayed routine and preventive care, overstressed healthcare systems, and the increased mental-health burden, may eventually seem more significant. Children—especially those from low-income families—suffered significant harm during prolonged school closures. And the economic harm and dislocation that the pandemic caused have decreased the quality of life for people around the world.
The vaccine development paradigm has been transformed for emergencies and, potentially, for more. Two years on, it is easy to forget how remarkable the development of COVID-19 vaccines was. Moving in just 326 days from a genomic sequence to the authorization of a COVID-19 vaccine by a stringent regulatory authority shattered all previous records. In addition, biomedical science delivered multiple vaccines with high efficacy against severe COVID-19 and a strong overall safety profile. The bar has risen , and there is now serious discussion of what it will take to cut the time from sequence to authorization to just 100 days for the next emerging threat.
Conversely, weaknesses in vaccine manufacturing and equitable distribution will require systemic change . Despite the successes of vaccine R&D, there have been persistent inequalities in access to its fruits. Allocation is an important question. So is manufacturing. Significantly increasing global vaccine-manufacturing capacity for emergencies would help ensure rapid access to future vaccines for the greatest number of people. The location of capacity also matters. Low-income regions are planning to develop their own local capacity so that they depend less on global agreements and long supply chains during the next infectious-disease crisis.
Trust is one of the most delicate but critical requirements for an effective pandemic response. Before the pandemic, it might have been assumed that safe vaccines offering high levels of protection against a frequently fatal and society-altering disease would be in high demand. In some countries, they have been, but in others vaccine skepticism has limited demand. 1 “ Estimates of vaccine hesitancy for COVID-19 ,” Centers for Disease Control and Prevention, cdc.org. In this pandemic, like so much else, success in public health has depended on both the public’s trust in government and in a shared social contract among citizens. The same principles apply to companies deciding on their policies for the return to in-person work . Trust is hard to manufacture during a crisis. Building confidence in specific areas—including biomedical science—can be especially important.
Agility and speed will be the new basis for differentiation. The pandemic has consistently defied expectations; our response to it has evolved through multiple chapters as new information and tools became available. Emerging evidence—on such topics as the benefits of masking, the chance of repeat infection, the risk of new variants, the difficulty of achieving herd immunity, and the benefits of boosters—has required policy and behavioral changes. Countries, businesses , and other stakeholders have had to balance the benefits of incorporating new evidence into their response plans against the confusion and frustration that frequent changes can cause. Our research shows that agility and strong communications have allowed some companies to respond more effectively to the crisis than others.
Government policy matters—but individual behavior sometimes matters more. This dynamic played out in a couple of ways, starting with lockdowns and mask mandates in early 2020. These were largely effective, but their effectiveness varied , depending on how seriously people took the rules and the ways in which people mixed . Later that year, when several manufacturers announced vaccines within a span of several weeks, hopes soared that countries could reach herd immunity quickly. That dream was no match for the realities of vaccine hesitancy . Around the world, a significant part of the population declined to take the vaccine. That may have helped SARS-CoV-2 to mutate and spread .
Schools are the true fulcrum for the functioning of society. We always knew this in an abstract way. But the pandemic brought it home. While school shutdowns were clearly necessary, they have put “a generation of kids at risk,” 2 “ Resetting education: lessons from Sesame Street on helping a generation at risk ,” World Economic Forum, October 2, 2020, weforum.org. wrecked the mental health of many people, 3 “ Mental health toll of pandemic ‘devastating’ – WHO ,” Inquirer, October 5, 2020, inquirer.net. and upended households around the world. Online learning proved to be “ a poor substitute ” for classrooms; kids still haven’t caught up with the lost learning. Lower-income students are further behind than others. The stress has not only been incredibly difficult for children and their parents and teachers but also boiled over into political activism in many places, defining elections in some.
Work will never be the same. The pandemic’s first year proved three things: our old definition of essential workers was inadequate; the numbers and kinds of workers we need are profoundly different now; and most knowledge workers can do the job from home. In the second year of the pandemic, people across the income spectrum internalized those lessons. Millions quit —especially women —and people who kept their jobs are questioning the old assumptions. Employees and employers see the world differently . That disconnect is having lots of effects. For one thing, it’s sharpening a labor shortage that had been slowly brewing. It is also causing owners and occupiers of real estate to rethink the role of the office .
Economic stimulus works, but only in concert with strong public-health measures. In early 2020, there was a public debate on the trade-off between protecting people from the virus and protecting the economy. At that time, we suggested that this framework was off the mark—there is no trade-off. Two years on, the facts are clear: no country kept its economy moving well without controlling the spread of the virus as well. The inverse is also true: countries that struggled to control the virus suffered worse economic outcomes. The size of the fiscal-stimulus package did not matter much. The ability to solve simultaneously for both problems, the virus and the economy, did.
Whether we experience these problems again will depend on the investments and institutions we establish now. In addition to the lives lost, the current pandemic has cost the global economy an estimated $16 trillion. Our article “Not the last pandemic” describes how new investments of $5 per person a year globally for disease surveillance, “always on” response systems, disease prevention, the preparation of hospitals, and R&D can help the global community respond more effectively to the next major infectious-disease threat. The global community, including the G7 and G20, has now begun to describe the potential architecture of a future system. Countries are dedicating new resources to the topic. Finding ways to track preparedness and to ensure that new funding is well spent will be critical. Clearly, the world understands that it must be more prepared for the next crisis.

If there’s one theme throughout these ten lessons, it is the need for humility. Many of our orthodoxies from past decades have been upended, and the need to continually learn has never been clearer, so that we can continue to adapt to today’s crisis and prevent the next one.

Matt Craven is a partner in McKinsey’s Bay Area office. Mark Staples is an executive editor in the New York office, where Matt Wilson is a senior partner.

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When will the COVID-19 pandemic end?

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‘Great Attrition’ or ‘Great Attraction’? The choice is yours

Not the last pandemic: Investing now to reimagine public-health systems

Ongoing lessons from a long pandemic

What COVID-19 has taught—and continues to teach—us two years in.

FOR ALMOST TWO YEARS, the coronavirus has battered the world, with millions of deaths and hundreds of millions of cases. This winter’s omicron variant surge is just the latest example of the pandemic’s unpredictable trajectory. It has resulted in personal tragedy for many. It has left survivors with long-COVID-19 symptoms, and it has overwhelmed health care systems and caused burnout among health workers. It has changed our behavior, acquainting people with mask wearing and social distancing. It has changed the way we work, forcing the fortunate to work remotely and resulting in furloughs or layoffs or constant risk of exposure for the less fortunate. And it has been an impetus to scientific innovation, with effective vaccines created and distributed at a historic pace.

The world is a different place from what it was two years ago, and we are still learning to live with all the sorrow and change the pandemic has brought. At the same time, COVID-19 has taught us a lot. Through the global crisis, we have reevaluated aspects of our societies and examined what is working—and what isn’t.

Here HKS faculty members and other experts examine lessons learned during the pandemic.

Matthew Baum and John Della Volpe: National suffering and solidarity
Hannah Riley Bowles: Understanding the “Shecession”
David Eaves: Lessons from digital government
Debra Iles: Executive education will never be the same
Anders Jensen: A time to rethink tax systems
Asim Khwaja: Prioritizing process to prepare for the next shock
Dan Levy: Thinking outside—and inside—the Zoom box

National suffering and solidarity

Matthew baum and john della volpe.

It is difficult to conceive of anything good borne of COVID-19. As of this writing, in the United States, more than 700,000 are dead; 5 million have fallen worldwide. Millions of us grieve the untimely loss of a family member, a loved one, or a friend. And while our team of researchers from the Covid States Project has charted the extreme stress, anxiety, and depression so many Americans are facing, we also have found reason for optimism.

Partnership between the public and private sectors has spurred tremendous innovation in vaccine development and distribution logistics, which will likely prove enormously beneficial in the future, both with routine vaccines and with future pandemics. COVID-19 has also provided a rare real-time window into the workings of science, which while not universally helpful, provides valuable education for many people. Life-saving developments like these are probably why the public’s trust in science has largely remained intact while trust in other institutions has fallen since we began tracking such measures in April 2020. In a recent wave of more than 21,000 interviews across 50 states and the District of Columbia, we found that 92% of American adults trust doctors and hospitals, nearly 90% trust scientists and researchers, 78% trust the CDC, 74% trust pharmaceutical companies, and 68% trust Dr. Anthony Fauci on how best to deal with the coronavirus. Although overall levels of confidence in the scientific community remain very strong in general, evidence suggests that trust has eroded somewhat over the past 18 months and bears watching.

“While our country and many communities feel as divided as they have ever been in our lifetimes, the bonds of family (whether nuclear or chosen) are stronger.”

Matt baum and john della volpe.

Additionally, the coronavirus has provided oxygen for many of us to reevaluate priorities and life choices, including family, work, and career. The racial reckoning that followed the death of George Floyd in 2020 would most likely not have been as profound if tens of millions of American families had not been locked down, watching the gruesome news coverage, and pressured by often younger family members to confront and discuss systemic racism and the sins of America’s past that led to the murder and civil unrest.

Today, millions of Americans, especially Millennials and Generation Z, are reconsidering what it means to be happy and live a fulfilling and purposeful life. The effects of their decisions are now recognized by economists and businesses in need of labor, but the values leading to workforce changes have been developing for more than a decade, only to be supercharged during the pandemic. While our country and many communities feel as divided as they have ever been in our lifetimes, the bonds of family (whether nuclear or chosen) are stronger.

More than 18 months ago, Amanda Gorman offered comfort to a nation that was unaware of the inordinate loss soon headed its way. She said, in part:

We ignite not in the light, but in lack thereof, For it is in loss that we truly learn to love. In this chaos, we will discover clarity. In suffering, we must find solidarity.

As science leads us to a brighter 2022, let’s hope that through our national suffering we can once again discover what’s important, not just for ourselves but for the nation.

Matthew Baum , the Marvin Kalb Professor of Global Communications, and John Della Volpe , director of polling at the Harvard Kennedy School Institute of Politics, are among the team involved with the Covid States Project, a multi-university collaboration of researchers in a range of fields, who have examined behaviors and outcomes across the United States since March 2020.

Understanding the “Shecession”

Hannah riley bowles .

Q: How is the intersection of race and gender at play for working mothers during the COVID-19 recovery phase?

The most detailed data we have is from a survey conducted by Women and Public Policy Program Fellow Alicia Modestino, which consisted of a national panel of 2,500 working parents between Mother’s Day and Father’s Day (May 10 to June 21) of 2020. These data, collected at the onset of the pandemic, indicated that women accounted for more than half of unemployed workers (consonant with other economic studies), with Black and Hispanic women suffering outsize job losses at 9.5% and 8.3%, respectively. This gender disparity in labor market outcomes, often dubbed the “She-cession,” reflected the disproportionate toll on female workers, who were more likely to hold in-person jobs in affected industries such as hospitality, childcare, and health care.

A distinctive strength of this survey was that it collected information on whether childcare conflicts directly contributed to job losses. In contrast, other studies could only infer why women with children were displaced from the labor market. Modestino and colleagues found that 26% of unemployed mothers reported a lack of childcare as the reason for losing their jobs, compared with 14% of unemployed fathers. Their time-use data confirm that COVID-19 made work-life balance disproportionately difficult for women, with significant increases in time spent on schoolwork and playing with children as well as cooking and cleaning. In comparison, men reported only small increases in basic household chores. Women of color were more likely to have those experiences. For example, the survey showed that 23% of Black women—versus 15% of non-Black women—reported that their hours were reduced due to a lack of childcare.

Thanks to a gift to WAPPP from the Jessica Hoffman Brennan Gender Inequality and COVID-19 Pandemic Recovery Research Fund for research on the effects of the pandemic on women’s labor-market participation, Modestino and I are launching a study to explore working mothers’ experiences during the COVID-19 recovery phase from an intersectional perspective, disaggregating data by race, income, education, and other demographics. We also seek to investigate the role of negotiations in “shock resilience”—namely, how negotiating with partners, employers, coworkers, immediate and extended family members, friends, and others who make up formal and informal support systems can help women manage family and paid labor.

“With the closure of schools during the COVID-19 pandemic, household dynamics became a significant factor in determining labor outcomes for women.”

Hannah riley bowles.

Q: How has the shock to childcare during COVID-19 varied among women with different household dynamics?

With the closure of schools during the pandemic, household dynamics became a significant factor in determining labor outcomes for women. In Modestino’s survey, women were more likely to report losses in work status if they were single, divorced, separated, or widowed (22% for not married versus 15% for married). Women living in households with annual incomes below $75,000 were also significantly more likely to report that difficulties with childcare had had an adverse effect on their labor-market participation. This effect was more acute for women with small children and those holding in-person jobs.

Q: Working mothers have been hit hard. How can policy support them?

The Modestino survey data suggest that access to paid family leave, remote-work arrangements, and childcare subsidies were the most important policies in enabling women to remain fully employed. Equally or even more important was the support of managers and coworkers—suggesting that formal policies and practices need to be backed up by family-friendly work cultures.

Access to backup childcare was another important factor that varied across communities, with lower-income families more likely to rely on family support networks. However, although 24% of working parents reported having access to paid family leave, only 4% had used it during the pandemic. Even worse, working parents who identify as Black or Hispanic are less likely to work in jobs that offer paid sick time and medical leave or to have COVID-19 policies available to them such as backup childcare subsidies and working from home.

Again, looking forward, we seek to understand what critical factors enable working mothers to recover from the pandemic, including formal and informal supports for managing work and family.

Roy E. Larsen Senior Lecturer in Public Policy and Management Hannah Riley Bowles is a codirector of the Center for Public Leadership and the Women and Public Policy Program (WAPPP). Her research focuses on gender, negotiation, career advancement, and work-family conflict.

Lessons from digital government

David eaves.

In the midst of the COVID-19 pandemic, digital service groups and digital government experts around the world started to codify what a good digital crisis response could look like. These efforts have resulted in documents such as the California Digital Crisis Standard , developed by the state’s COVID-19 response team. Another example comes from Ontario, where the digital service group leveraged previous work in Alberta to quickly deploy a COVID-19 self-assessment in days, helping lower call volumes to government help desks and reducing stress for citizens.

The broad takeaway is that in a crisis, tried-and-true practices become even more critical to executing digital service delivery. The experiences of California and Ontario tell us that:

Working in the open enables learning In a national emergency, working in the open allows multiple service providers—within the same governing system or outside it—to learn from one another, accelerating development timelines and surfacing creative solutions. The California Digital Crisis Standard was made possible by work that was shared, while the story of Alberta and Ontario demonstrates that leveraging others’ work can radically reduce the cost and time to deploy government services.
There is always time for user testing While some may view user testing as a time-consuming luxury that has no place in rapid crisis response, the experiences of California and Ontario highlight the importance of prioritizing user needs. If anything, user testing is more important in a crisis, because the consequences are more serious if services do not work for users.
Clear communication is essential Both examples underscore the importance of communicating simply and clearly with users of digital services. Doing so can reduce panic and confusion while creating trust between users and the government agencies managing the services.

Looking Ahead The experiences of California and Ontario don’t hold all the answers for an effective digital crisis response. No two crises are the same, and some degree of improvisation will always be necessary. But taking time to develop a framework for response—to understand how normal working processes might change or stay the same—helps mitigate the pressure teams face while handling any crisis. More important, the work that California and Ontario appeared to do “on the fly” was really the result of years of capacity building, changing policies, and acquiring the right talent to change how government works. The crisis just made the value of those new ways of working more apparent.

Digital service groups need to think proactively about how crises affect the development and deployment of digital technologies in the public realm and build a standard that draws on the elements of impactful crisis responses like those in California and Ontario.

Lecturer in Public Policy David Eaves, with coeditor Lauren Lombardo MPP 2021, produced a policy brief titled “2020 State of Digital Transformation,” with lessons from digital government service units that responded quickly and effectively to the pandemic. The excerpt above is an adaptation of material from this brief.

Executive education will never be the same

Only six weeks after we shuttered our offices due to the onset of COVID-19, in April 2020, HKS Executive Education brought together participants for our first pivoted online program in April 2020. Six weeks after that, we hosted our first free faculty-led webinar, which focused on helping our global community respond to the repercussions of the health crisis.

Before the pandemic, we had a few online programs. In general, though, our faculty and participants preferred being together in person and on campus. We stuck with that model because we knew it worked. We needed a crisis to embrace online learning.

And as was true for many during the pandemic, we learned a few things—fast. It turns out that online executive education can be excellent. Everyone is in the front row. The cost of travel has evaporated. Classroom diversity is enhanced. Different learning styles are welcomed, and extended program lengths allow people to test what they are learning in their jobs in real time. Deeply interactive discussions between faculty members and learners, a cornerstone of our in-person programs, came alive online.

“It turns out online executive education can be excellent. Everyone is in the front row.”

We also learned, through a difficult year, about the resilience of the Kennedy School team. The HKS faculty pulled together, building momentum and encouraging one another to move forward and revamp the curriculum for remote learning. The members of our staff rallied, expanding their skills to enable each program participant to be truly present in this new virtual world. Together, the faculty and the staff managed polls and chats, posted new video and audio materials, curated virtual study groups, and reviewed participants’ progress at every step.

Outside the classroom, we learned that many were eager to discover through our free webinars how COVID-19 was reshaping leadership, economics, and trade. We expanded what we thought was just a short-term offering to an ongoing series of faculty members sharing the latest research on racial justice, social justice, climate change, crisis, and new scholarship across the HKS spectrum. We’ve always known that the best leaders never stop learning, and thousands in our community showed up for this important content while they were facing some of the most extreme public challenges we’ve seen in decades.

Our mission has always been to bring HKS ideas and research to the broadest possible audience of senior-level leaders who are looking to apply new approaches to their work in real-time. Based on what we’ve learned this year, online learning’s expanded place in our programs is here to stay. Today we offer more than 60 online program sessions every year. And even when COVID-19 is behind us, we expect to stay 40% online.

Debra Iles is the senior associate dean for executive education at Harvard Kennedy School.

A time to rethink tax systems

Anders jensen.

The COVID-19 pandemic has forced us to think about tax policy in an evidence-based way. It has put a lot of pressure on government budgets for unemployment benefits and other public goods, which means that the government must collect more taxes to provide them. But at the same time, the tax base has eroded owing to the various forms of lockdown that were necessary to slow the spread of COVID-19.

Tax policies for the post-pandemic recovery period will thus require governments to be resourceful and to look at underutilized policy tools. To that end, the COVID-19 recovery phase may present a strong opportunity for a deeper overhaul of tax systems to improve efficiency and—perhaps even more important—equity.

Anders Jensen is an assistant professor of public policy who studies tax policy with a particular focus on countries’ capacity to tax.

Prioritizing process to prepare for the next shock

Asim khwaja.

The pandemic led to massive losses in many countries—of life, of livelihoods, and more. The biggest lesson that I believe we can learn from these years of loss is that process matters. Shocks happen, and there is only so much a society can do to prepare for the worst kinds of shocks, such as COVID-19—one of the most devastating our world has experienced.

What this specific shock revealed to me is that we didn’t have processes in place to navigate it in a way that wasn’t reactionary or destructive. We didn’t have measurement systems to figure out the extent of the problem, and we didn’t have ways to adjudicate the effectiveness of our policy responses to the problem. We were lacking the evidence we desperately needed as we designed costly policies, assuming that they would lead to a benefit instead of a huge cost. In some places around the world, policymakers overdid it, and in others, policies such as lockdowns to limit the spread of the virus, proved successful. These instances of failure or success derived more from reactionary decisions than from any evidence-based process. We could only depend on the loudest voices and a panicked desire to do something quickly in our policy responses.

“What this specific shock revealed to me is that we didn’t have processes in place to navigate the shock in a way that wasn’t reactionary or destructive.”

I hope that we have now learned how critical it is to have effective response processes in place before the challenges that we will inevitably face in the future. Doing so will allow us to have a more thoughtful, evidence-driven, and conceptually valid response, as opposed to an immediate and desperate reaction.

Asim Khwaja is the director of the Center for International Development and the Sumitomo-FASID Professor of International Finance and Development.

Thinking outside—and inside—the Zoom box

Dan levy .

Q: How prepared was HKS for online learning when COVID-19 hit in March 2020?

Prior to COVID-19, the Kennedy School was already doing online learning, but it was mainly driven by a small number of faculty members and staff who strongly believed in its power to both expand reach and improve teaching and learning. There were many interesting initiatives in executive education. And there were pioneer faculty members, including Marshall Ganz and Matt Andrews. Teddy Svoronos, Pinar Dogan, I, and others were doing it as part of a blended learning approach. Then, a couple of years before the pandemic, a group of us started working on the Public Leadership Credential, which is the School’s flagship online learning initiative.

When we were forced by the pandemic to move to online learning, we were very fortunate to be able to leverage those previous efforts, and I think the School was better prepared for online learning because of them. That doesn’t mean it was easy to do, but it does mean that we had in-house expertise to help bring everyone into online teaching and learning.

Many of us had experience with asynchronous learning, whereby learners engage with online material but are not interacting live with teachers. So even some of us who had some experience had to adjust quickly to live online teaching. I think it’s fair to say that there were growing pains. It was not easy at first, and I commend the spirit of the faculty and staff members. They looked for ways to innovate and make things work for students and were very resourceful and creative. That, to me, is one of the silver linings of the pandemic: the unleashing of creativity and resourcefulness that those involved in teaching and learning were able to bring to the enterprise.

“The pandemic has taught us to think more carefully about how to design successful learning experiences and programs for our students. We need to be better at putting ourselves in their shoes.”

Q: You wrote a book about teaching with Zoom. How did that come about?

We went to online learning at the Kennedy School in March of 2020. By mid-May, I was seeing faculty members, both here and outside the School, use Zoom in creative ways. I started documenting those examples because I wanted to learn what they were doing—and I ended up putting together a book. I felt that people needed a one-stop place to learn how to teach effectively with Zoom, since that’s the platform most people were using. I hope the book is helpful, not only to colleagues at the Kennedy School and at Harvard but more broadly.

Q: What can we take from Zoom to the physical classroom?

Some aspects of teaching in the classroom are better—such as the magic that happens when people can engage in person. But it became clear to me that there are also some things we can do better online. Now that we’re transitioning back to in-person teaching, we can think about how to incorporate some of those advantages. The use of chat during live instruction on Zoom is an incredibly powerful tool for finding out quickly what’s on our students’ minds. As we return to classrooms, where we don’t have chat, we should think about alternative ways to get the same benefits. Another plus with teaching on Zoom is the breakout rooms, where you can put learners in groups. We’ve always done group work in classrooms, but on Zoom we experimented with having the groups use collaborative tools to document their work. Being able to better leverage group work for post-group discussions is something I hope we can bring into the physical classroom.

Q: What’s one lesson from teaching fully online during COVID-19 that you think we should not forget?

The pandemic has taught us to think more carefully about how to design successful learning experiences and programs for our students. We need to be better at putting ourselves in their shoes. That is a simple principle that should always guide teaching and learning, and it was especially evident over the past two years.

Dan Levy is a senior lecturer in public policy. He is the faculty director of the Public Leadership Credential , Harvard Kennedy School’s flagship online learning initiative, and the author of Teaching Effectively with Zoom: A Practical Guide to Engage Your Students and Help Them Learn .

The White House is seen as a backdrop as people visit the 'In America: Remember' public art installation near the Washington Monument on the National Mall in Washington, DC. The installation commemorates all the Americans who have died due to COVID-19. Image by Kent Nishimura/Los Angeles Times via Getty Images

Inline images by Justin Sullivan/Getty Images, Andrei Pungovschi/Bloomberg /Getty Images, and Liu Guanguan/China News Service/Getty Images

Lessons learned from the COVID-19 pandemic

The COVID-19 pandemic has brought immense human suffering and loss of life, resulting in an unprecedented shock to health systems all over the world. And at least initially, it also left policymakers, health professionals, and decision makers scrambling for information and ideas on how to manage its impact. The research and information community responded with a number of online databases which were developed to track cases, deaths and hospitalizations, as well as country policy responses – mostly focusing on travel restrictions, fiscal measures and lockdowns [1] , [2] , [3] , [4] . While these provided key information, often in real time, a major deficiency in these initiatives was a lack of detailed information on how health systems were responding to the pandemic and how health systems transformed in response. Health systems naturally are one of the main factors that influence how well countries can handle a health crisis like the COVID-19 pandemic, and much has been done to strengthen health systems over the past two years. From increasing ICU bed capacity or expanding the health workforce, to managing vaccination rollouts, the measures put in place by health systems can help to explain why some countries have been able to keep death rates comparatively low even in the presence of severe COVID-19 outbreaks, or indeed, why select countries have avoided (at least some) COVID-19 waves almost entirely. Well-functioning and well-resourced health systems have also, in many cases, been able to limit disruptions to regular health service delivery, preventing sharp increases in waiting times. Alternatively, others have at times been forced to convert their health systems into almost exclusively Covid-care. For many countries, the inability of the health system to cope with the pressures of COVID-19 was a significant factor behind repeated lockdowns.

It is therefore of utmost importance to track how health systems responded to COVID-19, both for the sake of accountability as well as to support countries looking for policy options. In an effort to fill this gap in knowledge, the European Observatory on Health Systems and Policies, WHO European Regional Office and European Commission joined together to create the COVID-19 Health System Response Monitor (HSRM) [5] . The HSRM was established in March 2020 to collect and organize up-to-date information on how health systems in 50 countries, mainly in the WHO European Region, were responding to the COVID-19 pandemic.

The HSRM follows a structured template, which looks at key health system functions related to the pandemic and the context in which these functions operate, including prevention measures and the actions of other sectors. This approach helps to facilitate comparability across countries, as well as ensure that information on responses in key parts of the health system are not overlooked. The template has also been replicated outside of the European region, for example in Asia, led by the Asia Pacific Observatory [6] .

Maintaining the HSRM so that it is sufficiently up to date is a serious undertaking. The HSRM relied heavily on the work of the Health Systems and Policy Monitor (HSPM) Network of the European Observatory on Health Systems and Policy, which brings together an international group of high-profile institutions from Europe and beyond with high academic standing in health systems and policy analysis. The content collected on the HSRM platform has been used to enhance cross country learnings through topical policy snapshots, policy briefs, Eurohealth issues, studies, webinars and more [7] , [8] , [9] , [10] , [11] .

All articles in this Special Issue are based on the content collected in the HSRM, mainly during the period between March 2020 and late 2021. This issue contains both thematic articles, which focus on a topic contained in the template of the HSRM ( Table 1 ), and comparative country articles, which compare country responses from a selection of 3 to 8 countries ( Table 2 ). Each paper provides a synthesis of lessons learned and considers why some countries seem to have more successfully managed the pandemic while others have not, while flagging up perspectives for future research. This special issue aims to provide coherent and comprehensive insights on lessons learned from the COVID-19 response, which will support policymakers while they prepare for future outbreaks but also for other health system shocks that affect the supply and demand of health services. Below we briefly highlight some of the key findings coming out of the articles.

The HSRM template and corresponding thematic articles in this special issue

Comparative country articles in this Special Issue

The first set of articles are structured around the thematic areas of the template. Rajan et al. focused on ‘preventing transmission’ and identified valuable lessons for tackling future disease outbreaks [12] . The authors emphasize the importance of governance in introducing measures to reduce COVID-19 transmission, and identify the need for a clear strategy with explicit goals and a whole systems approach to implementation.

The next two articles look at ‘ Ensuring sufficient physical infrastructure and workforce capacity ’. First, Winkelmann et al. consider a range of options for boosting health system capacity that are particularly relevant currently as virtually all countries are tackling backlogs of care in their systems [13] . For example, many countries mobilized additional staff, redeployed existing staff, used private providers, expanded hospital and ICU capacities and used regional and cross-country patient transfers. Second, Berger et al. had an in-depth look at hospital and ICU capacity across countries [14] . They used HSRM data and combined this with national and international statistics on hospitals admissions, capacities and COVID-19 cases. They found substantial variation in strategies used to manage the surge in cases and huge variation in the utilization of hospital resources among COVID-19 patients (e.g. the duration of hospital treatment in the first wave of COVID-19 per SARS-CoV-2 case ranged from 1.3 (Norway) to 11.8 (France).

The special issue then turns to ‘ Providing health services effectively ’, a key challenge for health systems not only during system shocks. Adaptations in the provision of care revealed similarities across countries. Webb et al. identify the most common strategies for adapting service delivery, including postponing elective care, reconfiguring hospital wards, using private sector capacity, and increasing digital health services [15] . Kumpunen et al. look at primary care providers, who were often underutilized during the pandemic [16] . They document a transformation of primary care models that included the use of multi-disciplinary primary care teams, identification of vulnerable populations for medical and social outreach, and the expanded use of digital solutions. Both articles will inspire policymakers concerned with building back after the pandemic and highlight the need for new models of care.

The huge changes in demand for, and supply of, health care services as well as economic contractions in many European countries have required changes in ‘ paying for services ’ in virtually all countries. Thomson et al. take a broad view on health financing policy and discuss how to maintain adequate financial resources for health in the presence of economic shocks [17] . The authors highlight that most countries in the WHO European Region do not use automatic stabilizers for public revenue for the health system, which would automatically increase public spending on health as the economy declines, and suggests that permanent changes are needed to reduce procyclical financing and strengthen resilience. Waitzberg et al. review changes in payment mechanisms for hospitals and healthcare professionals, distinguishing between adjustments compensating income loss and those covering extra costs related to COVID-19 [18] . Here, the specifics of the health system's financing played a role – in countries that used salary or capitation payments for professionals and global budgets for hospitals, income loss did not occur because of the separation between volume levels and payment, whereas providers in countries with activity-based payments experienced income losses, which was compensated through extra budgets, higher fees, and new payments to incentivize and compensate remote services. Both articles show that yet more can be done to better prepare financing systems for unexpected drops in public revenues, smoothing provider income losses due to reduced demand, and covering extra costs related to providing new types of services.

The final thematic article underscores the importance of ‘governance’ in driving an effective health systems response to the COVID-19 pandemic. Greer et al. study one particular element of governance, the role of centralization vs. decentralization, in relation to the politics of credit and blame [19] . Their piece highlights that public health measures were relatively easier to implement earlier in the pandemic, but as time progressed, this shifted as populations pushed back against restrictions, particularly in countries where the population had lower trust in government, which becomes even more apparent in the comparative articles discussed below.

Indeed, the second set of articles of this Special Issue focus on country comparisons and highlight the breadth of the Health Systems and Policy Network, with 33 country experiences recorded in these papers. They complement the thematic articles described above either by narrowing in on certain aspects of the COVID-19 response or by providing a wider overview of the response across countries. Sperre Saunes et al. review the governance response in the Nordic countries of Denmark, Finland, Norway, and Sweden [20] . They found that the countries’ strong welfare systems and the high levels of trust in government contributed to a comparatively less devastating impact from the pandemic compared to other countries. Unruh et al. describe a very different experience in Canada, Ireland, the United Kingdom and the United States of America [21] . They found that inconsistent messaging and alignment between health experts and political leadership was a key factor in lacking compliance with public health measures in these countries (although less so in Ireland). Webb et al. compare the centralized responses of the Estonian, Latvian, and Lithuanian health system, and witnessed the creation of the Baltic bubble during the first wave, one of the few regional open border arrangements during the pandemic [22] . Sagan et al. look at the Visegrad countries of the Czech Republic, Hungary, Poland, and the Slovak Republic which managed to control the first outbreak with strict measures, but then saw an erosion in support and loosening of measures as political and economic considerations started to prevail [23] . Džakula et al. describe a similar experience in Bulgaria, Croatia, and Romania [24] . After initial success, political and economic interests started to become dominant while public trust in government faded. The countries in all four of these articles describe a common pattern in which after acting quickly to minimize the initial impact of COVID-19, over time, weaknesses appeared that emphasize the need to strengthen the health workforce and balance the flexibility of service delivery to care for both COVID and non-COVID patients.

Waitzberg et al. compare the country responses in Cyprus, Greece, Israel, Italy, Malta, Portugal, and Spain [25] . With Italy and Spain among the hardest hit in the early phases of the pandemic, the authors acknowledge the value of learning from others (or first movers as they call them), especially in conditions of uncertainty. Schmidt et al. also cover a large country group, focusing on social health insurance (SHI) countries including Austria, Belgium, France, Germany, Luxembourg, the Netherlands, Slovenia and Switzerland [26] . They found that, perhaps surprisingly, SHI funds which play an important role as purchasers in these health systems were generally not very involved in crisis management and that their responsibilities in some countries shifted to the national government. This implies that the roles of SHI funds as well as other key health system actors may need to be carefully assessed so that they can be better prepared for future shocks.

Taken together, these articles provide a wealth of information about the response to COVID-19 in the WHO European Region. We thank all of the authors and reviewers involved in creating this Special Issue.

When the articles for this special issue on the European response to the COVID-19 pandemic were commissioned in the autumn of 2020, we could not have imagined that COVID-19 would still be such a major policy priority more than two years after the WHO declared COVID-19 a global pandemic. By now, there is no country that has not been affected by the crisis. Indeed, many countries which appeared to be good performers early in the crisis or even when we began to write this special issue eventually experienced outbreaks, in some cases severe ones. The truth is that virtually no country has consistently managed the pandemic well. This is unsurprising given the difficulty in maintaining COVID-19 measures over a long period of time. Nevertheless, there are many examples of good practices and potentially innovative initiatives within countries contained in the articles of this special issue that provide options for countries as they continue to re-orient their health system to deal with COVID-19 or to prepare for future crises.

Going forward, most countries in Europe have opted to put their faith in vaccines, and to a lesser extent, kept in place some social distancing measures, which only recently are being lifted. Health systems are therefore likely to continue to experience COVID-19 waves for the foreseeable future; their ability to cope with these pressures, not to mention other shocks, depends on having good information and policy options. In support of this, the country information on the COVID-19 HSRM will remain available as an archive of policy responses and there will also be a focus on ongoing analysis of key issues related to the recovery from the pandemic and making the system more resilient. These include, among others, how to support, retain and train sufficient workforce (a key bottleneck laid bare during the pandemic); how to estimate and tackle care backlogs; how to implement new models of care, including multidisciplinary approaches to the management of long Covid patients; how to manage the increasing need for mental health services; and how to appropriately use digital and remote health services by assessing in which areas they work and do not.

In the coming months and years, countries would derive great benefit from undertaking health system stress tests to identify weaknesses in the context of a range of different shocks. To this end, country experiences contained in the COVID-19 HSRM archive can be utilized as a sort of menu to inform remedial actions. One of the key advantages of this resource is that countries do not need to rely solely on their own policy experiences but also can explore concrete examples that have been applied elsewhere, being mindful of course of specific country contexts. We would advocate that such opportunities for policy knowledge transfer can provide a kind of leap-frogging effect for countries in devising appropriate policy responses for the future, be they as preparedness blueprints for a number of theoretical scenarios or national strategies to address other health system shock events.

The COVID-19 Health System Response Monitor (HSRM) network

Gazmend Bejtja, WHO Regional Office for Europe, Country Office

Bettina Menne, WHO Regional Office for Europe, Country Office

Adrian Xinxo, WHO Regional Office for Europe, Country Office

WHO Regional Office for Europe, Country Office

Florian Bachner, National Public Health Institute

Katharina Habimana, National Public Health Institute

Anita Haindl, National Public Health Institute

Sonja Neubauer, National Public Health Institute

Andrea Schmidt, National Public Health Institute

WHO Health Emergencies Programme

Batyr Berdyklychev, WHO Regional Office for Europe, Country Office

Andrei Famenka, WHO Regional Office for Europe, Country Office

Viatcheslav Grankov, WHO Regional Office for Europe, Country Office

Sophie Gerkens, Belgian Health Care Knowledge Centre

Karin Rondia, Belgian Health Care Knowledge Centre

Bosnia and Herzegovina

Mirza Palo, WHO Regional Office for Europe, Country Office

Boris Rebac, WHO Regional Office for Europe, Country Office

Maria Rohova, Medical University of Varna

Antoniya Dimova, Medical University of Varna

Mincho Minev, Medical University of Varna

Sara Allin, North American Observatory on Health Systems and Policies; University of Toronto

Tiffany Fitzpatrick, University of Toronto

Michel Grignon, McMaster University

Nessika Karsenti, Schulich School of Medicine, Western University

Madeline King, North American Observatory on Health Systems and Policies; University of Ottawa

Anna Kurdina, University of Toronto

Greg Marchildon, North American Observatory on Health Systems and Policies; University of Toronto

Monika Roerig, North American Observatory on Health Systems and Policies; University of Toronto

Sterling Stutz, University of Toronto

Maja Banadinovic, School of Public Health Andrija Štampar, University of Zagreb

Aleksandar Dzakula, School of Public Health Andrija Štampar, University of Zagreb

Iva Miloš, School of Public Health Andrija Štampar, University of Zagreb

Maja Vajagić, School of Public Health Andrija Štampar, University of Zagreb

Chrystalla Charalampous, European University

Elena Gabriel, Ministry of Health

Marios Kantaris, Centre for Health Research & Policy

Mamas Theodorou, Open University

Czech Republic

Lucie Bryndová, Institute of Economic Studies, Charles University

Adam Poloćek, Charles University

Tomáš Roubal, WHO Regional Office for Europe, Country Office

Jana Votápková, Institute of Economic Studies, Charles University

Jan Žiaćik, Charles University

Allan Krasnik, University of Copenhagen

Hans Okkels Birk, University of Copenhagen

Signe Smith Jervelund, University of Copenhagen

Karsten Vrangbæk, University of Copenhagen

Triin Habicht, WHO Barcelona Office for Health Systems Strengthening

Kristiina Kahur, Private consultant

Kaija Kasekamp, Ministry of Social Affairs

Kristina Köhler, WHO Regional Office for Europe, Country Office

Marge Reinap, WHO Regional Office for Europe

Andres Vork, Johan Skytte Institute of Political Studies, University of Tartu

Salla Atkins, University of Tampere

Vesa Jormanainen, Finnish Institute for Health and Welfare (THL)

Ilmo Keskimäki, Finnish Institute for Health and Welfare (THL)

Meri Koivusalo, University of Tampere

Pauli Rautiainen, Finnish Institute for Health and Welfare (THL)

Eeva Reissell, Finnish Institute for Health and Welfare (THL)

Markku Satokangas, Finnish Institute for Health and Welfare (THL)

Liina-Kaisa Tynkkynen, University of Tampere

Marjaana Viita-aho, University of Tampere

Coralie Gandré, The Institute for Research and Information in Health Economics (IRDES)

Zeynep Or, The Institute for Research and Information in Health Economics (IRDES)

Silviu Domente, WHO Regional Office for Europe, Country Office

Tamila Zardiashvili, WHO Regional Office for Europe, Country Office

Juliane Winkelmann, University of Technology Berlin/European Observatory on Health Systems and Policies

Cristoph Reichebner, University of Technology Berlin

Charalampos Economou, Panteion University of Social and Political Sciences

Daphne Kaitelidou, National and Kapodistrian University of Athens

Olympia Konstantakopoulos, National and Kapodistrian University of Athens

Lilian Venetia Vildiridi, Ministry of Health

Peter Gaal, Health Services Management Training Centre, Semmelweis University

Viktoria Szerencses, Health Services Management Training, Semmelweis University Centre

Zita Velkey, Health Services Management Training Centre, Semmelweis University

Sigurbjörg Sigurgeirsdóttir, University of Iceland

Sarah Barry, The Centre for Health Policy and Management, School of Medicine, Trinity College Dublin

Sara Burke, The Centre for Health Policy and Management, School of Medicine, Trinity College Dublin

Rikke Siersbaek, The Centre for Health Policy and Management, School of Medicine, Trinity College Dublin

Malgorzata Stach, The Centre for Health Policy and Management, School of Medicine, Trinity College Dublin

Steve Thomas, The Centre for Health Policy and Management, School of Medicine, Trinity College Dublin

Shuli Brammli-Greenberg, Braun School of public health, The Hebrew University of Jerusalem and Myers-JDC-Brookdale Institute

Amit Meshulam, Myers-JDC-Brookdale Institute

Gideon Leibner, The Hebrew University of Jerusalem

Nadav Penn, Myers-JDC-Brookdale Institute

Ruth Waitzberg, Myers-JDC-Brookdale Institute, Ben Gurion University of the Negev, Israel; Technical University of Berlin, Germany

Giovanni Fattore, Bocconi University

Antonio Giulio de Belvis, Università Cattolica del Sacro Cuore

Alisha Morsella, Università Cattolica del Sacro Cuore

Gabriele Pastorino, WHO Regional Office for Europe

Andrea Poscia, Università Cattolica del Sacro Cuore

Andrea Silenzi, Università Cattolica del Sacro Cuore

Walter Ricciardi, Fondazione Policlinico Universitario A. Gemelli

Dana Abeldinova, WHO Regional Office for Europe, Country Office

Serzhan Aidossov, WHO Regional Office for Europe, Country Office

Nadira Yessimova, WHO Regional Office for Europe, Country Office

Aliina Altymysheva, WHO Regional Office for Europe, Country Office

Nazira Artykova, WHO Regional Office for Europe, Country Office

Tasnim Atatrah, WHO Regional Office for Europe, Country Office

Akbar Esengulov, WHO Regional Office for Europe, Country Office

Kaliya Kasymbekova, WHO Regional Office for Europe, Country Office

Monolbaev Kuban, WHO Regional Office for Europe, Country Office

Moldoisaeva Saltanat, WHO Regional Office for Europe, Country Office

Salieva Saltanat, WHO Regional Office for Europe, Country Office

Aigul Sydykova, WHO Regional Office for Europe, Country Office

Nurshaim Tilenbaeva, WHO Regional Office for Europe, Country Office

Daiga Behmane, Riga Stradins University

Jānis Misiņš, Riga Stradins University

Laura Miščikienė, Lithuanian University of Health Sciences

Agnė Slapšinskaitė, Lithuanian University of Health Sciences

Mindaugas Štelemėkas, Lithuanian University of Health Sciences

Malta Public Health COVID-19 Response Team, University of Malta and Ministry of Health

Republic of Moldova

Oxana Domenti, WHO Regional Office for Europe, Country Office

Iuliana Garam, WHO Regional Office for Europe, Country Office

Stela Gheorgita, WHO Regional Office for Europe, Country Office

Igor Pokanevych, WHO Regional Office for Europe, Country Office

Delphine Lanzara, Ministry of Health

Julie Malherbe, Ministry of Health

Senad Begić, WHO Regional Office for Europe, Country Office

Mina Brajović, WHO Regional Office for Europe, Country Office

Nemanja Radojević, WHO Regional Office for Europe, Country Office

Batrić Vukčević, WHO Regional Office for Europe, Country Office

The Netherlands

Peter Groenewegen, NIVEL – Netherlands Institute for Health Services Research

Judith de Jong, NIVEL – Netherlands Institute for Health Services Research

Madelon Kroneman, NIVEL – Netherlands Institute for Health Services Research

John Paget, NIVEL – Netherlands Institute for Health Services Research

North Macedonia

Simona Atanasova, WHO Regional Office for Europe, Country Office

Margarita Spasenovska, WHO Regional Office for Europe, Country Office

Jihane Tawilah, WHO Regional Office for Europe, Country Office

Haldor Byrkjeflot, University of Oslo

Anne Karin Lindahl, University of Oslo

Ingrid Sperre Saunes, Norwegian Institute of Public Health

Ilseth Vegard Skau, Norwegian Directorate of Health

Katarzyna Badora-Musiał, Institute of Public Health, Jagiellonian University Krakow

Maciej Furman, Institute of Public Health, Jagiellonian University Krakow

Małgorzata Gała˛zka-Sobotka, Lazarski University

Rafał Halik, National Institute of Public Health

Iwona Kowalska-Bobko, Institute of Public Health, Jagiellonian University Krakow

Magdalena Kozela, National Institute of Public Health

Kamila Parzonka, National Institute of Public Health

Christoph Sowada, Institute of Public Health, Jagiellonian University Krakow

Marzena Tambor, Institute of Public Health, Jagiellonian University Krakow

Ines Fronteira, Institute of Hygiene & Tropical Medicine, Nova University Lisbon

Gonçalo Figueiredo Augusto, Institute of Hygiene & Tropical Medicine, Nova University Lisbon

Silvia Gabriela Scintee, National School of Public Health

Dana Farcasanu, Centre for Health Policy and Services

Russian Federation

Aleksandr Goliusov, WHO Regional Office for Europe, Country Office

Amélie Schmitt, WHO Regional Office for Europe, Country Office

Melita Vujnovic, WHO Regional Office for Europe, Country Office

Elena Dmitrievna Yurasova, WHO Regional Office for Europe, Country Office

San Marino

Alessandra Melini, State Authority for Health and Social Security

Gabriele Rinaldi, State Authority for Health and Social Security

Aleksandar Bojovic, WHO Regional Office for Europe, Country Office

Miljan Rancic, WHO Regional Office for Europe, Country Office

Ivan Zivanov, WHO Regional Office for Europe, Country Office

Martin Smatana, Private consultant (formerly Ministry of Health)

Tit Albreht, National Institute of Public Health

Ester Angulo-Pueyo, Health Services and Policy Research Unit, Institute for Health Sciences in Aragon (IACS)

Enrique Bernal-Delgado, Health Services and Policy Research Unit, Institute for Health Sciences in Aragon (IACS)

Francisco Estupiñán-Romero, Health Services and Policy Research Unit, Institute for Health Sciences in Aragon (IACS)

John-Erik Bergkvist, Swedish Agency for Health and Care Services Analysis (Vårdanalys)

Kerstin Gunnarsson, Swedish Agency for Health and Care Services Analysis (Vårdanalys)

Alexander Hedlund Kancans, Swedish Agency for Health and Care Services Analysis (Vårdanalys)

Nils Janlöv, Swedish Agency for Health and Care Services Analysis (Vårdanalys)

Simon Jehrlander, Swedish Agency for Health and Care Services Analysis (Vårdanalys)

Switzerland

Stefan Boes, University of Lucerne

Sarah Mantwill, University of Lucerne

Tanya Kasper Wicki, University of Lucerne

Çetin Dikmen, WHO Regional Office for Europe, Country Office

Toker Erguder, WHO Regional Office for Europe, Country Office

Berk Geroglu, WHO Regional Office for Europe, Country Office

Tufan Nayir, WHO Regional Office for Europe, Country Office

Irshad A. Shaikhi, WHO Regional Office for Europe, Country Office

Pavel Ursu, WHO Regional Office for Europe, Country Office

Jarno Habicht, WHO Regional Office for Europe, Country Office

Nataliia Piven, WHO Regional Office for Europe, Country Office

United Kingdom

Natasha Curry, The Nuffield Trust

Selina Rajan, London School of Hygiene and Tropical Medicine

Matthew Alexander, Virginia Commonwealth University School of Medicine

Andriy Koval, Department of Health Management and Informatics, University of Central Florida

Lynn Unruh, Department of Health Management and Informatics, University of Central Florida

Management team

Suszy Lessof, European Observatory on Health Systems and Policies, Brussels

Jonathan Cylus, European Observatory on Health Systems and Policies, London Hub

Anna Maresso, European Observatory on Health Systems and Policies, Berlin Hub

Sherry Merkur, European Observatory on Health Systems and Policies, London Hub

Maurizio Uddo, European Observatory on Health Systems and Policies, Brussels

Ewout van Ginneken, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Editorial team

Miriam Blümel, Berlin Hub and University of Technology Berlin

Cristina Hernandez-Quevedo, European Observatory on Health Systems and Policies, London Hub

Marina Karanikolos, European Observatory on Health Systems and Policies, London Hub

Wilm Quentin, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Bernd Rechel, European Observatory on Health Systems and Policies, London Hub

Erica Richardson, European Observatory on Health Systems and Policies, London Hub

Susannah Robinson, WHO Regional Office for Europe

Anna Sagan, European Observatory on Health Systems and Policies, London Hub

Giada Scarpetti, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Nathan Shuftan, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Anne Spranger, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Ruth Waitzberg, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Erin Webb, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Gemma A Williams, European Observatory on Health Systems and Policies, London Hub

Juliane Winkelmann, European Observatory on Health Systems and Policies, Berlin Hub and University of Technology Berlin

Copenhagen Center for Disaster Research

Rethinking Vulnerabili...

Rethinking Vulnerability in the Nordic countries: Lessons from the COVID-19 Pandemic

Public health

From the paper's abstract:

The COVID-19 pandemic has highlighted the need to rethink our understanding of vulnerability. This conversation has started to emerge in different forums across the Nordics. In this context, the Nordics have seen different responses to the COVID-19 pandemic. In this piece, we present three dimensions needed to push beyond the traditional notions of categories in understanding vulnerability. We also present different examples on how vulnerability manifested itself through different dimensions which may be different to natural hazards.

Read the full paper here

'Lessons for Survival' reflects on motherhood, racial justice and climate change

Copy the code below to embed the wbur audio player on your site.

Emily Raboteau wrote the new essay collection "Lessons for Survival: Mothering Against 'The Apocalypse.'" (Courtesy)

Host Celeste Headlee speaks with author, photographer and CUNY professor Emily Raboteau about her new essay collection " Lessons for Survival: Mothering Against 'The Apocalypse .'"

The book explores the intersection of climate change with racial justice and economic inequality.

Book excerpt: 'Lessons for Survival'

By Emily Raboteau

This segment aired on April 19, 2024.

The Evolving Danger of the New Bird Flu

An unusual outbreak of the disease has spread to dairy herds in multiple u.s. states..

This transcript was created using speech recognition software. While it has been reviewed by human transcribers, it may contain errors. Please review the episode audio before quoting from this transcript and email [email protected] with any questions.

From “The New York Times,” I’m Sabrina Tavernise, and this is “The Daily.”

[MUSIC PLAYING]

The outbreak of bird flu that is tearing through the nation’s poultry farms is the worst in US history. But scientists say it’s now starting to spread into places and species it’s never been before.

Today, my colleague, Emily Anthes, explains.

It’s Monday, April 22.

Emily, welcome back to the show.

Thanks for having me. Happy to be here.

So, Emily, we’ve been talking here on “The Daily” about prices of things and how they’ve gotten so high, mostly in the context of inflation episodes. And one of the items that keeps coming up is eggs. Egg prices were through the roof last year, and we learned it was related to this. Avian flu has been surging in the United States. You’ve been covering this. Tell us what’s happening.

Yes, so I have been covering this virus for the last few years. And the bird flu is absolutely tearing through poultry flocks, and that is affecting egg prices. That’s a concern for everyone, for me and for my family. But when it comes to scientists, egg prices are pretty low on their list of concerns. Because they see this bird flu virus behaving differently than previous versions have. And they’re getting nervous, in particular, about the fact that this virus is reaching places and species where it’s never been before.

OK, so bird flu, though, isn’t new. I mean I remember hearing about cases in Asia in the ‘90s. Remind us how it began.

Bird flu refers to a bunch of different viruses that are adapted to spread best in birds. Wild water birds, in particular, are known for carrying these viruses. And flu viruses are famous for also being shapeshifters. So they’re constantly swapping genes around and evolving into new strains. And as you mentioned back in the ‘90s, a new version of bird flu, a virus known as H5N1, emerged in Asia. And it has been spreading on and off around the world since then, causing periodic outbreaks.

And how are these outbreaks caused?

So wild birds are the reservoir for the virus, which means they carry it in their bodies with them around the world as they fly and travel and migrate. And most of the time, these wild birds, like ducks and geese, don’t even get very sick from this virus. But they shed it. So as they’re traveling over a poultry farm maybe, if they happen to go to the bathroom in a pond that the chickens on the farm are using or eat some of the feed that chickens on the farm are eating, they can leave the virus behind.

And the virus can get into chickens. In some cases, it causes mild illness. It’s what’s known as low pathogenic avian influenza. But sometimes the virus mutates and evolves, and it can become extremely contagious and extremely fatal in poultry.

OK, so the virus comes through wild birds, but gets into farms like this, as you’re describing. How have farms traditionally handled outbreaks, when they do happen?

Well, because this threat isn’t new, there is a pretty well-established playbook for containing outbreaks. It’s sometimes known as stamping out. And brutally, what it means is killing the birds. So the virus is so deadly in this highly pathogenic form that it’s sort of destined to kill all the birds on a farm anyway once it gets in. So the response has traditionally been to proactively depopulate or cull all the birds, so it doesn’t have a chance to spread.

So that’s pretty costly for farmers.

It is. Although the US has a program where it will reimburse farmers for their losses. And the way these reimbursements work is they will reimburse farmers only for the birds that are proactively culled, and not for those who die naturally from the virus. And the thinking behind that is it’s a way to incentivize farmers to report outbreaks early.

So, OK, lots of chickens are killed in a way to manage these outbreaks. So we know how to deal with them. But what about now? Tell me about this new strain.

So this new version of the virus, it emerged in 2020.

After the deadly outbreak of the novel coronavirus, authorities have now confirmed an outbreak of the H5N1 strain of influenza, a kind of bird flu.

And pretty quickly it became clear that a couple things set it apart.

A bald eagle found dead at Carvins Cove has tested positive for the highly contagious bird flu.

This virus, for whatever reason, seemed very good at infecting all sorts of wild birds that we don’t normally associate with bird flu.

[BIRD CRYING]

He was kind of stepping, and then falling over, and using its wing to right itself.

Things like eagles and condors and pelicans.

We just lost a parliament of owls in Minneapolis.

Yeah, a couple of high profile nests.

And also in the past, wild birds have not traditionally gotten very sick from this virus. And this version of the virus not only spread widely through the wild bird population, but it proved to be devastating.

The washing up along the East Coast of the country from Scotland down to Suffolk.

We were hearing about mass die-offs of seabirds in Europe by the hundreds and the thousands.

And the bodies of the dead dot the island wherever you look.

Wow. OK. So then as we know, this strain, like previous ones, makes its way from wild animals to farmed animals, namely to chickens. But it’s even more deadly.

Absolutely. And in fact, it has already caused the worst bird flu outbreak in US history. So more than 90 million birds in the US have died as a result of this virus.

90 million birds.

Yes, and I should be clear that represents two things. So some of those birds are birds who naturally got infected and died from the virus. But the vast majority of them are birds that were proactively culled. What it adds up to is, is 90 million farmed birds in the US have died since this virus emerged. And it’s not just a chicken problem. Another thing that has been weird about this virus is it has jumped into other kinds of farms. It is the first time we’ve seen a bird flu virus jump into US livestock.

And it’s now been reported on a number of dairy farms across eight US states. And that’s just something that’s totally unprecedented.

So it’s showing up at Dairy farms now. You’re saying that bird flu has now spread to cows. How did that happen?

So we don’t know exactly how cows were first infected, but most scientists’ best guess is that maybe an infected wild bird that was migrating shed the virus into some cattle feed or a pasture or a pond, and cattle picked it up. The good news is they don’t seem to get nearly as sick as chickens do. They are generally making full recoveries on their own in a couple of weeks.

OK, so no mass culling of cows?

No, that doesn’t seem to be necessary at this point. But the bad news is that it’s starting to look like we’re seeing this virus spread from cow to cow. We don’t know exactly how that’s happening yet. But anytime you see cow-to-cow or mammal-to-mammal transmission, that’s a big concern.

And why is that exactly?

Well, there are a bunch of reasons. First, it could allow the outbreak to get much bigger, much faster, which might increase the risk to the food supply. And we might also expect it to increase the risk to farm workers, people who might be in contact with these sick cows.

Right now, the likelihood that a farmer who gets this virus passes it on is pretty low. But any time you see mammal-to-mammal transmission, it increases the chance that the virus will adapt and possibly, maybe one day get good at spreading between humans. To be clear, that’s not something that there’s any evidence happening in cows right now. But the fact that there’s any cow-to-cow transmission happening at all is enough to have scientists a bit concerned.

And then if we think more expansively beyond what’s happening on farms, there’s another big danger lurking out there. And that’s what happens when this virus gets into wild animals, vast populations that we can’t control.

We’ll be right back.

So, Emily, you said that another threat was the threat of flu in wild animal populations. Clearly, of course, it’s already in wild birds. Where else has it gone?

Well, the reason it’s become such a threat is because of how widespread it’s become in wild birds. So they keep reintroducing it to wild animal populations pretty much anywhere they go. So we’ve seen the virus repeatedly pop up in all sorts of animals that you might figure would eat a wild bird, so foxes, bobcats, bears. We actually saw it in a polar bear, raccoons. So a lot of carnivores and scavengers.

The thinking is that these animals might stumble across a sick or dead bird, eat it, and contract the virus that way. But we’re also seeing it show up in some more surprising places, too. We’ve seen the virus in a bottle-nosed dolphin, of all places.

And most devastatingly, we’ve seen enormous outbreaks in other sorts of marine mammals, especially sea lions and seals.

So elephant seals, in particular in South America, were just devastated by this virus last fall. My colleague Apoorva Mandavilli and I were talking to some scientists in South America who described to us what they called a scene from hell, of walking out onto a beach in Argentina that is normally crowded with chaotic, living, breathing, breeding, elephant seals — and the beach just being covered by carcass, after carcass, after carcass.

Mostly carcasses of young newborn pups. The virus seemed to have a mortality rate of 95 percent in these elephant seal pups, and they estimated that it might have killed more than 17,000 of the pups that were born last year. So almost the entire new generation of this colony. These are scientists that have studied these seals for decades. And they said they’ve never seen anything like it before.

And why is it so far reaching, Emily? I mean, what explains these mass die-offs?

There are probably a few explanations. One is just how much virus is out there in the environment being shed by wild birds into water and onto beaches. These are also places that viruses like this haven’t been before. So it’s reaching elephant seals and sea lions in South America that have no prior immunity.

There’s also the fact that these particular species, these sea lions and seals, tend to breed in these huge colonies all crowded together on beaches. And so what that means is if a virus makes its way into the colony, it’s very conducive conditions for it to spread. And scientists think that that’s actually what’s happening now. That it’s not just that all these seals are picking up the virus from individual birds, but that they’re actually passing it to each other.

So basically, this virus is spreading to places it’s never been before, kind of virgin snow territory, where animals just don’t have the immunity against it. And once it gets into a population packed on a beach, say, of elephant seals, it’s just like a knife through butter.

Absolutely. And an even more extreme example of that is what we’re starting to see happen in Antarctica, where there’s never been a bird flu outbreak before until last fall, for the first time, this virus reached the Antarctic mainland. And we are now seeing the virus move through colonies of not only seabirds and seals, but penguin colonies, which have not been exposed to these viruses before.

And it’s too soon to say what the toll will be. But penguins also, of course, are known for breeding in these large colonies.

Probably. don’t have many immune defenses against this virus, and of course, are facing all these other environmental threats. And so there’s a lot of fear that you add on the stress of a bird flu virus, and it could just be a tipping point for penguins.

Emily, at this point, I’m kind of wondering why more people aren’t talking about this. I mean, I didn’t know any of this before having this conversation with you, and it feels pretty worrying.

Well, a lot of experts and scientists are talking about this with rising alarm and in terms that are quite stark. They’re talking about the virus spreading through wild animal populations so quickly and so ferociously that they’re calling it an ecological disaster.

But that’s a disaster that sometimes seems distant from us, both geographically, we’re talking about things that are happening maybe at the tip of Argentina or in Antarctica. And also from our concerns of our everyday lives, what’s happening in Penguins might not seem like it has a lot to do with the price of a carton of eggs at the grocery store. But I think that we should be paying a lot of attention to how this virus is moving through animal populations, how quickly it’s moving through animal populations, and the opportunities that it is giving the virus to evolve into something that poses a much bigger threat to human health.

So the way it’s spreading in wild animals, even in remote places like Antarctica, that’s important to watch, at least in part because there’s a real danger to people here.

So we know that the virus can infect humans, and that generally it’s not very good at spreading between humans. But the concern all along has been that if this virus has more opportunities to spread between mammals, it will get better at spreading between them. And that seems to be what is happening in seals and sea lions. Scientists are already seeing evidence that the virus is adapting as it passes from marine mammal to marine mammal. And that could turn it into a virus that’s also better at spreading between people.

And if somebody walks out onto a beach and touches a dead sea lion, if their dog starts playing with a sea lion carcass, you could imagine that this virus could make its way out of marine mammals and into the human population. And if it’s this mammalian adapted version of the virus that makes its way out, that could be a bigger threat to human health.

So the sheer number of hosts that this disease has, the more opportunity it has to mutate, and the more chance it has to mutate in a way that would actually be dangerous for people.

Yes, and in particular, the more mammalian hosts. So that gives the virus many more opportunities to become a specialist in mammals instead of a specialist in birds, which is what it is right now.

Right. I like that, a specialist in mammals. So what can we do to contain this virus?

Well, scientists are exploring new options. There’s been a lot of discussion about whether we should start vaccinating chickens in the US. The government, USDA labs, have been testing some poultry vaccines. It’s probably scientifically feasible. There are challenges there, both in terms of logistics — just how would you go about vaccinating billions of chickens every year. There are also trade questions. Traditionally, a lot of countries have not been willing to accept poultry products from countries that vaccinate their poultry.

And there’s concern about whether the virus might spread undetected in flocks that are vaccinated. So as we saw with COVID, the vaccine can sometimes stop you from getting sick, but it doesn’t necessarily stop infection. And so countries are worried they might unknowingly import products that are harboring the virus.

And what about among wild animals? I mean, how do you even begin to get your head around that?

Yeah, I mean, thinking about vaccinating wild animals maybe makes vaccinating all the chickens in the US look easy. There has been some discussion of limited vaccination campaigns, but that’s not feasible on a global scale. So unfortunately, the bottom line is there isn’t a good way to stop spread in wild animals. We can try to protect some vulnerable populations, but we’re not going to stop the circulation of this virus.

So, Emily, we started this conversation with a kind of curiosity that “The Daily” had about the price of eggs. And then you explained the bird flu to us. And then somehow we ended up learning about an ecological disaster that’s unfolding all around us, and potentially the source of the next human pandemic. That is pretty scary.

It is scary, and it’s easy to get overwhelmed by it. And I feel like I should take a step back and say none of this is inevitable. None of this is necessarily happening tomorrow. But this is why scientists are concerned and why they think it’s really important to keep a very close eye on what’s happening both on farms and off farms, as this virus spreads through all sorts of animal populations.

One thing that comes up again and again and again in my interviews with people who have been studying bird flu for decades, is how this virus never stops surprising them. And sometimes those are bad surprises, like these elephant seal die-offs, the incursions into dairy cattle. But there are some encouraging signs that have emerged recently. We’re starting to see some early evidence that some of the bird populations that survived early brushes with this virus might be developing some immunity. So that’s something that maybe could help slow the spread of this virus in animal populations.

We just don’t entirely know how this is going to play out. Flu is a very difficult, wily foe. And so that’s one reason scientists are trying to keep such a close, attentive eye on what’s happening.

Emily, thank you.

Thanks for having me.

Here’s what else you should know today.

On this vote, the yeas are 366 and the nays are 58. The bill is passed.

On Saturday, in four back-to-back votes, the House voted resoundingly to approve a long-stalled package of aid to Ukraine, Israel and other American allies, delivering a major victory to President Biden, who made aid to Ukraine one of his top priorities.

On this vote, the yeas are 385, and the no’s are 34 with one answering present. The bill is passed without objection.

The House passed the component parts of the $95 billion package, which included a bill that could result in a nationwide ban of TikTok.

On this vote, the yeas are 311 and the nays are 112. The bill is passed.

Oh, one voting present. I missed it, but thank you.

In a remarkable breach of custom, Democrats stepped in to supply the crucial votes to push the legislation past hard-line Republican opposition and bring it to the floor.

The House will be in order.

The Senate is expected to pass the legislation as early as Tuesday.

Today’s episode was produced by Rikki Novetsky, Nina Feldman, Eric Krupke, and Alex Stern. It was edited by Lisa Chow and Patricia Willens; contains original music by Marion Lozano, Dan Powell, Rowan Niemisto, and Sophia Lanman; and was engineered by Chris Wood. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Andrew Jacobs.

That’s it for “The Daily.” I’m Sabrina Tavernise. See you tomorrow.

April 24, 2024 • 32:18 Is $60 Billion Enough to Save Ukraine?
April 23, 2024 • 30:30 A Salacious Conspiracy or Just 34 Pieces of Paper?
April 22, 2024 • 24:30 The Evolving Danger of the New Bird Flu
April 19, 2024 • 30:42 The Supreme Court Takes Up Homelessness
April 18, 2024 • 30:07 The Opening Days of Trump’s First Criminal Trial
April 17, 2024 • 24:52 Are ‘Forever Chemicals’ a Forever Problem?
April 16, 2024 • 29:29 A.I.’s Original Sin
April 15, 2024 • 24:07 Iran’s Unprecedented Attack on Israel
April 14, 2024 • 46:17 The Sunday Read: ‘What I Saw Working at The National Enquirer During Donald Trump’s Rise’
April 12, 2024 • 34:23 How One Family Lost $900,000 in a Timeshare Scam
April 11, 2024 • 28:39 The Staggering Success of Trump’s Trial Delay Tactics
April 10, 2024 • 22:49 Trump’s Abortion Dilemma

Hosted by Sabrina Tavernise

Produced by Rikki Novetsky , Nina Feldman , Eric Krupke and Alex Stern

Edited by Lisa Chow and Patricia Willens

Original music by Marion Lozano , Dan Powell , Rowan Niemisto and Sophia Lanman

Engineered by Chris Wood

Listen and follow The Daily Apple Podcasts | Spotify | Amazon Music

The outbreak of bird flu currently tearing through the nation’s poultry is the worst in U.S. history. Scientists say it is now spreading beyond farms into places and species it has never been before.

Emily Anthes, a science reporter for The Times, explains.

On today’s episode

Emily Anthes , a science reporter for The New York Times.

Two dead pelicans are pictured from above lying on the shore where the water meets a rocky beach.

Background reading

Scientists have faulted the federal response to bird flu outbreaks on dairy farms .

Here’s what to know about the outbreak.

There are a lot of ways to listen to The Daily. Here’s how.

We aim to make transcripts available the next workday after an episode’s publication. You can find them at the top of the page.

Special thanks to Andrew Jacobs .

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College of Liberal Arts and Sciences

Philosophy Department

Tiana-marie blassingale: jeezy’s lessons from adversity.

Please check out an excerpt from Philosophy Graduate Student Tiana-Marie Blassingale’s new review essay, “Jeezy’s Lessons from Adversity”:

On the surface, it seems like Adversity for Sale is a collection of short stories about a young Black man as he navigates his way through the street life into a position of an established entrepreneur who is capable of providing generational wealth for his family by any means. However, seen through a philosophical lens, the book highlights a new perspective on liberatory virtues and vices. It’s a curation of epistemology, learned through lived experiences, not only by Jeezy, but also by many others in the book and the hood, more generally speaking. The book provides a glimpse into a rich body of knowledge, which could be referred to as “Hood Philosophy,” otherwise known as “street smarts” or “street knowledge.”

You can read the full essay on the Blog of the APA here.

Congratulations, Tiana-Marie!

Meet Cami Rezabek, the student choreographer for the School of Music’s spring opera, Fierce

Cami Rezabek is a fourth-year BFA student in the Department of Dance with minors in English and Gender, Women’s and Sexuality Studies, the undergrad research assistant for the UIDC, and the student-choreographer for Fierce, a new 21 st -century opera that follows four teenage girls through a journey of discovery as they write their college admissions essays. Fierce makes its Iowa debut on the Hancher stage April 26-27, 2024.

Rezabek is originally from Cedar Rapids, Iowa. Her mother, Carol, is a dancer, choreographer, dance teacher, and an alum of the University of Iowa with BFA degrees in Dance and Theatre Arts—so naturally, Cami began dance lessons by the time she was 3 years old. And the UI was a natural fit, too, when it came time for college.

“The dance program here is so good,” she explains, “and my family has a history in this department, so it just made sense.”

Cami started dancing at the UI in Fall 2020, amidst strict COVID pandemic restrictions—switching between Zoom ballet lessons and social-distanced rehearsals where students danced in six-by-six squares taped to the studio floor.

“It was an interesting first year,” she says. “I feel like I got really close to the dancers I came in with but, because we weren’t in Halsey Hall, we didn’t have the opportunity to meet and mingle with the older students in the program.”

Since then, Rezabek had been actively participating in UI dance performances, touring with the UIDC, and seeking out opportunities to choreograph.

“I’ve always had a passion for choreography,” Rezabek describes her choreographic work. “For me, it’s all about creating or elevating a story, bringing meaning to movements. I like to build dances around a narrative or a message, and think about the way every step, every movement, and all these small moments can come together in the body.”

“For musicals or pieces that have an existing story, I spend a lot of time analyzing the story,” she explains. “Choreography can add another layer to the piece, so it’s important to examine what’s there and find moments where a movement can bring something new and enlightening to a character or a scene.”

During the fall semester, Rezabek flexed her interpretive skills in a different way, working as a research assistant with UIDC. For their 2023-2024 season, UIDC prepared an interactive program of dance and dialogue called Dances Described that put special emphasis on the use of Audio Description as a tool for making dance more accessible to audiences with blindness, low vision, and other visual impairment. While the company developed their new piece, “Winning,” led by UIDC Artistic Director and Assistant Professor of Dance Stephanie Miracle, Rezabek created the Audio Descriptions that are read aloud—live—during the dance performance.

“Writing the Audio Description as we were creating the piece was a huge benefit,” says Rezabek. “Hearing how the dancers describe their own movements has really expanded the way I write about dance, and I can better communicate the visual into language. It’s helped me become a better choreographer and a better dancer.”

Rezabek was also one of the 38 UI student dancers who performed Martha Graham’s Panorama during the GRAHAM100 concert at Hancher on March 29. In early January, Rezabek and the rest of the ensemble dancers were hard at work in Halsey Hall, learning the historic choreography and intense Graham Technique while snowstorms whirled outside.

“It was really the opportunity of a lifetime to share the Hancher stage with professional dancers who perform at such a high level,” Rezabek explains. “When I graduate, I want to get a job with a dance company. Being part of the Martha Graham performance was a professional experience that I could have never imagined, and one that I am so grateful to have as I move into the next phase of my career.”

Rezabek was still rehearsing for Panorama when she joined the creative team of Fierce . It was another remarkable opportunity, particularly for an undergraduate student.

“Honestly,” Rezabek admits, “I didn’t think I was going to get the job, so I was really excited when I did.”

Fierce was first commissioned by Cincinnati Opera and composed by UI assistant professor of Jazz Studies William Menefield, who wrote the music for the opera in collaboration with author and librettist Sheila Williams.

“Once I read the description of the opera, I knew I wanted to be a part of the project,” Rezabek describes her initial interest in Fierce. “The story is very relatable and it’s also very modern with jazz, R&B, and Latin influences. It’s such a robust musical score so there is so much material I can pull from as a choreographer.”

Her first task was to find four dancers to work with, which proved to be difficult since many of the dancers in the Department of Dance had packed schedules. “At one point I counted, and there were five dance shows that overlapped with the rehearsals for Fierce ,” Rezabek explains, “so I had to get a little creative.”

Eventually, she found her four dancers: Fabiola Casteneda-Santiago (BA student in Biology), Chloe Schwab (BA in Theatre Arts), Joslyn Sheley (BA in Psychology, Political Science, Pre-Law), and Trinity Woody (MA in Dance Pedagogy and Instruction, Pre-Business). “They’ve been amazing,” Rezabek explains, “I don’t have to coach them on how to add style to their movement, so I can really focus on developing the choreography and the ideas that we’re trying to elevate through dance.”

As part of her development process, Rezabek conducted extensive research on the various influences that Dr. Menefield has incorporated into his composition.

“There is a lot I can derive from the music itself, but I wouldn’t want the movements to feel false,” she describes her research process. “I really watched a lot of videos, going back and forth between basic tutorials and more advanced performances because it’s important for me to learn and know the styles that my choreography is referencing. For example, I’m not as familiar with salsa. I had to spend some time with the style so that I could present something authentic.”

During rehearsals, Rezabek arrives with her thoroughly marked-up script and, as the singers are practicing in the opera studio on the lower level of the Voxman Music Building, the dancers develop and work on their choreography upstairs. Then, she works with Dr. Menefield to incorporate the choreography into the blocking for the actors and other cast members.

“I’ve felt really respected in the process,” says Rezabek. “I think it really helps that Dr. Menefield is both composer and director. Not only can I hear the feeling and intention in the music itself, but he’s also there to provide me with feedback. He’s always treated me like a professional, so he’ll tell me if something’s not working and, on the other hand, he’s not afraid to show enthusiasm when the choreography comes together.”

“I’m so excited to see the evolution of this production,” Rezabek says, “and I can’t wait for audiences to see all the performers come into their character. We’re really going to turn it on and light up the Hancher stage.”

IMAGES

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Meet Cami Rezabek, the student choreographer for the School of Music's
Cami Rezabek is a fourth-year BFA student in the Department of Dance with minors in English and Gender, Women's and Sexuality Studies, the undergrad research assistant for the UIDC, and the student-choreographer for Fierce, a new 21 st-century opera that follows four teenage girls through a journey of discovery as they write their college admissions essays.