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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.

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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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9 Valuable Lessons We’ve Learned During The Pandemic

essay on important life lessons we learn from coronavirus

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With so much stress, loss, and pain at the forefront of our minds, it sometimes feels like we’re in a constant waiting game, counting down the minutes until our “normal” lives are back. But after a year like this, there’s no going back to normal because we’ve all been changed forever in one way or another. We’ve lived 12 years in the past 12 months, and we’ve grown in the process – and that is a silver lining to be proud of!

So we decided the best way to acknowledge and appreciate the growth we’ve experienced is by taking a second to reflect on this past year and find the positives that were woven through each day.

To see the good that has come from these hard times, we adopted a lens of learning and growing, and it empowered us to do just that! Here are nine important lessons we’ve learned in the midst of COVID-19.

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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15 Lessons the Coronavirus Pandemic Has Taught Us

What we've learned over the past 12 months could pay off for years to come.

sights from the pandemic people wearing masks a boy visiting his grandmother through a nursing home window a zoom meeting and a six foot distancing sign

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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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.

Read More: A Tool for Staying Grounded in This Era of Constant Uncertainty

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.

Read More: How Ice Cream Became My Own Personal Act of Resistance

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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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 .

10 COVID-19 lessons that will change the post-pandemic future

COVID-19 lessons: Together we can help stop the spread of COVID-19 poster – lessons from the pandemic

COVID-19 lessons: What happens next? Image: Michael Marais/Unsplash

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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

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

Life Lessons From the Pandemic

There has been so much loss. but with it comes new wisdom that may help positively reshape the way we go forward., sharing is nice.

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Our world has certainly seen its share of generation-defining events, from global wars to the 1918 influenza pandemic to the attacks of 9/11. And now, the COVID-19 pandemic . While each was unique, they all altered the lives of those who experienced them.

With the coronavirus pandemic , we've surely learned a lot. Some lessons have been painful—COVID-19 spotlighted healthcare inequities and the higher rates of infection and death in Black, Latino, and Native American populations. But recognizing what's been wrong will help push our systems in the right direction, experts say, and some of the disruptions the crisis caused may produce lasting benefits.

"There has been often a lot of focus on loss . . . now people are beginning to reflect on what was gained," says Vaile Wright, PhD, senior director of health care innovation at the American Psychological Association (APA).

For instance, many people say they want to continue to spend more time at home as the pandemic eases, according to a March 2021 Consumer Reports nationally representative survey of 2,144 American adults (PDF). And the vast majority hope the emphasis on cleanliness and hygiene continues.

But what pandemic-related changes are we most likely to hold on to? Here, five key lessons and how they may improve our lives in the long run.

We've Harnessed Tech for Health, Work, and Socializing

The tech revolution that seemed perpetually around the corner actually got here as the coronavirus spread—upending the way we work, socialize, and handle many basic needs.

Take telehealth. With restrictions on in-person visits, doctors saw patients via phone, tablet, or computer . More than 80 percent of clinicians who responded to a 2020 COVID-19 Health Coalition survey said telehealth improved the timeliness of care, and a subsequent HC survey found that patients were similarly satisfied. Experts say talk therapy also works well via telehealth. (What's unclear: whether insurers, who expanded coverage for virtual care during the pandemic, will continue their coverage.)

Countless Americans used tech tools for working at home —a full 70 percent of full- or part-time working adults were doing their jobs remotely at least some of the time in April 2020, a Gallup poll found. Many liked it: 81 percent of 1,500 surveyed professionals who worked remotely in the past year would prefer not to go back to the office at all or to have a hybrid schedule going forward, according to a recent Harvard Business School survey. "We learned a lot about the ability to telework and still get the work done," says Georges Benjamin, MD, executive director of the American Public Health Association (APHA). "The technology exists to do it effectively."

Some also turned to tech for leisure activities like virtual cooking, live-streamed museum tours, and interactive fitness classes. And people regularly "visited" with relatives and friends via Zoom or FaceTime. While remote schooling for children was widely unpopular, the expansion of virtual adult education may continue to appeal: About one-third of American adults said online classes offered the best value for them, in a July 2020 survey by the nonprofit Strada Education Network.

One tech issue the pandemic magnified is that not everyone has reliable home internet access. Though solutions may be a while in coming, President Biden's infrastructure bill aims to expand broadband to communities where it's lacking.

"I started a virtual game night a year ago and it's still going strong, joined an online group called Friends and Fiction. . . . It gave me an opportunity to get to know people more, even if it was on the computer."

Rhonda Perrett, Forest, Va.

We Picked Up Important Wellness Habits

Though we initially knew almost nothing about COVID-19, over the course of the pandemic many of us learned how strategies such as wearing masks , regular and proper hand-washing, distancing physically from those outside our household, ventilating indoor spaces, and staying home while sick could help reduce the spread of the illness.

At this point, experts as well as most consumers appear to want to see such infection-protective behaviors become the norm in the U.S. For instance, 79 percent of Americans say they feel positive about the focus on cleanliness and hygiene, and hope it remains after the pandemic is declared over, according to CR's March 2021 survey. "I think handshakes probably won't return real quickly," says the APA's Wright.

And just as many people in East Asia wore masks during daily activities such as commuting by public transit after the SARS outbreak there in 2003, some mask-wearing may persist in the U.S. for a while, says Barun Mathema, PhD, an assistant professor of epidemiology at the Mailman School of Public Health at Columbia University in New York.

This may be more likely in areas that were hit hard by COVID-19—or if a winter surge in coronavirus occurs in the U.S., according to Ali Mokdad, PhD, a professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, speaking at a news briefing in April 2021.

Importantly, smart health and hygiene habits have benefits beyond protecting against COVID-19. "The flu epidemic that comes every year didn't happen this year, because of mask-wearing, hand-washing, and social distancing—and vaccination," says the APHA's Benjamin.

We've Become Better at DIY

Those months at home gave some the chance to notice every area of their living spaces that needed fixing or upgrading. That, in turn, motivated consumers with time on their hands to try do-it-yourself projects, and built confidence in their abilities to wield a pair of pliers or a screwdriver, says Grant Farnsworth, president of The Farnsworth Group, which does market research on the construction, lawn, and home improvement industries.

The result: During the pandemic consumers started 5 to 10 percent more DIY home improvement projects—such as landscaping and installing lighting—than they typically do, Farnsworth says.

"I picked up bigger projects (at home): cleaned out and refurbished an old shed, installed a new kitchen door, and painted the kitchen cabinets. They look terrific—turned out so much better than expected."

Pete Quinn, Manasquan, N.J.

When spring 2021 rolled around, and COVID-19 vaccines became widely available , industry experts expected the DIY home fix-up trend to end. But it didn't. Instead, even as the professional contracting business has picked up, people are tackling DIY home improvements much as they did in 2020.

And the DIY movement went beyond home fixes. Thanks to guidance from friends, virtual classes, or video tutorials on YouTube, consumers learned to cut their own hair, designed and sewed face masks, and began breadmaking in such large numbers that flour became scarce in grocery stores. Many people also started crafting for fun, says Diana Smith, associate director of retail at market research firm Mintel, which predicts a rise in handmade gifts such as knit hats and home-baked cookies throughout 2021.

Whether this penchant for self-reliance will last is unclear, but the confidence that many gained from home projects could remain for life, Farnsworth says. And some of these DIY projects, Smith points out, offer a leisure option that "kind of feeds the soul."

We Began Shopping Differently

When the pandemic forced us to suddenly alter our shopping routines, many people opted for contactless pickup and online and other delivery-based options.

Before COVID-19, online shopping was growing—people already bought most electronics on the internet, for instance. But the pandemic accelerated this, says Mintel's Smith, particularly for groceries, household cleansers, and healthcare products, and tech gear useful for working at home. A nationally representative August 2020 Consumer Reports survey ( PDF ) of more than 2,000 U.S. adults found that the percentage of Americans who used delivery or pickup for groceries grew by more than 80 percent.

"I started ordering from [a] CSA, so I get seasonal produce all year-round while supporting local farms. I feel more connected to the food I'm eating, the businesses around me, and the people in them."

Airin Virgilio, Chicago

Consumers turned to local venues too, especially for food. A March 2021 survey by the International Food Information Council (IFIC) found that 44 percent of Americans ages 18 to 80 made an effort to support area restaurants and 25 percent purchased from nearby farmers.

The pandemic's economic blow also made it hard for some people to put food on the table. CR's August 2020 survey found that about 1 in 5 American grocery shoppers had used a food bank or pantry at some point since the pandemic began—and about half of them said they hadn't used these programs in the preceding year. In IFIC's March survey, more than 40 percent said they often or sometimes bought less food or less healthy food due to money worries.

Looking ahead, 55 percent of Americans say they hope contactless options like curbside pickup will last, CR's March 2021 survey found. Almost half say they're still shopping online more than in the past, Mintel says. But many may also continue to buy local, says Smith: "There's an emphasis and a focus on community and connection."

We've Reassessed Our Priorities

Throughout the ups and downs of the pandemic, many Americans have been reconsidering what matters most in life, and that's little surprise to the experts we interviewed.

As Richard Tedeschi, PhD, a professor of psychology at the University of North Carolina at Charlotte, points out, going through challenging experiences often leads us to think more deeply about our core beliefs—whether it's our personal relationships or health, the work we do, or how we spend our free time.

In addition, the coronavirus "caused people to realize that things could change in an instant," says Mintel's Smith. The firm's recent data found that 59 percent of Americans say they want to spend more time with family. And 44 percent said they enjoyed spending more time at home during the pandemic and hope that continues afterward, according to CR's March 2021 survey. "I think people have appreciated being forced to slow down," says the APA's Wright, "to actually be present in activities" with family and friends.

Mintel also found that 58 percent of people express a desire to take better care of their physical health . Home cooking could help there. According to CR's August 2020 survey, more than a third of grocery shoppers say they cooked from scratch or tried new recipes more often than they used to before the coronavirus.

On the job front, the dedication of healthcare workers throughout the pandemic appears to have inspired more people to become doctors. Applications to attend medical school in 2021 were roughly 18 percent higher than the previous year's numbers, according to the Association of American Medical Colleges. "After 9/11, [we] saw a big increase in individuals joining the armed forces," Wright says. "I think that this is probably similar."

The crisis motivated us to look out for our local communities, too, a trend that's likely to endure, Smith says. We saw this worldwide: COVID-19 drove a global surge of interest in volunteering with food banks and organizations that support the elderly, disabled, or migrant populations, according to the United Nations.

Finally, 35 percent of us say we yearn to try "something new," Mintel reports. But what? Only time will tell whether that means starting a blog or a business, learning a new language, raising chickens, relocating—or an entirely different kind of pursuit.

Editor's Note: This article also appeared in the August 2021 issue of Consumer Reports magazine.

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Lessons Learned from the COVID-19 Pandemic

The COVID-19 pandemic showed us how a disease can impact our lives—and society. While not a pandemic, we’ve learned of another recent public health threat as reports emerged of monkeypox spreading across Europe and America. Polio, which hasn’t been a major concern for decades, was also just identified in a man through local transmission in New York City. 

It’s enough to make some people worry. It’s also enough to make other people become apathetic.

While both reactions are understandable, it’s important to remember that we can do much to address infectious diseases and pandemics. Public health preparedness and response to emerging threats are now more robust within our state, the U.S., and across the globe. Scientists worldwide, including at University of Utah Health, are hard at work to identify and defeat disease outbreaks new and old. 

Even more importantly, each of us holds significant power to protect our own health—and the health of those around us—with some basic safety measures.

Monitoring COVID-19 and Watching for New Pandemics

From global events like the 1918 flu to COVID-19 today, such large intense outbreaks are likely to happen over time. That’s why it’s important to watch for, warn about, and help to mitigate threats from diseases. 

As the Chief Medical Epidemiologist for U of U Health, I help to oversee pandemic preparedness for the system and conduct surveillance to prevent drug-resistant organisms and hospital-associated infections. Infection & Prevention Control for University of Utah Hospitals and Clinics communicates information about infections to clinical teams, administrators, public health leaders, and other stakeholders.

Infection Prevention & Control closely monitors respiratory viral disease activity over the cold and flu season from multiple sources. Our data teams at U of U Health compile testing data from across our hospitals and clinics for respiratory viruses to help identify outbreaks and hot spots. We can pick up on potential contagious illnesses when employees call in sick or contact the Work Wellness Center in increasing numbers. Locally and nationally, other metrics, such as syndromic surveillance—complaints of sore throat, fever, and other symptoms—are used to measure severity of respiratory viral infections.

Wastewater is used to look for infectious organisms including SARS-CoV-2, resistant bacteria, and even polio. Epidemiologists also monitor social media and search queries to identify and track new outbreaks. For example, scientists at Johns Hopkins found they could predict when the flu is spiking by online searches for flu symptoms.

Illustration of scientists using magnifying glass with blue background

Jeanmarie Mayer, MD

Jeanmarie Mayer is the Chief Medical Epidemiologist for University of Utah Health. Mayer helps oversee pandemic preparedness for the system and conducts surveillance to prevent drug-resistant organisms and hospital associated infections. She is a professor of internal medicine at the Spencer Fox Eccles School of Medicine at the University of Utah. Mayer received an MD at the University of Rochester School of Medicine. She completed a residency in internal medicine and research fellowship in infectious disease at Hartford Hospital, followed by a fellowship in infectious disease at the University of Utah School of Medicine.

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Lessons learned from the COVID‐19 pandemic

Erwin J. Khoo

1 Department of Pediatrics, International Medical University, Kuala Lumpur Malaysia

John D. Lantos

2 Bioethics Center, Children’s Mercy Hospital, Kansas City MO, USA

The coronavirus disease 2019 (COVID‐19) outbreak raises unique ethical dilemmas because it makes demands on society from all sectors of life, nationally and across the globe. Health professionals must deal with decisions about the allocation of scarce resources that can eventually cause moral distress and may affect one's mental health. Everybody must deal with restrictions on freedom of movement that have shut down whole economies in an attempt to flatten the epidemic curve. Moving forward, there will be questions of when and how it will all end? In due course, some will question the ethics behind the search for effective treatments and the development of vaccines in a time of uncertainty and distress. These sorts of predicaments—and the people that they effect—are very different. While the lasting implications of the pandemic are yet to become apparent, we here outline some of the potential lessons and address its ethical dilemmas.

1. LIMITED RESOURCES

This pandemic is a stark reminder of the divide that exists in countries without universal health care, between those who can afford health care and those who cannot and may be forced into poverty as a result. 1 Good hygiene practices such as effective hand washing and physical distancing are effective means to flatten the curve and reduce the economic burden. In poorer societies, these simple measures may not be feasible.

Sadly, we live in a world that allows people to die when it costs too much. It happens all the time in areas like humanitarian aid, 2 road safety 3 and the funding of orphan drug research. 4 A financial limit on our efforts to save lives will always be present in every nation's healthcare budget. The ideal is for transparency in budget allocation that involves all stakeholders, guided by the ethical principles of utility and equity. 5 While the principle of utility requires allocating resources to maximise benefits and minimise burdens, the principle of equity requires attention to the fair distribution of benefits and burdens. Health equity is an ethical concept based on the principle of distributive justice. While an equal distribution of benefits and burdens may be considered fair, it may be fairer to give preference to groups that are more vulnerable. There is no easy solution to resolve potential tensions between utility and equity, but a balanced consideration between both is crucial.

The pandemic will require resource allocation decisions. We will have to decide who gets a ventilator or an intensive care bed when not everyone can. Decision‐making tools need to be developed to ensure that no person receives better or worse treatment due to his or her social status. Such efforts must be made to avoid unintended discrimination during pandemics. The Clinical Frailty Scale score 6 and a decision‐making committee are two exemplary options that can aid decisive factor for triage and admission to critical care. No matter what tools are used, it needs to be simple and regularly reviewed as the pandemic evolves. We learnt that many doctors succumbed to COVID‐19 while performing their duties. Preferential treatment for healthcare workers who risk their lives as front liners may be justifiable. This ethical principle of reciprocity implies that society have a duty to support individuals who risk their own health for protecting the public good. This must not be limited to healthcare providers alone, but also the hospital cleaners, technicians and security personnel among others.

2. MENTAL HEALTH

We need to be aware that the COVID‐19 pandemic will have mental health consequences. Resource allocation decisions generate conflicts and mixed sentiments for both healthcare providers and the general public. Moral distress affects all of us and must be respected and openly discussed. Such moral distress is a healthy sign, not a pathologic one.remuneration It means that we are trying to do the right thing, know that sometimes we cannot, yet must go on. There will be conscientious objectors when it comes to risking their own lives, and potentially the lives of their families when undertaking duties in a contagious outbreak. A compromise approach 7 strikes a balance between the needs of the patients and the healthcare workers’ conscience. A referral can then be made to a willing colleague. However, this approach might not be practical during pandemics. Applying the above‐mentioned principle of reciprocity, conscientious objection could be discouraged by offering better incentives and remuneration to non‐conscientious objectors.

There will be psychological impact to those who are stereotyped as being disease carriers. Racism and discrimination lead to chronic stress. They are barriers in realising the principles of equality, a core principle of human rights. The rights to non‐discrimination must remain central to all government responses. We must advocate countermeasures to address widespread stigmatisation that have adverse public health impact. Being a role model in our practice encourage people to come forward to seek treatment without fear.

For all of us to stay mentally healthy, every effort counts. Talking to our patients and their families about COVID‐19 helps people cope, especially when the situation remains fluid and where the public has many doubts. Answering, sharing facts and letting children know that it is fine to be upset, or scared help us face reality too.

3. RESTRICTION ON FREEDOM OF MOVEMENT

Quarantine, travel restrictions advisory and authorised measures to reduce transmission such as school and work closure can cause loneliness, confusion, anger, frustration, boredom and constant feeling of inadequate information. 8 While these measures are justified to safeguard the best interest of society, they impose a significant burden on individuals and indirectly violate the fundamental human rights of freedom of movement. Reports have shown of increased domestic violence and even alcohol abuse during quarantine. 8 Children are at risk, simply because they are powerless. Appeals to altruism might mitigate some of these problems. 8 Strategies and social awareness should be put in place to offer support and protection to minimise such risk to children and women.

In the hospital setting, quarantine can change the norms of death and dying. No one wants to die alone in isolation, amid chaos and with burnout healthcare providers. We have a moral imperative to ensure good care for dying patients that incorporates their spiritual needs. Our sense of empathy means we must ensure that modern technologies are available to enable families to interact with loved ones during isolation. Likewise, video‐based communication with families will give emotional support and ease the anxiety surrounding death and dying. In this challenging time, such small gestures mean a lot.

4. ECONOMIC IMPACT

While we focus on saving lives, an economic collapse is a catastrophic health risk, too. Access to health care will be a heightened concern for those in economic hardship, especially as the pandemic brings additional risks for less secure workers. 1 Many companies have instructed staff to work from home, but for many this is not an option. Eventually, the pandemic will economically impact everyone, and a global recession is imminent. A range of economic policy responses will be required. Cutting interest rates and massive stimulus package are possible effective responses. However, the impact is not only a demand management problem but also a multifaceted one that requires coordinated fiscal and health policy implementation. 9

There needs to be more investment in public health in all economies particularly in less developed countries where healthcare systems are less developed and population density is high. 10 Ultimately, we want to avoid the dilemma of affordability when a cure is found.

All this leads us to conclude that cross‐cultural global values and ethical standards are crucial for the success of the global market economy. Such a global ethic should be based on the principles of humanity and reciprocity and the basic standards of non‐violence, fairness, truthfulness and partnership. The Global Economic Ethic Manifesto 10 reminds each one of us in our diverse roles as entrepreneurs, investors, creditors, workers and consumers to bear a common responsibility for humanising the functioning of the global economy.

5. RESEARCH ETHICS

There is a need for interventions to curb the problem. We have an ethical obligation to learn as much as possible quickly to develop effective health policies, drugs and vaccines. Clinicians, researchers, administrators, ethics committees, regulators and sponsors have a duty to ensure that this is done without delay. Protocols can be developed to ensure accelerated ethics review without undermining basic ethical principles of beneficence, respect for persons and justice. One option is to authorise the advance review of generic protocols for conducting research, which can then be rapidly adapted and reviewed. 5 International collaboration can help ensure the research is viable. We need international collaboration and data sharing so that clinical trials can be done without delay. We need licensing agreements that cross international borders. 11

In conclusion, zoonotic diseases will continue to pose a threat to humanity with imminent potential for panic and fear that disrupts our everyday lives. Today, we witnessed solidarity, the justification of collective action in the face of a common threat. International community are slowly coming together as one to collaborate, coordinate, share lessons learnt and help one another. Yet, we must be mindful of the gap between social acceptance and ethical acceptability. While global cooperation, especially in the sphere of public health, research and economic development, is essential, politicians and leaders must not ignore scientific facts. We are working together for the good of mankind. What we must not do is to blame one another in this time of uncertainty. Until every country is safe, no country will be safe.

CONFLICT OF INTEREST

The authors have no conflict of interest to declare.

ACKNOWLEDGEMENTS

Thank you to Professor Dr Gerard B Loftus for his assistance in correcting grammatical and linguistic mistakes in the manuscript. We thank the anonymous reviewers for their careful reading of our manuscript and their many insightful comments and suggestions. Special thanks to Evelyn Xiling Khoo as she battles cancer in a world where many drugs are unaffordable; she inspired the writing of this manuscript.

Biographies

Articles in the series A Different View are edited by William Meadow ( [email protected] ). We encourage you to offer your own different view either in response to A Different View you do not fully agree with, or on an unrelated topic. Send your article to Dr. Meadow ( [email protected] ) .

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The Important Life Lessons We Can Take From COVID-19

18 May 2020

Mere months ago, accounts of a strange SARS-like virus began emerging from China. Fast-forward to today, and what we now know as COVID-19 has sent shockwaves around the world with the global death toll now standing at over 302,000 and the number of confirmed cases ringing in at more than 4 million.

Beyond this heartbreaking loss of life, the fallout from COVID-19 has ricocheted into all other areas of our lives. Unemployment has surged and experts are warning we're entering a deep economic recession, we have a mental health crisis on our hands, and our regular daily routines have been disrupted beyond recognition while we've been forced indoors to self-isolate.

There's no way of sugarcoating the situation around COVID-19: It has and continues to wreak devastating consequences we never dreamt possible in 2020.

At a time like this, it can be difficult to find many - or even any - positives. However, history has shown us that major catastrophes can serve as valuable catalysts for change. Besides providing possible guidelines for how we can handle future pandemics, COVID-19 has also given us further insights on the looming climate change crisis, and further brought to light the gross inequalities that exist within our societies.

While we continue to fight COVID-19, search for a vaccine, and come to grips with our 'new normal,' it's important we reflect on the valuable life lessons the pandemic has taught us and keep sight of these while working towards progress.

So, when we come out the other side of this pandemic, what will we have learnt?

Here are a few thoughts...

Human life on Earth is not a given

Although the extinction of many animal species has been well documented, many of us have never considered the possibility humans could one day become extinct too. COVID-19 has forced us to examine the fragility of our own mortality.

As grim as it is to consider, it is just one of many recent reminders that we may not be immune to being wiped out. In recent years, we've seen the global climate crisis escalate, coming to a crescendo in Australia with extreme weather events like droughts, floods and last summer's bushfire crisis .

Now, we're facing a pandemic unlike anything we've seen in modern times and it has brought life as we knew it to a halt. The pandemic has seen countries we've previously seen as strong and medically advanced - such as China, Italy and the US - brought to their knees. We've watched in horror as makeshift morgues and mass graves have appeared to whisk away inconceivable numbers of bodies in the worst-affected nations.

Swift, globally co-ordinated action is needed to protect against universal threats

Including future pandemics

COVID-19 has shown us not all our world leaders nor the systems we've placed faith in are equipped to cope with major global threats like COVID-19. We already knew from the early 2000's SARS-outbreak that better information-sharing between countries and swifter, globally co-ordinarted is one of the best lines of defence against future pandemics. Yet, we failed miserably when it came to remembering these learnings and working together.

Public health experts have argued that had we seen early, more-aggressive and globally-united responses to COVID-19 (such as synchronised lockdowns and perhaps universal financial support packages) we may have mitigated much of the social and economical carnage we've seen.

And, climate change

While reporting around climate change has largely been forced into the backseat lately, this looming crisis won't wait until the pandemic is over. We urgently need to apply the same principles of globally-united action to lower our greenhouse gas emissions before it is too late. No country is insulated against the effects of global warming and we are playing a dangerous game of Russian roulette with the planet the longer we delay.

Changes in human lifestyle and behaviour can have a meaningful impact on the planet's health

COVID-19 has highlighted the link between damaging human activity on Earth and climate change. Although we've seen many excited reports about the positive effect the pandemic has had on climate change (the cleaner air and recovery of wildlife has been impressive), the International Energy Agency (IEA) has predicted 2020's annual emissions to be down by just 6 to 8 per cent. Frighteningly, although it seems we've made huge improvements, this year is still on a collision course to be the hottest ever recorded.

Further , we remain on the brink of missing the internationally agreed target set during the Paris Agreement. Even the dramatic lockdowns and travel limits over the last few months haven't put us on track to reduce our emissions by the agreed 7.6% each year to 2050 that will allow us to limit global warming to 1.5C (above pre-industrial levels).

Although terrifying, these sobering statistics show us just how drastic the changes we'll need to make must be to make a meaningful impact in the fight against climate change.

If we can apply the same strategies of serious, speedy action, that we successfully used against the pandemic in Australia, to climate change, and look to countries like South Korea that are investing in green energy as part of their COVID-19 economic recovery plan, we'll stand a chance.

Being cynical is dangerous (and costly)

In the United States, we saw Trump continuously spreading disinformation and reassuring Americans COVID-19 was "under control," the US was in "great shape" and that they'd "pretty much shut [the virus] down coming in from China" all the while relying on the frighteningly misplaced hope that in April "it would disappear like a miracle" with warmer weather.

It didn't.

Dismissing claims the virus was serious, Trump remained bullish in his stance, refusing to lockdown the country and declaring repeatedly that America would be open for business again very soon. Meanwhile, his public health officials and many governors continued to warn that this strategy could result in a second wave of COVID-19 cases that would again overwhelm hospitals.

All the while, COVID-19 continued to spread around the United States at an alarming rate and the country quickly surpassed all others to become the hardest hit. Had the Trump administration acted faster and more aggressively to implement social distancing measures, testing and contact tracing, the United States may have had been in a far better position.

Looking to countries like Australia and Japan, it's clear early action is the most economically sound approach. Countries that ignored the advice of health experts are now the ones paying the biggest price both in loss of life and economic devastation.

Don't be afraid to take a sick day - it could save a life

In today's fast-paced world, working through illness is often seen as a badge of honour. Many of us feel extraordinarily guilty for calling in sick to work and will present ourselves to the office unless we're pretty much bedbound.

The result? We risk infecting our colleagues, which then has a greater flow-on effect on the company's productivity than if we'd just stayed at home and kept our germs to ourselves. Plus, we not only risk sharing the virus with our co-workers but also anyone we brush shoulders with commuting to work or while stepping out for lunch.

In the case of COVID-19, a number of 'super-spreaders' who kept going about their business while sick have been identified as being responsible for multiple outbreak clusters.

The lesson? If you're sick, stay home.

Temporarily compromising your personal freedom could save a life (or many)

As Australians, we're known for our optimistic, 'no worries' attitudes, and flouting the rules is often regarded as being 'cheeky' than seriously frowned upon. Ordinarily, this optimistic outlook is endearing but in a pandemic, it can be dangerous.

When our government began to roll out warnings around public gatherings, instead of heeding this advice with caution, record numbers of Sydney-siders flocked to Bondi Beach to enjoy the sun. After the beach was closed and further restrictions were broadcast around the nation, we started to get the idea. And, after we saw the global number of confirmed cases skyrocket what we dreamt possible, we really started to get the idea.

Let's remember, keeping physically distanced is one of the most effective measures against infectious diseases.

Keeping physical distance doesn't mean you need to be socially distanced

Many of us have interestingly found we've been more social with friends and family than before - even making contact via phone and video chatting with people in other states or countries that we ordinarily don't see regularly in person. Perhaps we're making much more of an effort to catch up virtually because we've suddenly become fearful of being 'socially distanced'?

Let's not wait for another pandemic to give ourselves reason to pick up the phone, let's keep this contact going. Thanks to COVID-19, we've now taught many of our grandparents and older generations to use tools like FaceTime to implement regular face-to-face catchups from a distance.

Pandemics are not 'great equalisers'; we have an enormous amount of work to do to 'close the gap'

COVID-19 has been dubbed the "great equaliser" by some who've argued the virus's inability to discern between race, class and socio-economic standing means it will affect all communities equally. But, this is not so.

It is far easier to 'work from home' in a white collar profession where simply all that is needed to perform one's duties are a computer and WiFi connection and human contact can be minimised. Research conducted in the UK found men in low-skilled jobs like manual labour are four times more likely to die from COVID-19 than men in professional occupations. Meanwhile, women working as carers are twice as likely to die as their counterparts in professional and technical roles.

The pandemic has laid bare the inequalities that exist in our society, hitting those from disadvantaged or minority backgrounds the hardest. We have intensive work to do to close the gap between the 'haves' and the 'have nots.'

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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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Policy brief article, lessons learnt from the covid-19 pandemic.

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

Essays about life during COVID-19

The boston book festival's community writing project comes to a close, with these short narratives by mayor marty walsh and other massachusetts residents describing what they've faced during this time and what they've learned.

(Boston, MA 6/4/20) Mayor Martin Walsh and other city officials and employees take part in an eight minute and 46 second “moment of silence” in memory of George Floyd outside Boston City Hall. (Mayor’s Office Photo by John Wilcox)

The last few months have been some of the most trying for our city. The lockdown tested all our systems and community strength — and we are being tested now again.

In the days following George Floyd’s murder, I sought out Black colleagues to ask how they were feeling and how they thought we should respond. Some are cabinet members and some are entry-level workers. Many have been participating in the protests and helping to support the movement for justice.

What I heard was heartbreaking. As a white person, you can and you should oppose racism. You can learn how it shapes our society. But when you make space for people you know to truly open up, and when you really hear what a daily experience racism is for them, it deepens your perspective and strengthens your resolve to be an ally and push for change.

When I got into recovery, I learned that it’s not just about stopping drinking, it’s about changing the human being. Many days, the Serenity Prayer kept me sober. God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

Injustice is something we can and we must change.

So I ask everyone who is white to listen, truly listen, to Black neighbors, friends, and colleagues. Listen, learn, and resolve to be part of the solution. Now is a moment to make a bold step forward in our nation’s progress. We must have the wisdom to embrace it.

Marty Walsh is Mayor of Boston

Last fall, I was walking home when a 30-ish white woman hastily crossed to my side of the street. Matching me stride for stride, she behaved as if she knew me, as if we were together. I had seen and experienced many things in my 50-plus years as a black man, but this was a first. I soon understood that she had moved to avoid the approach of three Black teenagers. I got a good look at these instantly familiar schoolboys as they juggled backpacks and bike helmets. They were gangly, garrulous, beautiful. Happily immersed in chatter, they seemed to have noticed the woman not at all. I’m reminded of such encounters on days when my wife and I venture outside for a bit of sun, masks firmly in place. When we see folks coming, we step off the curb as swiftly as our ancestors did, Mississippians who skillfully ducked the predations of Jim Crow. The big difference, of course, is the sight of our white neighbors hurrying to do the same. Sometimes we end up in each other’s path, zigging when we should have zagged. We slip into a parody of Alphonse and Gaston, or square dancers who’ve forgotten their steps.

Jabari Asim is associate professor of writing, literature, and publishing at Emerson College and author of “ We Can’t Breathe: On Black Lives, White Lies, and the Art of Survival”

In the before times, I got my hair cut once a year. I don’t miss it. The polyester smock, the small talk, the stylist’s response when I tell her my mother is Japanese. “I can tell from your hair.”

“We demand haircuts” reads the sign in a now viral photo. The entitlement. A deep contrast to those who demand justice, whose signs read “I can’t breathe.”

This pandemic, this uprising, have pared down my circle of friends. Rifts that were forming in the before times deepen, as it becomes clearer who continues to confront their anti-Blackness, and who can barely acknowledge “everything going on right now.” Now is also then, for this nation built on stolen land by enslaved hands. It is why Christian and Amy Cooper share a last name.

I, too, have been Amy: diminishing truths shared with me, harming through silence. Unlearning is forever work, with no final destination.

I put my growing hair up to protest. It’s hot, the ponytail practical. I take up less space, my role is to follow. I repeat the leaders’ chants, knowing they shift meaning uttered from my light-skinned lips. The mask makes it harder, but I can still breathe.

Anri Wheeler is a multiracial writer, anti-racist educator, and mother of three daughters

Jodi Burrel and her mother socialize through a glass window during the pandemic.

These days, I talk to my mother through her glass door. When a neighbor’s lawn mower starts or the wind kicks up, I have to press my ear to the glass to hear her. I don’t dare go into her house. She’s 76 — her age and mild heart condition place her at risk for COVID.

My mother and I live alone, apart, and she’s my best friend. So every week I sit in a plastic chair on her back deck while she sits inside at her café table. I study her through the double-paned glass. I see her face with trees reflected in it. I marvel at the way she sits in her chair, knees up, holding onto her bare feet, like babies do. We watch the family of groundhogs that lives under her gazebo.

“This is a long game,” she says to me.

I refuse to enter my mother’s house even to use her bathroom. So I bought a camping porta potty online and turned her shed into an outhouse. Now I can visit her all day. I know I’m lucky. Not everyone gets to visit their mom. I can visit mine as often as I like. Weather permitting.

Jodi Burrel is an educator at a college in Boston

“Just draw what you see,” he says. “When we’re told to draw a door, most of us have a preconceived idea of what a door looks like, and we draw what we see in our mind. But that’s not the door that’s in front of us.”

It’s my first Beginning Drawing class on Zoom. I’ve never been good at drawing, but I feel that familiar pressure to excel, just as I have felt at school, work, writing, athletics. Now, daily life itself. But my instructor is unfazed, telling us to draw with whatever we have lying around and encouraging us when our drawing isn’t perfect: “Sometimes it’s more interesting that way.”

Slowly, the pressure dissipates, and drawing random objects with a beat-up mechanical pencil becomes relaxing. Each time, I hear him saying, “Just draw what you see.” The lesson is there — about line and shading and contour and composition. But also about taking life as it comes, not as you build it up in your mind before it happens.

So, I put my pencil to the page and make my mark. I draw the door I see. Then I take a deep breath and walk through it.

Rachel Coppola works as a writer at a local health plan

Out of nine housemates, I’m one of the only people who is still working 9-to-5 hours. I savor my mornings alone: eating breakfast in silence, working to the lone sound of my keyboard taps, and embracing emptiness before the others wake. My bedroom is in the basement, directly below the kitchen. Around noon, I hear the first refrigerator slap of the day followed by the whisks of an egg scramble, then someone turns on a record. My housemates’ rhythmic and offbeat toe taps rumble above me, along to their punk, soul, or strange avant-garde music.

We’ve learned to move our bodies around the house like a game of Tetris: bumping elbows in the kitchen when trying to perfect recipes, jumping over limbs in the living room to water plants, and swiveling past each other for bathroom turns. We say “sorry” more, apologizing for how much our bodies are in each others’ ways now.

When I finish work for the day, sometimes I curl myself into my room, avoiding chats I’m not in the mood to have. Other times, I linger in the kitchen. Hoping to taste sweet human interaction. Hoping for a reminder of life before the pandemic.

Sherell Barbee is a writer from St. Louis now living in Boston

As the country went into lockdown, I bought several hundred dollars worth of groceries, ventured out of the house to walk on nearby trails, and bemoaned that my usual gatherings had to convene in Zoom rooms. My pen pal, an inmate, reported a different sort of lockdown. All visits were suspended, he anticipated a PB&J diet, and, immuno-compromised, he feared that COVID-19 would kill him. He reported watching TV news, incredulous at how blasé many Americans seemed to be about the threat. They were idiots and they were free.

A liberal in a leafy suburb, I believe in the inherent worth of every person. These days I’m uncomfortable seeing how communities are interconnected, that many people are taking risks to keep my lifestyle afloat. And I’m even more uncomfortable with the unseen, the incarcerated whose lives are valued only as profit centers. My heart clenches when the prison informs me that my “loved one” will receive a 25 cent e-mail stamp weekly, enabling him to reach out.

And yet, my pen pal and I both inquire whether the other is staying safe and well. To borrow a phrase, we are in the same storm, but in very different boats.

N.L. Cameron is a writer in Wellesley

I came from Nepal, arriving three years ago. With Americans, I am also terrified by COVID-19, which has taken away so many American lives. Like others, I was overwhelmed by anxiety, hopelessness, and fears for my life and family.

Amazon was hiring workers, so I applied and got hired. I was required to travel by public transportation despite the “stay home” order; I barely saw people on the T and felt alienated from others. I saw wild animals walking on the street.

I could have applied for unemployment benefits and SNAP, but I didn’t do that. I wanted to help our community get through this pandemic. At the Amazon warehouse, my responsibility was packing customers’ orders. I was thrilled when customers thanked us through reviews; our enthusiasm was climbing up to top of the mountain. That made us empowered to do our job. I was so grateful when they called us essential workers, “heroes of this critical time” with other front-line workers.

Lakpa Sange Sherpa is working to be self-dependent

“US Nears 100,000 Deaths” — The New York Times front page full of names was all over my social media feed. A Canadian friend wondered where was our outrage? What would it take to make Americans mad?

The question stuck with me. That number — 100,000 deaths — was bigger than the population of Somerville. Yet I felt nothing.

Over the course of quarantine, my emotional baseline got stuck somewhere between blah and neutral. I couldn’t even get annoyed when my husband left out the vacuum after he cleaned the kitchen. My household trudged along. My husband worked remotely. My daughter logged into her Google classroom. I signed up to pack food for people in need — so much food — but I stayed numb.

Then came George Floyd’s public murder. This fatality triggered the outrage tsunami. People were mad all over Greater Boston.

I went to a local vigil. I wore a mask and kept my distance, thanks to dots drawn in chalk at 6-foot intervals on the pavement. The vigil ended with eight minutes and forty-five seconds of silence. Another number, but this one made me feel something.

Emily Lacika is a writer, mother, and former expat

The ride home from the hospital was brutal. I winced every time we hit a bump in the road. My meds were wearing off, and so was my tolerance. I inverted my lips and pressed down, hoping to brace the pain. It reminded me of the roller coaster at Canobie Lake Park: the one that we all wanted to get on, then regretted once we did. I glanced over at my sleeping newborn, both in awe and terror. “I have a newborn, I have a child,” I repeated in my mind. This new world that she was introduced to was changing every day because of COVID-19.

What’s the new normal for her? I looked back at the hospital. The world was so muted. The slate-colored buildings seemed to accent the same hues in the misty sky. The inactivity on the streets gave an eerie sense of an abandoned city. I looked at my baby, innocent to how scary the world can be, and my heart broke. Will this “new normal” be the childhood I wish for her?

We pulled up to the house; her little body covered and cozy. Today our new story begins.

Kim E. Marshall is trying to figure out motherhood and the “new normal”

In the late afternoon on any of these quarantined days that is lit by low sun, I put on my wireless headphones and mask and transfer from manual to power wheelchair. I ride the bumpy sidewalk down Weld Hill, turn right onto the grit of Hyde Park Ave, zip up the ramp at the Forest Hills station, and breathe deeply as I am released to the Arboretum. On the streets on the way there, I listen to the troubling news on the radio but once among the trees, I turn to Mozart’s concertos. During these three months, I have toured forsythias, cherry blossoms, lilacs, rhododendrons, and roses with strings, flutes, and piano as the perfect soundtrack. The match-up between the music and lightly illuminated flora is a source of bliss during this devastation.

At my home, adjacent to the Forest Hills cemetery, where the number of burials has tripled, I hear the hum of backhoe loaders digging graves — a soundtrack I never experienced before. I live for those times I can escape to be escorted by Mozart through the beauty that still remains.

Carol R. Steinberg is an attorney, writer, and disability activist

To read more essays gathered as part of the At Home community writing project, visit bostonbookfest.org.

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Experts See Lessons for Next Pandemic as Covid Emergency Comes to an End

The United States’ struggle to respond to the virus has highlighted the importance of communicating with the public, sharing data and stockpiling vital supplies.

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Medical workers in scrubs and masks look at screens amid three patients in beds.

By Sheryl Gay Stolberg and Noah Weiland

A lot went wrong during the coronavirus pandemic as the virus tore through a polarized nation and public health leaders, policymakers and elected officials struggled to respond.

Chronic underinvestment in public health at the federal, state and local levels only made things worse. All told, more than 1.1 million people have died of Covid-19 in the United States, and more than 1,000 are still dying each week.

More than three years after the Trump administration declared the virus a public health emergency in January 2020, the government’s pandemic response is now entering a new phase. On Thursday, the Biden administration will allow the emergency declaration to expire , offering a moment to take stock of how the nation responded to the worst public health crisis in a century.

Here are some lessons from the country’s fight against the virus.

Get the messaging right.

Public health experts say that when managing an infectious disease outbreak, communication is not part of the response. It is the response.

The coronavirus pandemic showed that confusing messaging can worsen the spread of disease and erode faith in public health institutions. But messaging during a pandemic is a tricky business. The science is often changing, sometimes day by day, and instructions from public health officials — to mask or not to mask? — must change as well, which can create confusion and a lack of trust.

The key, experts say, is for public health leaders to bring their audience along with them by explaining that the guidance they are giving today may change tomorrow — and then acknowledging that what they said yesterday might have been wrong.

“When you’re in a daily conversation with the public, you can explain those mistakes, what you’ve learned from them,” said Dr. Richard E. Besser, a former acting director of the Centers for Disease Control and Prevention during the Obama administration. “You can own them.”

Make it easy to share data.

The C.D.C. was hamstrung during the pandemic by antiquated data systems and inconsistent data sharing between the federal government, states and health providers. And unlike Britain and Israel, which have national health care systems, the United States has no mechanism for a free flow of data between public health agencies and private providers.

Responding to a quickly mutating virus that poses different risks to different populations requires better and faster data, experts said.

“We were in the embarrassing position of having to call up the U.K. and Israel or South Africa to find out was going on — how many people were getting infected with this new infection, what the variant was,” said Dr. Anthony S. Fauci, who helped lead the pandemic response under both the Trump and Biden administrations. “How many people were getting vaccinated and what was the effect of those data? We literally had to wait months instead of getting it in real time.”

Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, cited school closures as an example where real-time data would have helped.

Some coronavirus variants were more lethal to children than others, he said, adding that if officials had had access to timely data on the effects of the virus on children, they might have been able to tailor school closures to when students were most at risk.

“We need instantaneous data to know what’s going on,” said Dr. Osterholm, who advised President Biden’s transition team. “And as conditions change, we have to change.”

Think carefully about school closures.

School closures have been a particularly contentious topic, but many experts now agree that some schools were closed for too long and that abruptly removing millions of children from American classrooms has had harmful effects on their emotional and intellectual health.

Both Dr. Fauci and Dr. Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania, said the pandemic had shown that officials should think carefully about school closures and keep them as limited as possible. Both said better indoor air circulation might be one way to safely keep schools open.

“One of the things we’ve learned is that we closed schools much longer than other countries, and we’ve had this terrible impact on educational attainment and we have seen the test scores go down,” said Dr. Emanuel, who also advised Mr. Biden’s transition team.

Dr. Fauci said that early in the pandemic, “at a point when the hospitals were literally a day or two from being overrun,” closing public places like restaurants, bars and schools was important for keeping health care systems operating by slowing the spread of the virus.

“But once you put a damper on the acceleration,” he said, “then you need to really examine how we keep the kids in school safely.”

Stockpile vital supplies.

In the early months of the pandemic, frontline health workers faced dramatic supply shortages , forcing them to reuse face masks, wear ill-fitting personal protective gear or go without such equipment altogether.

The federal government has substantially expanded its reserve of pandemic supplies since, giving it a head start in responding to another devastating coronavirus wave or a different viral outbreak that would require similar resources.

Before the pandemic, government purchases for the Strategic National Stockpile were heavily weighted toward protecting against bioterror agents like anthrax . In March 2020, the stockpile had 13 million N95 masks. As of early this month, it had 352 million. In the same period, the number of ventilators grew to about 150,000 from 12,700.

Invest in vaccines early.

As a model for responding to future pandemics, experts point to Operation Warp Speed, the Trump administration’s coronavirus vaccine development program. The initiative brought effective vaccines to Americans in record time — in part, Dr. Fauci said, because the federal government had spent years investing in basic scientific research.

Federal officials in the Warp Speed program made enormous bulk purchases of shots that were still in development. The federal government funded or supported clinical trials run by Moderna and Pfizer, the manufacturers of the two widely used coronavirus shots. And it lent expertise to the companies with clinical trial specialists, epidemiologists and budget experts.

Quickly set up large randomized trials.

Early treatments for the virus such as hydroxychloroquine and convalescent plasma were authorized by the Food and Drug Administration without strong data from large randomized controlled trials — considered the gold standard of evidence used by regulators to clear drugs and vaccines.

Trials for treatments stalled because of a lack of funding or participants . Scientists, physicians and federal regulators relied on foreign data, such as a British study on dexamethasone , a steroid used to treat Covid-19.

“Britain set up large randomized trials with very loose entry criteria, thousands of patients,” Dr. Emanuel said. “Within 30 to 60 days, we learned that steroids actually saved people who were hospitalized or very sick.”

Dr. Walid F. Gellad, a drug safety expert at the University of Pittsburgh, pointed to a current trial being conducted by British researchers that he said would soon deliver results on the effectiveness of Paxlovid, Pfizer’s antiviral drug for Covid-19 that is widely used in the United States.

“We didn’t have the infrastructure to collect data we needed to make decisions,” he said of the U.S. pandemic response.

But don’t rely only on vaccines.

Vaccines proved to be the most effective bulwark against hospitalization and death from Covid-19. But attention to vaccination often overshadowed efforts to develop and deliver treatments, public health experts said. Antibody medications critical for immunocompromised Americans are no longer cleared for use by the F.D.A., and experts say more antiviral drugs are needed.

The Biden administration has focused heavily on deploying booster shots, which have had steadily fewer takers since an initial round was authorized in the fall of 2021. But other strategies meant to prevent the spread of the virus, such as improving indoor air quality, have received comparatively modest attention.

“The myopic focus on vaccines alone at the exclusion of other areas that are really low-hanging fruit for a much superior response — it’s like saying you’re going to build a house with one wall or without a roof,” said Dr. Luciana Borio, a former acting chief scientist at the F.D.A. who advised Mr. Biden’s transition team.

Sheryl Gay Stolberg is a Washington Correspondent covering health policy. In more than two decades at The Times, she has also covered the White House, Congress and national politics. Previously, at The Los Angeles Times, she shared in two Pulitzer Prizes won by that newspaper’s Metro staff. More about Sheryl Gay Stolberg

Noah Weiland is a health reporter in the Washington bureau. He was part of a team that won a Pulitzer Prize for its coverage of Covid-19 in 2020. More about Noah Weiland

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Learning lessons from the COVID-19 experience: history saved lives

A medical historian whose team’s research on the 1918 flu influenced efforts to “flatten the curve” reflects on what the past three years have taught

Three years ago, the world stood on the precipice of a pandemic.

And as scientists raced to learn more about the virus that caused it, and medical teams tried desperately to save its first victims, nations turned to an unlikely source for protection.

In those early months, lessons from studying the 1918 influenza pandemic helped save as many as 1.7 million lives in the United States alone , research suggests. Other studies have made even greater estimates of infections prevented worldwide.

Those lessons were largely drawn in part from a study based at the University of Michigan Center for the History of Medicine . The team had found that steps taken in 1918 to reduce close indoor contact, encourage mask-wearing and increase ventilation had reduced the death toll .

In early 2020, their data informed efforts to keep the new coronavirus from spreading so quickly that it would overwhelm hospitals and clinics -- a concept the U-M team came to call “flattening the curve.”

And it worked, says Howard Markel, M.D., Ph.D., who led the U-M Medical School team that carried out the 1918 flu study with funding from the Centers for Disease Control and Prevention.

But now, looking back from the vantage point of three years, it’s clear that efforts to respond to future pandemics must use the recent history of COVID-19 as their main guide, he says.

That’s what he and others are now trying to help the Biden Administration’s COVID-19 response team do, by consulting on preparedness and response efforts.

“It’s not a matter of if we will have another pandemic, it’s a matter of when,” he said. “No one can tell where it’s going to come from, or when, or which virus – but it will happen.”

Learning from 1918

A physician and historian who has written dozens of books and essays on pandemics stretching back centuries, Markel is glad that the lessons revealed by the U-M team’s work had an impact during the height of COVID-19.

“History was incredibly helpful when informing us about social distancing, and it was really a privilege to be able to provide the numerical data to show that,” he said. “The participation in efforts to reduce spread around the world, before we had the tools we have now, was really remarkable and made a difference.”

Keeping society and healthcare afloat by heeding lessons from 1918 also bought time for scientists and companies to understand the virus, protect hospitals and infrastructure from beign flooded with patients, and develop vaccines and treatments.

In less than a year after the novel coronavirus was discovered, the first mRNA and traditional vaccines, and the first monoclonal antibody treatments, became available. The first rapid tests and oral medications were approved for use a few months later.

Learning from recent history

But the influenza virus and the novel coronavirus are very different from one another. And the political, information, medical and economic environments of the late 1910s and the early 2020s are light years apart.

The 1918 influenza research did show that resistance emerged to non-pharmaceutical interventions such as masking in public, as Markel’s colleague J. Alex Navarro wrote in a 2020 essay.

But it wasn’t anywhere near as vocal and visible as the resistance to mask-wearing and vaccination, and promotion of unproven remedies, that started early in the COVID-19 pandemic, says Markel. The fact that top-level political leaders engaged in this was especially damaging. Future pandemic responses may face the same – or worse, he warns.

Similarly, the team’s research showed that easing up on preventive measures too soon – which happened in some cities in 1918 and 1919 – also led to problems, as Navarro wrote in another piece , and Markel and Navarro wrote in the wake of a court ruling in Michigan regarding a governor’s ability to declare or extend states of public health emergency.

But in COVID-19 this happened much more broadly, Markel notes. So teams preparing for the next pandemic should harness recent data on the impacts of masking, vaccination and social distancing, and anticipate broad-based resistance to protective measures.

At the same time, some positive lessons have emerged from the past three years, he reflects.

The importance of basic biomedical research – scientists working in relative obscurity for decades on the biology of the coronavirus and the potential use of mRNA and monoclonal antibodies in vaccines and treatments --- paid off in powerful and rapid ways.

The increased communication between the medical community and public health community in the past three years has led to a greater recognition of how social, economic, geographic, political and environmental factors affect a person’s risk of disease and their likelihood of severe illness or death.

This newfound attention to the social determinants of health, Markel notes, may make it more possible to treat medicine and public health as a continuum, rather than two separate fields.

COVID-19 also revealed major shortcomings in funding for public health infrastructure that leaves society vulnerable to future pandemics, he says.

“This could be a golden moment to really fix the public health system -- or not,” he said.

Another key thing that wasn’t present in 1918, but that pandemic response must consider now and going forward, is the fact that millions of Americans now live with health conditions that 100 years ago, or even 30 years ago, would have killed them. And that means they’re more vulnerable to infections.

“People receiving chemotherapy, transplant patients, or people who are immunocompromised for other reasons, are still at risk right now, especially in light of the new viral variants,” said Markel. “Everyone wants to move on from COVID-19. But if we’re all in this together, then we’re all in this together – not just when it’s convenient for some.”

Continuing to develop treatments and vaccines that provide protection against new strains of coronavirus will help protect the vulnerable, he says. It could also help sustain the industrial infrastructure needed to respond to the next pandemic.

The U-M team studied a lot of newspaper coverage from 1918 and 1919 to perform their research, because that was the main mass communication method of the day in pre-radio, pre-television days. The COVID-19 experience, says Markel, has shown the importance of using modern communication platforms to get good information out and counteract misinformation that has been rampant, and studying how people get and decide to act on information about health threats.

No matter what pandemic disease emerges next, learning lessons from the COVID-19 experience and not succumbing to the “global amnesia” that has happened after previous pandemics, will be critical, says Markel.

“As humans, we don’t want to think about scary, terrible things,” he said. “But we need to stick together for the greater good, and have faith in medicine, science and public hea lth. That’s the only way we’re getting out of this pandemic, and the ones that are coming.”

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History. In those early months, lessons from studying the 1918 influenza pandemic helped save as many as 1.7 million lives in the United States alone, research suggests. Other studies have made even greater estimates of infections prevented worldwide.
Lessons learned from COVID-19: how did the pandemic affect children's
This is one of the largest studies of its kind, and the lessons learned can help countries to plan for future emergencies and pandemics."The lessons we have learned from the COVID-19 pandemic underscore the importance of implementing effective policies to improve food environments, encourage physical activity, and protect the health and well ...
Write an essay about the important lessons you have learned ...
Lessons learnt during covid-19 outbreak. 1. the most important thing learnt is to use sanitizer and face mask. This not only prevents the spread of coronavirus infection but also helps in in prevention of diseases which are caused due to pollutants. 2. The importance of hygiene is also learnt. 3.