essay on life post coronavirus

Greater Good Science Center • Magazine • In Action • In Education

Relationships Articles & More

How life could get better (or worse) after covid, fifty-seven scientists make predictions about potential positive and negative consequences of the pandemic..

How do pandemics change our societies? It is tempting to believe that there will not be a single sector of society untouched by the COVID-19 pandemic . However, a quick look at previous pandemics in the 20th century reveals that such negative forecasts may be vastly exaggerated.

Prior pandemics have corresponded to changes in architecture and urban planning, and a greater awareness of public health . Yet the psychological and societal effects of the Spanish flu, the worst pandemic of the 20th century, were later perceived as less dramatic than anticipated, perhaps because it originated in the shadow of WWI. Austrian psychoanalyst Sigmund Freud described Spanish flu as a “ Nebenschauplatz ”—a sideshow in his life of that time, even though he eventually lost one of his daughters to the disease. Neither do we recall much more recent pandemics: the Asian flu of 1957 and the Hong Kong flu from 1968.

Imagining and planning for the future can be a powerful coping mechanism to gain some sense of control in an increasingly unpredictable pandemic life. Over the past year, some experts proclaimed that the world after COVID would be a completely different place , with changed values and a new map of international relations. The opinions of oracles who were not downplaying the virus were mostly negative . Societal unrest and the rise of totalitarian regimes, stunted child social development, mental health crises, exacerbated inequality, and the worst economic recession since the Great Depression were just a few worries discussed by pundits and on the news.

Other predictions were brighter—the disruptive force of the pandemic would provide an opportunity to reshape the world for the better, some said. To complement the voices of journalists, pundits, and policymakers, one of us (Igor Grossmann) embarked on a quest to gather opinions from the world’s leading scholars on behavioral and social science, founding the World after COVID project.

The World after COVID project is a multimedia collection of expert visions for the post-pandemic world, including scientists’ hopes, worries, and recommendations. In a series of 57 interviews, we invited scientists, along with futurists, to reflect on the positive and negative societal or psychological change that might occur after the pandemic, and the type of wisdom we need right now. Our team used a range of methodological techniques to quantify general sentiment, along with common and unique themes in scientists’ responses.

The results of this interview series were surprising, both in terms of the variability and ambivalence in expert predictions. Though the pandemic has and will continue to create adverse effects for many aspects of our society, the experts observed, there are also opportunities for positive change, if we are deliberate about learning from this experience.

Three opportunities after COVID-19

Scientists’ opinions about positive consequences were highly diverse. As the graph shows, we identified 20 distinct themes in their predictions. These predictions ranged from better care for elders, to improved critical thinking about misinformation, to greater appreciation of nature. But the three most common categories concerned social and societal issues.

1. Solidarity. Experts predicted that the shared struggles and experiences that we face due to the pandemic could foster solidarity and bring us closer together, both within our communities and globally. As clinical psychologist Katie A. McLaughlin from Harvard University pointed out, the pandemic could be “an opportunity for us to become more committed to supporting and helping one another.”

Similarly, sociologist Monika Ardelt from the University of Florida noted the possibility that “we realize these kinds of global events can only be solved if we work together as a world community.” Social identities—such as group memberships, nationality, or those that form in response to significant events such as pandemics or natural disasters—play an important role in fostering collective action. The shared experience of the pandemic could help foster a more global, inclusive identity that could promote international solidarity.

2. Structural and political changes. Early in the pandemic, experts also believed that we might also see proactive efforts and societal will to bring about structural and political changes toward a more just and diversity-inclusive society. Experts observed that the pandemic had exposed inequalities and injustices in our societies and hoped that their visibility might encourage societies to address them.

Philosopher Valerie Tiberius from the University of Minnesota suggested that the pandemic might bring about an “increased awareness of our vulnerability and mutual dependence.”

Fellow of the Royal Institute for International Affairs in the U.K. Anand Menon proposed that the pandemic might lead to growing awareness of economic inequality, which could lead to “greater sustained public and political attention paid to that issue.” Cultural psychologist Ayse Uskul from Kent University in the U.K. shared this sentiment and predicted that this awareness “will motivate us to pick up a stronger fight against the unfair distribution of resources and rights not just where we live, but much more globally.”

3. Renewed social connections. Finally, the most common positive consequence discussed was that we might see an increased awareness of the importance of our social connections. The pandemic has limited our ability to connect face to face with friends and families, and it has highlighted just how vulnerable some of our family members and neighbors might be. Greater Good Science Center founding director and UC Berkeley professor Dacher Keltner suggested that the pandemic might teach us “how absolutely sacred our best relationships are” and that the value of these relationships would be much higher in the post-pandemic world. Past president of the Society of Evolution and Human Behavior Douglas Kenrick echoed this sentiment by predicting that “tighter family relationships would be the most positive outcome of this [pandemic].”

Similarly, Jennifer Lerner—professor of decision-making from Harvard University—discussed how the pandemic had led people to “learn who their neighbors are, even though they didn’t know their neighbors before, because we’ve discovered that we need them.” These kinds of social relationships have been tied to a range of benefits, such as increased well-being and health , and could provide lasting benefits to individuals.

Post-pandemic risks

How about predictions for negative consequences of the pandemic? Again, opinions were variable, with more than half of the themes were mentioned by less than 10% of our interviewees. Only two predictions were mentioned by at least ten experts: the potential for political unrest and increased prejudice or racism. These predictions highlight a tension in expert predictions: Whereas some scholars viewed the future bright and “diversity-inclusive,” others fear the rise in racism and prejudice. Before we discuss this tension, let us examine what exactly scholars meant by these two worries.

1. Increased prejudice or racism. Many experts discussed how the conditions brought about by the pandemic could lead us to focus on our in-group and become more dismissive of those outside our circles. Incheol Choi, professor of cultural and positive psychology from Seoul National University, discussed that his main area of concern was that “stereotypes, prejudices against other group members might arise.” Lisa Feldman Barrett, fellow of the American Academy of Arts & Sciences and the Royal Society of Canada, echoed this sentiment, noting that previous epidemics saw “people become more entrenched in their in-group and out-group beliefs.”

2. Political unrest. Similarly, many experts discussed how a greater focus on our in-groups might also exacerbate existing political divisions. Past president of the Society for Philosophy and Psychology Paul Bloom discussed how a greater dismissiveness toward out-groups was visible both within countries and internationally, where “countries are blaming other countries and not working together enough.” Dilip Jeste, past president of the American Psychiatric Association, discussed his concerns that the tendency to view both candidates and supporters as winners and losers in elections could mean that the “political polarization that we are observing today in the U.S. and the world will only increase.”

These predictions were not surprising— pundits and other public figures have been discussing these topics, too. However, as we analyzed and compared predictions for positive and negative consequences, we found something unexpected.

The yin and yang of COVID’s effects

Almost half of the interviewees spontaneously mentioned that the same change could be a force for good and for bad . In other words, they were dialectical , recognizing the multidetermined nature of predictions and acknowledging that context matters—context that determines who may be the winners and losers in the years to come. For example, experts predicted that we may see greater acceptance of digital technologies at home and at work. But besides the benefits of this—flexible work schedules, reduced commutes—they also mentioned likely costs, such as missing social information in virtual communication and disadvantages for people who cannot afford high-speed internet or digital devices.

Share Your Perspective

Curious about the world after COVID? So are we, and we'd love your opinion about possible changes ahead. Fill out this short survey to offer your perspective on the hopes and worries of a post-pandemic world.

Amid this complexity, experts weighed in on what type of wisdom we need to help bring about more positive changes ahead. Not only do we need the will to sustain political and structural change, many argued, but also a certain set of psychological strategies promoting sound judgment: perspective taking, critical thinking, recognizing the limits of our knowledge, and sympathy and compassion.

In other words, experts’ recommended wisdom focuses on meta-cognition, which underlies successful emotion regulation, mindfulness, and wiser judgment about complex social issues. The good news is that these psychological strategies are malleable and trainable ; one way we can cultivate wisdom and perspective, for example, is by adopting a third-person, observer perspective on our challenges.

On the surface, the “it depends” attitude of many experts about the world after COVID may be dissatisfying. However, as research on forecasting shows, such a dialectical attitude is exactly what distinguishes more accurate forecasters from the rest of the population. Forecasting is hard and predictions are often uncertain and likely wrong. In fact, despite some hopes for the future, it is equally possible that the change after the pandemic will not even be noticeable. Not because changes will not happen, but because people quickly adjust to their immediate circumstances.

The future will tell whether and how the current pandemic has altered our societies. In the meantime, the World after COVID project provides a time-stamped window into experts’ apartments and their minds. As we embrace another pandemic spring, these insights can serve as a reminder that the pandemic may lead not only to worries but also to hopes for the years ahead.

About the Authors

Igor Grossmann

Igor Grossmann, Ph.D. , studies people and cultures, sometimes together, and often across time. He is an associate professor of psychology at the University of Waterloo, where he directs the Wisdom and Culture Lab.

Oliver Twardus

Oliver Twardus is the lab manager for the Wisdom and Culture lab and an aspiring researcher. He will be starting his master’s in neuroscience and applied cognitive science in September 2021.

You May Also Enjoy

This article — and everything on this site — is funded by readers like you.

Become a subscribing member today. Help us continue to bring “the science of a meaningful life” to you and to millions around the globe.

Life after Covid: will our world ever be the same?

From cities, to science, to politics, six Observer writers assess how a post-pandemic world will emerge into a new normal

• Coronavirus – latest updates
• See all our coronavirus coverage

Here are some things that the pandemic changed. It accustomed some people – those whose jobs allowed it – to remote working . It highlighted the importance of adequate living space and access to the outdoors. It renewed, through their absence, an appreciation of social contact and large gatherings. It showed up mass daily commuting for the dehumanising drain on energy and resources that it is.

These changes do not add up to the abandonment of big cities and offices predicted by more excitable commentaries, not a future of rural bubbles and of tumbleweed blowing through the City of London, but a welcome shift in priorities. There will always be millions who want to live in cities and millions who want to live in towns and villages, but there are also those for whom these are borderline decisions, with pros and cons on each side.

These decisions might be based on life changes, such as having children. If you no longer have to go to an office daily, you can live further from the city in which it is placed. If the magic spell of the big city, which kept people in the tiny and expensive flats that now look so inadequate, is broken, then you might consider living in cheaper, more relaxed locations that hadn’t occurred to you before. Those ex-urbanites, still valuing social contact and public life, might seek towns and small cities rather than a lonely cottage in a field.

Such changes could help to address, without the pouring of any concrete or the laying of a brick, the imbalance in the nation’s housing that was at breaking point before Covid. On the one hand there are overheated residential markets in London, Bristol, Manchester, Edinburgh and elsewhere. On the other there are towns and small cities with good housing stock, an inherited infrastructure of parks and civic buildings and easy access to beautiful countryside, which through their location suffer from underinvestment and depopulation.

This is not to say that no new homes should be built, nor that there won’t be problems with such a shift. It could simply be gentrification, if done wrong, at a national scale. And this vision assumes that Covid passes, and that it is not one of a future series of equally vicious viruses. But there is at least a chance that the travails of 2020 could lead to a saner approach to the places where we live and work. Rowan Moore, Observer architecture critic

Interaction

The first kiss my baby niece blew me was bittersweet, because like so many pandemic interactions it happened not in person but on camera. Covid means that big chunks of her life have only been seen on a phone screen as she grows into a toddler. And I’m one of the lucky ones: I haven’t had to say goodbye to someone on FaceTime or break the worst news to someone over the phone.

If you live by yourself, you’ve made do without human touch for months on end; if you’re crammed into a small space with your partner, kids and your parents, you may have spent weeks craving time and space not encroached upon by other human beings. Totally different experiences of the same social earthquake: surely they cannot but profoundly change us for the long term?

I’m not so sure. Lockdown, then not-lockdown, then lockdown again have served as a reminder of just how adaptable we are as human beings. I was amazed at how quickly the idea of socialising with friends indoors became a fuzzy memory, then the norm, then distant again. The emotions I felt so acutely back in March – the sharp fear Covid could steal my parents, the communal endeavour of clapping for our carers every Thursday night – soon faded into a new normal, impossible to sustain even though many of the realities have barely changed.

The pandemic has underlined the extent to which digital interaction is no substitute for the real thing. In some ways, I’m more in touch with people than ever thanks to the numerous WhatsApp groups that revived themselves into a constant source of company. But tapping away in a couple of group chats while absent-mindedly watching the latest Netflix offering doesn’t come close to the wonderful feeling of hugging a friend, or spending three hours giving someone you haven’t seen for ages your undivided attention over a meal, or of having a conversation based not just on words but physical cues. I doubt the pandemic will seed a long-term distaste for crowds; if anything, I suspect that, if all goes well with the vaccine rollout, summer 2021 will see a crop of riotous street parties and carnivals.

But a return to life as usual will not mask the emotional toll Covid will have had on so many people. People who suffer from anxiety and depression; women in abusive relationships ; children experiencing abuse or neglect at the hands of their parents: they have had it the worst, and their experiences of isolation and loneliness during lockdown could have consequences for their personal relationships that will not magically disappear with a vaccine.

And that is before you factor in the added strain of the intense financial hardship so many are being forced to endure. As a society, recovering from Covid is about much more than antibodies: it cannot happen without support for those who have experienced its worst financial and mental health impacts. Sonia Sodha, the Observer’s chief leader writer

Britain has had an uncomfortable year in its battle to contain Covid. Failures to test, trace and isolate infected individuals allowed grim numbers of deaths to accumulate while deficiencies in the acquisition of stocks of Personal Protection Equipment (PPE) left countless health workers exposed to danger and illness. However, these deficiencies have been balanced by the manner and striking speed with which our scientists have turned away from existing projects in order to focus their attentions on ridding us of Covid. Their work has earned global praise for its swiftness and precision.

“The Brits are on course to save the world,” wrote leading US economist Tyler Cowen in Bloomberg Opinion about our scientists efforts last summer while the journal Science quoted leading international researchers who have heaped praise on British anti-Covid work. Science in the UK is perceived, correctly, to have done well in facing up to the pandemic.

A perfect example is provided by the UK’s Recovery trial, a drug-testing programme involving more than 3,000 doctors and nurses who worked with more than 12,000 Covid patients in hundreds of hospitals across the nation – from the Western Isles to Truro and from Derry to King’s Lynn. Set up within a few days of the pandemic reaching the UK, and carried out in intensive care units crammed with seriously ill people, Recovery revealed that one cheap inflammation treatment could save the lives of seriously ill Covid patients while two much-touted therapies were shown to be useless at tackling the disease.

No other country has come close to matching these achievements. “We had the people with the right skills and a willingness to drop everything else and contribute to the effort,” says one of Recovery’s founders, Martin Landray of Oxford University. “That made all the difference.” In a nation which had only recently reviled, openly, the concept of expertise, scientists like Landray have restored the reputation of the wise and the informed.

Fiona Fox, director of the Science Media Centre, also points to the willingness of our scientists to communicate. “Time after time, we have asked for comments from leading researchers, epidemiologists and vaccine experts on breaking Covid stories, and despite being inundated with work, they have taken the time to provide clear analyses that have helped to make sense of rapidly changing developments,” she says. “It has been extraordinary.”

And of course, the arrival of three effective vaccines against a disease that was unknown less than a year ago has only further enhanced the image of the scientist. Yes, they may be a bit geeky sometimes, but they have done a lot to help us win the battle against Covid. Robin McKie, Observer Science Editor

The more things change, the more they stay the same.

It may not feel like it at the moment, admittedly. But if this pandemic echoes other defining events in our recent history, from the 9/11 terror attacks to the 2008-09 banking crash, it will leave the political landscape utterly transformed in some respects yet wearily familiar in others.

Last week’s spending review , spelling out how the cost of battling Covid will shape national life for years to come, was a classic example. A public sector pay freeze, plus benefit cuts next April? Well, we’ve been there before; to many families it will feel like austerity all over again.

What’s different this time, however, is that Boris Johnson insists there’ll be no return to austerity-style spending cuts. Instead, taxes will rise. If he actually goes through with threats to target second-home owners or higher earners’ pensions, expect some mutiny in Tory ranks. (The bitter joke among Tory MPs is that they’re implementing more of Jeremy Corbyn’s manifesto than Corbyn ever will.) But the door to a long overdue debate about taxing wealth, as well as income, is at least now open.

The pandemic also seems to be changing what people look for in a leader. The last recession pushed angry, despairing voters towards populists with easy answers; make America great again, take back control. But Covid has been a brutal reminder that in life-and-death situations, competence is everything. Joe Biden isn’t wildly exciting but at least he doesn’t speculate aloud about the merits of drinking bleach. From New Zealand’s Jacinda Ardern to Germany’s Angela Merkel and Scotland’s Nicola Sturgeon, the leaders whose reputations have been enhanced by this crisis tend to be pragmatists and consensus-seekers, not excitable culture warriors. Keir Starmer’s rising poll ratings suggest a hunger for steady-as-she-goes leadership in Britain too.

Optimists will hope that this collective near-death experience brings a renewed political focus on what actually makes life worth living, from supportive communities to the beauty of a natural world that sustained many through lockdown. Pessimists, however, will worry that calls to “build back better”, or reset society along fairer and greener lines, could be an early casualty of a hard recession that leaves people focussed purely on economic survival.

For it would be naive not to expect a backlash against all of this. Nigel Farage is already trying to whip one up via his new anti-lockdown party , targeting voters angry at having freedoms curtailed. But if the last crash unleashed an era of radicalism and revolt, it’s not impossible this one will leave people craving a quiet life. After such turmoil, don’t underestimate the longing to get back to normal, even if the normal we once knew is gone. Gaby Hinsliff, Guardian columnist

We know that the spaces from which “culture” emerges won’t look the same after 2020 as they did before. Many theatres, bookshops, music venues and galleries won’t survive the catastrophe of shutdown, and if they do emerge it will be with diminished resources. But what about the attitude and the focus of creativity. Will it be shadowed by the pandemic post-vaccine or will it celebrate liberation?

History suggests both. The terrible mortality, social distancing and economic hardship resulting from the 1918-19 Spanish flu epidemic that followed the war were shaping forces in both the doom-laden experiments of modernism and the high hedonism of the jazz age. The Waste Land and the Charleston emerged within months of each other. TS Eliot wrote much of the former while suffering from the after-effects of the influenza, haunted, as his wife Vivienne noted, by the fear that as a result of the virus, “his mind is not acting as it used to do”. Certainly, that poem’s most memorable lines, with their stress on the mass gathering, read more pointedly from our current vantage point: “Under the brown fog of a winter dawn,/ A crowd flowed over London Bridge, so many,/ I had not thought death had undone so many./ Sighs, short and infrequent, were exhaled,/ And each man fixed his eyes before his feet.”

But, contrarily, the spirit of the post-pandemic age was equally alive in the bathtub-gin excitement of the Cotton Club, and the rarefied decadence of the Bright Young Things: raucous celebrations of seize-the-day freedoms after the misery of war and virus.

Not much literature or music that directly responds to the current pandemic has yet emerged. Zadie Smith’s brief book of essays , Intimations , hazarded something of what that response might look and sound like. In a memorable phrase, she described the events of this year as “the global humbling”. That moment when we collectively realised that the confident certainties of what we used to call “normal life” were only ever a heartbeat away from unknown threats – and that the US, Smith’s adopted home, having led the world in many things, was now leading the world in death.

Will such experience engender a new and deepening age of anxiety in the books we read and the films we watch? No doubt that apprehension of apocalypse, of environmental emergency, that draws us to The Road or to Chernobyl will become more insistent. But as Eliot also noted, humankind “cannot bear very much reality”. After this year in which the young have been denied so many of their rites of passage – chances to sing, dance, drink or love – we can surely hope for a post-viral creative outpouring of all those things that make us most happy to be alive. Tim Adams, Observer writer

”Imagine there’s no commuting, it’s easy if you try”, is a popular refrain in discussions of the post-Covid world of work predicting the imminent demise of the office. Sometimes it’s combined with the claim that low-earning hospitality and leisure jobs that have dried up mid-pandemic won’t be coming back and so shouldn’t get support now.

These different predictions are likely to be wrong for the same reason: they pay too much attention to crystal balls, and not enough to rear-view mirrors. Yes, the pandemic itself has meant big changes to the world of work. It has changed where some people (generally higher earners) work while hitting the ability of many lower earners to work at all. But imagining a world without lockdowns is best done by focusing on those pandemic-driven trends that reinforce, rather than run against, patterns visible pre-crisis .

So, expect the pandemic’s turbo-charging of retail’s online shift (with Arcadia’s likely administration the latest example) to continue – there will be fewer cashiers and more delivery drivers. But don’t believe the hype on the decline of hospitality and leisure. Workers in those sectors are twice as likely to have lost their jobs or been furloughed as the pandemic has left us spending more on buying things than going out, but the long-term trend is the opposite: hotels and restaurants accounted for a fifth of the pre-pandemic employment surge.

Working from home (or living in the office, as it can feel like) has been the big change for professional Britain. But history warns against the idea that the office is finished. Only one in 20 of us worked entirely remotely pre-crisis. But three times that number worked at home at least one day a week, a trend that was rapidly growing. Hybrid home/office working is the future. But be careful about assuming this transforms Britain’s disgracefully big economic gaps: some will benefit from more choice about where to live but offices in poorer areas, rather than those in central London, may be the ones that end up empty. And remember, we’re only talking about a fraction of the workforce here. Post-Covid, waiters and cleaners won’t be doing their jobs from their spare room or kitchen table.

As well as predicting the future, we should be trying to shape it. Higher pay and more security for the low paid workers who faced the biggest health and economic risks from this crisis would be a good place to start. Torsten Bell, chief executive of the Resolution Foundation

• The Observer
• Coronavirus
• Work & careers
• Vaccines and immunisation

Most viewed

• PERSPECTIVES
• SUBMIT A PERSPECTIVE
• A NEW MAP OF LIFE

THE NEW MAP OF LIFE

AFTER THE PANDEMIC

It is said that culture is like the air we breathe. We don’t notice it until it’s gone.

The COVID-19 pandemic is bringing into focus a once invisible culture that guides us through life. Seemingly overnight, we experienced profound changes in the ways that we work, socialize, learn, and engage with our neighborhoods and larger communities.

For a short time, before new routines and practices replace familiar old ones, we can see with greater clarity the positive and negative aspects of our former lives. The suddenness and starkness of this transformation allows us to examine daily practices, social norms and institutions from perspectives rarely allowed.

The fragility of the global economy becomes glaringly apparent as critical supply chains faulter, unemployment surges, and markets vacillate. Tacit assumptions about health care systems become clear as we see how they function, fail to function, and have long underserved large parts of the population. Just as sure, sheltering in place allows us to appreciate precious details of our lives that we have taken for granted: the appeal of workplaces, the comfort of human touch, dinner parties, travel, and paychecks. Indeed, through ambivalent eyes we also recognize ways that life is better as we shelter in place.

The premise of the New Map of Life:™ After the Pandemic project is that we have a fleeting window of time that affords us an unprecedented opportunity to examine our lives.  Going forward, life will be different and by compiling the insights we have today we can inform and guide the culture that will inevitably emerge from our collective experience. Your insights can contribute to the reshaping of social norms, systems, and practices that shape our collective futures.

Since the founding of the Stanford Center on Longevity, we have advocated for a major redesign of life that better supports century-long lives. More recently, we undertook the New Map of Life ™ initiative, which focuses on envisioning a world where people experience a sense of purpose, belonging, and worth at all stages of life. As tragedies unfold before our eyes, we aim to capture the lessons they teach. With your help, we can compile current insights, fleeting thoughts and deeper reflections about the ways we live now so that going forward we bolster, modify and reinvent cultures that improve quality of life for ourselves, our children, and future generations.

The opinions, beliefs, and viewpoints expressed by the various authors on this website do not necessarily reflect the opinions, beliefs and viewpoints of the Stanford Center on Longevity or official policies of the Stanford Center on Longevity. 

Elizabeth Lesser Shares How She Lifted Herself Out of Pandemic Despair

The cofounder of the Omega Institute admits that even as a teacher of mindfulness, sometimes, she is her own worst student.

When it became apparent that a virus was spreading around the globe, my first reaction was one of disbelief: We’ll surely eradicate this before it turns into a pandemic! Soon enough my disbelief morphed into fear, and then horror and grief for those who were sick and dying in Asia, Europe, and slowly, steadily...everywhere. Along with those feelings came a strange kind of optimism, a faith that we all might learn something important. Like when I watched videos of people in Italy under lockdown standing on their balconies holding candles and singing songs of hope into the darkened streets. Or as travel ceased and traffic stood still and the world got a little quieter, the air a little cleaner—I could almost hear the trees breathing sighs of relief.

In the early spring of 2020, when the pandemic took hold here in the United States and life as we knew it ground to a halt, I wondered, even with the trauma and loss, could this be the Great Slowdown we needed? People retweeted the quote “Mother Nature has sent us to our rooms.” Could that message portend a teachable moment? Maybe doing less, and doing with less, would reveal the value of enough instead of chasing after more, more, more. Maybe now we’d start to truly appreciate the people whose work keeps us alive and well: the farmers, truckers, grocery baggers; the staff who work in our hospitals; the home health aides who care for our parents; the daycare instructors and school teachers who safeguard our children’s future. And maybe, just maybe, the pandemic would finally confirm for us thick-headed humans this plain truth: What happens to even just one of us affects all of us.

My grand optimism began to waver as the weeks of isolation became months and Covid-19 cases doubled, then tripled. Schools closed. Hospitals ran out of masks and ventilators; millions of people got sick, and hundreds of thousands died. People lost their jobs, their homes, their loved ones, their mental health, their way of life. Almost no individual, community, or business was untouched by fear or pain or loss, including my own nonprofit center, which for 40 years had been teaching people to meditate, to heal, to spin trauma into the gold of growth.

.css-meat1u:before{margin-bottom:1.2rem;height:2.25rem;content:'“';display:block;font-size:4.375rem;line-height:1.1;font-family:Juana,Juana-weight300-roboto,Juana-weight300-local,Georgia,Times,Serif;font-weight:300;} .css-mn32pc{font-family:Juana,Juana-weight300-upcase-roboto,Juana-weight300-upcase-local,Georgia,Times,Serif;font-size:1.625rem;font-weight:300;letter-spacing:0.0075rem;line-height:1.2;margin:0rem;text-transform:uppercase;}@media(max-width: 64rem){.css-mn32pc{font-size:2.25rem;line-height:1;}}@media(min-width: 48rem){.css-mn32pc{font-size:2.375rem;line-height:1;}}@media(min-width: 64rem){.css-mn32pc{font-size:2.75rem;line-height:1;}}.css-mn32pc b,.css-mn32pc strong{font-family:inherit;font-weight:bold;}.css-mn32pc em,.css-mn32pc i{font-style:italic;font-family:inherit;} “What happens to even just one of us affects all of us.”

As 2020 came to a close, I began to wonder if my dream of the Great Slowdown was becoming a sorrowful nightmare: the Great Meltdown. As a teacher of mindfulness, sometimes I am my own worst student; life during lockdown tested me greatly, and watching the news or doom-scrolling through social media didn’t help. I began to flunk out of inner-peace school, started reacting to stress in decidedly unenlightened ways, yelling at the TV or exploding in anger during interminable Zoom meetings.

I gave in to despair when we had to let go of another staff member at work, or when I couldn’t see my kids, who live in far-flung places. I had stopped accessing my “balcony brain”—that part of myself that can calmly observe any situation, pause before reacting, and make wise, compassionate decisions. I was spending more time in my “basement brain,” heeding the vigilant, volatile caveman within. Eventually, my burnout caught up with me, and I landed in the emergency room with a gastrointestinal issue. It was then that my darling husband suggested I try some of my own medicine—the stuff I have written several books about. “You know,” he said gently, “things like meditation and exercise. Things for your trauma and grief. Things for your soul.” Duh!

So here’s what I did. I turned to the words of some of my greatest teachers. I keep a basket of their quotes on my desk. I’m always adding to it—beautiful lines from poets, mind-blowing bits from scientists, motivation from activists, quiet wisdom from spiritual leaders. I often choose one to guide me through the day. This time, I decided that whatever quote my hand touched first would serve as my GPS back into what I call the four landscapes of the human journey: mind, body, heart, and soul.

The first words I picked gave me goosebumps: “Today’s mighty oak is yesterday’s nut that held its ground.” The phrase is attributed to Rosa Parks, and I felt as though she had reached down from the heavens to remind me that everything I needed was already within me. I could be that little acorn again and reroot and rise strong. I knew how to do that. I had done so before in other difficult times. I had held my ground in the shattered aftermath of divorce and come out the other side a stronger and more empathetic person. I had rooted myself in my inner strength when I was my sister’s bone marrow donor. And when we lost her, I found in those ashes the true heart of friendship. Here I was again, trying, like so many of us, to reemerge from the pandemic with lessons learned, inner strength, and something of value to offer.

I followed Mrs. Parks’ guidance and went back to the tools that never fail me: Meditation to activate my “balcony brain” and lift the veil from my clouded mind. Exercise to reclaim my body and physical vitality. The simple prayer of putting my hand on my heart and feeling flooded with forgiveness and tenderness, hope and gratitude. Walks in nature and dips back into my favorite spiritual texts to reconnect with my all-knowing soul. As I felt my strength returning, I was reminded how despair and negativity can spread like a virus, too. When they do, taking the soul’s vaster view and being an agent of uplift feels almost revolutionary. Doing so is an act of sanity and an offering of healing.

Historically, pandemics have jump-started innovation or they have slid humanity backwards into oppression. This is our era; we get to choose. Life after Covid-19 does not have to be a Great Meltdown, or a Great Slowdown. Maybe, just maybe, it will be a Great Wake-up—a global event that breaks us open and waters the seeds of our best selves. Because each one of us can be that acorn, holding our ground, lifting our sights, and, together, becoming a forest of mighty oaks.

Elizabeth Lesser is the author of Cassandra Speaks: When Women Are the Storytellers, The Human Story Changes as well as the bestselling Broken Open: How Difficult Times Can Help Us Grow and Marrow: Love, Loss & What Matters Most . She is the cofounder of Omega Institute, has given two popular TED talks, and is a member of Oprah Winfrey’s Super Soul 100.

From The Magazine

The Essential Guide to Wigs

10 Ways to Spark Change in Your Community

Spending Less Added Value to My Life

How One Woman Found Freedom—and Joy—in Failure

She Found Love Where She Least Expected It

Expert Tips on How to Shift Your Perspective

Facing Childhood Trauma Led a Grown Son to Healing

One Woman Discovers That Joy Can Be Easy

How to Make Your Life More Joyful—Right Now

4 Perfect HolidayCocktails and Mocktails

The Power of the Thank-You Note

We Asked 10 People To Imagine Life After The Pandemic. Here's What They Said

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

<iframe width="100%" height="124" scrolling="no" frameborder="no" src="https://player.wbur.org/cognoscenti/2021/03/17/imagining-life-after-the-covid-19-pandemic"></iframe>

• Cloe Axelson

As more and more people get vaccinated, the number of COVID-19 infections and deaths are finally declining. We know this pandemic won’t last forever.

But — what happens next? Do we just pick up where we left off in March 2020? Or have things changed in a fundamental way?

We asked 10 people to imagine life after the pandemic.

What will work look like after COVID? What about parenting? Friendship? Faith? Will our understanding of public health change, as epidemiologists race to get ahead of the next pandemic?

The truth is, nobody knows exactly what comes next. Uncertainty continues to reign. But for the first time in a long time, it feels like we can reasonably contemplate the future — we are no longer locked in the “perpetual present.”

Read through each contributor's short essay below, or jump around to different topics using this navigation:

• Friendship | Joanna Weiss
• Health | Sandro Galea
• Aging | Julie Wittes Schlack
• Parenting | Sara Petersen
• Faith | Taymullah Abdur-Rahman
• Education | Neema Avashia
• Work | Julie Morgenstern
• Community | Roseann Bongiovanni
• Creativity | Desmond Hall
• Climate | Philip Warburg

I’m Ready To Double Down On The Joys Of Physical Friendship

In the beginning, we had Zoom, and it was fine: virtual happy hours and online game nights that kept friendships alive when we had to be physically apart. But the pandemic separation couldn’t last.

In late spring, I took my first illicit walk with friends; we wore masks and glanced sideways to see if we’d be shamed. By summer, we were venting our frustrations during walks around a pond, holding birthday dinners outdoors, taking socially-distanced selfies with the timers on our phones. When winter came, we layered up like ice fishermen and huddled around fire pits on 30-degree nights.

I want to double-dip in the guacamole. I want to sip your cocktail to see if I like it, too. Joanna Weiss, Editor, Experience Magazine

We’ve needed each other, and that’s good to know. One of the hardest things about COVID has been the way it rendered friendship dangerous — so many transmissions springing from in-person gatherings, as friends came together despite the directives. You can condemn all of those people as cavalier about public health. Or you could see their lapses as a feature of humanity.

We’ve learned, this past year, that connection isn’t the same when it’s remote. And while many of us have broken the rules at least once or twice, we should acknowledge the lengths we’ve gone to see each other in relative safety.

When the COVID threat is gone, I predict that we’ll double down on the joys of physical friendship. I want to live dangerously with my besties. I want to double-dip in the guacamole. I want to sip your cocktail to see if I like it, too. I want to scream together into a karaoke microphone. I’ll pick the first song: “With a Little Help From My Friends.” --   Joanna Weiss ,  Editor, Northeastern University's  Experience magazine

We Need To Think About 'Health' In A New Way

In some ways, COVID-19 will be remembered as a triumph of biomedical science. We developed safe and effective vaccines — something that usually takes a decade or more — in less than a year. And, despite a number of stumbles, improved therapeutics reduced mortality from the virus in hospitals more than fourfold in a matter of months.

But COVID-19 provided, even more memorably, a terrifying and revealing view of our failure to create a world that generates health.

Once this pandemic ends, we’ll undoubtedly be having more conversations about how to prevent future pandemics, and ensure a healthier future. But will we be thinking about health in a bigger sense?

Fundamentally, health is not health care. Sandro Galea, Dean, Boston University School of Public Health

Fundamentally, health is not health care. Decades of underinvestment in healthy environments, adequate education, safe workspaces and livable wages resulted in a country that was unhealthy and vulnerable to the ravages of a novel virus. The U.S. has had the highest per capita rate of COVID-19 infections throughout the pandemic.

This moment should teach us that avoiding the next pandemic will require us to rethink how we approach health, so there are no haves and have nots. It’s recognition that we cannot be healthy, unless we build a world with safe housing, good schools, livable wages, gender and racial equity, clean air, drinkable water, a fair economy.

It’s time to change how we think about health. --   Sandro Galea ,  Dean, Boston University, School Of Public Health

The Pandemic Deepened The Lessons Of Aging

My husband and I are in our late 60s. Fed, housed, and able to freelance, we’ve weathered the past year with gratitude and relative ease. But like many of our peers, the pandemic has intensified our feelings about how we want to live the rest of our lives, in intentional community. Our choices feel quite personal, but they are representative of emerging trends.

In a post-pandemic future, we can expect to see the biggest change in where and with whom the elderly live. With 40% of all fatalities, the virus’s impact on residents of nursing homes has been earth-shaking, fueling people’s desire to age in place or live in settings where mutual aid is the norm. Stunned by the isolation of the pandemic, most of the new recruits to our co-housing community have been people over 60. Local programs supporting in-home care are on the rise, and state and federal programs paying family caregivers are also likely to expand.

Technological advances will also pave the way for aging in place. Telehealth is more widely accepted, and devices like smart speakers will soon notify loved ones if you call out for help. Indeed, the pandemic has highlighted our intergenerational interdependence. With schools and daycares closed, working parents have moved in with their parents so that they can help mind the kids, and many adult children, having been deprived of the ability to see their quarantined loved ones, are determined to pre-empt that scenario in the future.

Don’t take your family and friends for granted. Protect your health. Accept that you’re going to die and live accordingly. Julie Wittes Schlack, Writer, Retired Marketing Executive

Will market volatility make it less likely that people will retire? Or will the COVID-induced knowledge of our own vulnerability fuel our urgency to pursue what we value versus what we’re paid for? I don’t know. But I do know that COVID has deepened the lessons that aging inevitably bestows: Don’t take your family and friends for granted. Protect your health. Accept that you’re going to die and live accordingly. --   Julie Wittes Schlack , Writer

Mothers Continue To Hold Up A Broken System

I never harbored any illusions about living in a culture that values mothers. From day one, my experience as a mom has been peppered with moments of rage and periods of existential crisis. I love the love of motherhood, but the work of mothering is mostly unsupported and un-respected. The nonstop parenting, teaching, cooking, cleaning that mothering has entailed during the pandemic has confirmed that this type of labor is also, for me, largely a drag.

Although the beauty of motherhood is widely celebrated on Instagram and elsewhere, our primary value lies in our ability to raise the next generation of workers and consumers. As the pandemic has shown, mothers’ needs don’t really seem to matter. Our needs don’t impact the bottom line.

The pandemic calcified my fury that mothers are expected to hold up the whole of a very broken system, while being given nothing in return. Sara Petersen, Writer

The pandemic calcified my fury that mothers are expected to hold up the whole of a very broken system, while being given nothing in return. In the past year, we’ve seen a flurry of essays and reporting showing that women and mothers have been disproportionately burdened with the impossible task of keeping society afloat (the latest New York Times series is appropriately titled, “ The Primal Scream .”) The coverage is affirming and necessary, but not a single mother I know has been surprised about any of the awful statistics or heartbreaking personal stories.

When this is over, I’m looking forward to no longer being the sole provider of all things to my kids. But I also wonder if the tidal wave of momentum inspired by the pandemic will carry us through to something better than think-pieces.

We need equal and fair pay for mothers. We need humane prenatal and postnatal care, and paid parental leave legislation. We need to reform our racist health care system that has led to countless Black mothers’ deaths. We need to end the debate on whether women’s reproductive rights are actual rights. And we need to radically rethink our capitalist system, which uses mothers and other care workers to uphold the primary concerns of buying and selling, while denying them adequate compensation — or even cultural respect for their indispensable work.

I wonder if women’s rage will coalesce into action. I hope so. --  Sara Petersen , Writer

The Pandemic Forced Us To Take Faith Into Our Own Hands

I spent many nights in the last year contemplating God’s wisdom and purpose, while fielding the despair and weariness of many Muslims who sought my counsel. They wanted to know, was COVID a pandemic or the plague, and what was the difference? Was it God’s wrath or God’s cleansing? Was there a collective spiritual remedy to make it all go away?

As we begin to see a light at the end of the tunnel, I wonder if and how our faith as Americans has changed.

It was no coincidence that the height of the pandemic in Massachusetts last spring struck during the Holy days of all three Abrahamic faiths. Easter, Passover and Ramadan came and went in our homes. We had to learn to celebrate without the pomp of public worship. People who attended church, temple and mosque — but never took it upon themselves to utter their own personal prayers — were forced to petition God themselves.

God forced us to stop our schedules to give us a moment to take faith into our own hands... Taymullah Abdur-Rahman, Imam

I watched my own teenage children reluctantly read the Quran aloud at home for the Eid Holidays (without the help of the entire mosque). As life returns to normal, I suspect we’ll have a deeper appreciation for our respective worship-communities and the spaces of comfort they provide us.

I also think the goals of the American faithful have shifted slightly. We want a little less of the world now, and more authentic connections with real people. God forced us to stop our schedules to give us a moment to take faith into our own hands — and for the most part we did.

Now I believe God will allow us to embrace one another again, both literally and figuratively. --  Taymullah Abdul-Rahman , Imam, Massachusetts Department of Correction

I Worry Education In A Post-COVID World Won't Change Enough

My greatest fear is that K-12 education in a post-COVID world will not change enough. As an 8th grade teacher, the past 12 months have completely changed how I approach my work.

In-person, Ms. Avashia was all about urgency and rigor and content, content, content. Pandemic-teaching Ms. Avashia moves much more slowly with her students.

Now, I focus my efforts on deep learning, instead of coverage of pages of standards. Each day, we work through one meaningful task, instead of trying to speed through three or four. We play more in class — using riddles or visual puzzles, telling jokes in the chat, changing our Zoom profile pictures, to make each other laugh. I’ve even dressed up in costumes multiple times this year just to bring kids some moments of humor.

Teaching during the pandemic has pushed me to be so much more human with my students, and to teach into their humanity. And that, at its core, is completely different from how education has traditionally been structured in our society.

I believe deeply in the democratic cornerstone of public education. But we have never succeeded in fulfilling its promise for all of our students, particularly those students most impacted by racial and economic injustice in our country.

Our school buildings have been sites of over-policing of students’ bodies, of adultifying and criminalizing adolescent behavior, of reducing student learning down to what can be demonstrated on standardized tests.

We have an opportunity to walk away from those practices forever. To build educational settings that are grounded in students’ humanity, and designed with their voices, needs and interests at the center. To ensure that our schools are structured and staffed to prioritize relationship-building, robust mental health services and targeted academic supports. We can affirm the notion that schools are cornerstones of both our democracy and our communities, by fully funding the work that we as a society are asking them to do.

We can affirm the notion that schools are cornerstones of both our democracy and our communities... Neema Avashia, Teacher, Boston Public Schools

We can do all of this. We should do all of this. The question is: Will we? --  Neema Avashia , Teacher, McCormack Middle School

COVID Forced Companies To Be More Flexible. Will They Harness The Lessons Learned?

The “culture of time” at many companies wasn’t healthy before the pandemic. Some organizations were trying to address bad habits (no time to think, everything-gets-done-by-meetings culture), before new problems like Zoom fatigue and FOLO (Fear Of Logging Off) took hold.

The pandemic accelerated a comeuppance about how the workplace can and should evolve. I think the lessons we learned this year will almost certainly lead to greater flexibility in the long term.

This year proved that a lot of work can be done remotely. It also made clear the handful of things better done in person — bonding, mentoring and new relationship building. Companies will need to bring people together regularly to ensure the kismet that happens in 3D.

The pandemic accelerated a comeuppance about how the workplace can and should evolve. Julie Morgenstern, Author, Productivity Expert

Every worker needs time and space for quiet work, time and space for meetings, and time and space for informal and more casual communication. This was true pre-pandemic, and it’s still true. Future workspaces are likely to reflect these needs: large library-like areas where people can go to do their thinking (like the quiet car on a train); lots of formal and informal meeting areas; and administrative spaces to deal with email and chat with coworkers.

Back-to-back meetings — 7 to 10 Zooms a day — is not an effective way to work. It leaves no time to think, or to actually do the work generated in those meetings.

Companies seem to have finally learned that their employees are whole people. Work is part of their lives, and their lives beyond work are essential and valuable to their well-being. In our post-COVID world, I suspect the role of chief people officer and chief wellness officer will evolve, and be seen as a critical role for a healthy organization.

COVID forced organizations to change. It forced them to be more flexible, and that experience highlighted what went missing in a 100% remote environment. The job of leaders is now to stop, reflect and embrace what we discovered in the last year, and consciously build workplaces and workspaces that harness those lessons, to enable companies to achieve their goals and workers to feel fulfilled. --   Julie Morgenstern , Productivity Expert , Author

We Must Do Right By The Communities, Including Chelsea, That Suffered The Most

I’ve lived in Chelsea my whole life, but I don’t remember my community ever being in the news as much as it was during the first peak of the pandemic. With the highest infection rate in Massachusetts — and blocks’ long lines of people waiting for food — Chelsea was on display for the world to see. Even my family in Argentina saw news reports of our city being slammed by the raging pandemic.

During those difficult days, people opened up their hearts for the residents of our community. Those of us involved in addressing the coronavirus pandemic in Chelsea, received an outpouring of support through donations, volunteering, well wishes and prayers for recovery and hope.

Other low-income, ethnically and racially diverse communities like Chelsea faced the same wrath. Years of structural oppression and racism leading to health, environmental and economic disparities, have made the effects of COVID-19 so much more pronounced.

My post-pandemic hope is that the hearts and minds of those outside of these cities remember how much communities like Chelsea have sacrificed. Will you remember us in six months? Six years? Sixteen years from now?

Will the people of Massachusetts continue to have communities like Chelsea in their hearts and minds? Roseann Bongiovanni, Executive Director, GreenRoots

Will the people of Massachusetts continue to have communities like Chelsea in their hearts and minds? Will you reflect on our disproportionate environmental and industrial burdens, poor public transportation, food insecurity, housing instability and low wages for essential workers? Will others say, “We can shoulder a little bit of the burden, so it’s not all on the backs of low-income communities of color?”

We must learn from the past year, and from the reasons for Chelsea’s soaring infection rates. We must pass laws to protect environmental justice communities. We must say “no” to new toxic facilities. We must prioritize the health and well-being of all people, but particularly those who have faced oppression, discrimination and racism, which caused these health disparities. --   Roseann Bongiovanni , Executive Director, GreenRoots

Will Art Remain The Unifying Force It’s Always Been?

I’m sitting behind my screen, fractured from the world.

I don’t feel the need to see other people as much as I did earlier in the pandemic. Has something happened to me on a molecular level? Is the isolation hitting other writers and artists the way it’s hitting me?

We already live in a world of separate platforms. News broadcasts spin the same events in different ways for different people. The platforms dictate what we see based on what the platforms think we want to see. They strut the arrogance of knowing us better than we do. And now the pandemic has further alienated all of us.

I hope the isolation we’ve endured this year won’t stunt our ability to connect to each other. Desmond Hall, Novelist, Visual Artist

This worries me, because I love when artists create the specific that’s felt universally. I wrote a book about a boy and his family in rural Jamaica . So far it has resonated in other parts of the world. But if we continue to be so isolated will we be too separated to partake in varied experiences?

It was only a short while ago when some Hollywood execs deemed a movie like “Black Panther” was too ethnic to have widespread appeal. They doubted that the specific had universality. The film proved them wrong, but what if we continue to grow apart, divided? Will some art be discarded as irrelevant because large swaths of people can’t relate, can’t see the universality?

I believe in art as a unifying force, as a medium that reveals our commonalities and reasons to strive together. I hope the isolation we’ve endured this year won’t stunt our ability to connect to each other. --  Desmond Hall , Author, Visual Artist  

Behavior Change Won't Be Enough To Avert Climate Catastrophe

With more than half a million lives lost in the U.S., the COVID crisis has yielded a sobering lesson about human resistance to change, even in the face of devastating consequences.

Wearing masks in public? A no-brainer. Avoiding large indoor gatherings? Ditto. Yet when official directives and common sense have impinged on individual choice, too often they have collided with indifference, indignation and defiance.

Some wonder if there are lessons to be learned from the pandemic as we seek to avert the worst ravages of climate change. With many working remotely rather than traveling daily to their offices, reduced commuting has doubtless contributed to the past year’s drop of more than 10% in U.S. greenhouse gas emissions. It’s a pretty sure bet, though, that commuters will refill our highways, with more people than ever traveling by car for fear of infection on public transit.

Air travel, too, is likely to rebound as business trips come back into vogue and leisure travelers take to the skies.

The COVID crisis has yielded a sobering lesson about human resistance to change, even in the face of devastating consequences Philip Warburg, Senior Fellow, Boston University Institute Of Sustainable Energy

Rather than placing our bets on behavioral change, we need to demand of government and industry what we cannot expect of ourselves. All levels of government must require a true gearing-up of renewable energy as our primary electricity source.

In addition, the federal government must mandate a shift to cleaner, leaner motor vehicles — a challenge bigger than simply electrifying the behemoths that now roll off our production lines. And governing bodies at all levels must embrace an unprecedented commitment to energy justice, making it possible for low-income people to make their homes more efficient, buy energy-efficient appliances, and install solar power on their rooftops and in their communities.

It would be folly to rely on new patterns of human behavior emerging from the COVID catastrophe to address climate change. We need to make an all-out investment in retooling the engines of our society. --   Philip Warburg , Senior Fellow, Boston University Institute Of Sustainable Energy

Amy Gorel, Lisa Creamer and Kathleen Burge helped with the production of this piece. The audio essay was was produced by Cloe Axelson, with help from David Greene; it was mixed by Michael Garth.

Follow Cognoscenti on Facebook and Twitter .

• Molly Colvin: Why You Can't Shake Pandemic Anxiety
• On Point: Coronavirus, 1 Year Later: How The Pandemic Has Changed Us
• Lisa Creamer and Laney Ruckstuhl: By The Numbers: What We've Lost, A Year Into The COVID-19 Pandemic

Cloe Axelson Senior Editor, Cognoscenti Cloe Axelson is an editor of WBUR’s opinion page, Cognoscenti.

Advertisement

Find anything you save across the site in your account

All products are independently selected by our editors. If you buy something, we may earn an affiliate commission.

The World We Want to Live in After COVID

By Dhruv Khullar

In 1909, the French ethnographer Arnold van Gennep published a book called “ The Rites of Passage .” In it, he explored the rituals that cultures use to transition people from one stage of life to the next. Birth, puberty, graduation, religious initiation, marriage, pregnancy, promotions, the seasons—we’re always on the threshold of one phase or another. How do communities shepherd individuals from the pre- to the post-?

Van Gennep argued that certain universal principles underlie rites of passage across cultures and eras. First, there’s the “pre-liminal” phase, in which “rites of separation” detach individuals from their earlier thoughts, feelings, and perspectives: the Old You dies. Next comes the “liminal” phase, a volatile interregnum that’s simultaneously disorienting and ambiguous, destructive and constructive, during which “rites of transition” open up the possibility of a new and different future. Finally, in the “post-liminal” phase, the “rites of incorporation” allow one to reënter society somehow changed. A New You is inaugurated. “Life itself means to separate and to be reunited, to change form and condition, to die and to be reborn,” van Gennep wrote. “It is to act and to cease, to wait and to rest, and then to begin acting again, but in a different way.”

Van Gennep’s observations were a landmark in the nascent field of anthropology. “Elements of ceremonial behavior were no longer the relics of former superstitious eras,” the anthropologists Richard Huntington and Peter Metcalf later wrote, but “keys to a universal logic of human social life.” In the century since, scholars have applied van Gennep’s framework not just to individuals but to societies in times of turmoil and transformation. Famines, wars, political revolutions, economic downturns, civil-rights movements—societies, too, move from one way of life to another, often experiencing intense periods of renunciation, restructuring, and rebirth.

2020, when the pandemic began, was a pre-liminal year—a headlong, vaccine-less descent away from normality and into calamity. We were torn from our established ways, undergoing separation, loss, and upheaval. 2021 was a liminal year—neither here nor there, not quite normal but not wholly abnormal, either. The inauguration of Joe Biden , the widespread availability of vaccines, and the return of weddings, dining, travel, and sports all coexisted alongside vaccine holdouts, breakthrough infections, new variants, booster shots, and regional surges.

Today, Omicron might make it feel as though we’re still squarely in the liminal phase. But, in fact, we may soon be tipping into a post-liminal paradigm. Omicron’s extraordinary contagiousness—combined with rising vaccination and booster rates—could mean that, in the coming months, nearly all Americans will have some level of immunity to COVID . Repeat infections and breakthrough cases will still occur, but, as our individual and collective immunity broadens, these will become milder and less disruptive. The influenza pandemics of the twentieth century each lasted around two years; now, twenty-one months into our battle with the coronavirus, Omicron is accelerating what could be this pandemic’s final chapter. It’s becoming possible to ask, and perhaps answer, some broad questions: Where will we end up in our attitudes toward ourselves and the social web in which we live? Who will we be on the other side of our transition?

The coronavirus crisis is first and foremost a health crisis, and many of the most obvious changes in our attitudes have to do with health. Some of us have come to reflect more regularly on our age and medical conditions. We’ve gained familiarity with obscure scientific jargon, from PCR tests to mRNA. We meditate on the trade-offs involved in social events, examine the threats we pose to others (and vice versa), and judge people for their choices. Americans differ hugely on what to think and do about all this—the behavior of people in one community can seem unfathomable to those in another—but, at least for now, health has shifted from a narrow individual consideration to a more expansive, social one. Going to work, attending a concert, hosting a dinner party, boarding a flight—if you have a cough, a fever, or just the sniffles, these activities now carry an ethical dimension. Will this remain true after the acute threat of COVID -19 has subsided? We may return to inflicting colds, flus, and various G.I. bugs on one another—or, possibly, we’ll adopt some version of the physician’s oath to do no harm.

The sense that making others sick is an action we’ve taken—and that, conversely, it’s within our power to avoid becoming agents of contagion—reflects a more general paradox of the pandemic. Since COVID arrived, we’ve been both powerless and empowered. Many aspects of our lives have been changed by events beyond our control; at the same time, we have sometimes been pushed to make consequential decisions and chart our own course. Over the past two years, for instance, Americans have quit their jobs in record numbers; in some cases, they’ve been forced to do so—perhaps by medical vulnerability, or unprecedented disruptions in schooling—while, in others, the pandemic’s chaos presented an opportunity to reëvaluate priorities. Regardless, faced with historical circumstances, they made big changes. In this crisis, as in many rites of passage, we don’t just passively recite our lines; we write them, taking vows that may reverberate for decades.

One of the questions we face now is whether we can make such changes on a social level, in addition to an individual one. The pandemic’s school disruptions are the result not just of a novel virus but of years of underinvestment that have yielded underpaid teachers, crowded classrooms, and poorly ventilated buildings. We’ve seen the same pattern in many aspects of our pandemic experience. Decades of investment in basic science allowed American scientists to race from genomic sequencing to an effective COVID vaccine in less than a year—but, during the same period, a public-health system that had been neglected for decades hampered our ability to contain the virus at every turn. We’ve made real changes in our lives. Can we make them in our society, too, building capacity so that our institutions can be more resilient and flexible?

The pandemic has posed similar questions for the world as a whole. COVID -19 struck during the seventy-fifth anniversary of the creation of the United Nations, and arrived at a moment characterized by a sharp rise in nationalism and a broadening skepticism about the international arrangements that have governed since the Second World War. Even before the virus, the multilateral system of international coöperation was fraying. After the 2008 financial crisis, Americans had grown increasingly suspicious of globalization and frustrated by their leaders’ failure to address its consequences: inequality, job displacement, social atomization. Now the coronavirus has shown that globalization moves not just goods and people across borders but pathogens, too.

In March, the National Intelligence Council released a report arguing that, in the coming years, the world will face global crises—pandemics, extreme-weather events, technological disruptions—with growing frequency. At the same time, greater international fragmentation and tension will impede our ability to respond to them. The report outlined several possible futures. In the optimistic scenario, called the “renaissance of democracies,” the world settles into a new equilibrium characterized by technological progress, rising incomes, and responsive democratic governance, led by the U.S. and its allies. In another future, “a world adrift,” the international system is “directionless, chaotic, and volatile”; global problems are largely ignored, and multilateral institutions lose their influence.

At a global level, as at the national one, the health crisis of the pandemic has put another preëxisting crisis into sharper relief. Effective pandemic response requires coördination across nations; this is the work of the World Health Organization, of which America has long been the largest funder. In 2019, the U.S. contributed more than four hundred million dollars to the W.H.O., but in April, 2020, Donald Trump announced that the U.S. would stop its funding. For much of the year, the U.S. also declined to join COVAX , the world’s primary global vaccine-distribution mechanism. Today less than nine per cent of people in low-income countries have received a single dose of a COVID vaccine; the rise of ever more concerning variants, such as Delta and Omicron, is due, in part, to a failure of the U.S. and other wealthy countries to vaccinate the world.

Recently, the G-20—a forum comprising nineteen nations and the European Union, which together account for ninety per cent of the world’s economic output—proposed key steps for strengthening the global response to future infectious threats: higher and more consistent funding for the W.H.O.; greater collaboration between governments and the W.H.O. on data collection, humanitarian support, and vaccine development; and the establishment of global norms for the reporting of emerging pathogens. Will countries unite in making such changes? That depends, in large part, on their willingness to act multilaterally—to see that their own security is interwoven with the security of others. It’s an issue that’s larger than the virus. COVID -19, like the Second World War, has created a hinge in the history of the world, which could swing either toward greater cohesion or toward disarray.

In 1954, a researcher named Muzafer Sherif conducted what would become one of the most famous experiments in social psychology. Sherif was interested in the dynamics of group conflict: how easily loyalties form; how little it takes for rival factions to quarrel; what, if anything, can be done to repair relations. As my colleague Elizabeth Kolbert wrote recently, in a piece on political polarization , Sherif invited twenty-two fifth-grade boys to a summer camp at Robbers Cave State Park, in southeastern Oklahoma. The boys were all white, from middle-class, Protestant, two-parent households. Sherif and his team divided them into two groups, each unaware that the other was housed in a cabin at another end of the camp. In the first phase of the study, lasting about a week, the groups, which named themselves the Eagles and the Rattlers, bonded over shared interests and activities—hiking, swimming, a treasure hunt with a ten-dollar reward. In the second phase, the groups were brought together in a series of zero-sum competitions: baseball, tug-of-war, touch football. The researchers, who doubled as camp counsellors, orchestrated hijinks. One group was delayed in arriving at a picnic; when they got there, they were led to believe that the other group had eaten their food. Tensions rose. The Eagles burned the Rattlers’ flag; the Rattlers raided the Eagles’ cabin. Researchers had to step in to break up fights. Division had set in.

The goal of the third phase was to defuse the animosity. As a first step, the researchers organized a series of noncompetitive activities. The boys shared meals, watched a movie together, and celebrated the Fourth of July. Little changed. Only when the campers were given tasks requiring collaboration on a common endeavor—restarting a stalled food truck, pitching a tent with missing supplies, raising money for a movie night—did conflict decline. In the end, one group bought the other malted milk.

The findings of the Robbers Cave experiment have become a staple of undergraduate seminars and psychology textbooks. But they appear not to apply to our current moment. Never before has it been so clear that our work, behavior, and fates are inextricably linked to those around us. Working together to control the virus should have been the ultimate shared goal. And yet, facing viral invasion, Americans couldn’t agree not to sneeze on one another. While fighting the pandemic, America has remained one of the world’s most polarized nations.

It turns out that the Robbers Cave experiment doesn’t tell the whole story. As Gina Perry explains in her book “ The Lost Boys ,” Sherif had conducted a near-identical experiment the year before, in 1953. He’d invited a similar cohort of boys to a camp in upstate New York and divided them into groups: the Panthers and the Pythons. The researchers had carried out a similar series of conflict-generating shenanigans: they’d stolen clothes, ransacked tents, and broken a boy’s ukulele. This time, however, the boys caught on—they realized that they were being manipulated. Instead of fighting one another, they turned on the adults. “Maybe you just wanted to see what our reactions would be,” one boy suggested to a researcher. ​​One of the groups decided that their clothes must have gone missing because of a laundry mishap; both sides worked together to restore an overturned tent. As the experiment unravelled, Sherif began drinking heavily. He grew so despondent that he nearly punched a research assistant in the face. The experiment was stopped early; Sherif never published the findings.

In an era of social-media virality, cable-news punditry, and political celebrity, we, too, are being manipulated. The ire we direct at one another is, at least in part, a result of forces that aim to extract political or financial gain by stoking division and appealing to our basest instincts. Despite knowing better, people in power traffic in half-truths, adding to the cacophony of conflict. They reflect our discord but also create it. We don’t yet know what post-liminal life looks like—but recognizing that truth may be the first step to healing the divide.

More on the Coronavirus

How China’s response set the stage for a worldwide wave of censorship .

Why are preschoolers subject to the strictest COVID rules in New York City ?

Ecuador’s largest city endured one of the world’s most lethal outbreaks .

What it was like to treat some of the oldest and sickest people in New York’s jails .

Young New Yorkers grapple with the pandemic’s mental toll .

In the COVID era, the success of the chickenpox vaccine is staggering to contemplate.

Sign up for our daily newsletter to receive the best stories from The New Yorker .

By signing up, you agree to our User Agreement and Privacy Policy & Cookie Statement . This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

By Amy Davidson Sorkin

By Sam Knight

By Gideon Lewis-Kraus

By Andrew Marantz

COVID-19: Where we’ve been, where we are, and where we’re going

One of the hardest things to deal with in this type of crisis is being able to go the distance. Moderna CEO Stéphane Bancel

Where we're going

Living with covid-19, people & organizations, sustainable, inclusive growth, related collection.

The Next Normal: Emerging stronger from the coronavirus pandemic

• Newsletters

Site search

• Israel-Hamas war
• 2024 election
• TikTok’s fate
• Supreme Court
• All explainers
• Future Perfect

Filed under:

Read these 12 moving essays about life during coronavirus

Artists, novelists, critics, and essayists are writing the first draft of history.

Share this story

• Share this on Facebook
• Share this on Twitter
• Share this on Reddit
• Share All sharing options

Share All sharing options for: Read these 12 moving essays about life during coronavirus

The world is grappling with an invisible, deadly enemy, trying to understand how to live with the threat posed by a virus . For some writers, the only way forward is to put pen to paper, trying to conceptualize and document what it feels like to continue living as countries are under lockdown and regular life seems to have ground to a halt.

So as the coronavirus pandemic has stretched around the world, it’s sparked a crop of diary entries and essays that describe how life has changed. Novelists, critics, artists, and journalists have put words to the feelings many are experiencing. The result is a first draft of how we’ll someday remember this time, filled with uncertainty and pain and fear as well as small moments of hope and humanity.

At the New York Review of Books, Ali Bhutto writes that in Karachi, Pakistan, the government-imposed curfew due to the virus is “eerily reminiscent of past military clampdowns”:

Beneath the quiet calm lies a sense that society has been unhinged and that the usual rules no longer apply. Small groups of pedestrians look on from the shadows, like an audience watching a spectacle slowly unfolding. People pause on street corners and in the shade of trees, under the watchful gaze of the paramilitary forces and the police.

His essay concludes with the sobering note that “in the minds of many, Covid-19 is just another life-threatening hazard in a city that stumbles from one crisis to another.”

Writing from Chattanooga, novelist Jamie Quatro documents the mixed ways her neighbors have been responding to the threat, and the frustration of conflicting direction, or no direction at all, from local, state, and federal leaders:

Whiplash, trying to keep up with who’s ordering what. We’re already experiencing enough chaos without this back-and-forth. Why didn’t the federal government issue a nationwide shelter-in-place at the get-go, the way other countries did? What happens when one state’s shelter-in-place ends, while others continue? Do states still under quarantine close their borders? We are still one nation, not fifty individual countries. Right?

Award-winning photojournalist Alessio Mamo, quarantined with his partner Marta in Sicily after she tested positive for the virus, accompanies his photographs in the Guardian of their confinement with a reflection on being confined :

The doctors asked me to take a second test, but again I tested negative. Perhaps I’m immune? The days dragged on in my apartment, in black and white, like my photos. Sometimes we tried to smile, imagining that I was asymptomatic, because I was the virus. Our smiles seemed to bring good news. My mother left hospital, but I won’t be able to see her for weeks. Marta started breathing well again, and so did I. I would have liked to photograph my country in the midst of this emergency, the battles that the doctors wage on the frontline, the hospitals pushed to their limits, Italy on its knees fighting an invisible enemy. That enemy, a day in March, knocked on my door instead.

In the New York Times Magazine, deputy editor Jessica Lustig writes with devastating clarity about her family’s life in Brooklyn while her husband battled the virus, weeks before most people began taking the threat seriously:

At the door of the clinic, we stand looking out at two older women chatting outside the doorway, oblivious. Do I wave them away? Call out that they should get far away, go home, wash their hands, stay inside? Instead we just stand there, awkwardly, until they move on. Only then do we step outside to begin the long three-block walk home. I point out the early magnolia, the forsythia. T says he is cold. The untrimmed hairs on his neck, under his beard, are white. The few people walking past us on the sidewalk don’t know that we are visitors from the future. A vision, a premonition, a walking visitation. This will be them: Either T, in the mask, or — if they’re lucky — me, tending to him.

Essayist Leslie Jamison writes in the New York Review of Books about being shut away alone in her New York City apartment with her 2-year-old daughter since she became sick:

The virus. Its sinewy, intimate name. What does it feel like in my body today? Shivering under blankets. A hot itch behind the eyes. Three sweatshirts in the middle of the day. My daughter trying to pull another blanket over my body with her tiny arms. An ache in the muscles that somehow makes it hard to lie still. This loss of taste has become a kind of sensory quarantine. It’s as if the quarantine keeps inching closer and closer to my insides. First I lost the touch of other bodies; then I lost the air; now I’ve lost the taste of bananas. Nothing about any of these losses is particularly unique. I’ve made a schedule so I won’t go insane with the toddler. Five days ago, I wrote Walk/Adventure! on it, next to a cut-out illustration of a tiger—as if we’d see tigers on our walks. It was good to keep possibility alive.

At Literary Hub, novelist Heidi Pitlor writes about the elastic nature of time during her family’s quarantine in Massachusetts:

During a shutdown, the things that mark our days—commuting to work, sending our kids to school, having a drink with friends—vanish and time takes on a flat, seamless quality. Without some self-imposed structure, it’s easy to feel a little untethered. A friend recently posted on Facebook: “For those who have lost track, today is Blursday the fortyteenth of Maprilay.” ... Giving shape to time is especially important now, when the future is so shapeless. We do not know whether the virus will continue to rage for weeks or months or, lord help us, on and off for years. We do not know when we will feel safe again. And so many of us, minus those who are gifted at compartmentalization or denial, remain largely captive to fear. We may stay this way if we do not create at least the illusion of movement in our lives, our long days spent with ourselves or partners or families.

Novelist Lauren Groff writes at the New York Review of Books about trying to escape the prison of her fears while sequestered at home in Gainesville, Florida:

Some people have imaginations sparked only by what they can see; I blame this blinkered empiricism for the parks overwhelmed with people, the bars, until a few nights ago, thickly thronged. My imagination is the opposite. I fear everything invisible to me. From the enclosure of my house, I am afraid of the suffering that isn’t present before me, the people running out of money and food or drowning in the fluid in their lungs, the deaths of health-care workers now growing ill while performing their duties. I fear the federal government, which the right wing has so—intentionally—weakened that not only is it insufficient to help its people, it is actively standing in help’s way. I fear we won’t sufficiently punish the right. I fear leaving the house and spreading the disease. I fear what this time of fear is doing to my children, their imaginations, and their souls.

At ArtForum , Berlin-based critic and writer Kristian Vistrup Madsen reflects on martinis, melancholia, and Finnish artist Jaakko Pallasvuo’s 2018 graphic novel Retreat , in which three young people exile themselves in the woods:

In melancholia, the shape of what is ending, and its temporality, is sprawling and incomprehensible. The ambivalence makes it hard to bear. The world of Retreat is rendered in lush pink and purple watercolors, which dissolve into wild and messy abstractions. In apocalypse, the divisions established in genesis bleed back out. My own Corona-retreat is similarly soft, color-field like, each day a blurred succession of quarantinis, YouTube–yoga, and televized press conferences. As restrictions mount, so does abstraction. For now, I’m still rooting for love to save the world.

At the Paris Review , Matt Levin writes about reading Virginia Woolf’s novel The Waves during quarantine:

A retreat, a quarantine, a sickness—they simultaneously distort and clarify, curtail and expand. It is an ideal state in which to read literature with a reputation for difficulty and inaccessibility, those hermetic books shorn of the handholds of conventional plot or characterization or description. A novel like Virginia Woolf’s The Waves is perfect for the state of interiority induced by quarantine—a story of three men and three women, meeting after the death of a mutual friend, told entirely in the overlapping internal monologues of the six, interspersed only with sections of pure, achingly beautiful descriptions of the natural world, a day’s procession and recession of light and waves. The novel is, in my mind’s eye, a perfectly spherical object. It is translucent and shimmering and infinitely fragile, prone to shatter at the slightest disturbance. It is not a book that can be read in snatches on the subway—it demands total absorption. Though it revels in a stark emotional nakedness, the book remains aloof, remote in its own deep self-absorption.

In an essay for the Financial Times, novelist Arundhati Roy writes with anger about Indian Prime Minister Narendra Modi’s anemic response to the threat, but also offers a glimmer of hope for the future:

Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.

From Boston, Nora Caplan-Bricker writes in The Point about the strange contraction of space under quarantine, in which a friend in Beirut is as close as the one around the corner in the same city:

It’s a nice illusion—nice to feel like we’re in it together, even if my real world has shrunk to one person, my husband, who sits with his laptop in the other room. It’s nice in the same way as reading those essays that reframe social distancing as solidarity. “We must begin to see the negative space as clearly as the positive, to know what we don’t do is also brilliant and full of love,” the poet Anne Boyer wrote on March 10th, the day that Massachusetts declared a state of emergency. If you squint, you could almost make sense of this quarantine as an effort to flatten, along with the curve, the distinctions we make between our bonds with others. Right now, I care for my neighbor in the same way I demonstrate love for my mother: in all instances, I stay away. And in moments this month, I have loved strangers with an intensity that is new to me. On March 14th, the Saturday night after the end of life as we knew it, I went out with my dog and found the street silent: no lines for restaurants, no children on bicycles, no couples strolling with little cups of ice cream. It had taken the combined will of thousands of people to deliver such a sudden and complete emptiness. I felt so grateful, and so bereft.

And on his own website, musician and artist David Byrne writes about rediscovering the value of working for collective good , saying that “what is happening now is an opportunity to learn how to change our behavior”:

In emergencies, citizens can suddenly cooperate and collaborate. Change can happen. We’re going to need to work together as the effects of climate change ramp up. In order for capitalism to survive in any form, we will have to be a little more socialist. Here is an opportunity for us to see things differently — to see that we really are all connected — and adjust our behavior accordingly. Are we willing to do this? Is this moment an opportunity to see how truly interdependent we all are? To live in a world that is different and better than the one we live in now? We might be too far down the road to test every asymptomatic person, but a change in our mindsets, in how we view our neighbors, could lay the groundwork for the collective action we’ll need to deal with other global crises. The time to see how connected we all are is now.

The portrait these writers paint of a world under quarantine is multifaceted. Our worlds have contracted to the confines of our homes, and yet in some ways we’re more connected than ever to one another. We feel fear and boredom, anger and gratitude, frustration and strange peace. Uncertainty drives us to find metaphors and images that will let us wrap our minds around what is happening.

Yet there’s no single “what” that is happening. Everyone is contending with the pandemic and its effects from different places and in different ways. Reading others’ experiences — even the most frightening ones — can help alleviate the loneliness and dread, a little, and remind us that what we’re going through is both unique and shared by all.

Will you help keep Vox free for all?

At Vox, we believe that clarity is power, and that power shouldn’t only be available to those who can afford to pay. That’s why we keep our work free. Millions rely on Vox’s clear, high-quality journalism to understand the forces shaping today’s world. Support our mission and help keep Vox free for all by making a financial contribution to Vox today.

We accept credit card, Apple Pay, and Google Pay. You can also contribute via

Next Up In Culture

Sign up for the newsletter today, explained.

Understand the world with a daily explainer plus the most compelling stories of the day.

Thanks for signing up!

Check your inbox for a welcome email.

Oops. Something went wrong. Please enter a valid email and try again.

Why is there so much lead in American food?

Multigenerational housing is coming back in a big way

You can’t afford to buy a house. Biden knows that.

Want a 32-hour workweek? Give workers more power.

The harrowing “Quiet on Set” allegations, explained

The chaplain who doesn’t believe in God

You are using an outdated browser. Upgrade your browser today or install Google Chrome Frame to better experience this site.

• IMF at a Glance
• Surveillance
• Capacity Development
• IMF Factsheets List
• IMF Members
• IMF Timeline
• Senior Officials
• Job Opportunities
• Archives of the IMF
• Climate Change
• Fiscal Policies
• Income Inequality

Flagship Publications

Other publications.

• World Economic Outlook
• Global Financial Stability Report
• Fiscal Monitor
• External Sector Report
• Staff Discussion Notes
• Working Papers
• IMF Research Perspectives
• Economic Review
• Global Housing Watch
• Commodity Prices
• Commodities Data Portal
• IMF Researchers
• Annual Research Conference
• Other IMF Events

IMF reports and publications by country

Regional offices.

• IMF Resident Representative Offices
• IMF Regional Reports
• IMF and Europe
• IMF Members' Quotas and Voting Power, and Board of Governors
• IMF Regional Office for Asia and the Pacific
• IMF Capacity Development Office in Thailand (CDOT)
• IMF Regional Office in Central America, Panama, and the Dominican Republic
• Eastern Caribbean Currency Union (ECCU)
• IMF Europe Office in Paris and Brussels
• IMF Office in the Pacific Islands
• How We Work
• IMF Training
• Digital Training Catalog
• Online Learning
• Our Partners
• Country Stories
• Technical Assistance Reports
• High-Level Summary Technical Assistance Reports
• Strategy and Policies

For Journalists

• Country Focus
• Chart of the Week
• Communiqués
• Mission Concluding Statements
• Press Releases
• Statements at Donor Meetings
• Transcripts
• Views & Commentaries
• Article IV Consultations
• Financial Sector Assessment Program (FSAP)
• Seminars, Conferences, & Other Events
• E-mail Notification

Press Center

The IMF Press Center is a password-protected site for working journalists.

• Login or Register
• Information of interest
• About the IMF
• Conferences
• Press briefings
• Special Features
• Middle East and Central Asia
• Economic Outlook
• Annual and spring meetings
• Most Recent
• Most Popular
• IMF Finances
• Additional Data Sources
• World Economic Outlook Databases
• Climate Change Indicators Dashboard
• IMF eLibrary-Data
• International Financial Statistics
• G20 Data Gaps Initiative
• Public Sector Debt Statistics Online Centralized Database
• Currency Composition of Official Foreign Exchange Reserves
• Financial Access Survey
• Government Finance Statistics
• Publications Advanced Search
• IMF eLibrary
• IMF Bookstore
• Publications Newsletter
• Essential Reading Guides
• Regional Economic Reports
• Country Reports
• Departmental Papers
• Policy Papers
• Selected Issues Papers
• All Staff Notes Series
• Analytical Notes
• Fintech Notes
• How-To Notes
• Staff Climate Notes

Finance & Development

Life Post–COVID-19

Daniel Susskind , James Manyika , Jean Saldanha , Sharan Burrow , Sergio Rebelo , Ian Bremmer

Download PDF

Six prominent thinkers reflect on how the pandemic has changed the world

Daniel Susskind

In March 2020, Rabbi Jonathan Sacks, an influential figure in British intellectual life, described the COVID-19 catastrophe as “the nearest we have to a revelation for atheists.”

At the time I thought the comparison was apt. It captured the biblical sense of shock that many of us felt in the face of such a sudden, extreme, and swiftly accelerating crisis. We “have been coasting along for more than half a century,” he remarked, and all at once “we are facing the fragility and vulnerability of the human situation.”

Now, a few months on, Rabbi Sacks’ comparison with revelation still seems fitting, but for a different reason, and one that matters for thinking about a world after COVID-19.

This crisis is alarming, in part, because it has several new and unfamiliar features. A global medical emergency caused by a virus we still do not fully understand. A self-inflicted economic catastrophe as a necessary policy response to contain its spread.

And yet as time has passed, it has also become clear that much of what is most distressing about this crisis is not new at all. Striking variations in COVID-19 infections and outcomes appear to reflect existing economic inequalities. Remarkable mismatches between the social value of what “key workers” do and the low wages they receive follow from the familiar failure of the market to value adequately what really matters.

The happy embrace of disinformation and misinformation about the virus was to be expected, given a decade of rising populism and declining faith in experts. And the absence of a properly coordinated international response ought to have come as no surprise, given the celebration of “my country first” global politics in recent years.

The crisis then is a revelation in a far more literal sense—it is focusing our collective attention on the many injustices and weaknesses that already exist in how we live together. If people were blind to these faults before, it is hard not to see them now.

What will the world look like after COVID-19? Many of the problems we will face in the next decade will simply be more extreme versions of those that we already confront today. The world will only look significantly different this time if, as we emerge from this crisis, we decide to take action to resolve these problems and bring about fundamental change.

James Manyika

The world after COVID-19 is unlikely to return to the world that was. Many trends already underway in the global economy are being accelerated by the impact of the pandemic.

This is especially true of the digital economy, with the rise of digital behavior such as remote working and learning, telemedicine, and delivery services. Other structural changes may also accelerate, including regionalization of supply chains and a further explosion of cross-border data flows.

The future of work has arrived faster, along with its challenges—many of them potentially multiplied—such as income polarization, worker vulnerability, more gig work, and the need for workers to adapt to occupational transitions. This acceleration is the result not only of technological advances but also of new considerations for health and safety, and economies and labor markets will take time to recover and will likely emerge changed.

With the amplification of these trends, the realities of this crisis have triggered reconsideration of several beliefs, with possible effects on long-term choices for the economy and society. These effects range from attitudes about efficiency versus resilience, the future of capitalism, densification of economic activity and living, industrial policy, our approach to problems that affect us all and call for global and collective action—such as pandemics and climate change—to the role of government and institutions.

Over the past two decades, in advanced economies, responsibility has generally shifted from institutions to individuals. Yet health systems are being tested and often found wanting, while benefits from paid sick leave to universal basic income are getting a second look. There is potential for a long-term shift in how institutions support people, through safety nets and a more inclusive social contract.

As history has shown, choices made during crises can shape the world for decades to come. What will remain critical is the need for collective action to build economies that deliver inclusive economic growth, prosperity, and safety for all.

Jean Saldanha

In The Pandemic Is a Portal , Indian author Arundhati Roy writes, “Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next.”

The way multilateralism operates will have to change to reflect this very different world. The COVID-19 pandemic has been testing the limits of global cooperation. Support for developing economies in particular remains inadequate. They were hit early by the global economic downturn, including through record capital outflows and tightening financial conditions. Facing the worst humanitarian crisis since World War II, these economies are experiencing unprecedented pressure on their already limited fiscal capacity to tackle urgent public health and social needs.

Choices made now will have far-reaching consequences. Reliance on more of the same is untenable and ignores the scale of human suffering unleashed by the pandemic.

A fitting UN-led reform agenda must include the IMF in addressing the structural problems that have driven debt vulnerability across developing economies. Such an agenda must shift development finance away from market-friendly reforms and incentives for private investment. It must abandon the dogma of austerity. Furthermore, rich countries must finally meet their official development assistance commitments.

Power imbalances in global institutions must also be corrected to give fair recognition to the needs and rights of the two-thirds of the world’s population who reside in the Global South.

If the international community fails to respond decisively now, the 2030 Agenda and the Paris Agreement will be fatally derailed. A new multilateralism—in which reform of the Bretton Woods institutions will play a key role—is needed now and must be based on a vision of development that puts human rights, gender equality, and climate at its center.

Sharan Burrow

The world after the first wave of COVID-19 must be more inclusive, resilient, and sustainable. Today, we live in a world in which inequality between and within countries has grown as a result of businesses’ race to the bottom and working poverty among a vast portion of the global workforce. Too many countries suffered the external shocks of COVID-19 without universal social protection, robust public health systems, a plan to reach net-zero carbon emissions by 2050, or a sustainable real economy with quality jobs.

The Bretton Woods conference occurred while a war was still raging and helped formed the basis of a postwar social contract. Similarly, we need to craft an ambitious reconstruction plan while working to end the pandemic. International support is a matter of collective survival and an investment in the future of health, the global economy, and multilateralism. The choice is ours, and the actions of the IMF and the multilateral system will be a deciding factor.

Our goal for recovery should be full employment and a new social contract. Public investment in the care economy, education, and low-carbon infrastructure can form the backbone of stimulus that reduces inequality. Wage policy, collective bargaining, and labor market regulation can revive demand and income while putting an end to a business model that allows companies to take no responsibility for their workers.

Debt should be addressed through a relief process focused on the United Nations Sustainable Development Goals and enduring economic growth for every country. Shortsighted fiscal consolidation hindered debt management and reduction after the global financial crisis and would again leave us even less able to deal with future health and economic crises.

Shared prosperity can be the fruit of a COVID-19 world marked by shared ambition and global solidarity.

Sergio Rebelo

COVID-19 will leave a lasting imprint on the world economy, causing permanent changes and teaching important lessons.

Virus screening is likely to become part of our life, just like security measures became ubiquitous after 9/11. It is important to invest in the infrastructure necessary to detect future viral outbreaks. This investment protects economies in case immunity to COVID-19 turns out to be temporary.

Many economies adopted versions of Germany’s Kurzarbeit (short work) subsidy during the pandemic. This policy keeps workers employed at reduced hours and pay, with the government compensating some of the shortfall in wages. By keeping matches between firms and workers intact, the economy is better prepared for a quick recovery. It is important to improve the implementation of these policies and make them a permanent part of our economic recovery tool kit.

Remote work is likely to become more common. We had some evidence that working from home is at least as productive as working at the office . However, many companies were reluctant to embrace remote work. Now that many have tried it with good results, remote work might be here to stay.

The pandemic crisis has accelerated the pace of digital transformation, with further expansion in e-commerce and increases in the pace of adoption of telemedicine, videoconferencing, online teaching, and fintech.

Companies with international supply chains are dealing with shortages and bottlenecks. We are likely to see many of these companies reshore some of their production. Unfortunately, this trend will not create many jobs because most of the production is likely to be automated.

Governments will be bigger after playing the role of insurer and investor of last resort during the crisis. Public debt will balloon, creating financial challenges around the world.

The most important lesson from the COVID-19 pandemic is the importance of working together on problems that affect the entire human race. We are much stronger united than divided.

Ian Bremmer

The global order was in flux well before the COVID-19 crisis. Coronavirus has accelerated three of the key geopolitical trends that will shape our next world order… which will await us on the other side of this pandemic.

The first trend is deglobalization ; the logistic difficulties brought to light by the current crisis are already pointing to a shift away from global just-in-time supply chains. Yet as economic difficulties mount, the inevitable growth of nationalism and “my nation first” politics will push companies to localize business operations that favor national and regional supply chains.

The third trend, China’s geopolitical rise , has been more than three decades in the making. But while China has successfully transformed itself into an economic and technological superpower, no one expected it to become a “soft power” superpower. This crisis can change that, if China’s crisis diplomacy continues and the perception endures that Beijing has been far more effective than the rest of the world in its response to the outbreak.

Of course, just because China appears to be faring better doesn’t mean it actually is. There’s a reason people take Chinese numbers with a grain of salt. This general distrust was further fueled by the initial Chinese cover-up of the outbreak, which enabled its global spread. Donald Trump and his administration are leaning into this narrative as an election strategy and to deflect attention from their own handling of the pandemic. China won’t take this lying down, making it increasingly likely that once the world emerges from the current pandemic, we will be plunged into a new cold war, this time between the United States and China.

New world order or not, some things just don’t change.

Daniel Susskind  is a research professor at King's College London and a senior research associate at the Institute for Ethics in AI at Oxford University.

James Manyika is chairman and director of the McKinsey Global Institute.

Jean Saldanha is director of the European Network on Debt and Development.

Sharan Burrow is general secretary of the International Trade Union Confederation.

Sergio Rebelo is a professor of international finance at the Kellogg School of Management at Northwestern University.

Ian Bremmer is president and founder of Eurasia Group and GZERO Media.

Opinions expressed in articles and other materials are those of the authors; they do not necessarily reflect IMF policy.

Related Features

You might also like.

• March of the Models
• The Social Costs of Price
• A Place for Politics
• Gillian Tett on Anthropology for the Modern Economist
• A Road Well Traveled
• Revisiting the Soviet Breakup
• F&D HOMEPAGE

Latest Issues

December 2023

September 2023

• About F&D Magazine

Social Media

• F&D on Facebook
• F&D on LinkedIn

F&D STAFF

• Gita Bhatt, Editor-In-Chief
• Maureen Burke, Managing Editor
• Peter J. Walker, Senior Editor
• Jeff Kearns, Senior Editor
• Nicholas Owen, Senior Editor
• Smita Aggarwal, Assistant Editor
• Andrew Stanley, Assistant Editor
• Bruce Edwards, Multimedia Content
• Noha Elbadawy, Multimedia content
• Melinda Weir, Production Manager
• Rekia Ennaboulssi, Web Manager
• Marta Doroszczyk, Digital Marketing
• Kwabena Akuamoah-Boateng, Social Media Editor

Featured Topics

Featured series.

A series of random questions answered by Harvard experts.

Explore the Gazette

Read the latest.

Finding middle way out of Gaza war

Roadmap to Gaza peace may run through Oslo

Why Democrats, Republicans, who appear at war these days, really need each other

Rose Lincoln/Harvard Staff Photographer

What will the new post-pandemic normal look like?

Alvin Powell

Harvard Staff Writer

Outbreak forced changes big and small, some of which are here to stay

Will the wearing of bowties ever rebound with the once-fashion-conscious who’ve grown used to every day being pandemic casual? How about the dollar bill, now that so much spending has gone online and onto plastic? What about doctors’ visits, when the recent past showed that virtual appointments — minus traffic, parking, and schedule juggling — very often do the trick?

The coronavirus pandemic has exerted enormous pressure on American society and forced a host of changes to how we live and work. But those pressures have ebbed and flowed with the outbreak’s progress. When it all recedes in the likely not-too-distant future, experts expect older, more familiar ways of doing things to return, undoing some of the changes we’ve seen since March.

Harvard experts say some of our adaptations have accelerated already existing trends, like the development of a cashless society, the increase in remote work, and the decline of brick-and-mortar retail. And, they expect, some of these will become a more permanent part of the post-pandemic’s “new normal.”

They also say, however, that the most lasting impact may turn out to be one that is invisible: the marking of those coming of age in the pandemic era, much as the Great Depression and World War II marked their generations, with broad but hard-to-predict effects that will affect society for decades to come.

A generation defined?

Karestan Koenen , professor of psychiatric epidemiology at the Harvard T.H. Chan School of Public Health, views the effects of the pandemic as both acute and long-lasting, similar to those wrought by economic depression and war. Unlike shocking events that punctuated recent generations — the Kennedy assassination, or the Challenger disaster  — the pandemic packs a more enduring punch, affecting nearly every aspect of life with its long duration and widespread personal impacts like the deaths of loved ones and losses of jobs and businesses. The times are particularly difficult for those growing into adulthood and finding their place in the world.

“That ongoing uncertainty takes a big toll. That’s the basis of a traumatic stressor — unpredictability, uncontrollability — until it exceeds the ability of the organism to cope,” Koenen said. “It’s affecting every milestone: graduation, entering school, leaving school. For the older Gen-Zers: marriages, dating, jobs — in fact, there aren’t jobs. That’s a formative period in their lives when people are figuring out: What’s important to me? What do I want my life to look like compared to my parents’ life?”

While it’s likely that the coming-of-age generation will bear long-term impacts, it’s less clear what those might be, Koenen said. Today’s young adults may think of health differently from earlier generations, as more of a common good than something intrinsically personal. If mask-wearing endures, they may not remember a time when not wearing one was acceptable. The pandemic’s traumas could lead to a rise in hopelessness. Physical distancing may accelerate existing trends to connect via social media rather than in person, which, though compensating somewhat for pandemic-induced isolation, may hold its own negative effects.

Younger Americans already exhibit higher levels of anxiety and depression than older generations, and Koenen is concerned that will be exacerbated in the years to come. Harder to measure, Koenen said, is the impact of missed opportunities. One characteristic of youth is a willingness to reach out and try new things, even when those things provoke anxiety. During normal times, initial worries fade as a new skill is learned or with the recognition that something isn’t as bad as feared. Enforced isolation and curtailed activities are effectively swapping new experiences and challenges for time on the couch and on Zoom.

“There are things in our lives that are good to do for our development and those things may provoke anxiety at first,” Koenen said. “What happens if you’re able to avoid normal developmental challenges? What happens when you don’t get those opportunities?”

Working from what office?

For those older and in the workforce, an obvious — and dramatic — change has been how their jobs have been affected. Advances in videoconferencing and other remote technologies have allowed many to continue to produce — and collect a paycheck — working from home.

Though many will eventually return to the office, Tsedal Neeley , Harvard Business School ’s Naylor Fitzhugh Professor of Business Administration, said the shutdown highlighted the ease with which modern technology handled the shift from one location to another, as well as the ability of many office workers to get the job done even when not under their manager’s eye. It also showed companies that there may be benefits — like saving money on office space — to the new arrangements.

“I don’t think remote work will be permanent at the scale we saw in March, but I have no doubt that remote work will increase,” said Neeley, whose forthcoming book is “Remote Work Revolution: Succeeding from Anywhere.” “We’re definitely going to see a much bigger population working remotely.”

One function of the shutdown was forcing those unfamiliar with applications like Zoom, Microsoft Teams, and Google Meet to take the plunge and learn. And what many learned is it’s not as hard as they thought.

“What people have feared in the past is the technology aspects of it. And what we have seen is that the technology part is the easiest thing that people have taken up. They’re on Zoom, Slack, Microsoft Teams, and with this ease, the possibilities open up,” Neeley said. “I think that’s what’s going to break this open for many, many people, especially if people in top positions see this is as an effective work format that they can now incorporate as part of their workforce planning.”

Benefits of that shift can accrue both to businesses, whose office overhead has declined, and workers, who are able to maintain a stable financial footing despite the crisis, save time commuting, and keep closer tabs on children. But the change hasn’t been without negative side effects. Spending hours videoconferencing can sap energy, and home workers report fewer social connections and more time alone. Managers say it’s harder to stay engaged with workers. Unanticipated situations have also cropped up, Neeley said, like a company that hired 800 people and brought all of them on board virtually, never having met them face-to-face.

“They said, ‘How on earth are we going to do that?’” Neeley said. “A lot of firsts are happening.”

The repercussions of the shift are potentially far-reaching. Not only has it already transformed the workdays of millions, it could create a self-perpetuating cycle, as more workers become familiar with the virtual tools needed to work remotely and organizations change to accommodate those working out of the office. The move to remote work may also ripple through high-priced commercial real estate markets as companies take advantage of potential savings. Software company Culdesac announced last spring that it is moving workers online and closing its high-priced San Francisco offices. In July, Google announced that those whose functions don’t require them in the office can work from home through July 2021 and, as the pandemic has stretched into the fall, other companies, like Microsoft and Ford Motor Co., have said offices will be closed through next summer. Twitter, meanwhile, has announced permanent remote work as an option for its employees. Its go-slow approach lets workers decide what is right for them, after which the company can reassess its office footprint without alienating staffers.

“All the satisfaction comes when people are given a choice. Choice and autonomy are crucial for people to appreciate remote work and the chance afforded them,” Neeley said.

A tougher nut to crack

While related to office occupancy, city center traffic may be a tougher nut to crack, according to Carole Voulgaris , assistant professor of urban planning at the Harvard Graduate School of Design . One widely appreciated effect of the shutdown has been the ease of navigating roadways, even in parts of the country where traffic congestion is legend.

The deepest traffic reductions were fleeting, and many roads and highways have since seen significant rebounds, according to an August report by the International Bridge, Tunnel and Turnpike Association. Still, the Port Authority of New York and New Jersey reported that traffic remained down 14 percent from pre-pandemic levels — it had dropped 65 percent in April. Similarly, the Ohio Turnpike reported early August traffic still down 15.8 percent after having dropped 50 percent in April. Other locations — the Pennsylvania Turnpike, still down 22.9 percent, and the San Francisco Bay area, 22 percent — reported recoveries that were less dramatic, and Voulgaris said it is likely that each would eventually recover to pre-COVID levels of congestion.

That’s because even though city planners, traffic engineers, and environmental advocates talk about reducing traffic by improving public transportation, adding tolls and other measures, traffic is firmly linked to economic activity. Victory in the battle, she said, likely won’t come from a single step, but rather systemic change — which has so far evaded planners — that allows the economy to grow vigorously without increasing traffic headaches.

“I think it’s helpful to think about what we’re after as decoupling economic activity from congestion rather than just talking about reducing congestion. … I don’t think that during the pandemic we’ve found ways of doing that,” Voulgaris said. “I sometimes joke that it’s actually really easy to reduce congestion if you just sabotage the local economy.”

Voulgaris acknowledged that the traffic slowdown has created an opening for other modes to expand. Some cities allocated roadway to bikes, pedestrians, and other alternate ways of getting around and, though Voulgaris expects many of those changes to be reversed, some — like Boston’s decision to retain new bike lanes around its Common and Public Gardens — may become permanent.

Cycling is one mode — in a compact city like Boston, anyway — that can benefit from rethinking the commute, Voulgaris said. Cyclists have been hitting the streets in force. Boston’s BlueBikes bike-share system announced in early September that it had recorded its highest-ever single-day ridership of more than 14,400 trips. And that could make roads safer for bikers by fostering a new understanding of and appreciation for riders among those who’ve tried out urban cycling and then gotten back behind the wheel.

Empty storefronts, but Amazon is booming

Among the names on pandemic’s casualty roll are some familiar to generations of Americans — J.C. Penney, Lord & Taylor, Brooks Brothers, Neiman Marcus, Pier 1, all of which filed for bankruptcy, citing reduced sales due to COVID-19. Online retail giant Amazon, on the other hand, has reported record profits, while electronics seller Best Buy reported increased second-quarter sales due to online purchases driven by home office needs.

Clearly, said Rajiv Lal , the Stanley Roth Sr. Professor of Retailing at Harvard Business School, the COVID crisis has hit different retail sectors differently. Some — mainly online — retailers have weathered the storm well, while others, particularly big-box, brick-and-mortar retailers that were already struggling with online competition, have seen declines accelerate dramatically as customers were locked out of stores.

Mall-based retailers, already part of a decade-long downward trend, are in serious trouble, Lal said. While they were closed during the shutdown, their customers shopped online, including some who had been uncomfortable buying online. Post-pandemic, Lal said, at least some of them will be more comfortable with the quirks of online shopping, such as buying clothes they can’t try on and having to return things by mail.

“Consumer behavior is moving to accept online shopping at an increasing pace,” Lal said. “I think online retailers are doing a lot of things that will overcome consumer inhibitions.”

For physical stores open during the pandemic, Lal said it’s important that managers create an environment in which consumers feel safe. That might mean digitizing as much of their operations as possible and reducing contact during checkout. Longer-term success may depend on rethinking shopping, offering an in-person, window-shopping type of experience coupled with ordering items online, with the expectation from the start that some will be returned.

“Businesses have to do things where people feel it’s a safe place to shop. The government cannot do that; the businesses themselves have to do this,” Lal said.

Monthly retail numbers show that sales nationally are continuing to recover from the depths of March and April, but also that the pace of recovery has slowed each month since May’s 17.7 percent bounce. That slowing recovery — August sales rose just 0.6 percent over July — likely reflects government stimulus, paycheck protection program loans, and enhanced unemployment benefits running out, Lal said. Without a renewal of those benefits, he said, retailers will face a difficult fall, since cash-strapped consumers may put off purchases until Christmas.

When they do buy, Lal said, the shifting office environment — with so much activity now remote and online — means some clothing categories will suffer more than others. Formalwear in particular has taken a beating.

“What’s the future of ties and bow ties? It’ll be a while until I run into someone wearing a tie or a bow tie,” Lal said. “Formal clothes will get hit hard. Everything related to dressing up will be hit quite significantly.”

It may also be that time is running out on large, department-store-style retailers, Lal said. Their problem is that they sell many similar brands so there aren’t strong incentives to visit in person. In Europe, he said, retailing in the many boutique-style neighborhood stores is healthy, which may bode well for the smaller stores in U.S. city centers that can offer varied merchandise and bring customers back as offerings change.

“A lot of people are predicting bankruptcies for these stores, especially apparel retailers with a lot of merchandise that is not really unique,” Lal said. “I think navigating these short-term, medium-term challenges will be extremely difficult. … A second wave of COVID-19 would be devastating to the retail business.”

Where stuff comes from

A downside of the globalized economy became clear as the pandemic struck the U.S. and prompted the question: When the whole world wants something, how do you get to the head of the line?

Personal protective equipment, much of which had been made in China, was in short supply last spring. Without it, hospitals and emergency workers were forced to scramble, innovating new designs and homemade alternatives that drew on volunteer labor, 3D printers, ingenuity, and more than a little desperation.

The spring’s shortages were blamed on the globalized economic system and the decline in U.S. manufacturing, exacerbated by a failure of foresight that anything could simultaneously halt the entire globe’s manufacturing, air cargo, and ocean shipping businesses.

Willy Shih , Harvard Business School’s Robert and Jane Cizik Professor of Management Practice in Business Administration, has heard the calls to dismantle the global manufacturing system. He’s heard arguments for “re-shoring” production and stockpiling key products and parts so that the shortages caused by the pandemic across an array of industries doesn’t happen again.

“We’ve been teaching people to run tight inventory and be efficient, but that depends on everything working,” Shih said. “We never envisioned such a major disruption of air cargo. We never envisioned so many ‘blanked’ ocean sailings. Then the lack of inventory starts to bite the other way.”

While Shih is sympathetic to the notion that building up inventory and moving manufacturing home would be protective, he’s also skeptical. The cheap labor and reduced manufacturing costs that drove production overseas in the first place haven’t changed. In fact, he said, an argument could be made that with the global economic downturn, they are a greater draw than ever, with millions out of work and short on money.

“You can do those things, but it better not cost more because consumers won’t be willing — or necessarily able — to pay those costs,” Shih said. “Those things [re-shoring and low costs] are in direct contradiction now. That’s what’s so interesting.”

Even if manufacturers of items like essential medical equipment are brought home, Shih said the problem isn’t solved. Demand as the pandemic struck likely outstripped production capacity anywhere — or everywhere — by more than 20 times for products like N95 medical masks. No manufacturer would build a factory with that much surge capacity in order to let it sit idle, awaiting the next pandemic. If that’s the goal, he said, the government would have to commit to purchasing excess products, perhaps for a national stockpile, to make it worth the company’s while to build and maintain the extra capacity.

“If you want resiliency, that costs you something. Will you pay for it?” Shih said. “Now people say ‘Yes, we want resiliency,’ but with the economic downturn people are going to want to save money on food and essentials.”

Shih’s skepticism about economic nationalism shifting a lot of production doesn’t mean changes aren’t ahead. If the global economic collapse showed anything, it is the danger of relying on one major supplier for key products. Some manufacturers, Shih said, may decide to bring home production of essential parts, or to diversify production from one nation to multiple, which Shih called “China plus one” or “China plus two.”

“I see it as a continued evolution,” Shih said. “I think the more lasting changes, especially if the pandemic drags on, is ‘I’m not going to single source, it’s a China plus one or China plus two strategy.’”  

Your cash ain’t nothing but trash (someday)

How we pay for all those goods is another shift, as the coronavirus’ pressures can be felt not only in our paychecks, but on our legal tender as well. The use of cash in financial transactions has long been on the decline, with the FDIC reporting in 2017 that it was used in just 30 percent of all payments, according to an article by Shelle Santana , assistant professor of business administration at Harvard Business School.

According to research by Santana and the online payments processing and financial services company Square, last spring’s shutdown led to an enormous jump in the percentage of U.S. retailers that were effectively cashless, defined as 95 percent or more of all transactions completed via credit, debit, or mobile. On March 1, about 8 percent of U.S. retailers using Square’s payment service were effectively cashless, but by April 23 the number had soared to 31 percent.

Santana and Square economist Felipe Chacon attributed the “crazy” increase directly to the extreme conditions facing consumers: confined to home yet needing to meet basic needs. As with other COVID-driven changes, those proved temporary and the percentage of effectively cashless businesses fell by the middle of June to just under 20 percent.

Santana and Chacon expect the numbers of cashless businesses to roughly track the pandemic, rising and falling according to local conditions. They said the numbers will also be affected by business adaptations that bring customers back through the doors — or to recently installed drive-up windows — where using cash is again an option.

As the pandemic fades, Santana expects a return to a more cash-friendly normal, but not back to where it stood in February. Instead of 8 percent of U.S. businesses being effectively cashless as they were before COVID’s spring disruption, she expects the number to fall to between 12 and 15 percent.

What’s occurring, she said, is that the pandemic is forcing older consumers who came of age when credit cards were used primarily for large purchases or kept unused for emergencies to rethink their plastic habits. It’s making them more comfortable using cards for everyday purchases and even small items like a cup of coffee, something today’s youth already see as no big deal. In 2015, half of Square’s businesses consumers used a credit or debit card for an $8 transaction, while in 2019, half used it for a $4.50 purchase.

Santana and Chacon said that the longer the COVID crisis impacts retail habits — boosting online and digital shopping, hurting in-person stores — the larger the signal that will remain when it leaves. Business owners agree. According to a Square study, 69 percent of small business owners say COVID-19 will accelerate the adoption of cashless transactions. And they now think a cashless society will occur six years earlier — in 13 years — than they did in 2019.

“Pre-COVID, there was no reason to try mobile payment or in-app payment,” Santana said. “A segment of the population is going to stick with that behavior because of ease and habit.”

  Ease is a factor behind experts’ belief that the recent expansion of telehealth services will be enduring, as is another familiar one: money. Early on in the pandemic, insurance companies agreed to pay for telehealth services as they do for in-person services. The Harvard Chan School’s Koenen said that important change enabled an expansion in telemedicine during the pandemic.

For mental health services, Koenen sees the shift easing access even after the pandemic fades, extending providers’ reach to those reluctant to seek help in person.

Thomas DelBanco , the John F. Keane & Family Professor of Medicine at Harvard Medical School , said the recent surge in doctor appointments via telehealth is decades overdue. Delbanco is a driving force behind the international OpenNotes movement , based at Beth Israel Deaconess Medical Center. OpenNotes encourages patients to review clinicians’ notes after their visits through secure, electronic patient portals. More recently, he’s pushed the adoption of OurNotes, with patients joining their providers in generating the notes themselves. Before a visit, patients send in updates and their goals for the encounter, and these are incorporated into the note itself. In addition, they are asked to provide some of the routine information health aides typically collect at the start of an office visit.

Delbanco said people have been talking about a shift to telemedicine for 20 years, but before COVID, just 7 percent to 8 percent of care was done remotely. Overnight that number jumped to 95 percent, forced by the immediacy of the pandemic — though enabled by years of technological development.

“I think it will become part and parcel of medicine,” Delbanco said. “There are times when doctors, nurses, or therapists really need to see you — no question about it. But there are also times when they really don’t.”

Share this article

More like this.

Surveying a landscape of economic uncertainty in COVID era

Why some Americans refuse to social distance and wear masks

What might COVID cost the U.S.? Try $16 trillion

Battle for LGBTQ rights amid the pandemic

Five simple steps would tame COVID-19

You might like.

Educators, activists explore peacebuilding based on shared desires for ‘freedom and equality and independence’ at Weatherhead panel

Former Palestinian Authority prime minister says strengthening execution of 1993 accords could lead to two-state solution 

Political philosopher Harvey C. Mansfield says it all goes back to Aristotle, balance of competing ideas about common good

College accepts 1,937 to Class of 2028

Students represent 94 countries, all 50 states

Pushing back on DEI ‘orthodoxy’

Panelists support diversity efforts but worry that current model is too narrow, denying institutions the benefit of other voices, ideas

So what exactly makes Taylor Swift so great?

Experts weigh in on pop superstar's cultural and financial impact as her tours and albums continue to break records.

A return to normal life post-COVID

A state hygiene assistant vaccinates a patient at the Wetrivi Condji Health Center in the Bè district, Lomé.

Banléman Kombaté / World Bank

STORY HIGHLIGHTS

• COVID-19 pandemic response measures, including vaccination, have led to a decline in the number of cases, thereby paving the way for the easing of health restrictions and a gradual return to normal life.
• With support from the World Bank, health workers have strengthened response activities and improved vaccination coverage.
• As of November 4, 2022, more than 3,385,600 doses of vaccine have been administered to 1,777,986 persons.

LOME, September 30, 2022. Félicité is a heroine in the fight against the health crisis in Togo. A hygiene assistant at the National Institute of Hygiene (INH) in Lomé, she is one of thousands of health workers on the front lines of the fight against COVID-19. After a tough two-year battle,  the return to normal life is a real relief for her.

“There are no more lockdowns or curfews, health restrictions have been lifted, cultural and sporting activities have resumed, and people are going to the beach; I am happy to have contributed to this fight,” she says. “It wasn’t easy getting this result because people were hesitant to get the COVID-19 vaccine. But now the pandemic has definitely subsided because of awareness raising, vaccination campaigns, and advanced strategies that involve vaccinating people in remote areas.”

Misinformation was rife on social media in the first weeks of the vaccination campaign and sowed doubt in people’s minds about the vaccine’s reliability. Actions have been undertaken by the Togolese government to increase community awareness, build trust, and better inform the population, which helped increase acceptance of and demand for COVID-19 vaccines.

The INH laboratory - a major asset

A health worker analyzes Covid-19 test samples at Lomé airport laboratory.

Actions taken by INH were key to the success of COVID-19 screening and vaccination in Togo. Before the pandemic, the INH was equipped to handle routine vaccinations, such as for yellow fever and other diseases. However, the arrival of COVID-19 completely upended its operations and increased its workload.

“The number of samples to be tested has exploded, and this has led to a high demand for reagents that exceeded national capacity. Now we have supplemented the range of what was needed for sequencing. And this was all made possible by the partners,” says Dr. Issaka Maman, technical director of the INH molecular biology laboratory.

Félicité shared her optimism, saying “Now I am certain that we are equipped to deal with other crises.”

A health worker takes a PCR sample from a traveler at Lomé airport.

Togo was the first African country to receive Johnson & Johnson’s single-shot COVID-19 vaccine through the African Vaccine Acquisition Trust (AVAT), under the World Bank-financed Togo COVID-19 Emergency Response and System Strengthening Project . This support has contributed to the rapid increase in vaccine coverage. As of November 4, 2022, more than 3,385,600 doses of vaccine have been administered to 1,777,986 persons.

This site uses cookies to optimize functionality and give you the best possible experience. If you continue to navigate this website beyond this page, cookies will be placed on your browser. To learn more about cookies, click here .

More From Forbes

Life after covid-19.

• Share to Facebook
• Share to Twitter
• Share to Linkedin

(Photo by Miguel Pereira/Getty Images)

Covid-19 created a record-level disruption across several industries, forcing employers to respond at a record-level pace — including implementing remote jobs on the spot, while, as much as possible, easing employees' concerns to reduce worry and stress. Now, in a few weeks, states will reopen and many of us will return to an unrecognizable life. Leaving most of us will be wondering, what will the new normal be?

No one can predict the future, but we can see trends, and the more you are able to spot them, the better your chances are of having retaining a (good) job and securing your future. 

As long as there is no vaccine and there is no cure, the way we engage with physical product and services will change. Many will reframe from the desire to touch or be touched. In just a few months, human contact (in large parts of the world) has become one of the most feared gestures, not to mention the unthinkable scenario being in a small room with many people. 

There are now fears about what life post-COVID-19 will look like, which can take an emotional toll. It can drain one's energy and   eat away at one’s creativity and ability to stay innovative. As a result, businesses should acknowledge the long-term changes created by the spread of Covid-19 and adjust to thrive through these  turbulent times , whether it is expanding product offerings or services, learning new ways to showcase your product, such as virtually, or transforming your existing physical store into an online shop, all while exploring various marketing strategies that will retain and attract customers, even post-COVID.  

The time we are in now can remind us of World War II, in that sense, many of the innovations we enjoy today were invented during the war or right after. Crises, challenges, and constraints can be used as a driving force. 

Just six months ago, many feared losing their jobs to robots and automation. Almost overnight, we are no longer talking about that fear, or at least we're talking about it less. However, COVID19 may increase that automatization trend to eliminate human contact and minimize coronavirus risk. Soon, we will see many more ways of paying, buying without touching or being touched, and vending machines, I predict they will make a serious comeback, selling virtually everything you'll need, such as masks and food.

Total Solar Eclipse Emoji Map Meme Tells You All You Need To Know

The walking dead the ones who live season finale review super easy barely an inconvenience, the top 10 richest people in the world april 2024.

The world will become "hands-free", and by that, I mean the delivery of products and services completely without physical human contact of any kind - we will not "touch and do not want to be touched".

For example. Japan has a restaurant chain named "Ichiran,” a so-called "low-interaction dining." The customers order food with as little human connection as possible. We will see more concepts like this. Be it robot coffee shops, hydromassage, etc., you name it! 

I know it can be hard to see the "light at the end of the tunnel," especially if you have lost your job or your business is closed. The future will undoubtedly be different; however, it will not be job-free, but instead, hands-free.

Therefore, companies must read the market and deliver what customers are looking for. For example, the tourism industry has adjusted drastically, offering armchair experiences that will allow us to experience destinations right from the comfort of our own homes, while also inspiring travel to these destinations as soon as travel restrictions ease.

For example, New York State, the home to many beloved attractions, is offering dozens of online events, virtual tours, webcams and live streams events. Whether it's taking a 360-degree tour of the Wild Center or the Corning Museum of Glass , visiting a cuddly animal at a zoo, browsing a world-class art collection, or practicing deep breathing in a live stream yoga class, you can basically experience an entire state and even country right from your couch!

Workplace Post-Covid 19   

Post-Covid-19, there will be an influx of new talent in the market, take this opportunity to invest in your workplace culture.

The right workspace culture and setup can inspire and allow employees to make the most of their time in the office or home office. It is crucial to inspire and motivate your employees to be the best they can be. If they feel uninspired, they will find reasons to work less, and their work quality can decrease. Perhaps it is time for companies to allocate resources and a budget for employees' at-home workstations? How about investing in your employee's wellness? Perhaps it’s time to provide them with free meditation apps, healthy meals that can be delivered to their door, an online wellness coach, a spinning bike, to stay fit and healthy mentally and physically.

According to Oztanık and Satıroğlu co-founders at Assembly Buildings, "Workplace culture has a decisive role in shaping employee experience. As a result, employee experience has become a crucial subject. Over the last decade, we have observed how leading companies take care of their community and employees delicately. At Assembly Buildings, we combine human resources, information technology and facility management and office operations that companies can customize for their employees to create purposeful work-life destinations.” Oztanık and Satıroğlu continue, “A tailored set of physical spaces, interactive programs, service offerings, wellbeing products, [and] remote working infrastructures must be delivered both by private companies and by commercial property buildings as common practice." The founders continue, "Soon, we will see an agile mix and match portfolio approach that companies, employees, and building owners enjoy, such as an HQ office, satellite offices, and remote working options, that deliver a customized, high caliber user experience while optimizing office expenses by up to 50%."

The alteration of the customary office culture will not only boost employee confidence but can also trigger creativity that can produce results. Many employees are working from home or will look for employers that can offer flexible workplace options as many will still feel uncomfortable working in close proximity to others. 

Mental health Post-COVID-19 

The coronavirus crisis will continue to have many feeling lonely, helpless and looking for support, especially for those who have lost loved ones, may not have a job or a business to return to.  

Additionally, for many people, the general uncertainty of what lies ahead has created a heightened level of anxiety and burnout. According to a recent  survey  published by the Kaiser Family Foundation, nearly half of the people living in the United States feel the coronavirus crisis is harming their mental health .

According to Fernanda Neis and Gustavo Oliveira experts at the DeRose Meditation , “In a brief period, the pandemic may have accelerated or created challenges companies and professionals have been facing during modern times. These challenges can include the immense volume of information we deal with, hyper-connectivity, the complexity and uncertainty about the future, the speed of change, and working from home.” 

Neis and Oliveira also recommend that company leaders should provide ways for professionals to develop new skills such as self-managing their personal and professional lives in the same space, staying focused while working at home, establishing trust in virtual relationships, and handling increased levels of anxiety caused by the uncertainty of the future. 

Solving these challenges will be critical to the company's success since it will profoundly impact employee engagement, productivity and the ability to adapt to adversity. Remember, life after Covid-19 does not have to be scary. Take this time to turn challenges into opportunities and be the leader that will rise to the 'occasion'.

• Editorial Standards
• Reprints & Permissions

How to Write About Coronavirus in a College Essay

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

Writing About COVID-19 in College Essays

Getty Images

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

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

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

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

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

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

Writing About COVID-19 for a College Application

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

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

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

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

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

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

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

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

Above all, she urges honesty.

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

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

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

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

Writing About Coronavirus in Main and Supplemental Essays

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

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

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

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

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

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

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

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

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

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

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

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

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

Searching for a college? Get our complete rankings of Best Colleges.

10 Ways to Discover College Essay Ideas

Tags: students , colleges , college admissions , college applications , college search , Coronavirus

2024 Best Colleges

Search for your perfect fit with the U.S. News rankings of colleges and universities.

College Admissions: Get a Step Ahead!

Sign up to receive the latest updates from U.S. News & World Report and our trusted partners and sponsors. By clicking submit, you are agreeing to our Terms and Conditions & Privacy Policy .

Ask an Alum: Making the Most Out of College

You May Also Like

How to decide if an mba is worth it.

Sarah Wood March 27, 2024

What to Wear to a Graduation

LaMont Jones, Jr. March 27, 2024

FAFSA Delays Alarm Families, Colleges

Sarah Wood March 25, 2024

Help Your Teen With the College Decision

Anayat Durrani March 25, 2024

Toward Semiconductor Gender Equity

Alexis McKittrick March 22, 2024

March Madness in the Classroom

Cole Claybourn March 21, 2024

20 Lower-Cost Online Private Colleges

Sarah Wood March 21, 2024

How to Choose a Microcredential

Sarah Wood March 20, 2024

Basic Components of an Online Course

Cole Claybourn March 19, 2024

Can You Double Minor in College?

Sarah Wood March 15, 2024

• Open access
• Published: 04 February 2022

Studying the post-COVID-19 condition: research challenges, strategies, and importance of Core Outcome Set development

• Daniel Munblit   ORCID: orcid.org/0000-0001-9652-6856 1 , 2 , 3   na1 ,
• Timothy R. Nicholson 4   na1 ,
• Dale M. Needham 5 , 6 , 7   na1 ,
• Nina Seylanova 8   na1 ,
• Callum Parr 9 ,
• Jessica Chen 9 ,
• Alisa Kokorina 10 ,
• Louise Sigfrid 11 ,
• Danilo Buonsenso 12 , 13 , 14 ,
• Shinjini Bhatnagar 15 ,
• Ramachandran Thiruvengadam 15 ,
• Ann M. Parker 5 , 6 ,
• Jacobus Preller 16 ,
• Sergey Avdeev 17 ,
• Frederikus A. Klok 18 ,
• Allison Tong 19 ,
• Janet V. Diaz 20 ,
• Wouter De Groote 20 ,
• Nicoline Schiess 21 ,
• Athena Akrami 22 , 23 ,
• Frances Simpson 24 ,
• Piero Olliaro 25 ,
• Christian Apfelbacher 26 ,
• Regis Goulart Rosa 27 , 28 ,
• Jennifer R. Chevinsky 29 , 30 ,
• Sharon Saydah 29 , 31 ,
• Jochen Schmitt 32 ,
• Alla Guekht 3 , 10 ,
• Sarah L. Gorst 33 ,
• Jon Genuneit 34 ,
• Luis Felipe Reyes 35 , 36 ,
• Alan Asmanov 37 ,
• Margaret E. O’Hara 38 ,
• Janet T. Scott 39 ,
• Melina Michelen 25 , 40 ,
• Charitini Stavropoulou 40 ,
• John O. Warner 41 ,
• Margaret Herridge 42 , 43 &
• Paula R. Williamson 44   na1  

BMC Medicine volume  20 , Article number:  50 ( 2022 ) Cite this article

23k Accesses

67 Citations

52 Altmetric

Metrics details

A substantial portion of people with COVID-19 subsequently experience lasting symptoms including fatigue, shortness of breath, and neurological complaints such as cognitive dysfunction many months after acute infection. Emerging evidence suggests that this condition, commonly referred to as long COVID but also known as post-acute sequelae of SARS-CoV-2 infection (PASC) or post-COVID-19 condition , could become a significant global health burden.

While the number of studies investigating the post-COVID-19 condition is increasing, there is no agreement on how this new disease should be defined and diagnosed in clinical practice and what relevant outcomes to measure. There is an urgent need to optimise and standardise outcome measures for this important patient group both for clinical services and for research and to allow comparing and pooling of data.

Conclusions

A Core Outcome Set for post-COVID-19 condition should be developed in the shortest time frame possible, for improvement in data quality, harmonisation, and comparability between different geographical locations. We call for a global initiative, involving all relevant partners, including, but not limited to, healthcare professionals, researchers, methodologists, patients, and caregivers. We urge coordinated actions aiming to develop a Core Outcome Set (COS) for post-COVID-19 condition in both the adult and paediatric populations.

Peer Review reports

The coronavirus disease 2019 (COVID-19) pandemic has necessitated rapid responses from healthcare systems and research networks globally. Although a large amount of comprehensive data on acute symptoms and clinical management has been collected and analysed, there are currently no established clinical definition or Core Outcome Sets (COS). Indeed, even the terminology of the condition is debated with variable terms and definitions for the post-COVID-19 condition including long COVID , “long haulers”, post-acute sequelae of SARS-CoV-2 infection (PASC) , or post-COVID-19 condition , the term used by the World Health Organization (WHO). With over 217 million confirmed COVID-19 cases globally [ 1 ], post-COVID-19 condition risks affecting millions of people worldwide, making it an urgent research priority [ 2 ]. Although wide-scale vaccination may eventually lead to a decline in the number of COVID-19 cases, with cases rising worldwide, the pandemic is far from over. There is an urgent need for consensus on critically important core outcomes to be measured in post-COVID-19 condition . Establishing a COS will ensure that critically important outcomes are measured and reported in a consistent manner in research and practice settings. The consistent use of the most important outcomes across studies and clinical practice is essential to compare and collate the research findings with translation into clinical recommendations for patient care.

In this manuscript, we discuss the existing data known about post-COVID-19 condition research following WHO’s systematic approach to identifying research gaps [ 3 ] with the principal purpose of suggesting and outlining the implementation of a COS for the post-COVID-19 condition (i) to allow for the assessment of outcomes which are of the greatest relevance and importance to stakeholders and relevant target populations including patients, families, clinicians, researchers, health systems, public health policymakers, industry, and funding organisations; (ii) to improve the consistency and quality of data collection; and (iii) to build a foundation for data sharing for pooled analysis for meta-analysis and comparison of results across studies and global regions.

Given the current immediate need for an accepted post-COVID-19 condition COS, the development of a COS for the post-COVID-19 condition could act as a guide over the next few years until more is known and/or review or reassessment is indicated.

Post-COVID condition health consequences

Recent editorials [ 4 , 5 , 6 ] and National Institutes of Health (NIH) [ 7 ] and WHO [ 8 ] sponsored conferences have drawn attention to an increasing number of people experiencing health consequences following the acute phase of SARS-CoV-2 infection and are calling for research into the risk factors, clinical features, diagnosis, management, and outcomes. Increasing funding opportunities have subsequently followed [ 9 , 10 ]. It is important to note that most data regarding post-COVID-19 condition have been generated prior to the condition definition announcement. Thus, earlier studies may not fit the proposed definition criteria. Post-COVID-19 condition extends beyond the cardio-respiratory system to affect most other bodily systems both anatomically and physiologically [ 11 ]. Although causes of post-COVID-19 condition are unclear, persistent immune activation may be involved [ 12 ]. Risk factors for different syndromes of post-acute SARS-CoV-2 sequela have not been characterised, but it has been hypothesised that several post-COVID-19 condition phenotypes may exist, although pathophysiology, management, and outcomes are currently unknown.

Long-term health consequences of COVID-19 remain unknown, but reports suggest that prolonged symptom duration and limitations in functioning are common among hospitalised as well as non-hospitalised adults [ 13 , 14 ] and children [ 15 , 16 ]. The spectrum of long-lasting symptoms is wide and varies from mild discomfort to severe adverse effects on physical, cognitive, and psychosocial health [ 17 ], with important wider implications on functioning, including employment and school attendance.

Multiple studies from different countries found that many individuals experienced persistent symptoms 6 months after COVID-19, with fatigue or muscle weakness, sleep difficulties, and anxiety or depression among the most common sequelae [ 13 , 14 , 18 ]. A recent study suggests that although most COVID-19 survivors recover both physically and functionally a year after acute infection, some still experience problems with mobility, pain or discomfort, and anxiety or depression compared with non-COVID-19 controls [ 19 ]. The data emerging from the controlled studies are in agreement with the earlier reports. A recent analysis of the data from over 250,000 electronic health records demonstrated that more than one in three individuals had one or more features of post-COVID-19 condition recorded between 3 and 6 months after a diagnosis of COVID-19, which was significantly higher when compared with individuals with influenza [ 20 , 21 , 22 , 23 , 24 ]. Disease severity, female sex, and younger age were associated with a higher risk of post-COVID-19 condition development.

Yet, it is unknown whether persistent symptoms and associated abnormalities will fully resolve or whether some may leave life-long dysfunction. It is also worth noting that investigations into the post-COVID-19 condition can be difficult, with high loss to follow-up, frequent use of unvalidated measurement instruments, lack of inclusion of controls during the pandemic, and censoring of data (e.g. for death) not always fully considered in published studies. Differential diagnosis can be challenging with specific symptoms attributed to post-COVID-19 condition being a sign of an ongoing problem (e.g. dysautonomia in people reporting heart rate variability) [ 25 ].

Investigation of potential post-COVID-19 condition treatment options is still in its early days. Approaches mainly focus on rehabilitation and symptomatic management. Some experts suggest that antibodies and T cells able to recognise SARS-CoV-2 induced by vaccine “may help the immune system to stop the virus during its first few replications before it can establish hidden reservoirs in the body” [ 26 ]; however, the evidence regarding the effectiveness of SARS-CoV-2 vaccines in post-COVID-19 condition treatment is somehow conflicting [ 27 , 28 ]. One of the major obstacles in the development of intervention strategies for post-COVID-19 condition is the lack of agreed outcomes to be assessed in clinical trials.

The pandemic and subsequent mitigation strategies have also had a substantial impact on the psychosocial well-being of the general population worldwide, with many people experiencing anxiety and depression, due to isolation, economic instability, job insecurity, sickness/death of infected family members, COVID-19-related stigma, lack of trust in government agencies, and constant media attention focused on the pandemic threats [ 29 ]. Disruption of care for those with pre-existing conditions has also had a large impact. For example, according to the WHO Pulse survey on continuity of essential health services during the COVID-19 pandemic [ 30 ], 45% of countries still reported disruptions to services for mental, neurological, and substance use disorders in the first quarter of 2021. On a similar scale, rehabilitation services disruptions continue to be reported by 53% (of 89 countries).

In addition, indirect impacts of COVID-19 on mental health [ 31 ], psychosocial, and neurological sequelae have been reported in adults following COVID-19 [ 32 ], and many patients are facing a variety of consequences including fatigue, shortness of breath, and cognitive dysfunction as well as reduced quality of life [ 18 ] with an impact on everyday functioning, even months following acute infection [ 19 ].

With millions of people affected by COVID-19, even a small percentage developing the post-COVID-19 condition will result in a detrimental effect on society and public health, with many people in need of long-term follow-up, management, and support[ 5 ]. A recent study has reported that previously hospitalised patients with COVID-19 had increased rates of multiorgan dysfunction compared with the general population [ 33 ].

Terminology and clinical definitions

With many unresolved issues regarding this condition, the inclusion of patients’ perspectives has become increasingly important to the development of a COS. Importantly, there is currently no agreement on a clinical definition and which outcomes should be measured and how they should be measured. WHO has recently completed a Delphi consensus to finalise a clinical case definition of post-COVID-19 condition as described below [ 34 ]. This official WHO definition was published recently and is formulated as the following: “post-COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, and cognitive dysfunction, but also others and generally have an impact on everyday functioning. Symptoms may be new onset following the initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time” [ 35 ].

Other organisations have also proposed interim definitions such as the United Kingdom National Institute for Health and Care Excellence (NICE) who suggest an interim definition of post-COVID-19 syndrome as “signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks, and are not explained by alternative diagnoses” [ 36 ]. Due to the scarcity and high degree of heterogeneity of existing studies, the definition may change with the emergence of new evidence, but diversity in diagnostic criteria, methodology, and outcomes measured may slow down the progress. There is a need for terminology harmonisation, and consensus between major public health and government research organisations and professional bodies should be reached for the benefit and convenience of clinicians, researchers, and most importantly patients. With the growing evidence on COVID-19 consequences, there is a risk that the number of different terms used for the post-COVID-19 condition will increase further with increasing phenotyping of this condition.

Core Outcome Set definition and relevance

Outcomes are measured in clinical research or practice to help evaluate relevant associations, safety and efficacy, risk factors, and effectiveness of interventions [ 37 ]. The lack of agreed upon outcomes and associated measurement instruments may complicate the evidence synthesis due to the inability to pool data in meta-analyses [ 38 ], resulting in a heterogeneous, incomplete, and low-quality evidence base and a barrier to clinical guideline development and policymaking. A COS comprises a minimum list of outcomes recommended for assessment in all studies, clinical practice setting, or both, for a specific condition and is necessary to harmonise research outputs and increase their comparability, quality, and generalisability to ensure their relevance to all interested partners. The failure to consider the views of patients and their families in selecting outcomes may result in less relevant outcome measures being evaluated, while the most important outcomes may be missed.

Core Outcome Sets for COVID-19 and post-COVID-19 condition

A number of COVID-19-related COS are registered at the Core Outcome Measures in Effectiveness Trials (COMET) Initiative web-registry of planned, ongoing, and completed COS studies [ 39 ]. These initiatives provide clinicians, researchers, and policymakers with important information on the relevant aspects of COVID-19 and allow for the generation of harmonised high-quality data. Notably, COVID-19 COS development projects were undertaken in a rapid fashion, in contrast with the usual COS development process which typically takes several years.

Although none of the available COVID-19-related COS projects is solely dedicated to the post-COVID-19 condition , some include outcomes for “rehabilitation period”, “longer term impacts”, and “recovery” outcomes [ 40 , 41 ]. Despite a well-established and standardised approach to COS development, which is generally guided by the COMET Handbook, the development of COS for the post-COVID-19 condition may be a complex task given the diversity and multisystem nature of infection sequelae [ 33 ]. COS previously developed for other conditions, which may be relevant for people recovering from COVID-19, should be considered a potential option for certain groups of individuals (e.g. acute respiratory failure/acute respiratory distress syndrome survivors after hospital discharge) [ 42 ]. We reviewed studies; assessed in the living systematic review of long COVID [ 43 ], data from the clinical trial registries, and available case report forms; and outlined outcomes previously measured in long COVID studies (Table 1 ).

Considerations and limitations within vulnerable populations

The development of a COS in vulnerable populations such as people with disabilities/comorbidities, undergoing complex treatment (e.g. chemotherapy or transplantation), elderly, racial and ethnic minority groups, pregnant women, and children have special challenges that merit additional considerations. These challenges revolve not just around the constellation of symptoms but also the right time for the assessment and the individual on whom these are assessed. For a pregnant woman who was infected in the first trimester and recovered fully before delivery, any adverse birth outcome, such as preterm birth, stillbirth, or pregnancy complication (e.g. preeclampsia or gestational diabetes), may or may not be part of the post-COVID-19 condition [ 44 ]. Whether the congenital anomalies in the neonate or any neonatal complication following maternal COVID-19 can be defined as a potential post-COVID-19 condition for the neonate or infant requires consideration. It is particularly important to differentiate an adverse birth outcome that could be attributed to maternal COVID-19 from one that would have occurred otherwise due to other risk factors, irrespective of maternal COVID-19 status. This is similar to ruling out other aetiologies within the general population (non-pregnant adults).

Considerations and limitations within low-middle income settings

There are multiple implications to the COVID-19 pandemic on low- and middle-income countries (LMICs) including lack of available healthcare resources to meet the needs of the local population, not only with COVID-19 infection, but for other acute and chronic conditions as well [ 45 ]. Another anticipated challenge for LMICs is the recognition of the post-COVID-19 condition . Post-acute care of physical, cognitive, and mental health disabilities may go under-recognised, especially in low-resource contexts in which all efforts are focused on containing COVID-19 dissemination and providing an appropriate care for severely ill patients. This may impact research on the post-COVID-19 condition as well as identification and management in LMICs.

Current definitions for the assessment of specific outcomes involve advanced laboratory and imaging techniques which require resources and skills. Such skills and resources may not be readily available in resource-limited settings. An inclusive approach should be taken while compiling the COS, by including alternate definitions and methods of measurement which may be acceptable for low-middle income settings. Extraordinary care must be taken to strike a balance between accuracy of the assessment and feasibility across the globe. The development of a COS for post-COVID-19 condition should account for cultural and social differences and restrictions in access and resources. Clinicians, researchers, and patient representatives from LMICs should be engaged in the COS development process to ensure global representability and future applicability of the COS.

Limitations to existing research

Although attention to the problem of the post-COVID-19 condition is increasing, there are still many unanswered questions and important limitations impacting research quality and understanding of COVID-19 sequelae.

We outline these as well as potential mitigation strategies following a systematic approach [ 3 ] or defining research priorities through planning, implementation, publishing, and evaluation phases in Table 2 . The table was drafted by DM and critically appraised and approved by all the authors. Post-COVID-19 condition still has no consensus definition, well-defined clinical phenotypes, or clearly explained underlying physiological mechanisms. WHO has highlighted “three Rs” related to post-COVID-19 condition —recognition, research, and rehabilitation, and initiated working groups aiming to provide a post-COVID-19 condition clinical definition [ 46 ] and outline plausible explanations of the physiological mechanisms as well as proposed an interim clinical case definition through a multi-disciplinary, gender-based, international Delphi consensus [ 34 ].

The number of studies assessing post-COVID-19 condition is increasing, generating a large amount of data, where validity remains unknown. There is a large variability in reporting and quantification of post-COVID-19 condition symptoms among the studies. It is important to note that not only symptom presence is essential, but symptom duration and severity also merit consideration. The lack of pre-morbid data for comparison is one of the major limitations of post-COVID-19 condition research. Any abnormalities found are normally attributed to post-COVID-19 condition assuming that the patient did not have asymptomatic abnormal testing before infection.

Few international initiatives have created instruments for data collection. The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) has developed follow-up protocols and surveys for adults and children to assess the prevalence and risk factors for long-term physical and psychosocial health consequences following COVID-19 diagnosis. A post-COVID-19 condition case report form has been designed by the WHO to report standardised clinical data from individuals after hospital discharge or after the acute illness to examine the medium- and long-term consequences of COVID-19. Although these instruments assist harmonised data collection, an increasing number of tools from reputable organisations may result in data heterogeneity with different centres prioritising different instruments.

There are few ongoing initiatives tackling the problem of data heterogeneity by systematically reviewing available evidence in the live format [ 43 ], which may inform COS initiatives and assist with the long list of outcome development. However, systematic reviews will not address the problem of instrument validity. Assessment of the validity may take a long time, and meanwhile, a COS should be developed.

A significant gap and limitation within post-COVID-19 condition research exist within paediatric and adolescent development considering that life-long consequences may exist [ 47 ]. Outcomes of interest in children and adolescents may be very different to the adult population, and COS for this age group should be specifically developed engaging the children and adolescents themselves, as well as their parents and carers.

This manuscript was written by a multidisciplinary (allergists, critical care specialists, ENT specialists, infectionists, immunologists, neurologists, psychiatrists, paediatricians, pulmonologists, specialists in global and public health experts, epidemiologists, methodologists, rehabilitation specialists, and people with lived experience of post-COVID-19 condition ), gender-balanced, international group of experts, including members of the ISARIC Consortium, US Centers for Disease Control and Prevention (CDC), experts involved in the WHO post-COVID condition clinical characterisation group, leads of international COVID-19 cohorts, members of Core Outcome Measures for post-COVID-19 condition/long COVID initiative and patient representatives, to outline the unmet needs and justification for Core Outcome Set development for the post-COVID-19 condition which may become a major public health burden. Previous research in various medical fields has demonstrated the importance and usefulness of COS in both research and clinical practice. There is a need to rapidly develop a COS for the post-COVID-19 condition which will allow for the improvement in data quality, harmonisation, and comparability between different geographical locations. The joint initiative requires input from all relevant partners, including, but not limited to, healthcare professionals, researchers, methodologists, patients, and carers. We urge local and international funding agencies to provide support for coordinated actions aiming to develop COS for post-COVID-19 condition in adults and children.

Availability of data and materials

Not applicable.

Abbreviations

US Centers for Disease Control and Prevention

Core Outcome Measures in Effectiveness Trials Initiative

• Core Outcome Set

Coronavirus disease 2019

International Severe Acute Respiratory and Emerging Infection Consortium

Low- and middle-income countries

National Institute for Health and Care Excellence

National Institutes of Health

• Post-acute sequelae of SARS-CoV-2 infection

Severe acute respiratory syndrome-related coronavirus 2

World Health Organization

World Health Organization. WHO Coronavirus (COVID-19) Dashboard [ https://covid19.who.int/ ]

Lerner AM, Robinson DA, Yang L, Williams CF, Newman LM, Breen JJ, et al. Toward understanding COVID-19 recovery: National Institutes of Health Workshop on Postacute COVID-19. Ann Intern Med. 2021;174(7):999–1003. https://doi.org/10.7326/M21-1043 .

Article   PubMed   Google Scholar  

World Health Organization. A systematic approach for undertaking a research priority setting exercise [ https://apps.who.int/iris/bitstream/handle/10665/334408/9789240009622-eng.pdf ]

The Lancet. Facing up to long COVID. Lancet. 2020;396(10266):1861. https://doi.org/10.1016/S0140-6736(20)32662-3 .

Article   CAS   PubMed   PubMed Central   Google Scholar  

Meeting the challenge of long COVID. Nat Med 2020, 26(12):1803.

The Lancet. Understanding long COVID: a modern medical challenge. Lancet. 2021;398(10302):725. https://doi.org/10.1016/S0140-6736(21)01900-0 .

National Institutes of Health. NIH experts discuss post-acute COVID-19 [ https://www.nih.gov/news-events/news-releases/nih-experts-discuss-post-acute-covid-19 ]

National Institutes of Health. Expanding our understanding of post COVID-19 condition: report of a WHO webinar. 2021 [ https://www.who.int/publications/i/item/9789240025035 ]

National Institutes of Health. NIH makes first infrastructure awards to support research on post COVID conditions [ https://www.nih.gov/about-nih/who-we-are/nih-director/statements/nih-makes-first-infrastructure-awards-support-research-post-covid-conditions ]

National Institute for Health Research. £19.6 million awarded to new research studies to help diagnose and treat long COVID [ https://www.nihr.ac.uk/news/196-million-awarded-to-new-research-studies-to-help-diagnose-and-treat-long-covid/28205 ]

Chevinsky JR, Tao G, Lavery AM, Kukielka EA, Click ES, Malec D, et al. Late conditions diagnosed 1-4 months following an initial COVID-19 encounter: a matched cohort study using inpatient and outpatient administrative data - United States, March 1-June 30, 2020. Clin Infect Dis. 2021;73(Supplement_1):S16. https://doi.org/10.1093/cid/ciab338 .

Article   CAS   Google Scholar  

Peluso MJ, Lu S, Tang AF, Durstenfeld MS, Ho HE, Goldberg SA, Forman CA, Munter SE, Hoh R, Tai V, Chenna A, Yee BC, Winslow JW, Petropoulos CJ, Greenhouse B, Hunt PW, Hsue PY, Martin JN, Daniel Kelly J, Glidden DV, Deeks SG, Henrich TJ. Markers of Immune Activation and Inflammation in Individuals With Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection. J Infect Dis. 2021;224(11):1839–48.

Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220–32. https://doi.org/10.1016/S0140-6736(20)32656-8 .

Munblit D, Bobkova P, Spiridonova E, Shikhaleva A, Gamirova A, Blyuss O, et al. Incidence and risk factors for persistent symptoms in adults previously hospitalised for COVID-19. Clin Exp Allergy. 2021;51(9):1107–20. https://doi.org/10.1111/cea.13997 .

Buonsenso D, Munblit D, De Rose C, Sinatti D, Ricchiuto A, Carfi A, et al. Preliminary evidence on long COVID in children. Acta Paediatr. 2021;110(7):2208–11. https://doi.org/10.1111/apa.15870 .

Osmanov IM, Spiridonova E, Bobkova P, Gamirova A, Shikhaleva A, Andreeva M, et al. Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: a prospective cohort study. Eur Respir J. 2021:2101341. https://doi.org/10.1183/13993003.01341-2021 .

Crispo A, Bimonte S, Porciello G, Forte CA, Cuomo G, Montagnese C, et al. Strategies to evaluate outcomes in long-COVID-19 and post-COVID survivors. Infect Agent Cancer. 2021;16(1):62. https://doi.org/10.1186/s13027-021-00401-3 .

Sigfrid L, Drake TM, Pauley E, Jesudason EC, Olliaro P, Lim WS, et al. Long COVID in adults discharged from UK hospitals after Covid-19: a prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol. Lancet Reg Health Eur. 2021;8:100186. https://doi.org/10.1016/j.lanepe.2021.100186 .

Article   PubMed   PubMed Central   Google Scholar  

Huang L, Yao Q, Gu X, Wang Q, Ren L, Wang Y, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747–58. https://doi.org/10.1016/S0140-6736(21)01755-4 .

Mendez R, Latorre A, Gonzalez-Jimenez P, Feced L, Bouzas L, Yepez K, et al. Reduced diffusion capacity in COVID-19 survivors. Ann Am Thorac Soc. 2021;18(7):1253–5. https://doi.org/10.1513/AnnalsATS.202011-1452RL .

Townsend L, Dowds J, O’Brien K, Sheill G, Dyer AH, O’Kelly B, et al. Persistent poor health post-COVID-19 is not associated with respiratory complications or initial disease severity. Ann Am Thorac Soc. 2021;18(6):997–1003. https://doi.org/10.1513/AnnalsATS.202009-1175OC .

Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nat Med. 2021;27(4):626–31. https://doi.org/10.1038/s41591-021-01292-y .

Raman B, Cassar MP, Tunnicliffe EM, Filippini N, Griffanti L, Alfaro-Almagro F, et al. Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge. EClinicalMedicine. 2021;31:100683. https://doi.org/10.1016/j.eclinm.2020.100683 .

Taquet M, Dercon Q, Luciano S, Geddes JR, Husain M, Harrison PJ. Incidence, co-occurrence, and evolution of long-COVID features: a 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med. 2021;18(9):e1003773. https://doi.org/10.1371/journal.pmed.1003773 .

Barizien N, Le Guen M, Russel S, Touche P, Huang F, Vallee A. Clinical characterization of dysautonomia in long COVID-19 patients. Sci Rep. 2021;11(1):14042. https://doi.org/10.1038/s41598-021-93546-5 .

Ledford H. Do vaccines protect against long COVID? What the data say. Nature. 2021;599(7886):546–8. https://doi.org/10.1038/d41586-021-03495-2 .

Article   CAS   PubMed   Google Scholar  

Arnold DT, Milne A, Samms E, Stadon L, Maskell NA, Hamilton FW. Symptoms after COVID-19 vaccination in patients with persistent symptoms after acute infection: a case series. Ann Intern Med. 2021;174(9):1334–6. https://doi.org/10.7326/M21-1976 .

Office for National Statistics. Coronavirus (COVID-19) vaccination and self-reported long COVID in the UK: 2021 [ https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19vaccinationandselfreportedlongcovidintheuk/25october2021 ]

Nekliudov NA, Blyuss O, Cheung KY, Petrou L, Genuneit J, Sushentsev N, et al. Excessive media consumption about COVID-19 is associated with increased state anxiety: outcomes of a large online survey in Russia. J Med Internet Res. 2020;22(9):e20955. https://doi.org/10.2196/20955 .

World Health Organization. Second round of the national pulse survey on continuity of essential health services during the COVID-19 pandemic [ https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS-continuity-survey-2021.1 ]

De Picker LJ, Dias MC, Benros ME, Vai B, Branchi I, Benedetti F, et al. Severe mental illness and European COVID-19 vaccination strategies. Lancet Psychiatry. 2021;8(5):356–9. https://doi.org/10.1016/S2215-0366(21)00046-8 .

Williams S, Wynford-Thomas R, Robertson NP. Long-COVID: neurological manifestations and management. J Neurol. 2021;268(12):4915–7. https://doi.org/10.1007/s00415-021-10847-5 .

Ayoubkhani D, Khunti K, Nafilyan V, Maddox T, Humberstone B, Diamond I, et al. Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ. 2021;372:n693. https://doi.org/10.1136/bmj.n693 .

Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV. WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2021:S1473-3099(21)00703–9.

World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus, 2021 [ https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 ]

The National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing the long-term effects of COVID-19 [ https://www.nice.org.uk/guidance/indevelopment/gid-ng10179 ]

Schmitt J, Apfelbacher C, Spuls PI, Thomas KS, Simpson EL, Furue M, et al. The Harmonizing Outcome Measures for Eczema (HOME) roadmap: a methodological framework to develop core sets of outcome measurements in dermatology. J Invest Dermatol. 2015;135(1):24–30. https://doi.org/10.1038/jid.2014.320 .

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60. https://doi.org/10.1136/bmj.327.7414.557 .

Core Outcome Set developers’ response to COVID-19. 2021. [ https://comet-initiative.org/Studies/Details/1538 ]

Tong A, Baumgart A, Evangelidis N, Viecelli AK, Carter SA, Azevedo LC, et al. Core outcome measures for trials in people with coronavirus disease 2019: respiratory failure, multiorgan failure, shortness of breath, and recovery. Crit Care Med. 2021;49(3):503–16. https://doi.org/10.1097/CCM.0000000000004817 .

Tong A, Elliott JH, Azevedo LC, Baumgart A, Bersten A, Cervantes L, et al. Core Outcomes Set for trials in people with coronavirus disease 2019. Crit Care Med. 2020;48(11):1622–35. https://doi.org/10.1097/CCM.0000000000004585 .

Needham DM, Sepulveda KA, Dinglas VD, Chessare CM, Friedman LA, Bingham CO 3rd, et al. Core outcome measures for clinical research in acute respiratory failure survivors. An International Modified Delphi Consensus Study. Am J Respir Crit Care Med. 2017;196(9):1122–30. https://doi.org/10.1164/rccm.201702-0372OC .

Michelen M, Manoharan L, Elkheir N, Cheng V, Dagens A, Hastie C, O'Hara M, Suett J, Dahmash D, Bugaeva P, Rigby I, Munblit D, Harriss E, Burls A, Foote C, Scott J, Carson G, Olliaro P, Sigfrid L, Stavropoulou C. Characterising long COVID: a living systematic review. BMJ Glob Health. 2021;6(9):e005427.

Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: the INTERCOVID Multinational Cohort Study. JAMA Pediatr. 2021;175(8):817–26. https://doi.org/10.1001/jamapediatrics.2021.1050 .

Bong CL, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 pandemic: effects on low- and middle-income countries. Anesth Analg. 2020;131(1):86–92. https://doi.org/10.1213/ANE.0000000000004846 .

Wise J. Long COVID: WHO calls on countries to offer patients more rehabilitation. BMJ. 2021;372:n405. https://doi.org/10.1136/bmj.n405 .

Munblit D, Sigfrid L, Warner JO. Setting priorities to address research gaps in long-term COVID-19 outcomes in children. JAMA Pediatr. 2021;175(11):1095–6. https://doi.org/10.1001/jamapediatrics.2021.2281 .

Download references

Acknowledgements

We would like to thank Nikita A Nekliudov for his help with the literature search for this manuscript.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the International Severe Acute Respiratory and Emerging Infection Consortium, and the World Health Organisation.

This manuscript received no specific funding.

Author information

Daniel Munblit, Timothy Nicholson, Dale M. Needham, Nina Seylanova and Paula R. Williamson contributed equally to this work.

Authors and Affiliations

Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child’s Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Daniel Munblit

Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK

Research and Clinical Center for Neuropsychiatry, Moscow, Russia

Daniel Munblit & Alla Guekht

Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

Timothy R. Nicholson

Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA

Dale M. Needham & Ann M. Parker

Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Dale M. Needham

Sechenov Biomedical Science and Technology Park, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Nina Seylanova

Faculty of Medicine, Imperial College London, London, UK

Callum Parr & Jessica Chen

Pirogov Russian National Research Medical University, Moscow, Russia

Alisa Kokorina & Alla Guekht

ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK

Louise Sigfrid

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

Danilo Buonsenso

Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy

Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy

Maternal and Child Health Program, Translational Health Science and Technology Institute, Faridabad, Delhi, National Capital Region, India

Shinjini Bhatnagar & Ramachandran Thiruvengadam

Clinical Management, WHO, WHE, Geneva, Switzerland

Jacobus Preller

Department of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Sergey Avdeev

Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands

Frederikus A. Klok

Sydney School of Public Health, The University of Sydney, Sydney, Australia

Allison Tong

NCD Department, Rehabilitation Programme, WHO, Geneva, Switzerland

Janet V. Diaz & Wouter De Groote

WHO Brain Health Unit, Geneva, Switzerland

Nicoline Schiess

Sainsbury Wellcome Centre, UCL, London, UK

Athena Akrami

Patient-Led Research Collaborative, Washington, DC, USA

Coventry University, Coventry, UK

Frances Simpson

ISARIC Global Support Centre, Nuffield Department of Medicine, University of Oxford, Oxford, UK

Piero Olliaro & Melina Michelen

Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany

Christian Apfelbacher

Critical Care Department, Hospital Moinhos de Vento, Porto Alegre, Brazil

Regis Goulart Rosa

Brazilian Research in Intensive Care Network (BRICNet), São Paulo, Brazil

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA

Jennifer R. Chevinsky & Sharon Saydah

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA

Jennifer R. Chevinsky

Respiratory Viruses Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

Sharon Saydah

Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany

Jochen Schmitt

Department of Health Data Science, University of Liverpool, Liverpool, UK

Sarah L. Gorst

Paediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany

Jon Genuneit

Universidad de La Sabana, Chía, Colombia

Luis Felipe Reyes

Clínica Universidad de La Sabana, Chía, Colombia

The Research and Clinical Institute for Pediatrics named after Academician Yuri Veltischev of the Pirogov Russian National Research Medical University, Moscow, Russia

Alan Asmanov

Long COVID Support, London, UK

Margaret E. O’Hara

MRC-University of Glasgow, Centre for Virus Research, Glasgow, UK

Janet T. Scott

School of Health Sciences, City, University of London, London, UK

Melina Michelen & Charitini Stavropoulou

Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK

John O. Warner

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada

Margaret Herridge

Department of Medicine, University Health Network, Toronto, ON, Canada

MRC/NIHR Trials Methodology Research Partnership, Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), Liverpool, UK

Paula R. Williamson

You can also search for this author in PubMed   Google Scholar

Contributions

DM drafted the manuscript. All authors critically appraised and edited the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Daniel Munblit .

Ethics declarations

Ethics approval and consent to participate, consent for publication, competing interests.

DM, TRN, DN, and PW are leading the development of the Core Outcome Set for post-COVID-19 condition as a part of the PC-COS project team. The other authors declare that they have no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Munblit, D., Nicholson, T., Needham, D.M. et al. Studying the post-COVID-19 condition: research challenges, strategies, and importance of Core Outcome Set development. BMC Med 20 , 50 (2022). https://doi.org/10.1186/s12916-021-02222-y

Download citation

Received : 19 October 2021

Accepted : 20 December 2021

Published : 04 February 2022

DOI : https://doi.org/10.1186/s12916-021-02222-y

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• COVID-19 sequalae
• Post-COVID-19 condition

BMC Medicine

ISSN: 1741-7015

• Submission enquiries: [email protected]
• General enquiries: [email protected]

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Springer Nature - PMC COVID-19 Collection

Life before COVID-19: how was the World actually performing?

Salvatore f. pileggi.

1 School of Information, Systems and Modelling (ISM), University of Technology Sydney, Sydney, Australia

2 Centre on Persuasive Systems for Wise Adaptive Living (PERSWADE), University of Technology Sydney, Sydney, Australia

The COVID-19 pandemic has suddenly and deeply changed our lives in a way comparable with the most traumatic events in history, such as a World war. With millions of people infected around the World and already thousands of deaths, there is still a great uncertainty on the actual evolution of the crisis, as well as on the possible post-crisis scenarios, which depend on a number of key variables and factors (e.g. a treatment, a vaccine or some kind of immunity). Despite the optimism enforced by the positive results recently achieved to produce a vaccine, uncertainty is probably still somehow the predominant feeling. From a more philosophical perspective, the COVID-19 drama is also a kind of stress-test for our global system and, probably, an opportunity to reconsider some aspects underpinning it, as well as its sustainability. In this article we focus on the pre-crisis situation by combining a number of selected global indicators that are likely to represent measures of different aspects of life. How was the World actually performing? We have defined 6 macro-categories and inferred their relevance from different sources. Results show that economic-oriented priorities correspond to positive performances, while all other distributions point to a negative performance. Additionally, balanced and economy-focused distributions of weights propose an optimistic interpretation of performance regardless of the absolute score.

Introduction

The unpredictable and overwhelming COVID-19 pandemic has completely and radically changed our lives and lifestyle in a way comparable with the most traumatic events in history, such as a World war. With millions of people infected around the World and already thousands of deaths (Dong et al. 2020 ), there is still a great uncertainty on the actual evolving of the crisis, as well as on the possible post-crisis scenarios, which depend on a number of key variables and factors (e.g. a treatment Felsenstein et al. 2020 , a vaccine Le et al. 2020 or some kind of immunity Weitz et al. 2020 ). Despite the optimism enforced by the positive results recently achieved to produce a vaccine, uncertainty is probably still somehow the predominant feeling (Chater 2020 ).

The whole scientific community is currently committed to face the challenging situation and to provide solutions and mitigation plans as a response to the complex dynamics at different levels. Indeed, the actual impact of COVID-19 on the different aspects of life (e.g. socio-economic Bashir et al. 2020 , environmental Collivignarelli et al. 2020 and psycological Fofana et al. 2020 ) is still not completely clear. Even relatively obvious or largely predictable macro-effects, such as a huge economic recession, present great elements of uncertainty at the moment (Altig et al. 2020 ). Additionally, a large number of studies have been conducted to explore the role of different factors [e.g. temperature Jamil et al. 2020 and air pollution  Fattorini and Regoli ( 2020 )].

From a more philosophical perspective, the COVID-19 drama is also a kind of stress-test for our system and, probably, an opportunity to reconsider some aspects underpinning it, as well as its sustainability (Naidoo and Fisher 2020 ). However, in order to re-design the World and our lives accordingly, we should first of all fully understand them. We definitely recognise the importance of cultural factors, opinions, personal values and beliefs. At the same time, we believe that it would be valuable to understand global performance in a data-driven and relatively systematic way.

In this article we focus on the pre-crisis situation by combining a number of selected global indicators to represent macro-categories that are likely to represent measures of different aspects of life: how was the World actually performing before pandemic?

We believe that answering the previously stated research question by adopting a relatively unbiased and customizable analysis framework can first of all (1) contribute to have a concise understanding of global development evolution and its priorities in the pre-pandemic period; additionally, it should (2) facilitate a better holistic understanding of the post-pandemic scenario; last but not least, (3) a similar approach can be adopted to estimate and analyse more specific aspects (e.g. global or country resilience to pandemic).

Previous work and background This paper is based on the method proposed in Pileggi ( 2020 ) which adopts a Multi-Criteria Decision Analysis (MCDA) philosophy (Ishizaka and Nemery 2013 ; Velasquez and Hester 2013 ). That paper focuses on the method in itself, which is explained in detail and applied to a number of examples using real data. This work is conceptually different and addresses the result, as the method previously defined has been applied to concretely measure global performance from heterogeneous criteria with emphasis on sustainable development (Hopwood et al. 2005 ). The idea of indices in such an area (e.g. Bravo 2014 ; Shaker 2018 ; Barrera-Roldán and Saldıvar-Valdés 2002 ) is a well consolidated concept. Furthermore, many studies explicitely focus on underlying correlations (e.g. Shaker 2018 , 2015 ).

As discussed later on in the paper, the original method has been slightly modified for this concrete application: on one side, the definition of the categories and their relation with numerical indicators has been simplified (see Sect.  3.1 ); on the other side, some extension has been provided in the weighting phase to better model the trade-offs existing among the different aspects considered (see Sect.  4.1 ). Last but not least, the interpretation of computations has been better formalised (see Sect.  5 ).

Structure of the paper This introductory part is followed by a detailed description of the research methodology. Each of the three phases identified in the methodological section is object of one of the core sections which deal, respectively, with the selection of criteria (Sect.  3 ), the weighting of such criteria (Sect.  4 ) and the performance analysis based on the resulting computations (Sect.  5 ). The paper finishes with a typical conclusions and future work section.

Methodology and approach

The methodology adopted in this study is summarised in concept in Fig.  1 . The target system is modelled by selecting a number of categorised indicators, which are global indicators in this study. The model also assumes weights and semantics associated with indicators and it’s the input for the computational method (Pileggi 2020 ). Interpretations are based on both qualitative and quantitative metrics. The three main seamless phases are briefly discussed in this section both with key design decisions, possible biases and uncertainties.

Method in concept. The target system is modelled by a number of categorised indicators and by the weights and the semantics associated. Such a model is the input for the computational method. Results are analysed by adopting qualitative and quantitative metrics

Criteria selection: macro-categories and representative indicators The normal approach (adopted also in previous work (Pileggi 2020 ) as well as by many reputable studies and publications, such as Our World in Data ) is to group the different indicators in classes which represent, therefore, an abstracted categorization of the considered indicators. It is very useful, especially considering the great availability of data, dependencies and the need to consider multiple aspects together.

In the context of this work, we have defined a number of categories of interest, each one represented by one single indicator that should be chosen to effectively characterise the target category. In terms of model (Fig.  1 ), given M categories and N indicators, we are assuming N = M and cardinality 1:1. Such a simplification allows an easier weighting and modelling within the method adopted (Pileggi 2020 ). We are assuming the definition of categories and the selection of representative indicators as an intrinsic bias, which is referred to as selection bias . Additionally, as the different indicators are expressed by different units and scales which don’t necessarily reflect their relevance in the resulting system or model, we assume a second kind of bias called numerical bias . The latter will be further discussed in Sect.  3.1 .

Weighting Weighting the target categories or indicators is a critical step. Indeed, while indicators themselves may be considered objective measures, their weighting should reflect the different relevance/importance of the various criteria in the context of the considered system or model. Weights may be estimated in different ways. For instance, they may reflect the opinions within a given group or community, normally elicited by surveys or interviews. Alternatively, weights may be inferred by capturing input parameters by the users of tools that adopt the method (Pileggi 2020 ). Either ways, to be relevant, the weighting should be based on a significant number of samples. Moreover, in general, survey/interview defines a static approach as it is based on a concrete selection of indicators. Changing indicators implies the need to re-estimate weights. Such a process is very demanding and definitely it is not agile.

In this study we have adopted a more pragmatic and, at the same time, flexible approach to establish weights that are inferred by analysing reports on global priorities, issues or challenges. Although, due to the different intent and extent of the selected reports, it is not possible to define a systematic method to infer weights, this approach assures weighting according to different foci and perspectives. As proposed later on in the paper, the analysis of different reports leads to weight configurations that may vary very much from each other.

Last but not least, unlike in the original method, in this work we assume finite resource for weighting to better model the trade-offs raising in a limited resource world (see Sect.  4 ).

Computation and analysis The final step is the computation of the results based on the input as defined in the two previous phases. The computational method should support the systematic combination of heterogeneous indicators and associated semantics, measure uncertainty and biases, as well as provide a framework for the interpretation of results. Results based on the application of the original method (Pileggi 2020 ) with the modifications previously explained are discussed in Sect.  5 .

Categories and indicators

The very first logical step of the study assumes the definition of macro-categories and the consequent selection of representative indicators. Such a step is described in the following subsection, while Sect.  3.2 deals with numerical bias and its minimization.

Inspired by Our World in Data , we have defined our own marco-categories (summary in Table  1 ) reflecting different aspects of life as follows:

• Environment/sustainability Several indicators might represent this macro-category as either global environmental measures (e.g. temperature anomaly or CO2 emissions) or indicators in sub-categories (e.g. energy) potentially express the performance trend. In the context of this work, we consider temperature anomaly (Morice et al. 2012 ; Ritchie and Roser 2017 ) as a representative indicator which we want, evidently, to decrease.
• Health/demographic change Life expectancy (Temperature 2020 ; Riley 2005 ; Zijdeman and Ribeira da Silva 2005 ; Max Roser and Ritchie 2013 ) has been selected to represent this macro-category. Indeed, an increasing life expectancy reflects, normally, an improved healthcare, as well as it implies population increasing. In terms of wished trend, we want life expectancy to increase, although an higher population may have negative implications in terms of global sustainability.
• Economy It is represented by the classic GDP per capita (World Development Indicators, Roser 2013b ), as more sophisticated indicators (e.g. Economic Complexity Index Hausmann et al. 2014 ) are normally understood at a country level and might be not very indicative if considered globally. The GDP represents somehow an economical model that assumes never ending growing. The impact of the COVID-19 pandemic on global economy is expected to be much more consistent than in recent crisis (Kotz 2009 ) and to be comparable with the second World war.
• Poverty/inequality We consider that the number of people living in extreme poverty (Roser and Ortiz-Ospina 2013 ; Ravallion 2015 ) is the ideal measure to properly integrate economic indicators that express a generic increasing well-being by introducing the concept of inequality. Although we recognise an intrinsic interdependency, we prefer to keep this category separated from the previous one as we want to be able to differentiate ideas and concerns related to the economic growth in itself from the others that explicitly address poverty and inequality.
• Human rights/freedom By considering democracy as one of the most relevant achievements of all times, we believe that the number of people living in democracy (Roser 2013a ) may be an effective representative for human rights and, more in general, freedom. Indeed, we consider democracy as a condition necessary (although not always sufficient) to create a socio-political environment in which individual freedom and human rights are likely to be fully respected.
• Violence/instability The selection of a single indicator to express violence and instability in general terms is not easy. Looking at recent happenings, we consider that measures related to terrorism (Ritchie et al. 2013 ) may be a very reasonable choice. From one side, it’s not always easy to understand terrorism and classify terrorist attacks according to the same criteria worldwide. However, a clear definition for terrorism and a number of unanimously recognised principles currently exist (Ritchie et al. 2013 ). Terrorism is normally generated by situations of war or local conflict and it definitely causes uncertainty, violence and instability.

Summary of the criteria considered in this study

Each criterion is understood as a macro-category associated with a representative indicator adopted in computations and with an associated wished trend

All indicators selected are based on objective measures, while others that result from perceptions or opinions (e.g. happiness Frey and Stutzer 2012 ) have not been included.

For the numerical analysis proposed in the paper, we are considering recent years and, more concretely, the time range 2000–2015. Unfortunately, it is not possible to include in the study later years as the indicator measuring people currently living in democracy is available only up to 2015. As per previous explanations, we consider such an indicator as very relevant for the extent and the intent of this research, so we prefer to keep it and reduce the target time range. Additionally, the indicator on people living in extreme poverty is measured at a different granularity of all others, which are available by year. We have indeed adopted approximations considering the available values for the years 2002, 2005, 2008, 2010, 2011, 2012, 2013 and 2015.

In terms of wished trends (Table  1 ), we want the temperature anomaly, people living in poverty and deaths caused by terrorism to decrease, while an increasing trend is wanted for life expectancy, people living in democracy and GDP. The actual trends in the considered time range is shown in Fig.  2 on the left. In the same figure, the contribution to global performance by considering the wished trends (Pileggi 2020 ) is shown on the right. According to this view, positive trends in the chart contributes positively to global performance. Likewise, negative trends have a negative impact on the performance.

Selected indicators expressed as the percentage of variation with respect to the initial state (left). The contribution of the different indicators to performance as the function of the associated wished trend is reported on the right

Looking at the data reported, health/demographics, economy, poverty/inequality and freedom/human rights are positively performing. On the other side, environment/sustainability and violence/instability present strongly negative performance.

Dealing with numerical bias

At a more theoretical level, the definition of a restricted number of meaningful categories in the extent and intent of the current study can be considered a kind of bias in itself. It’s somehow inherent in study design.

At a practical level, it is almost impossible to provide a numerically balanced set of indicators. Indeed, indicators are normally very heterogeneous, adopts their own units of measure and may present very different numerical variations. In general, the variation of a given indicator is not comparable in terms of relevance with the variation of another indicators. Therefore, numerical proportions are not semantically relevant for the purpose of the considered study, meaning that numerical variations are not necessarily proportional with the relevance in the system or model.

We have represented all indicators uniformly as the percentage variation with respect to the initial state. As shown in Fig.  2 , for the considered set of indicators, the variation of deaths by terrorism is numerically much more relevant than any other. Also the temperature anomaly presents a strong pattern in this sense. However, it is not numerically comparable with the previous. As both indicators contribute potentially in a negative way on global performance, the resulting indicator framework is strongly biased (numerically) in this case and may affect the fairness of the computation.

The numerical differences among the considered indicators imply the need to deal with different scales when computing the different aspects together. In order to minimise numerical biases, we adopt the mechanism described in Pileggi ( 2020 ) in addition to weighting. A detailed description of such an adaptive mechanism is out of the scope of the paper. An example of the numerical bias using and not using the mechanism is reported in Fig.  3 .

Visualization of numerical bias by considering a linear combination of the different criteria by adopting the reference computational method (Pileggi 2020 ) (left). Such numerical bias can be reduced by applying adaptive tuning as per reference method (Pileggi 2020 ) (right)

Once target criteria are defined, the weighting stage may result extremely subjective. The most natural way to weight criteria is probably by survey, as it is relatively simple to map weights into an opinion-based survey. In such a way, opinions from a generic public as well as opinions within defined communities may be captured and converted in a corresponding set of weights.

However, capturing people’s opinions in a meaningful way requires a large number of samples. Therefore, we have preferred to adopt a completely different and more pragmatic approach that aims to infer weights from the analysis of popular reports (e.g. from United Nations 1 and Global Economic Forum 2 ). On one side, the simplified approach adopted in the selection phase allows to weight categories rather than single indicators. It makes the mapping much easier. On the other side, the interpretation of certain kind of report may be subjective.

In the following subsections, we first describe an extension to the reference method to better model existing trade-offs and, then, we discuss the inference of weight sets from different sources of information.

Finite-resource assumption to model trade-offs

The original method (Pileggi 2020 ) doesn’t assume specific constraints for weights: the different indicators are weighted independently within a minimum value W min and a maximum value W max . Thus, any indicator i is associated with the corresponding weight W min ⩽ w i ⩽ W max , for instance in a range [0,10].

That independent weighting intrinsically assumes an infinite resource model. For instance, it is possible to associate the maximum weight with all indicators ( w i = W max , ∀ i ). It doesn’t force decisions which should model the trade-offs existing among the different aspects of life. In order to model such trade-offs in a more effective way, we introduce a constraint for the overall weighting value, W tot = ∑ i = 1 n w i ≤ n k , where n is the number of considered criteria and k is a value between W min and W max . In the context of this work we are using six different criteria ( n = 6 ) and weighting in the range [1,10] ( 1 ≤ w i ≤ 10 , ∀ i ) rather than [0,10] as we want all criteria to contribute to overall performance. We consider k = 5 , which implies W tot = 30 .

Weighting based on report analysis

In this sub-section we propose different weightings based on the analysis of different sources of information. As previously explained, probably such an inference cannot be completely objective. In order to minimise the impact of interpretations and biases in the analysis, for each case considered, the criteria and conclusions are explained and briefly discussed. Additionally, we have restricted the analysis to sources of information that allow a relative easy mapping. We have excluded those sources that potentially provide very good insight but are objectively hard to be converted in a clear weight set to the target criteria.

A summary of the weights produced by analysing the different reports is proposed in Fig.  4 . Each case is separately analysed and explained in the remaining part of this sub-section.

Weighting based on the analysis of different sources. Each weights set is compared with an homogeneous distribution of the resources—i.e. Neutral Weighting

Weighting based on the analysis of UN Global Issues The UN Global Issues report proposes 22 different global issues. Each issue in the report can be associated to no-one, one or more than one of the categories identified in this study.

According to our analysis, the category Environment/Sustainability is associated with 5 issues from the report (Atomic Energy, Climate Change, Food, Water), Health/Demography with 5 issues (Africa, Ageing, AIDS, Health, Population), Economy with no issue directly, Poverty/Inequality with 6 issues (Africa, Children, Decolonization, Ending Poverty, Food, Water), Human Rights/Freedom with 6 issues (Africa, Democracy, Gender Equality, Human Rights, International Law and Justice, Refugees) and Violence/Instability with 2 issues (Africa, Peace&Security). Resulting weights are reported in Table  2 . As previously discussed, the minimum weight assumed is 1.

Weighting based on UN Global Issues

Weighting based on the analysis of WEF 10 biggest global challenges (2016) The WEF 10 biggest global challenges [8] is a report with a much more economic focus. The criteria to map the 10 challenges in the report into weights are the same as in the previous case.

From our analysis, Environment/Sustainability is directly related to 2 challenges (Food Security, Climate Change), Health/Demographics to 1 challenge (Healthcare), Economy to 5 challenges (Inclusive Growth, Unemployment, Financial Crisis, Global Trade, Investment Strategy), Poverty/Inequality to 2 challenges (Food Security, Inclusive Growth), Human Rights/Freedom to 1 challenge (Gender Equality) and Violence/Instability to no challenge. The resulting weighing is reported in Table  3 .

Weighting based on WEF—10 biggest global challenges

Weighting based on the analysis of 10 most important global issues from The Borgen Project The Borgen Project, a nonprofit organization that is addressing poverty and hunger, has provided a list of 10 most important global issues [5].

According to our analysis of such a source, Environment/Sustainability is directly associated with 3 of the 10 issues (Climate Change, Pollution), Health/Demographics with 4 (Pollution, Security and Wellbeing, Malnourishment and Hunger, Substance Abuse), Economy with 1 (Unemployment), Poverty/Inequality with 3 (Lack of Education, Malnourishment and Hunger, Security and Wellbeing), Human Rights/Freedom with 1 (Government Corruption) and Violence/Instability with 3 (Violence, Security and Wellbeing, Terrorism). The resulting weights are reported in Table  4 .

Weighting based on The Borgen Project—Top 10 most important current Global Issues

Weighting based on the analysis of Global Shapers Survey 2017 Global Shapers Survey 2017 by WEF reflects opinion of millennials. Business Insider Australia has recently provided a list of the 10 most critical problems in the World according to millennials based on the Global Shapers Survey. In order to assure uniformity and consistency with previous cases, we have considered the list of problems provided but not the relevance associated with each of them.

According to our analysis, Environment/Sustainability matches with 2 problems (Food and water security, Climate change/Destruction of nature), Health/Demographics with 1 (Safety/Security/Wellbeing), Economy with 1 (Lack of economic opportunity and unemployment), Poverty/Inequality with 4 (Lack of education, Food and water security, Poverty, Inequality), Human Rights/Freedom with 1 (Government accountability and transparency/Corruption) and Violence/Instability with 3 (Safety/Security/Wellbeing, Religious conflicts, Large scale conflict/Wars ). Weights are reported in Table  5 .

Weighting based on Global Shapers Survey 2017 and its analysis

Performance analysis

Performance analysis is based on two main metrics as follows:

• Score This is the primary metric for analysis and it is based uniquely on the absolute performance according to computations (Pileggi 2020 ): positive scores are associated with positive performance, as well as negative scores correspond to negative performance.
• Interpretation It is a relative metric defined by comparing the score of a given computation with the corresponding neutral computation, which assumes fair weighting (Pileggi 2020 ). In qualitative terms, scores higher than neutral computation correspond to an optimistic interpretation, while lower scores are associated with a pessimistic interpretation.

The two metrics as defined are completely independent as all qualitative combinations of the two metrics (positive/optimistic, positive/pessimistic, negative/optimistic and negative/pessimistic) are possible.

Looking at the analysis framework more holistically, two additional analysis factors may be considered:

• Uncertainty In the context of this study, rather than a proper uncertainty, such a metric defines higher and lower bounds based on the potential weighting variance. Such an estimation provides a more consistent support for analysis in context.
• Numerical bias Even though it is limited by the method adopted, numerical bias directly affects the absolute result. It is expressed by the neutral computation and can play a relevant role not only in the analysis phase but also when selecting criteria, as it can drive the selection of balanced set of indicators.

Computations for the different weight sets are presented in Fig.  5 , while a qualitative summary of results is presented in Table  6 .

Summary of results (qualitative)

For each computation, the qualitative score—i.e. POSITIVE/NEGATIVE —and the qualitative interpretation—i.e. OPTIMISTIC/PESSIMISTIC —is reported

Computations based on the different weight sets. On the left, computed results assuming a given weights set are compared with the corresponding assuming homogeneous weighting ( Neutral Weighting ). On the right, results are considered looking at the extreme possible computations

Looking at Fig.  5 , the score associated with the different weight sets is represented by the blue line. Such a score is compared with the corresponding neutral computations in the charts on the left, while it is represented both with extreme computations in the charts on the right.

Weights from the analysis of UN Global Issues propose a relatively balanced distribution with a priority on Poverty/Inequality, Human Rights/Freedom, Health/Demographics and Environment/Sustainability. Additionally, there is a relative low priority for Violence/Instability and no economical focus. The resulting computation shows contrasting results, including a negative performance but also an optimistic interpretation. The weight set resulting from the analysis of the 10 biggest global challenges by WEF presents a much more economic oriented focus with a significant attention also for Environment/Sustainability and Poverty/Inequality. Human Rights/Freedom is still considered a kind of priority, while there is no explicit attention for Violence/Instability. Such a distribution of weights result in a very positive understanding of global performance. By focusing explicitly on addressing poverty, the weights from The Borgen Project proposes an interesting case study. The priority is clearly on 3 criteria, Health/Demographics, Poverty/Inequality and Violence/Instability. The computations associated show a clear negative trend in terms of either performance and interpretation (pessimistic). The analysis based on opinions of Millennials proposes a much more radical distribution with a clear priority on Poverty/Inequality and a significant attention on Environment/Sustainability and Violence/Instability. Final results are very similar to the ones related to the previous case (negative/pessimistic).

Average weights are reported in the last chart in Fig.  4 . As shown, the different case studies considered seem to balance each other. The average case proposes however a priority on Poverty/Inequality. Computations for the average case point out negative performance and optimistic interpretation (Fig. ​ (Fig.6 6 ).

Computation based on average weights. On the left, the computed result adopting average weighs is compared with the corresponding assuming homogeneous weighting ( Neutral Weighting ). On the right, that same result is considered looking at the extreme possible computations

As expected, the priorities defined by the different weight sets play a key role in the final assessment of performance from a quantitative perspective. However, as shown, it’s the contextual interpretation of such metrics that is considered the final assessment. We believe that the research framework proposed can be simple and effective to assess holistically the post-pandemic scenario, as well as to properly assess and reflect mindset and priorities changes behind the numerical estimations or measures.

Looking at possible interpretations of the results, we would like to remark that the method adopted works in terms of dynamic trend rather than of static snapshot, according to a philosophy of continuous evolution of the World. Such an approach is reflected in the computation of metrics. Therefore, a positive score in a given time-frame should be understood like the World is becoming a better place rather than the World is a good place (Pileggi 2020 ).

Conclusions and future work

By adopting a MCDA-based method, we considered 6 different macro-categories to measure global performance. The method provides a relatively fair analysis framework which allows the systematic combination of heterogeneous criteria. The weights associated with the different criteria play a key role in terms of final result. We have adopted a model that assumes finite resource in order to empathize the trade-offs existing among the different aspects considered.

In order to assess global performance and, more in general, global development trends, we have considered four different case studies with a very different focus. Results show that economic-oriented priorities correspond to positive performances, while all other distributions point to a negative performance. Additionally, balanced and economy-focused distributions of weights propose an optimistic interpretation of performance regardless of the absolute score.

Future work is expected to be developed in different directions. In line with the current focus, we will aim more fine grained studies at a country level. We will explore further secondary data sources to infer priorities accordingly (e.g. World Values Survey — http://www.worldvaluessurvey.org/ ). We will also propose and analyse in context additional case studies with a more community-oriented focus to be established by survey (e.g. Danowski and Park 2020 ).

The results obtained contribute to provide a concise understanding in context of the global development evolution and its underpinning priorities in the pre-pandemic period. We believe that such a dynamic snapshot can be useful to facilitate a better holistic understanding of the post-pandemic scenario that will be object of our future research. Indeed, we expect a significant mindset change triggered by the pandemic that will probably have an impact in setting priorities for a sustainable development. Last but not least, we will adopt a similar approach to estimate and analyse more specific aspects (e.g. global or country resilience to pandemic).

Acknowledgements

Our most sincere gratitude to the anonymous reviewers who provided extensive and constructive feedback. The comments received were very valuable to produce a significantly improved version of the paper.

1 United Nations— https://www.un.org/en/ .

2 World Economic Forum— https://www.weforum.org .

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

• Altig D, Baker S, Barrero JM, Bloom N, Bunn P, Chen S, Davis SJ, Leather J, Meyer B, Mihaylov E, et al. Economic uncertainty before and during the covid-19 pandemic. J. Public Econ. 2020; 191 :104274. doi: 10.1016/j.jpubeco.2020.104274. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Barrera-Roldán A, Saldıvar-Valdés A. Proposal and application of a sustainable development index. Ecol. Ind. 2002; 2 (3):251–256. doi: 10.1016/S1470-160X(02)00058-4. [ CrossRef ] [ Google Scholar ]
• Bashir MF, Benjiang MA, Shahzad L. A brief review of socio-economic and environmental impact of covid-19. Air Qual. Atmos. Health. 2020; 13 :1403–1409. doi: 10.1007/s11869-020-00894-8. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bravo G. The human sustainable development index: new calculations and a first critical analysis. Ecol. Ind. 2014; 37 :145–150. doi: 10.1016/j.ecolind.2013.10.020. [ CrossRef ] [ Google Scholar ]
• Chater N. Facing up to the uncertainties of covid-19. Nat. Hum. Behav. 2020; 4 (5):439–439. doi: 10.1038/s41562-020-0865-2. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Collivignarelli MC, Abbà A, Bertanza G, Pedrazzani R, Ricciardi P, Miino MC. Lockdown for covid-2019 in milan: what are the effects on air quality? Sci. Total Environ. 2020; 732 :139280. doi: 10.1016/j.scitotenv.2020.139280. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Danowski JA, Park HW. East asian communication technology use and cultural values. J. Contemp. Eastern Asia. 2020; 19 (1):43–58. [ Google Scholar ]
• Dong E, Du H, Gardner L. An interactive web-based dashboard to track covid-19 in real time. Lancet Infect. Dis. 2020; 20 (5):533–534. doi: 10.1016/S1473-3099(20)30120-1. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fattorini, D., Regoli, F.: Role of the chronic air pollution levels in the covid-19 outbreak risk in Italy. Environ. Pollut. 114732 (2020) [ PMC free article ] [ PubMed ]
• Felsenstein S, Herbert JA, McNamara PS, Hedrich CM. Covid-19: Immunology and treatment options. Clin. Immunol. 2020; 215 :108448. doi: 10.1016/j.clim.2020.108448. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fofana NK, Latif F, Sarfraz S, Bashir MF, Komal B, et al. Fear and agony of the pandemic leading to stress and mental illness: an emerging crisis in the novel coronavirus (covid-19) outbreak. Psychiatry Res. 2020; 291 :113230. doi: 10.1016/j.psychres.2020.113230. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Frey BS, Stutzer A. The use of happiness research for public policy. Soc. Choice Welf. 2012; 38 (4):659–674. doi: 10.1007/s00355-011-0629-z. [ CrossRef ] [ Google Scholar ]
• Global terrorism database (GTD). University of Maryland
• Hausmann R, Hidalgo CA, Bustos S, Coscia M, Simoes A, Yildirim MA. The Atlas of Economic Complexity: Mapping Paths to Prosperity. Cambridge: Mit Press; 2014. [ Google Scholar ]
• Hopwood B, Mellor M, O’Brien G. Sustainable development: mapping different approaches. Sustain. Dev. 2005; 13 (1):38–52. doi: 10.1002/sd.244. [ CrossRef ] [ Google Scholar ]
• Ishizaka A, Nemery P. Multi-criteria Decision Analysis: Methods and Software. Hoboken: Wiley; 2013. [ Google Scholar ]
• Jamil T, Alam I, Gojobori T, Duarte CM. No evidence for temperature-dependence of the covid-19 epidemic. Front Public Health. 2020; 8 :436. doi: 10.3389/fpubh.2020.00436. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kotz DM. The financial and economic crisis of 2008: a systemic crisis of neoliberal capitalism. Rev. Radic. Polit. Econ. 2009; 41 (3):305–317. doi: 10.1177/0486613409335093. [ CrossRef ] [ Google Scholar ]
• Le TT, Andreadakis Z, Kumar A, Roman RG, Tollefsen S, Saville M, Mayhew S. The covid-19 vaccine development landscape. Nat. Rev. Drug Discov. 2020; 19 (5):305–306. doi: 10.1038/d41573-020-00073-5. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• LOUDENBACK, TANZA, JACKSON, ABBY: Business Insider Australia: The 10 most critical problems in the world, according to millennials. https://www.businessinsider.com.au/world-economic-forum-world-biggest-problems-concerning-millennials-2016-8
• Max Roser, E.O.O., Ritchie, H.: Life expectancy. Our world in data (2013). https://ourworldindata.org/life-expectancy
• Morice CP, Kennedy JJ, Rayner NA, Jones PD. Quantifying uncertainties in global and regional temperature change using an ensemble of observational estimates: the HadCRUT4 data set. J. Geophys. Res. 2012; 117 :(D08101). doi: 10.1029/2011JD017187. [ CrossRef ] [ Google Scholar ]
• Naidoo, R., Fisher, B.: Reset sustainable development goals for a pandemic world (2020) [ PubMed ]
• Our World in Data. https://ourworldindata.org . Accessed 11 June 2020
• Pileggi SF. Is the world becoming a better or a worse place? Data Driven Anal. Sustain. 2020; 12 (1):88. [ Google Scholar ]
• Ravallion M. The Economics of Poverty: History, Measurement, and Policy. Oxford: Oxford University Press; 2015. [ Google Scholar ]
• Riley JC. Estimates of regional and global life expectancy, 1800–2001. Popul. Dev. Rev. 2005; 31 (3):537–543. doi: 10.1111/j.1728-4457.2005.00083.x. [ CrossRef ] [ Google Scholar ]
• Ritchie, H., Joe Hasell, C.A., Roser, M.: Terrorism. Our World in Data (2013). https://ourworldindata.org/terrorism
• Ritchie, H., Roser, M.: CO2 and greenhouse gas emissions. Our World in Data (2017). https://ourworldindata.org/co2-and-other-greenhouse-gas-emissions
• Roser, M., Ortiz-Ospina, E.: Global extreme poverty. Our World in Data (2013). https://ourworldindata.org/extreme-poverty
• Roser, M.: Democracy. Our World in Data (2013). https://ourworldindata.org/democracy
• Roser, M.: Economic growth. Our World in Data (2013). https://ourworldindata.org/economic-growth
• Shaker RR. The spatial distribution of development in europe and its underlying sustainability correlations. Appl. Geogr. 2015; 63 :304–314. doi: 10.1016/j.apgeog.2015.07.009. [ CrossRef ] [ Google Scholar ]
• Shaker RR. A mega-index for the americas and its underlying sustainable development correlations. Ecol. Ind. 2018; 89 :466–479. doi: 10.1016/j.ecolind.2018.01.050. [ CrossRef ] [ Google Scholar ]
• Temperature anomalies. Met Office Hadley Centre. https://www.metoffice.gov.uk/hadobs/hadcrut4/index.html . Accessed 11 June 2020
• The Borgen Project: The top 10 most important current Global Issues. https://borgenproject.org/top-10-current-global-issues/
• United Nations: Global issues overview. https://www.un.org/en/sections/issues-depth/global-issues-overview/ . Accessed 11 June 2020
• Velasquez M, Hester PT. An analysis of multi-criteria decision making methods. Int. J. Oper. Res. 2013; 10 (2):56–66. [ Google Scholar ]
• Weitz JS, Beckett SJ, Coenen AR, Demory D, Dominguez-Mirazo M, Dushoff J, Leung CY, Li G, Măgălie A, Park SW, et al. Modeling shield immunity to reduce covid-19 epidemic spread. Nat. Med. 2020; 26 :849–854. doi: 10.1038/s41591-020-0895-3. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• World Development Indicators: The world bank. http://data.worldbank.org/data-catalog/world-development-indicators
• World Economic Forum: What are the 10 biggest global challenges? https://www.weforum.org/agenda/2016/01/what-are-the-10-biggest-global-challenges/ . Accessed 11 June 2020
• World Economic Forum’s Global Shapers Survey 2017. http://shaperssurvey2017.org/static/data/WEF_GSC_Annual_Survey_2017.pdf . Accessed 11 June 2020
• Zijdeman, R., Ribeira da Silva, F.: Life expectancy at birth (total), ISH Data Collection, V1 (2005). https://hdl.handle.net/10622/LKYT53

• Skip to main content
• Keyboard shortcuts for audio player

• Your Health
• Treatments & Tests
• Health Inc.
• Public Health

How to Thrive as You Age

U.s. drops in new global happiness ranking. one age group bucks the trend.

Allison Aubrey

The U.S. ranks higher in the world happiness report when it comes to people aged 60 and older. Thomas Barwick/Getty Images hide caption

The U.S. ranks higher in the world happiness report when it comes to people aged 60 and older.

How happy are you? The Gallup World Poll has a simple way to gauge well-being around the globe.

Imagine a ladder, and think about your current life. The top rung, 10, represents the best possible life and the bottom rung, 0, represents the worst. Pick your number.

Researchers use the responses to rank happiness in countries around the globe, and the 2024 results have just been released.

This year, Finland is at the top of the list. Researchers point to factors including high levels of social support and healthy life expectancy, to explain the top perch of several Scandinavian countries.

Goats and Soda

Can a picture make you happy we asked photographers and here's what they sent us.

North America does not fare as well overall. As a nation, the United States dropped in the global ranking from 15th to 23rd. But researchers point to striking generational divides.

People aged 60 and older in the U.S. reported high levels of well-being compared to younger people. In fact, the United States ranks in the top 10 countries for happiness in this age group.

Conversely, there's a decline in happiness among younger adolescents and young adults in the U.S. "The report finds there's a dramatic decrease in the self-reported well-being of people aged 30 and below," says editor Jan-Emmanuel De Neve , a professor of economics and behavioral science, and the director of the Wellbeing Research Centre at Oxford University.

This drop among young adults is also evident in Canada, Australia and, to a lesser extent in parts of western Europe and Britain, too. "We knew that a relationship existed between age and happiness, but the biggest surprise is that it is more nuanced than we previously thought, and it is changing," says Ilana Ron-Levey , managing director at Gallup.

"In North America, youth happiness has dropped below that of older adults," Ron-Levey says. The rankings are based on responses from a representative sample of about 1,000 respondents in each country.

There are a range of factors that likely explain these shifts.

De Neve and his collaborators say the relatively high level of well-being among older adults is not too surprising. Researchers have long seen a U-shaped curve to happiness.

Children are typically happy, and people tend to hit the bottom (of the U) of well-being in middle age. By 60, life can feel more secure, especially for people with good health, financial stability and strong social connections. Living in a country with a strong social safety net can also help.

Shots - Health News

Can little actions bring big joy researchers find 'micro-acts' can boost well-being.

"The big pressures in life, [such as] having small children, a mortgage to pay, and work, have likely tapered off a bit," De Neve says. But what's so unexpected he says is the extent to which well-being has fallen among young adults.

"We would expect youth to actually start out at a higher level of well-being than middle-age individuals," De Neve says.

"People are hearing that the world is going to hell in a handbasket and the young especially are feeling more threatened by it," says John Helliwell , Professor Emeritus at the University of British Columbia, and a co-author of the study.

He says many younger people may feel the weight of climate change, social inequities, and political polarization which can all be amplified on social media.

But hope is not lost, Helliwell says.

He points to countries in eastern Europe where levels of well-being are on the rise among young people.

He says the older generations in the countries that make up the former Yugoslavia, tend to be less happy. "They are bearing the scars of genocide and conflict," he says.

But he says the younger people are looking beyond this history. "A new generation can put it in the past and think of building a better future and feel that they can be part of that," Helliwell says.

Stuck In A Rut? Sometimes Joy Takes A Little Practice

This story was edited by Jane Greenhalgh

• world happiness report

How US life expectancy rates changed as COVID deaths wane, drug overdoses persist

Life expectancy rose to 77.5 years on average in 2022, a slight increase of 1.1 years from 2021, according to new studies from the Centers for Disease Control and Prevention.

"Life expectancy at birth increased 1.1 years...largely because of decreases in mortality due to COVID-19, heart disease, cancer, unintentional injuries, and homicide," the report stated.

Although life expectancy has slightly improved, it continues to remain below its peak of 78.9 years, occurring a decade ago. The U.S. life expectancy also falls behind other comparable countries.

Life expectancy varies by sex

For men, life expectancy increased 1.3 years from 73.5 in 2021 to 74.8 in 2022. For women, life expectancy increased 0.9 year from 79.3 in 2021 to 80.2 in 2022. That's a 5.4 year age difference in life expectancy between men and women, according to the CDC.

What is contributing to the decade-long decline in life expectancy?

The COVID-19 pandemic and fatal drug overdoses are causing a large death toll in the U.S. COVID deaths  took about 186,552 lives in 2022. In comparison, fatal overdoses consumed 107,941 lives.

According to the study, "Age-adjusted rate of drug overdose deaths nearly quadrupled from 8.2 in 2002 to 32.6 in 2022." The rate did not significantly change between 2021 and 2022.

Heart disease and cancer are the leading causes of death in the U.S and have been so since the early-to-mid 1990's, according to the CDC. COVID-19 was the third-leading cause of death in 2021, but in 2022 it fell behind "unintentional injuries," which includes drug overdoses.

Want to live healthier longer?: Visual guide shows how longevity science looks to slow diseases of aging

Feeling hangry?: From food cravings to brain fog, blood sugar spikes may be the cause

Why do some people live longer than others? 

Dr. Amit Shah, an internist and geriatrician with Mayo Clinic in Arizona told USA TODAY that "up to 25% of longevity is genetic." The rest, he says, comes down "to factors that are in our control." Diet and exercise are two factors that can impact our longevity.

Socioeconomic status also plays a major role in healthy aging and longevity, with impoverished areas that have  limited access to healthcare  being the hardest hit. "People who live in societies that have the most long-lived individuals (as outlined in the book "Blue Zones" by Dan Buettner), have a high level of social engagement with roles for older individuals to have in the family and society," Shah told USA TODAY.

Contributing: Daryl Austin

• SUGGESTED TOPICS
• The Magazine
• Newsletters
• Managing Yourself
• Managing Teams
• Work-life Balance
• The Big Idea
• Data & Visuals
• Reading Lists
• Case Selections
• HBR Learning
• Topic Feeds
• Account Settings
• Email Preferences

Research Roundup: How the Pandemic Changed Management

• Mark C. Bolino,
• Jacob M. Whitney,
• Sarah E. Henry

Lessons from 69 articles published in top management and applied psychology journals.

Researchers recently reviewed 69 articles focused on the management implications of the Covid-19 pandemic that were published between March 2020 and July 2023 in top journals in management and applied psychology. The review highlights the numerous ways in which employees, teams, leaders, organizations, and societies were impacted and offers lessons for managing through future pandemics or other events of mass disruption.

The recent pandemic disrupted life as we know it, including for employees and organizations around the world. To understand such changes, we recently reviewed 69 articles focused on the management implications of the Covid-19 pandemic. These papers were published between March 2020 and July 2023 in top journals in management and applied psychology.

• Mark C. Bolino is the David L. Boren Professor and the Michael F. Price Chair in International Business at the University of Oklahoma’s Price College of Business. His research focuses on understanding how an organization can inspire its employees to go the extra mile without compromising their personal well-being.
• JW Jacob M. Whitney is a doctoral candidate in management at the University of Oklahoma’s Price College of Business and an incoming assistant professor at Kennesaw State University. His research interests include leadership, teams, and organizational citizenship behavior.
• SH Sarah E. Henry is a doctoral candidate in management at the University of Oklahoma’s Price College of Business and an incoming assistant professor at the University of South Florida. Her research interests include organizational citizenship behaviors, workplace interpersonal dynamics, and international management.

Partner Center

• Share full article

Advertisement

Supported by

How Much Would You Pay to Make Sure You Never Sawed Off a Finger?

By Ben Blatt

Ben Blatt is a reporter for The Upshot and an amateur woodworker who once received stitches for a band saw injury.

What’s it worth to you to minimize the risk of cutting off a finger?

$300? $600? $1,200? Or perhaps it’s worth nothing, if you think you’re already careful enough?

If you’re a woodworker willing to spend enough money, you can buy a table saw that detects fingers and stops the blade like this:

(The hot dog is your finger.)

So, would you pay extra for this feature? What if the government said you had no choice but to pay up? And what if only one company held the patents for the safety mechanism?

Government mandates of new safety technology are classic trade-offs, whether the product is a power tool or a car or a pill. In this case, regulations requiring that table saws be sold with this safety device might mean a few thousand fingers saved per year. But they might also lead to higher costs for consumers.

When the technologies are patented, the trade-offs can become even more clear, like the high prices (and high profits) of drug companies in exchange for the innovation of new drugs. With table saws, it might similarly lead to a period of less competition and more profit for the company that developed the safety mechanism.

Among tools likely to be found in someone’s garage, table saws are the biggest driver of serious woodworking-related injuries: Each year they are responsible for about 30,000 injuries that require emergency department treatment — and nearly 4,300 amputations.

By comparison, the thousands of other products tracked by the Consumer Protection Safety Commission, a federal agency, are responsible for roughly 3,600 amputations per year combined .

Amputations from consumer products

There are various table-saw safety guards available, made out of metal and plastic. But only one company, SawStop, sells a consumer table saw that can stop and retract the blade in milliseconds once it detects the small electrical signal from a finger.

SawStop holds over 100 patents, many directly related to the safety mechanism. Its table saws cost several hundred dollars more than the most popular competing models, and sometimes more than $1,000 extra.

Few consumers choose to pay the price. In 2016, the most recent year with available sales data, less than 2 percent of the 675,000 table saws sold in the United States were SawStop saws.

Now the safety commission is considering mandating that the finger-detection system be included in every new table saw. SawStop currently produces the only consumer table saws that could be sold under the proposed rule.

Bench or compact table saws

Budget saws for basic use, jobsite table saws, mobile saws with wheels, cabinet or professional table saws, powerful saws with precision alignment fence.

At a testy agency hearing in February, Richard Trumka Jr., a Democratic commissioner, accused large power tool companies of not caring about the safety of their consumers and held up photos of people who had amputations after table saw injuries.

Peter Feldman, the lone Republican commissioner, chastised SawStop’s chief executive for not agreeing to license the technology. “Rather than seeking to compete fairly,” Mr. Feldman told him, “I see what you’re doing as rent-seeking behavior, pure and simple.”

SawStop was founded by a patent attorney in 2000 and at first did attempt to license its finger-detection technology to other companies. After that failed, SawStop petitioned the safety commission in 2003 to require finger-detection systems on all table saws — the type of rule the commission may soon approve.

And once it started selling its own saws, SawStop developed a reputation for litigiousness: In 2015 it sued Bosch to stop it from selling a table saw that had a similar safety feature, citing patent infringement.

But the safety commission generally doesn’t concern itself with the potential for patent litigation or effective monopoly. “The C.P.S.C. doesn’t deal with competition implications; it deals with problems of safety,” said Herbert Hovenkamp, an antitrust expert at the University of Pennsylvania Law School.

The commission has debated table saw safety on and off ever since that 2003 SawStop petition. In 2017, a Republican commissioner argued that regulation was unnecessary, pointing out that consumers knew how dangerous the saws were but most made the choice not to pay the SawStop premium.

But in an interview, Robert S. Adler, a Democratic commissioner from 2009 to 2021, said that table saw injuries are not a “reasonable” risk outside the reach of the agency. “All it takes” to slice a finger, he said, “is a sneeze or a knot in the wood.”

The agency calculated that mandating the safety mechanism would have an average “net societal benefit” of about $3,000 for each new bench table saw, the type of saw most hobbyists or beginner contractors are likely to buy. That figure encompasses medical bills and lost income, though almost 70 percent of it is for “pain and suffering.”

The agency estimated that new bench table saws would cost $338 to $1,210 more with the finger-detection system.

The commissioners’ vote is likely to fall along partisan lines: Three of the four current commissioners are Democrats, and the rule will probably pass.

It would go into effect after three years. SawStop’s chief executive, Matt Howard, has pledged to open one of the company’s key patents to competitors when that happens.

He said it would be “incomprehensible” if other companies did not have their own offerings in three years, and blamed them for failing to invest in research and development.

But the Power Tools Institute, an industry group, has said rival companies won’t be able to start development before SawStop releases the patent, because SawStop could sue the companies for using the patent in prototypes.

Bosch, which settled with SawStop over its competing product, said it would take six years to bring it back to market. Shabir Balolia, the chief operating officer of Grizzly Industrial, another competitor, said it would probably take four years to develop a new saw after the patent was released.

Matt Outlaw, who runs a popular woodworking YouTube channel , said he was concerned about possible price increases for amateur woodworkers, but supported the proposed rule overall. Mr. Outlaw, a former Arkansas state trooper, recalled the seatbelt laws he used to enforce: Not everyone likes them, but the safety benefits are proven.

When it comes to table saws, he said, “who wouldn’t trade $400 for a finger?”

Ben Blatt is a reporter for The Upshot specializing in data-driven journalism. More about Ben Blatt

From The Upshot: What the Data Says

Analysis that explains politics, policy and everyday life..

Pandemic School Closures: ​A variety of data about children’s academic outcomes and about the spread of Covid-19 has accumulated since the start of the pandemic. Here is what we learned from it .

Affirmative Action: The Supreme Court effectively ended race-based preferences in admissions. But will selective schools still be able to achieve diverse student bodies? Here’s how they might try .

Parenting: Surveys of young adults show that most parents are highly involved in their grown children’s lives. Yet in many ways, their relationships seem healthy and fulfilling .

N.Y.C. Neighborhoods: We asked New Yorkers to map their neighborhoods and to tell us what they call them . The result, while imperfect, is an extremely detailed map of the city .

Dialect Quiz:  What does the way you speak say about where you’re from? Answer these questions to find out .