short essay about war on covid 19

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War on COVID: Warfare and its Discontents

Introduction.

This Essay critically analyzes the wartime framing that both Presidents Donald Trump and Joe Biden relied upon in fighting a “War on COVID -19.” According to this militarized framing, they sought to, in Trump’s words, “fight that invisible enemy,” the coronavirus. [2] The conundrum this Essay explores is: Even as Biden has announced plans to let the coronavirus health emergency declaration expire in May 2023 [3] (as this Essay goes to press), for the future, how should lawmakers address crises, such as COVID -19, with the urgency of a social emergency without reinforcing our overly-militarized, securitized, and policed state implicated by national security emergencies? [4] The problem with a militarized, securitized approach to a health crisis, such as COVID -19, is that security “is a deeply indeterminate concept, whose power derives not only from its association with particular issues or threats, but from the way that it combines fundamental ambiguity with a sense of heightened urgency.” [5] As a normative and practical matter, a militarized, securitized approach to the interrelated health and economic crises catalyzed by coronavirus is flawed due to the indeterminacy of war discourse and its relationship to legality in exceptional moments.

Importantly, this project fits within the body of scholarship critiquing and redefining national security law studies—by questioning what is meant by “security,” [6] by “racing national security,” [7] and by applying feminist [8] and other critical lenses which interrogate the levers of decision making and power that the concept of security highlights and erases. [9] Building on “critical insights concerning the structure of international law and politics,” this broader body of scholarship raises significant questions, such as: to what extent is security defined primarily by state actors in contrast to nonstate actors? [10] Relatedly, whose knowledge matters in identifying and responding to security threats? [11] What is the relationship of security to legality? In moments of emergency, does security require exceptionalism? [12] How do we prevent security measures adopted in times of emergency from bleeding over into ordinary law in normal times? [13]

At the time of writing, the number of individuals who have died directly from COVID -19 is nearly 6.9 million globally [14] 14 and well over one million in the United States alone. [15] While the health emergency (and, with it, the war on COVID -19) had been open-ended, once Biden declared the pandemic was “over” in September 2022, the U.S. government’s response involved pivoting to an endemic phase, [16] paving the way for the revocation of emergency powers and raising questions about the government’s ongoing long-term commitment to the economic inequalities laid bare and exacerbated by the COVID -19 crisis.

This project builds on my recent scholarship on the “Color of Covid” and its intersection with the “Gender of Covid” which address security concerns in the context of differential economic insecurity and structural inequality experienced during COVID -19. [17] Going beyond my earlier work, this Essay explores new questions concerning the use of the security framework by both Presidents Trump and Biden in the context of wartime rhetoric and war-related legal authority to address the COVID -19 pandemic and to plan for the postpandemic economy. Strikingly, civil rights leader Sherrilyn Ifill has called not simply for a Marshall Plan in recovering from the pandemic-era recession (referring to the post-World War II economic recovery program providing aid to Western Europe), but a Thurgood Marshall Plan to build a more inclusive economy. [18] Utilizing the Marshall Plan as a reference point reflects a comfort with securitizing our understanding of the current moment (even while seeking to appropriate the security trope). [19] As discussed further in Part III , the connection between national security and civil rights has an important basis in history.

Along similar lines, as Ben Heath notes, transnational actors are offering “alternative visions of security that either complement or contest” the state-actor model. [20] Traditionally, the state defines national and international security concerns and objectives; thus, alternative visions require mapping out new approaches to human security aimed at transforming power structures. [21] For example, “transnational social movements declaring that Black Lives Matter point toward alternative imaginations of security based on divestment from policing and carceral systems, and investment in communities.” [22] While sympathetic to the propensity to appropriate the securitization framework, this Essay seeks an alternative framing that more fully refines and rejects the more militarized dimensions of the security framework, along parallel lines explored by Ben Heath and Mary Dudziak. [23]

Part I of this Essay outlines the “War on COVID -19” framework, specifically exploring the invocation of wartime rhetoric and war and emergency powers legal authority. Part II explores the benefits and shortcomings of framing our current COVID -19 crisis as a war—as a legal and normative matter. Part III draws on three historical analogies to reflect on the paradoxical allure of the war and emergency power paradigm to better understand the current moment: The Civil War to Reconstruction, the Great Depression to the New Deal, and World War II to the Marshall Plan. Despite the tragedy inherent in war and other moments of crisis, these particular moments in U.S. history have prompted calls for and shown the promise of transformative change. In Part IV, I propose an alternative approach to meet the current moment with an ethics, politics, and law of care, rather than a framework of war, militarization and securitization, as these latter approaches often promote “law and order” over justice.

I. WARTIME FRAMEWORK : PRESIDENTIAL OVERREACH AND UNDERREACH

In this Part of the Essay, I outline the “War on COVID -19” as a framework of rhetoric and legal authority. The war paradigm provides expanded powers, such as those under the Defense Production Act (DPA), allowing the president to act in moments of crisis in the short term. But the war framework has been ill-suited to address social and economic trade-offs of responses to the COVID -19 crisis over the longer term, including paving the way toward an inclusive recovery. Due to problems of both executive overreach and underreach in the Trump and Biden administrations, the war paradigm is inadequate for addressing the interconnected health and economic crises we experienced with COVID -19 and is subject to abuse. [24]

Subpart A outlines the use of wartime rhetoric as a way to frame the COVID - 19 crisis for political purposes, such as rallying public support. Subpart B focuses on the president’s expanded legal authority under emergency and war powers. Subpart C explains the notions of executive overreach and underreach, while Subparts D and E then examine specific instances of overreach and underreach under both Presidents Trump and Biden pursuant to their expanded legal powers.

A. Presidential Rhetoric: Using a War Framing for the COVID -19 Crisis

As a way to build public support during the COVID -19 lockdown, then- President Donald Trump claimed broader wartime powers, announcing that the fight against COVID -19 was “our big war,” and “a medical war. We have to win this war. It’s very important.” [25] Yet rather than simply using the rallying cry of war to unify against a common enemy—COVID-19—Trump instead used the wartime framing in divisive ways. For example, Trump added fuel to the fire for a trade war with China as well as anti-Asian hatred, referring to the battle against the pandemic as “our war against the Chinese virus.” [26] In fact, Trump sought to blunt criticism of his own mishandling of the response to the pandemic [27] by pushing blame onto a foreign power. [28]

President Joe Biden continued this wartime framing to call attention to the massive government effort needed to address the pandemic. In remarks at the Centers for Disease Control and Prevention (CDC) on March 19, 2021, for example, Biden noted the government’s COVID -19 efforts, emphasizing that “this is a war” and urging that Americans think of themselves in militarized terms: “[Y]ou are the Army. You’re the Navy. You’re the Marines. You’re the Coast Guard. I really mean it.” [29] Since then, the Biden administration has authorized the National Guard to assist with the transportation and distribution of the COVID - 19 vaccine—particularly when the vaccine was initially made available, to meet the high demand—in an effort to make the vaccine as quickly and widely available as possible. [30]

B. Presidential Power and Legal Authority

President Trump declared the COVID -19 pandemic a national emergency on March 13, 2020 under the Stafford Act [31] and National Emergencies Act, [32] following Health and Human Services Secretary Alexander Azar’s announcement of a public health emergency (under the Public Health Services Act) [33] in January 2020. [34] Beyond rhetorical value, declaring a war against COVID -19 permitted Trump and Biden to seize immense power under the overlapping legal frameworks of emergency and war powers. These legal frameworks are overlapping because declaring a national emergency enables the use of military personnel [35] and other powers otherwise largely reserved for wartime, such as the DPA . [36] In this Subpart, I focus on two important emergency power legal tools that Trump and Biden used: the DPA [37] and a provision of the Public Health Services Act (known as Title 42).

A Cold War era statute, the DPA was adopted in 1950, in response to the start of the Korean War. [38] It had its origins in the World War II era War Powers Acts of 1941 and 1942. [39] The DPA permits the president, “largely through executive order, to direct private companies to prioritize orders from the federal government.” [40] The president is authorized to “allocate materials, services, and facilities” for national defense purposes; take actions to restrict hoarding of necessary supplies; [41] make purchases; and require that companies coordinate with each other. [42] As with the War Powers Resolution, [43] the DPA provides the executive branch with expanded powers—and discretion—during emergency situations to act unilaterally, within designated authority when the executive branch finds an emergency exists.

The invocation of emergency powers also enabled the Trump administration to “erect a shadow immigration enforcement power” [44] under Title 42 along United States’ southern border. Under Title 42, the CDC Director:

may prohibit, in whole or in part, the introduction into the United States of persons from designated foreign countries (or one or more political subdivisions or regions thereof) or places, only for such period of time that the Director deems necessary to avert the serious danger of the introduction of a quarantinable communicable disease. [45]

While basing these restrictions on public health grounds, the Trump administration invoked national security to exclude noncitizens generally, even while specifically enabling agricultural and other essential, temporary laborers, who are not citizens, to enter. Biden promised to terminate Title 42, but he was initially slow to do so. [46]

C. Executive Underreach and Overreach

Both the DPA and Title 42 provide examples of how the militarized, wartime rhetoric and emergency law powers can have significant consequences on presidential action and presidential inaction. Specifically, the centralization of power in the executive with wartime powers can lead to the twin problems of executive overreach and executive underreach. Professors Aslı U. Bâli and Hannah Lerner note how war powers often shift authority to the executive branch, resulting in executive overreach. [47] They argue for a larger ongoing role for the legislature, particularly in the context of health and other social emergencies (in contrast to national security emergencies). [48] 48 They contend that the legislative branch is better equipped than the executive branch to weigh scientific expertise, deliberate over difficult social and economic tradeoffs in a more transparent manner than the executive branch, and adjust responses as new scientific evidence comes to light. [49] According to Bâli and Lerner, the legislative branch’s broader deliberative nature assists in securing more extensive input and therefore buy-in from more constituencies. [50]

By contrast, Professors David Pozen and Kimberle Scheppele note the potentially equally troubling problem of executive underreach in response to the pandemic. [51] According to Pozen and Scheppele, executive underreach is “a national executive branch’s willful failure to address a significant public problem that the executive is legally and functionally equipped (though not necessarily legally required) to address.” [52]

In the next two Subparts, I explore how the centralization of power in the executive with wartime powers led to the twin problems of executive overreach and executive underreach with regard to the DPA and Title 42 under Presidents Trump and Biden.

D. Executive Underreach and Overreach during the Trump Administration

Trump’s initial anemic response to the COVID -19 crisis [53] reflected executive underreach. As Pozen and Scheppele note:

Throughout the winter of 2020, Trump minimized the danger posed by the virus, declined to order the Centers for Disease Control and Prevention to prioritize it, ignored a National Security Council playbook on fighting infectious diseases, and failed to ensure adequate production and distribution of test kits, ventilators, or protective medical gear. [54]

Moreover, from around the time of the first COVID -19 death in the United States, Trump proclaimed, “You know, a lot of people think that goes away in April with the heat—as the heat comes in. Typically, that will go away in April.” [55] He repeatedly made comments about the virus disappearing up through the November 2020 election. [56] Further, Trump did not use the DPA until late March 2020, and at that point, in a manner “that fell far short of what many experts recommended.” [57] Having dragged his feet to provide medical supplies from the national stockpile, Trump finally did so in late March, when the decision seemed “to have favored states with Republican governors.” [58] As further evidence of Trump’s executive underreach during the COVID -19 crisis, Pozen and Scheppele point out:

Trump has additionally threatened to pull the United States out of the WHO ; peddled dubious and dangerous cures; refused to wear a face mask in public; criticized governors who imposed lockdowns or followed public health advice to reopen gradually; and, by June 2020, started holding largely mask-free indoor rallies to gin up support for his reelection. [59]

While Trump was slow to invoke the DPA to accelerate production of personal protective equipment (PPE), [60] his executive underreach problem stopped once he eventually appropriately ordered 3M Company to produce N95 respirator masks and General Motors to produce ventilators for the federal government. [61] Further, he properly issued one executive order to prevent the hoarding of PPE [62] and another to expand domestic production of PPE and other health equipment. [63]

Yet in an act of executive overreach, Trump issued a controversial order preventing distributors from exporting PPE . [64] The power to restrict exports had not been used since the Cold War, and the order was criticized because of the risk that such export restrictions might “work to the detriment of the world’s ability to distribute these scarce medical resources to where they are needed most with the minimal amount of red tape.” [65]

In another act of executive overreach, Trump used his authority under the DPA to issue Executive Order No. 13,917, which required that meat processing plants remain open, ostensibly to protect the food supply chain and related “critical infrastructure." [66] Assembly line workers in these plants were (and still are) disproportionately Black and Latinx, and had limited protection from Occupational Safety and Health Administration (OSHA) enforcement at the time. [67] Pursuant to Executive Order No. 13,917, Trump instructed Agriculture Secretary Sonny Perdue, “as he deems appropriate, . . . to ensure that meat and poultry processors continue operations,” claiming scarcity of meat and poultry. [68] The difficulty of workers being able to socially distance on the assembly line led to outbreaks at numerous poultry plants. [69]

In short, the poultry workers were forced to risk their lives on the ostensible frontlines in the president’s “War on COVID -19.” Different rhetoric, along with legal protections to safeguard the health and safety of these workers, would have recognized them as people deserving of rights, rather than, in effect, soldiers who signed up to sacrifice their lives for the good of the country. Misconceiving of the workers in this way was especially troubling in that it disproportionately impacted Black and Latinx people whose lives were at risk.

Trump’s use of Title 42, [70] which blocked migrants from entering the United States through its southern border, is an additional instance of executive overreach. [71] In relying on this obscure provision from a 1944 law, [72] the Trump administration “originally concocted” the Title 42 ban “on dubious legal grounds as a means to close down the southern border to asylum seekers,” [73] Professor Jaya Ramji-Nogales explains:

The policy was implemented on March 20, 2020, reportedly over the objection of the then-Director of the Centers for Disease Control and Prevention, Dr. Robert Redfield. Public health experts have repeatedly criticized the program, describing the public health justification as specious, and offering guidance in the form of alternate measures that could protect public health while permitting asylum seekers to obtain protection in the United States. [74]

Trump’s inappropriate use of the “War on COVID -19” as a justification to divert Pentagon funding to build his southern border wall [75] —which, as I have discussed elsewhere, had roots in racial tropes concerning Latinx communities— serves as a final, related example of his executive overreach. [76] What began as an effort to divert military funding to build his border wall even before the pandemic hit, the continued push to improperly use defense funds for the border wall during the pandemic was yet another example of executive overreach in that it was neither justified as a matter of law or policy. Besides likely unconstitutionally infringing on U.S. Congress’s spending powers, [77] Trump’s policy was misguided and justified based on false information. He claimed that the border wall was needed to keep COVID -19 from spreading from Mexico to the United States. However, Mexico was not the problem: COVID -19 rates were actually higher on the U.S. side of the border at the time. [78] Moreover, border wall construction under Trump seemed likely to create more problems than it would solve with regards to COVID -19 because the influx of construction workers headed to remote towns posed a potential public health threat in the border region. [79]

Nonetheless, war powers were a convenient shield for Trump, who asserted that, “To this day, nobody has seen anything like what they were able to do during World War II . . . Now it’s our time. We must sacrifice together because we are all in this together and we’ll come through together.” [80] 80 In sum, even as Trump initially erred through executive underreach in responding too slowly and inadequately to the pandemic, he later blundered through executive overreach in his use of military rhetoric, nationalism, racism, and expansive, potentially unjustified exercises of power under the DPA , ignoring the sacrifice of low-income poultry workers and cloaking his long-term goal of building a Southern Wall on the border with Mexico.

E. Executive Underreach and Overreach in the Biden Administration

By contrast, Biden initially used wartime powers to appropriately and effectively accelerate the emergency response to the COVID -19 pandemic, rather than as a pretext to undermine worker rights protections or build a border wall. However, as an example of executive underreach, the Biden administration dragged its feet on reversing damaging Trump-era policies, particularly with regard to Title 42.

Biden, on his first day in office, issued Executive Order 14,001 [81] 81 directing his administration to “identif[y] shortfalls in the provision of pandemic response supplies,” and to use the DPA to address any shortfalls, if necessary. [82] Further, the Executive Order tasked his administration to ensure the adequacy of such supplies for future pandemics, including by improving supply chains and expanding the Strategic National Stockpile of PPE . [83]

Since then, the Biden administration relied on the DPA to speed up vaccine production by assisting manufacturers to secure the equipment and components needed to make doses. [84] Furthermore, the Biden administration also relied on the DPA to expand access to COVID -19 testing. [85] In the midst of the fast-spreading Omicron variant, in December 2021, the Biden administration leveraged the DPA in its plans to distribute half a billion COVID -19 tests. [86]

Yet as an example of both executive overreach and underreach, Biden was slow to end Trump-era pandemic restrictions under Title 42, [87] 87 continuing the blockade on migrants from the U.S. southern border. [88] Biden’s continuance of the policy illustrated ongoing executive overreach, while his delay in reversing the policy demonstrated underreach. The Biden administration eventually announced it was terminating Title 42 in spring 2022, [89] amidst the easing of COVID -19 rates and travel restrictions. But Biden’s efforts to rescind Title 42 were paused once a lawsuit was filed challenging his plans to end the policy. [90] The Biden administration argued before the U.S. Supreme Court “that its intent to let the coronavirus public health emergency expire in May [2023 would] moot the ongoing case over a Trump-era border restriction.” [91] And, indeed, once the coronavirus public health emergency expired in May 2023, Biden lifted the Title 42 restrictions. [92]

II. PROS AND CONS OF A MILITARIZED , SECURITIZED FRAMEWORK

This Part of the Essay explores the pros and cons of using a militarized, securitized framework for the COVID -19 crisis—both as a legal and rhetorical matter. Subpart A summarizes the benefits of the wartime framing and Subpart B summarizes the downsides.

A. The “War on COVID -19”: The Allure of the War Framework

On the one hand, invoking war as a way to define a crisis—in this case as a battle against an “invisible enemy,” [93] a virus—allowed President Trump and now President Biden to rally support and exercise extraordinary presidential powers quickly in the face of an emergency. [94] Beyond the rhetorical value of securing public support for efforts combatting COVID -19, as Americans rally around the flag to support wars that appear justified, [95] declaring war also establishes a legal hook and justification for invocation of the DPA . [96]

As discussed in Part I, while slow to invoke the DPA , Trump eventually did resort to it to accelerate production of PPE , prevent hoarding of essential supplies, and increase the domestic production capacity of essential health products. [97] Biden also sought to identify shortfalls in pandemic response supplies, secure supplies for future pandemics, improve supply chains, speed up vaccine production and distribution, and expand access to COVID -19 testing. [98]

Thus, a benefit of the DPA is that it offers emergency authorization for the president to respond with dispatch in times of crisis. While the DPA grew out of the context of World War II and the Korean War, war is not a prerequisite for the president to invoke it as a source of legal authority, [99] which further enhances its usefulness as a basis of presidential authority to act quickly in times of emergency. The “Declaration of Policy” section of the statute states that “the security of the United States is dependent on the ability of the domestic industrial base to supply materials and services for the national defense and to prepare for and respond to military conflicts, natural or man-caused disasters, or acts of terrorism within the United States.” [100]

Given the broad language of the DPA , many crises beyond military conflicts fall within this basket. For example, the Federal Emergency Management Agency (FEMA) relies on the DPA when responding to disasters, “bumping its orders for items such as food and bottled water to the front of the line. The DPA was also used to supply natural gas to California during the 2000–2001 energy crisis.” [101] In sum, the war powers legal framework that undergirds the DPA provides the president with broad authority to respond with swiftly in times of crisis.

B. The Downsides of a Militarized Framework

On the other hand, reliance on a heavily militarized framing risks reinforcing the legitimacy of domestic militarization, strengthening the carceral state, and undermining more transparent, democratic forms of governance. War is a malleable term that has been used to rhetorically wage battles in the “War on Drugs” and “War on Poverty.” [102] Even where the term “war" is used to invoke legal authority—as it has been with invocation of the DPA to fight COVID -19—emergency and related war powers can be distorted to justify measures based on the pretext of an emergency. [103]

For example, as discussed in Part I, in pointing to the pandemic crisis, Trump sought to justify redoubling efforts to build his proposed southern border wall. [104] As further illustrated in Part I , Trump used the COVID -19 crisis as a basis to force the predominantly Black and Latinx poultry worker labor force to risk their lives on the frontlines in the president’s “War on COVID -19” by requiring that meat processing plants remained open, ostensibly to protect the food supply chain and related critical infrastructure. [105] Additionally, Trump’s militarized rhetoric concerning COVID -19 weaponized it as a white supremacist tool that fueled anti- Asian hate. According to a UC San Francisco study, “[i]n the week after former President Donald J. Trump tweeted about ‘the Chinese virus,’ the number of coronavirus-related tweets with anti-Asian hashtags rose precipitously.” [106] Trump had tweeted, “The United States will be powerfully, supporting those industries, like Airlines and others, that are particularly affected by the Chinese Virus. We will be stronger than ever before!” [107] Both Trump’s text and this study came amidst “a rash of violent attacks on people of Asian descent” and lent validity “to warnings by public health experts that naming a disease after a place is stigmatizing.” [108]

The warfare paradigm is also negative because it harkens back to harmful extensions of U.S. military power and colonialism abroad that have been ill- advised, including the recent occupation of Iraq. [109] Analogous to that war, it was not clear when the “War on COVID -19” would end. Only once the COVID -19 virus is completely subdued? Until recently, the United States had been engaged in a decades-long forever war against Al Qaeda and its successor entities, leading to warfare with an ill-defined ending point. [110] Martin Luther King, Jr. had warned against such endless wars in the context of the Vietnam War. [111]

Wars are expensive, yet Congress rarely imposes sunset clauses and has been slow to otherwise bring wars to a close. [112] Characterizing the fight against the coronavirus—an invisible enemy—as a war raises parallel challenges of determining when the emergency is over. The legal battle over ending Title 42 restrictions on migrants crossing the U.S. southern border is an example of how the ongoing emergency declaration harmed Brown and Black migrants (for example, from Latin America and Haiti). [113]

On the domestic front, the militarization of American policing also reveals a dangerous downside of military models and militarized rhetoric. In the early days of the pandemic, the “War on COVID -19” was enforced through police stopping people who failed to wear face masks in predominantly Black and Brown communities. [114] As I have noted elsewhere, “the New York Police Department violently arrested individuals in communities of color, while politely handed out face masks to white sun bathers in Central Park.” [115]

Nonetheless, historically, periods of militarization have been followed by transformative change.

III. CRISIS AND CONSTITUTIONAL CHANGE

This Part draws on historical analogies to reflect on the paradoxical allure of the war and security framework in moments of crisis. Despite the hardship and loss inherent in these periods, these moments in U.S. history often prompt calls for transformative change following the tragedy. Given the contemporary interlocking pandemics of COVID -19, economic devastation, and inequality [116] —and the calls for change prompted by these interrelated crises—we can look to historical analogies to better understand the urgency implied by the militarized framing of the COVID -19 crisis.

Here, I examine three historical analogies that have been raised to suggest that the COVID -19 crisis marks a moment for transformative change. Subpart A explores the shift from the Civil War to Reconstruction. Subpart B examines the pivot from the Great Depression to the New Deal. Subpart C turns to the transition from World War II to the Marshall Plan. Based on an understanding of how these three historical shifts operated within frameworks of national and economic security, the potential transition from pandemic to a postpandemic recovery has similarly been framed within the context of security, specifically health and economic security. We are at a pivot point: either we return to the status quo of the pre pandemic period, or we use the pandemic as a portal [117] to a new normal.

A. From Civil War to Reconstruction

A familiar historical analogy, which draws directly on the notion of wartime and recovery, is the idea of Reconstruction as a period of rebuilding after the fractures and devastation of the Civil War. Following the Civil War, Congress adopted the Reconstruction Amendments, which freed enslaved Blacks, provided for at least formal equality, and enfranchised Black men to vote. [118] These constitutional guarantees paved the way for Congress to adopt civil rights legislation during the Reconstruction era. However, progress was limited due to the Supreme Court’s adoption of cramped interpretations of the law as well as political backlash against race equality. [119] Similarly, Jim Crow laws paved the way for the civil rights era of the 1960s, which was viewed as a Second Reconstruction, yet that reconstruction too was met with political backlash and over time an increasingly hostile reception in the Supreme Court. [120]

Today, some observers have called for a “Third Reconstruction” or “New Reconstruction,” using the post-Civil War and first Reconstruction era as a model. [121] In light of George Floyd’s murder at the start of the pandemic, the current health crisis has overlapped with a broader period of racial reckoning. [122] In fact, having lost his job in the midst of the pandemic, Floyd’s arrest for a crime of poverty demonstrated ways the racial reckoning and pandemic were intertwined. Thus, the idea of a new Reconstruction is more than an analogy—it builds upon the idea of the unfinished Reconstruction following the Civil War.

Just as Reconstruction faced backlash and ultimately Jim Crow, [123] U.S. voting rights and other civil rights are similarly experiencing a period of retrenchment. [124] Hope for a renewed Reconstruction that addresses concerns over equality and inclusion has been dimmed by both the rise of a conservative supermajority on the U.S. Supreme Court [125] as well as the inability of U.S. Congress to adopt responses toward a more inclusive economic recovery and police accountability. [126] However, Part IV of this Essay outlines proposals to move beyond the current impasse and to usher in a new Reconstruction-like era.

B. From Great Depression to New Deal

In light of the current twin health and economic crises, perhaps the most relevant historical analogy is the Great Depression and the New Deal period that followed. The New Deal was important as an immediate response to the Great Depression, and it was also forward-looking in that it laid a foundation for social safety nets, labor regulations, and the modern welfare state more broadly. While the Great Depression itself was not war, it occurred in the interwar period and has been largely framed in terms of economic insecurity, with Social Security and other New Deal initiatives intended to address this insecurity. [127] Book-ended by World Wars I and II, the joblessness and economic suffering of the Great Depression paved the way for the New Deal’s establishment of programs to address social and economic security, embedding the notion of securitization into federal policy. [128] The war framework and war powers themselves were essential to economic recovery, as World War II helped to further accelerate recovery from the Great Depression. [129] At the same time, federal labor laws adopted during this period excluded the predominantly Black sectors of domestic workers and agricultural workers. [130]

Today, the grandson of Franklin and Eleanor Roosevelt, James Roosevelt, Jr., among others, has suggested that the current moment calls for a new New Deal. [131] Not unlike the Great Depression of the last century, the pandemic recession resulted in record unemployment due to quarantine measures and other COVID - 19 restrictions that necessitated a largely stay-at-home pandemic economy. [132] Of course, the digital economy—which was already expanding before COVID -19— exploded during the pandemic, with the rapid growth of Zoom and other videoconference systems; the accelerated rise of app-based delivery services and taskers; and the popularity of a vast array of communication technologies and social media platforms for communication, social interaction, entertainment, and economic activity. [133] In terms of employment, however, beyond the frontline workers who continued to work in-person and those who were able to work remotely, a record number of people were furloughed or fired. [134]

Biden’s effort to “build back better” from this economic wreckage clearly harkens back to FDR ’s New Deal. [135] Further, his infrastructure legislation [136] is an echo of the National Industrial Recovery Act, [137] which created the Public Works Administration, helping to employ Americans through largescale public works construction projects. [138] On the one hand, beyond the short-term support provided by stimulus checks that Congress supported in 2020 and 2021, lawmakers fell short of enacting more transformative, longer-term changes to build a more inclusive economy. [139] Biden’s “human infrastructure” proposal largely languished on Capitol Hill, and he backed away from shoring up, much less expanding, the social safety nets established during the New Deal. [140] On the other hand, he was ultimately able to secure passage of the Inflation Reduction Act, which will, among other things, support the growth of the green economy and continued economic recovery, both of which were deemed essential as the nation recovered from the twin health and economic crises. [141]

C. From World War to Marshall Plan

A final historical analogy is World War II and the postwar recovery period, as seen through the Marshall Plan, the post-World War II economic recovery program providing aid to Western Europe. Biden made this direct connection between COVID -19 recovery and recovery from the world wars in his first primetime address from the White House in March 2021—on the one-year anniversary of the COVID -19 shutdown [142] (and the day he signed the American Rescue Package [143] ). Speaking about the COVID -19 crisis, he stated: “As of now, the total deaths in America: 527,726. That’s more deaths than in World War One, World War Two, the Vietnam War, and 9/11 combined.” [144]

Beyond the Marshall Plan’s assistance to support allies abroad, the United States also played a leadership role in supporting the emergence of human rights at home and abroad. [145] As with the Marshall Plan, however, the United States’ approach to the human rights regime has ultimately largely focused on rights abroad rather than at home. [146] Putting a more domestic and contemporary spin on the analogy, civil rights leader Sherrilyn Ifill called for a Thurgood Marshall Plan, named for the first Black Supreme Court justice, to build a more inclusive economy as the United States (and the world) recovers from the pandemic-era recession. [147] Along similar lines, founder and CEO of Girls Who Code, Reshma Saujani, has called for a “Marshall Plan for Moms,” that is, “a plan to pay our mothers for their unseen, unpaid labor.” [148] Saujani’s demand has been published in full-page ads in the New York Times and Washington Post, signed onto by a number of influential women. [149]

Unlike the original Marshall Plan, proposals like those from Ifill and Saujani focus on the United States’ domestic commitments to economic security. These proposals also vary from the post-World War II Marshall Plan in that they advance an approach to security grounded in economic security, economic justice, and racial and gender inclusion. The original Marshall Plan, in contrast, was primarily about economic growth, as opposed to inclusion and human development, reflecting the broader approach to economic development. [150]

Building a bridge between national security and civil rights has a significant basis in history. The civil rights bar has long sought to hold the country to its founding values of democracy, equality, and fundamental rights—ideals the United States fought for abroad to defend national security during World War II, the Marshall Plan, and Cold War. [151] For example, even as securing these ideals abroad was central to maintaining peace and stability following World War II, [152] the Department of Justice’s (DOJ) Civil Rights Division notably made the connection between the country’s national security and foreign policy on the one hand and civil rights and domestic policy on the other, insisting on democracy and civil rights at home as well as abroad. [153] 153 Noting the hypocrisy of the United States fighting for democracy and human rights abroad during World War II and the Cold War while not guaranteeing equality and democracy at home during Jim Crow, in its Brown v. Board of Education amicus brief, the DOJ argued:

[T]he existence of discrimination against minority groups in the United States has an adverse effect upon our relations with other countries. Racial discrimination furnishes grist for the Communist propaganda mills, and it raises doubts even among friendly nations as to the intensity of our devotion to the democratic faith. [154]

The NAACP argued a similar point when Brown was reargued, asserting that the “[s]urvival of our country in the present international situation is inevitably tied to resolution of this domestic issue.” [155]

In sum, in each of these historical examples a moment of deep national or economic insecurity was followed by a moment of transformation. Understanding these periods of crisis and recovery as moments of insecurity and rebuilding security helps clarify why the transformation that followed in each instance was necessarily somewhat limited.

IV. Alternative Framework: An Ethics of Care

Given the flaws of the war paradigm historically (as discussed in Part III ) as well as in the current “War on COVID -19” (as discussed in Part II), in this final Part of the Essay, I propose an ethics of care as an alternative to the wartime approach, which, as discussed above, privileges presidential power and law and order over justice. [156] An ethics of care provides a basis for a politics and law of care, which are more appropriate for addressing the current health and economic challenges over a longer time horizon, [157] in contrast to the initial onset of the pandemic in which the war and emergency powers framework was expedient for the short run response, given the relatively unforeseen crisis.

Before I detail my proposed alternative approach to our longterm recovery from the pandemic, I want to acknowledge that the notion of national security itself is being redefined. [158] For example, the United Nations has reframed notions of national security to include “human security” [159] and activists and scholars have begun calling for food, housing, and other forms of economic security to be included as well, [160] perhaps harkening back to the FDR -era beginnings of the notion of Social Security. While this redefining of security is helpful, it fails to fully address our need in the current moment to reexamine our commitments to each other and the state’s role in supporting those commitments. Notwithstanding the past moments of crisis—such as the Civil War and Great Depression—that ushered in a more robust role for the government in the protection of rights and economic security for all, this current moment calls for a reevaluation through an ethics of care given a slippage in protection of these rights.

In Subpart A, I describe the notion of an ethics of care and suggest how to scale this notion up and embed it into a politics and law of care. In Subpart B, I argue that just as the pandemic has perhaps forever changed our notions of work and economy, so too should it upset and call upon us to radically reimagine our notions of community and commitment to each other.

A. What is an Ethics of Care?

An ethics of care is a view of morality that centers care and responsibility. The notion grows out of feminist theory. Yet because caring and caring relationships are universal human attributes, an ethics of care approach assumes that care is ethically basic to humans in general, not just women, if not always pursued in practice. [161] In theorizing an ethics of care approach, the philosopher of education Nel Noddings built on ideas previously developed by the applied psychologist Carol Gilligan. [162] Gilligan asserted that women have a different moral voice than men, and Noddings sought to develop an ethics for this claim. [163] Gilligan had “sketched an outline of moral development centered on care and responsibility as complementary to the prevailing model focused on justice and rights.” [164] Noddings was also critical of a view of morality that focused, according to her, on justice, propositions, and justifications—that is, grounded in reasoning that derives rational conclusions from hierarchically entrenched principles. [165] As an alternative, Noddings argued for an “affective foundation of existence”— beginning “not from moral reasoning, but from the human longing for goodness.” [166] In contrast to Gilligan, Noddings is interested in an ethics of caring rather than the development of caring patterns. [167]

While women have historically disproportionately played primary caregiving roles, both Noddings and Gilligan disavow an essentialist notion of women as caregivers. [168] On the one hand, the disproportionate impacts of pandemic quarantine measures on women drove home the ongoing gendered construction and devaluing of care work and other forms of work in which women predominate; women dropped out of the workforce in higher numbers than men to care for children who had to learn remotely from home during pandemic peaks. [167] On the other hand, this gendered role is a social (not biological) construct grounded in historical structures of dominance and subordination. [170]

In scaling up an ethics of care such that it is a government obligation, feminist legal theorist Martha Fineman offers a theory based on vulnerability as “an argument for a radical ‘ethics of care’ as the foundation for governance[.]” [171] Fineman’s approach to vulnerability contends that because vulnerability is a universal condition in that all humans are vulnerable at various stages in life (whether in infancy, old age, or illness), we need a theory of the state that responds to this reality. [172] Fineman’s “argument . . . recognizes that human vulnerability provides the primary legitimating justification for the coercive ordering of human relationships and endeavors through law,” [173] which would support caregiving arrangements. Of course, the pandemic illustrated how necessary such caregiving arrangements are. Fineman’s vulnerability theory plays a critical role in scaling up an ethics of care to address our universal vulnerability, in that, as Fineman observes:

Feminist ethics-of-care theories are based on individual relationships of care By contrast, vulnerability theory centres on the institutional, not the individual, and the corresponding responsibility to care is the governmental obligation to care for everyone subject to the structures and mechanisms of governance . . . form[ing] the foundation of governmental legitimacy. [174]

Applying this insight to the pandemic, a vulnerability analysis of COVID - 19—with an ethics of care at its core—reveals that many people who were dependent on caregiving relationships found themselves to be suddenly undermined. This dramatic loss of care happened across many contexts: childcare, eldercare, healthcare, and care and cooperation among workers, friends, and neighbors. Further, while vulnerability to COVID -19 was a universal human condition, the pandemic revealed differential vulnerability. [175] While we were all vulnerable to COVID -19 during the worst of the pandemic, front-line workers (who were disproportionately Black and Latinx) were more susceptible to transmission than remote workers. [176] The structural inequalities in the labor market thus revealed differential racial vulnerability to the pandemic. [177]

Because the pandemic created a universal experience, we witnessed a convergence of interests [178] that helped pave the way for robust government assistance, at least in the first stages of the pandemic. For example, the government provided stimulus checks to those who had lost employment. [179] The shared sense of vulnerability helped lay a foundation for new laws and policies—one based on an ethics of care. As Ruha Benjamin has noted: We had been told that universal access to healthcare was not possible; then the pandemic taught us that universal vaccination and testing programs were, in fact, not only possible, but indispensable. [180] We had been told that a guaranteed basic income was a pipe dream; then with the pandemic, coronavirus stimulus checks were provided to the unemployed. [181]

B. Scrambling Our Notions of Commitments to Each Other

As discussed above, the wartime framing of COVID -19 has so far failed to deliver on the promise of broader transformation. Now COVID -19 is shifting from pandemic (and extraordinary law and politics) to endemic (and ordinary law and politics). [182] Just as COVID -19 has scrambled our notions of work and economy, so too should it scramble our notions of community and commitment to each other. In prompting requirements to socially distance, wear face masks, and receive COVID -19 vaccination shots and boosters geared toward protecting one another, [183] the pandemic has called on all of us to re-envision our commitments to one another as members of a polity.

As a thought experiment in exploring how an ethics of care might inform ways the pandemic can usefully scramble our notions of commitment to each other, I first offer a reflection on how an ethics of care might be applied to the care economy, [184] among other sectors of the economy. Next, I return to the historical analogies—and the militarized, securitized approaches therein embedded— examined in Part III above and how they can shed light on the utility of an ethics of care, thus offering lessons on mistakes we might avoid making again.

1. The Care Economy: A Quintessential Case Study

Elsewhere, I have focused on how—beyond the digital and green economies—care work is core to imagining the “future of work,“ given the aging of the baby boomer generation and their care needs. [185] Beyond being a case study in the future of work, the care economy is also a paradigmatic example of how the crisis of COVID -19 paves the way for us to re-envision our commitments to each other through an ethics of care. More so than the wartime framing of the COVID -19 crisis, an ethics of care approach would be more transformative toward moving society toward a fuller recovery and a new normal over the longer term. A new normal would be a more equitable and, therefore, a more sustainable baseline.

The U.S. workforce is aging. [186] With baby boomers aging, eldercare is a growth sector, yet cannot be easily automated. [187] As has become apparent during the pandemic, care workers are key to the provision of care for so many at different stages and in different ways—children, the elderly, the sick, and others in need. [188] Yet care workers, who were already underpaid and lacking in benefits, [189] were especially hard hit by the pandemic. These caregivers included both those who work in the home [190] as well as those who work in assisted living facilities, where COVID -19 cases skyrocketed at various points during the pandemic. [191]

Besides supporting those in need of care, caregivers allow others to outsource care work responsibilities, especially working mothers. Thus, the care economy is a critical and undervalued engine for gender equality. Caregiving jobs are job-enabling jobs: caregivers enable other workers to work. [192] As such, caregivers provide a double-benefit to the economy. Yet care workers are largely excluded from many federal labor laws. [193] This has roots in the exclusion of domestic workers, like farm workers, from labor laws adopted during the New Deal period—an exclusion that historians find was related to the fact that the domestic and farm worker sectors were overwhelmingly Black. [194]

In driving home the critical role of caregivers, the pandemic seemed likely to establish a convergence of interests among those in need of care and care workers who needed to find ways to continue to safely provide care in the midst of COVID -19. [195] The moment is ripe to recognize the tremendous value of care work—to us all and the economy as a whole—by extending labor law protections to this sector and affording caregivers living wages afforded to most other workers, health benefits, and other protections.

As a quintessential example of how an ethics of care can be embedded in a politics and law of care, a movement has emerged to call on lawmakers to reimagine work and the human infrastructure that supports work. Rather than treat care workers as second-class citizens by excluding them from federal labor laws, for example, an ethics of care would value their critical work in law and policy. The Care Infrastructure Campaign (spearheaded by Caring Across Generations and partnering organizations) deftly recognizes that caregiving affects many constituencies, including children, working parents, older individuals, and those in need of health assistance. [196]

Just as investment in physical infrastructure creates literal bridges to enable commuting to work, so too investment in our care infrastructure is a critical bridge in connecting employees to work. [197] While Biden’s proposed “Build Back Better” plan would have addressed shortfalls in the U.S. care infrastructure by providing $150 billion for in-home care workers through Medicaid, [198] Congress’s failure to pass the broader bill highlights the need to pursue support for the care economy through more targeted legislation and bi-partisan efforts. [199] At a moment of bipartisan agreement to improve bridges, tunnels, and other physical infrastructure, we also need investment in our human infrastructure, namely our infrastructure of care. [200]

Lastly, the growing need for care across generations could demonstrate law professor Derrick Bell’s interest convergence theory: progress is made only when a variety of interests converge, including those of the dominant group. [201] Even the most powerful among us in our society were vulnerable during the earliest days of the pandemic. This universal vulnerability helped align the interests of those most powerful with those who experienced differential vulnerability during the pandemic. [202]

Rather than being completely autonomous individuals, we are socially situated. Over the course of a lifetime, we depend on each other, because each of us will inevitably be vulnerable [203] and in need of care. An ethic of care has a greater potential to tap this interdependence for social change than the wartime framing over the longer run because of the interest many have or will have in the care economy either directly or by outsourcing care.

2. How Might an Ethics of Care Apply Beyond the Care Economy

While the care economy is perhaps an obvious example of how the pandemic demands an ethics of care that calls for rethinking our notions of community and commitment to each other, an ethics of care that is grounded in our pandemic experience might also be called for in other sectors of the economy as well. Just as COVID -19 has forced us to reimagine our commitments to each other by social distancing, masking, and getting vaccinated, so too has it forced us to reimagine our commitments to the planet, and, in effect to each other on a global scale. In just a few months—during the strictest global lockdown—our planet experienced an almost 15 percent decrease in global ozone emissions. [204]   Imagine if we could find ways to reduce emissions in an ongoing way.

By utilizing an ethics of care that is grounded in our global, planetary interdependence, developing a politics and law of care through supporting a greener economy is essential for our literal survival. While the reduction in emissions during COVID -19 shutdowns was not prompted by a concern over the climate changing, the impact on emissions was so notable that it prompted us to realize that reduced emissions is possible in practice, not merely in theory. Notably, the Green New Deal, one of the foremost proposals for a green future, builds off of the FDR -era New Deal. [205]

Thus I return to the historical analogies discussed in Part III as a way to apply lessons learned from the past to the future in envisioning an ethics of care.

3. Why We Must Pivot from Past Approaches to an Ethics of Care

Returning to the historical analogies—and the militarized, securitized approaches inherent in those moments—I reconsider how those earlier moments can shed light on the current “War on COVID -19” framing. By looking more closely at shortcomings in the law and policy responses to these historical examples of crisis, particularly in terms of race, I argue that an ethics of care is a more adequate framing for the long-term response to the pandemic.

From Civil War to Reconstruction: As professor Henry Louis Gates Jr. notes, even after the Civil War and abolition of slavery during the Reconstruction period, “[c]otton remain[ed] the most profitable United States export all through the 19th century, well into the 20th century, through the 1930s.” [206] But there remained a “pesky problem of who was going to pick all that cotton?” [207] During the period of “redemption,” Reconstruction was rolled back in at least two critical ways. First, progress was reversed when southern whites “institute[ed] a system of peonage and sharecropping, which is as close to slavery as you can get without actually being slavery” and paved the way for Black people to be, in effect, forced to continue to pick cotton. [208] Second, many states, especially in the American South, rolled back voting rights for Black men, after which the Black community had limited options for demanding equality. [209] With Black people concentrated in agricultural work and care work, they have been paid poverty wages through the systems of peonage, sharecropping, and various forms of care giving. Paradoxically, this is the very employment that was suddenly recognized during the pandemic as “essential work.”

An ethics of care would have recognized the fundamental humanity of African Americans and ensured human rights as a universal norm. Yet, even as the country transitioned during the New Deal, many of the racist underpinnings of the U.S. economy, labor market, and political system were still in place—the legacy of which has become stark during COVID -19 in ways that a wartime framing does not adequately address over the longer run. The transformation that the Reconstruction initiated following the Civil War was cut short in a reversal that continues to haunt the country and calls for a new paradigm to address entrenched structural inequality and economic fragility.

From Great Depression to New Deal: The New Deal was a period of reimagining the federal government’s relationship to individuals, paving the way for a range of federal protections. But by excluding domestic and agricultural workers (who were overwhelmingly Black) from labor protections, [210] the New Deal undermined support for care workers as well as farm workers who ensured the nation’s food supply. [211] While we view the New Deal as a period that shored up economic security, excluding these categories of workers from labor protections undermined human and economic security of these workers. It also undermined the broader security of the care economy and food security, [212] both of which were revealed to be fragile during COVID -19. [213] An ethics of care would have recognized the fundamental humanity of these workers. As the country moves forward with a longer-term response from COVID -19, we must learn from the mistakes of the past. We must not repeat the New Deal’s exclusion of essential workers, such as care and farm workers.

From World War II to Marshall Plan: Finally, implementation of the G.I. Bill after World War II involved another mistake that is relevant to the COVID -19 crisis and the shortcomings of a more traditional security framework. Following World War II, the G.I. Bill created a social compact of sorts with veterans. The G.I. Bill provided the housing and education benefits and is credited with helping to build America’s middle class following the war. [214] Many Black veterans who qualified for G.I. Bill benefits, however, were wrongly denied. As one report explains:

[Black] [v]eterans had to go to their local veterans’ administration offices. These were staffed almost exclusively by [w]hite officials and this is a particular problem in the South They were denied access to mortgages . . . college tuition [and] a chance to participate in the post-war economic boom, which saw [w]hite wealth surge and Black wealth barely keep up with inflation. [215]

Thus, while the G.I. Bill created postwar economic prosperity and security for some, these benefits were not extended on an equal basis reflecting an ethics of care. The G.I. Bill might have been a cornerstone for shoring up security—human and economic security of veterans and their families—had it been extended on an equal basis. Instead, and as COVID -19 starkly revealed, the nation continues to be plagued by deep underlying racial inequalities of wealth, housing, education, and health access, among other inequalities. These gross inequalities led to disproportionate impact on Black and Latinx communities in particular during the pandemic—a phenomenon I have coined the “Color of Covid.” [216]

In this Essay, I have argued that the “War against COVID -19” framework is inadequate for addressing the twin health and economic crises of the pandemic now that we are beyond the immediate onset of these crises. The militarization and securitization paradigms privilege law and order over justice. As an alternative approach, I argue for an ethics of care. Past moments of crisis—such as the Civil War, Great Depression, and World War II—ushered in periods of transformation, establishing a more robust role for the government in the protection of rights and economic security. In providing security to some, but not all, however, the transformative potential of these earlier periods was limited. The current moment calls for significant rethinking of our commitments to each other and the state’s role in supporting those commitments. By applying an ethics of care, we can take advantage of the transformative potential from this crisis—even while honoring the tremendous tragedy and loss endured— to go further than previous moments of crisis. Lawmakers must build on this moment by adopting laws that better protect the pay and well-being of all workers, including those in the care economy.

In sum, this pandemic has forever colored our understanding of not only the crisis of contagion, but also of the ethics of community, connection and care. As Arundhati Roy suggests, we must acknowledge the tragedy of the pandemic, while also utilizing this crisis for transformational change by viewing the pandemic as a “portal” to a more just and equal world [217] —where we are each valued as essential, not disposable.

[1] President Joseph R. Biden, Remarks by President Biden and Vice President Harris During a Briefing at the Centers for Disease Control and Prevention , White House (Mar. 19, 2021), https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/03/19/ remarks- by-president-biden-and-vice-president-harris-during-a-briefing-at-the-centers-for- disease-control-and-prevention [perma.cc/4CX3-UQCB]. It is challenging to determine to whom to attribute the specific phrase, “War On COVID -19,” as many similar formulations emerged worldwide early on in the pandemic. But one prominent proponent of the wartime framework globally was United Nations (UN) Secretary-General Antonio Guterres. In what might be viewed as a pivot from “Global War on Terror” to “Global War Against COVID ,” the UN chief stated that the world is “at war” against COVID -19 and claimed that “[w]e need the logic and urgency of a war economy, to boost the capacity of our weapons[.]” UN Chief Says World at ‘War’ Against COVID -19 , Al Jazeera (May 24, 2021), https://www.aljazeera.com/news/2021/5/24/un-chief-says-world-at-war-against-covid-19 [https://perma.cc/6NWA-MT9R]; see also Oscar Guinea & Iacopo Monterosa, A Global Effort to Win the War Against COVID -19 , EUR. CTR . INT ’L POL . ECON . (Mar. 2020), https://ecipe.org/blog/global-effort-against-covid19 [perma.cc/BX4K-VMGY].

[2] . Jack Shafer, Opinion, Behind Trump’s Strange ‘Invisible Enemy’ Rhetoric , Politico (Apr. 9, 2020, 4:24 PM), https://www.politico.com/news/magazine/2020/04/09/trump- coronavirus-invisible-enemy-177894 [https://perma.cc/724A-3J33].

[3] . Sharon LaFraniere & Noah Weiland, U.S. Plans to End Public Health Emergency for Covid in May , N.Y. Times (Jan. 30, 2023), https://www.nytimes.com/2023/01/30/us/politics/biden- covid-public-health-emergency.html [https://perma.cc/3BAE-V947]. In fact, as this article goes to press, the Biden administration has just lifted the U.S. national emergency, which allowed the government to take sweeping steps to respond to the virus and support the country’s economic, health and welfare systems,” though “[t]he public health emergency [which] underpins tough immigration restrictions at the U.S.-Mexico border . . . is set to expire on May 11[,]” as announced previously. The Associated Press, Biden Ends COVID National Emergency After Congress Acts , NPR (Apr. 11, 2023), https://www.npr.org/2023/04/11/1169191865/biden-ends-covid-national-emergency [https://perma.cc/S6TV-535K].

[4] . For the purposes of this Essay, I rely on the helpful distinction between “national security emergencies” and “social emergencies” that Aslı Bâli and Hanna Lerner have proposed. See Aslı U. Bâli & Hanna Lerner, Social Emergency: Rethinking Emergency Framings in the Age of COVID -19 and Climate Change (manuscript at 1) (on file with author)[hereinafter Bâli & Lerner, Social Emergency] (analyzing and distinguishing “the institutional implications of social emergencies, which require more deliberative, inclusive and participatory mechanisms of democratic decision-making, compared with the national security emergency model of decisive top-down executive action checked by judicial oversight”).

[5] . J. Benton Heath, Making Sense of Security , 116 AM. J. INT ’L L. 289, 291 (2022) [hereinafter Heath, Making Sense of Security]; see also Arnold Wolfers, “National Security” as an Ambiguous Political Symbol , 67 Pol. Sci. Q. 481, 481 (1952) (highlighting dangers of the ambiguities inherent in the inchoate notion of security). But see David A. Baldwin, The Concept of Security , 23 Rev. Int’l Studs. 5, 12 (1997) (arguing that security is not “essentially contested” but rather “a confused or inadequately explicated concept”).

[6] . See, e.g. , Aziz Rana, Who Decides on Security? , 44 Conn. L. Rev. 1417 (2012) (raising critical questions concerning the scope of security and who defines it); Antony T. Anghie, Introduction to the Symposium on J. Benton Heath, “Making Sense of Security,” 116 Am. J. Int’l L. Unbound 225 (2022) (introducing symposium and raising critical questions about the notion of security).

[7] . See, e.g. , Matiangai Sirleaf, Racing National Security: Introduction to the Just Security Symposium , Just Sec. (July 13, 2020), https://www.justsecurity.org/71373/racing-national- security-introduction-to-the-just-security-symposium [https://perma.cc/4NYY-26VF] (introducing symposium and providing an overview of the notion of racing national security). For my contribution to the “Racing National Security” symposium, see Catherine Powell, “Viral Convergence”: Interconnected Pandemics as Portal to Racial Justice , Just Sec. (Aug. 5, 2020), https://www.justsecurity.org/71742/viral-justice-interconnected-pandemics-as- portal-to-racial-justice [https://perma.cc/9PEG-ELYF] [hereinafter Powell, Viral Convergence] (placing the idea of racing national security within the context of Black thinkers who have, throughout history, helped redefine what is meant by notions of security).

[8] . See, e.g. , Cynthia H. Enloe, Bananas, Beaches And Bases: Making Feminist Sense Of International Politics (Univ. of Cal. Press, 2014) (pioneering work developing feminist criticism of prevailing notions of national security); Cynthia Enloe, Globalization & Militarism: Feminists Make The Link 55 (2d ed. 2016).

[9] . See generally Symposium on J. Benton Heath, “Making Sense of Security” , Am. J. Int’l L. 225 (2022), https://www.cambridge.org/core/journals/american-journal-of- international-law/ajil-unbound-by-symposium/j-benton-heath-making-sense-of- security [https://perma.cc/ZE5W-VW4Y] (symposium exploring various critical perspectives on security law).

[10] . Heath, Making Sense of Security , supra note 5, at 293. As Heath wisely notes: A key theme here is the struggle by non-state actors—whether overpoliced communities, Indigenous groups, small-scale food producers, or communities living near the sites of extractive industry—to have their own knowledge about their security interests recognized and prioritized as authoritative. Achieving such recognition is particularly difficult in an international legal system that has historically privileged diplomats acting through foreign offices, or, more recently, networked groups of trained and recognized experts on a wide array of global problems. This disconnect raises critical insights regarding the extent to which international regimes—even those that claim to uphold a humanized vision of security—remain undemocratic, unresponsive, and inaccessible. Id .

[11] . Id . at 291 (arguing that underlying different approaches to “security” is “a deeper struggle over whose knowledge matters when constructing and responding to the most pressing threats”). Drawing links between international law and critical security studies, Health points out, “The connection between knowledge, politics, and power is a key ingredient of many critical theories to which this Essay is in some degree of debt.” Id., at 291, n.26 (citing Roberto Mangabeira Unger, Knowledge And Politics (1975); Michel Focuault, Security, Territory, Population: Lectures At The Collège De France 1977–1978 (Michel Senellart ed., Graham Burchell trans., 2007); Catharine A. MacKinnon, Feminism, Marxism, Method, and the State: Toward Feminist Jurisprudence , 8 Signs 635 (1983)).

[12] . See Julian Arato, Kathleen Claussen, & J. Benton Heath, The Perils of Pandemic Exceptionalism , 114 Am. J. Int’L L. 627, 628 (defining exceptionalism as “a paradigm of justification according to which deviations from primary rules are absolved by way of ‘exceptions’ (express or implied), and in which claims of exception can be expected to proliferate”). This insight also draws inspiration from Mary Dudziak’s work (and conversations with her) on the culture of war and on linkages between war, race, and American democracy. See generally Mary L. Dudziak, War Time: An Idea, Its History, Its Consequences (2012).

[13] . See David Cole, Judging the Next Emergency: Judicial Review and Individual Rights in Times of Crisis , 101 Mich. L. Rev. 2565, 2587–88 (2004) (arguing for the role of courts in checking the political branches and noting that “[i]f the line between emergency and normal is evanescent, a doctrine of extraconstitutional authority cannot be safely cabined to emergency times”).

[14] . WHO Coronavirus (COVID-19) Dashboard , World Health Org. , https://covid19.who.int [https://perma.cc/FUV4-NSRB].

[15] . Situation by Region, Country, Territory & Area , World Health Org. , https://covid19. who.int/table [https://perma.cc/CB83-G2JR]. More broadly, countless people have died and suffered indirectly from COVID -19 due to factors including (1) the impact of the pandemic on other aspects of the healthcare system (including more restricted access to healthcare to treat other severe illness, due to the strain on the healthcare system), (2) the mental health impacts, and (3) the economic wreckage resulting from various quarantine limitations, including lockdown measures that forced employers to suspend operations or close permanently, leading to loss of jobs and income for workers. See, e.g. , John D. Birkmeyer, Amber Barnato, Nancy Birkmeyer, Robert Bessler & Jonathan Skinner, The Impact of the Covid-19 Pandemic on Hospital Admissions in the United States , 39 Health Affairs 2010 (Sept. 24, 2020), https://www.healthaffairs.org/doi/epdf/10.1377/hlthaff.2020.00980 [https://perma.cc/7CYF-SQVZ]. Noting: Hospital admissions fell . . . with the declaration of the [COVID-19] pandemic in the US in March 2020, with several reports of hospitals operating at less than 50 percent capacity. Volumes fell in part because hospitals purposefully curtailed elective surgery and other noncritical medical services. . . [and because] many patients with acute medical illness, whether life threatening or not, did not seek hospital care out of fear of contagion or concerns about access at COVID - 19 overrun hospitals. Id . at 2010. See also Stress in America 2021: One Year Later, a New Wave of Pandemic Health Concerns , Am. Psych. Ass’n (Mar. 11, 2021), https://www.apa.org/news/press/releases/stress/ 2021/one- year-pandemic-stress [https://perma.cc/HE53-CR6S] (highlighting impact on mental health); Chart Book: Tracking the Recovery From the Pandemic Recession , CTR. ON BUDGET AND POL ’Y PRIORITIES , (Mar. 31, 2023), https://www.cbpp.org/research/economy/tracking-the- recovery-from-the-pandemic-recession [https://perma.cc/HU4Y-YKXZ] (noting how the “COVID-19 pandemic precipitated a devastatingly sharp contraction of economic activity and huge job losses in early 2020, as government restrictions and fear of the virus kept people at home and businesses shut”).

[16] . Ayana Archie, Joe Biden Says the COVID -19 Pandemic Is Over. This is What the Data Tells Us , NPR (Sept. 19, 2022), https://www.npr.org/2022/09/19/1123767437/joe-biden-covid-19- pandemic-over [https://perma.cc/2BKB-365X] (indicating that COVID -19 was shifting to a new phase, though Biden’s own top medical advisor, Dr. Anthony Fauci, seemed to question President Biden’s characterization that “[t]he pandemic is over,” raising questions as to whether the pandemic is truly over and at what point it has or will became endemic, similar to the seasonal flu).

[17] . Catherine Powell, Color of Covid and Gender of Covid: Essential Workers, Not Disposable People , 33 Yale J.L. & Feminism 1 (2021) [hereinafter Powell, Color of Covid and Gender of Covid ]; Catherine Powell, Color of Covid: The Racial Justice Paradox of our new Stay-at-Home Economy , CNN : Op. (Apr. 18, 2020, 9:13 AM), https://www.cnn.com/2020/ 04/10/opinions/covid-19-people-of-color-labor-market-disparities-powell/index.html [https://perma.cc/TH62-77KG] (coining “Color of Covid,” acknowledged by Don Lemon and Van Jones in their CNN cable news mini-series, “The Color of Covid”); Catherine Powell, The Color and Gender of Covid: Essential Workers, Not Disposable People , Think Global Health (June 4, 2020), https://www.thinkglobalhealth.org/article/color-and-gender-covid-essential- workers-not-disposable-people [https://perma.cc/TZ9Y-BZW7] (coining and theorizing “Gender of Covid” as well as its intersection with the Color of Covid).

[18] . See Legal Defense Fund, This Defining Moment: A Conversation with Sherrilyn Ifill and Bryan Stevenson , YouTube (Oct. 22, 2020), https://www.youtube.com/watch?v=19IxQtW-hK0 [perma.cc/73NJ-3Y7Q] (calling for a “Marshall Plan—a (Thurgood) Marshall Plan,” Sherilynn Ifill stresses the urgent need to redress the disproportionate impact of COVID on communities of color). Note that at the time of this talk, Sherilyn Ifill was Director-Council of the NAACP Legal Defense and Educational Fund. She has since stepped down from that role and is now the Vernon E. Jordan, Jr., Esq. Endowed Chair in Civil Rights at Howard University, where she is founding the 14th Amendment Center for Law & Democracy. The original Marshall Plan grew out of a 1947 commencement address by Secretary of State George C. Marshall at Harvard University, where Marshall called for U.S. assistance to restore the economic infrastructure of Europe, “[a]s the war-torn nations of Europe faced famine and economic crisis in the wake of World War II, [and] the United States proposed to rebuild the continent in the interest of political stability and a healthy world economy.” The Marshall Plan , Nat’l Archives, https://www.archives.gov/exhibits/featured-documents/marshall- plan [https://perma.cc/B4QL-9B8J]. In calling for a “Thurgood Marshall Plan,” Ifill invokes the bold economic recovery of the original Marshall Plan and calls upon Thurgood Marshall’s legacy of racial equality from his work as her predecessor as the NAACP Legal Defense and Educational Fund Director-Counsel and later the first Black U.S. Supreme Court Justice. In considering a postpandemic recovery, it is important to note that we may not fully “recover” from the pandemic anytime soon as COVID -19 itself may become endemic, according to health experts. See Nicky Phillips, The Coronavirus is Here to Stay—Here’s What That Means , Nature (Feb. 16, 2021), https://www.nature.com/articles/d41586–021–00396–2 [https://perma.cc/8HN4-S5LE]

[19] . For further discussion, see Part III .C. More broadly, civil rights leaders have used the discourse of “crisis,” to provide urgency to the “fierce urgency of now.” See Martin Luther King, I Have a Dream , March on Washington (Apr. 28, 1963) (explaining that the “fierce urgency of now” illustrates that in a divided country, we need one another and that we are stronger when we move forward together). See also History of the Crisis , NAACP , https://naacp.org/find-resources/history-explained/history-crisis [https://perma.cc/JA4E-LG8Y] (quoting WEB Dubois, speaking in his first editorial at the 1910 founding of The Crisis, which became the NAACP ’s official magazine, of the “danger of race prejudice” and “that this is a critical time in history of the advancement of men[.]”).

[20] . Heath, Making Sense of Security , supra note 5, at 290–291 (quoting Christine Chinking & Mary Kaldor, International Law And New Wars 564 (2017)).

[21]   Id .

[22] . Id . at 291; see also Amna A. Akbar, Toward a Radical Imagination of Law , 93 N.Y.U. L. Rev. 405, 452–53 (2018); Monica Bell, Black Security and the Conundrum of Policing , Just Sec. (July 15, 2020), https://www. justsecurity.org/71418/black-security-and-the- conundrum-of-policing [https:// perma.cc/GQS2-5582].

[23] . See, e.g. , Arato et al., supra , note 12; Dudziak , supra , note 12.

[24] . Cf . Arato et al., supra note 12, at 628.

[25] . Brian Bennet & Tessa Berenson, ‘Our Big War.’ As Coronavirus Spreads, Trump Refashions Himself as a Wartime President , Time , https://time.com/5806657/donald-trump- coronavirus-war-china/ [https://perma.cc/ETD3-ACEV] (“President Lyndon Johnson declared a war on poverty. President Richard Nixon declared a war on drugs. Now President Donald Trump has gone to war with a virus.”).

[26] . Id . (noting a picture of Trump’s prepared remarks, in one instance, which showed “corona” crossed out and replaced with “Chinese”).

[27] . Eric Lipton, David E. Sanger, Maggie Haberman, Michael D. Shear, Mark Mazzetti, & Julian E. Barnes, He Could Have Seen What Was Coming: Behind Trump’s Failure on the Virus , N.Y. Times (July 20, 2021), https://www.nytimes.com/2020/04/11/us/politics/ coronavirus-trump- response.html [https://perma.cc/W2YS-TLJV] (discussing missteps and inept response of the Trump administration); Edward Luce, Inside Trump’s Coronavirus Meltdown , Fin. Times (May 13, 2020), https://www.ft.com/content/97dc7de6-940b-11ea-abcd-371e24b679ed [https://perma.cc/435S-P3C3].

[28] . Bennet & Berenson, supra note 25 (“Trump’s rhetorical shift to saying the country is at war reflects a strategy to blunt criticism and push blame onto a foreign power.”).

[29] . Biden, supra note 1.

[30] . Jennifer Steinhauer, Overwhelmed, More States Turn to National Guard for Vaccine Help , N.Y. Times (Jan. 14, 2021), https://www.nytimes.com/2021/01/14/us/politics/coronavirus-vaccine- national-guard.html [https://perma.cc/9JEY-GU5H]. For the authorization by the Biden administration, see Memorandum from the White House to the Sec’y of Def., Sec’y of Homeland Sec., to Extend Federal Support to Governors’ Use of the National Guard to Respond to COVID - 19 and to Increase Reimbursement and Other Assistance Provided to States (Jan. 21, 2021), https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/21/extend- federal-support-to-governors-use-of-national-guard-to-respond-to-covid-19-and-to- increase-reimbursement-and-other-assistance-provided-to-states [https://perma.cc/W945- BSA2 ].

[31] . Robert T. Stafford Disaster Relief and Emergency Assistance Act, Pub. L. No. 93-288 (1974) (codified as amended at 42 U.S.C. §§ 5121–5208 (1988)). See also , Alexandra Phelan, Explainer National Emergency Declarations and COVID -19 , Just Sec . (Mar. 13, 2020), https://www.justsecurity.org/69190/explainer-national-emergency-declarations-and-covid-19 [https://perma.cc/BZ4N-WNJH].

[32] . National Emergencies Act, 50 U.S.C. § 1621 (1976).

[33] . Public Health Services Act, 42 U.S.C. § 265 (2012).

[34] . Id . For a more detailed discussion, see Mark Nevitt, The Coronavirus, Emergency Powers, and the Military: What You Need to Know , Just Sec . (Mar. 16, 2020), https://www.justsecurity.org/69215/the-coronavirus-emergency-powers-and-the- military-what-you-need-to-know [https://perma.cc/M29Y-DEU6] (discussing the Trump administration’s declaration of a public health emergency in January 2020).

[35] . Nevitt, supra note 34 (discussing the Trump administration’s declaration of a public health emergency in January 2020, including implications for the use of military personnel).

[36] . Defense Production Act of 1950, 50 U.S.C. §§ 4501–4568.

[37]   Id .

[38] . Anshu Siripurapu, What Is the Defense Production Act? , Council On Foreign Rels . (Dec. 22, 2021, 3:40 PM), https://www.cfr.org/in-brief/what-defense-production-act [https://perma.cc/D8ZY-LPUQ].

[39] . Id . (noting that these earlier statutes gave then-president Franklin D. Roosevelt sweeping powers to control the nation’s domestic economy during World War II). Created with the aim of harnessing the industrial capacity of the nation for war, the DPA has been reauthorized numerous times since 1950, amended to reach not only the traditional defense industrial base, “but also the nation’s critical infrastructures, like public health and critical technologies.” James E. Baker, Use the Defense Production Act to Flatten the Curve , Just Sec . (Mar. 20, 2020), https://www.justsecurity.org/69275/use-the-defense-production-act-to-flatten-the-curve [https://perma.cc/XD3L-M4ZK] (“The Act includes authority to prioritize existing contracts, allocate resources, incentivize the manufacture of materials and products, and survey industry to determine which entities are producing or can produce needed materials, services, and goods.”).

[40]  Siripurapu, supra note 38.

[41] . 50 U.S.C. § 4511(a)(2); see also Siripurapu, supra note 38.

[42] . Siripurapu, supra note 38 (noting that companies can be authorized to “coordinate with each other, which might otherwise violate antitrust laws”).

[43] . War Powers Resolution of 1973, 50 U.S.C. §§ 1541–1548 (providing the president authority to wage war for sixty days prior to congressional authorization).

[44] . Lucas Guttentag, Coronavirus Border Expulsions: CDC ’s Assault on Asylum Seekers and Unaccompanied Minors , Just Sec . (Apr. 13, 2020), https://www.justsecurity.org/69640/ coronavirus-border-expulsions-cdcs-assault-on-asylum-seekers-and-unaccompanied- minors [https://perma.cc/4YAB-VGU4].

[45] . 42 C.F.R. § 71.40 (issued pursuant to Public Health Services Act, 42 U.S.C. Section 265 (2012)) (emphasis added).

[46] . Suzanne Monvak, Supreme Court Keeps Title 42 Border Policy in Place for Now , Roll Call (Dec. 19, 2022), https://rollcall.com/2022/12/19/supreme-court-keeps-title-42-border- policy-in-place-for-now [https://perma.cc/P66A-R3AC] (“The Supreme Court . . . put a temporary hold on a lower court order that would end the so-called Title 42 policy this week as the justices considered a request from over a dozen Republican-led states to preserve the pandemic-related border restrictions.”)

[47] . Bâli & Lerner, Social Emergency , supra note 4; Hanna Lerner & Aslı U. Bâli, Power to the Parliaments , Boston Rev . (Aug. 27, 2020), https://www.bostonreview.net/articles/asli- u-bali-hanna-lerner-power-parliaments [https://perma.cc/U9AD-V4C4] [hereinafter Lerner & Bâli, Power to the Parliaments ].

[48] . Lerner & Bâli, Power to the Parliaments , supra note 47.

[49] . Bâli & Lerner, Social Emergency , supra note 4.

[50] . Id .

[51] . David E. Pozen & Kim Lane Scheppele, Executive Underreach, in Pandemics and Otherwise , 114 Am. J. Int’L L. 608 (2020). “Legal scholars are familiar with the problem of executive overreach . . . Yet in other countries, including the United States and Brazil, a very different and in some respects opposite problem has arisen, wherein the national executive’s efforts to control the pandemic have been disastrously insubstantial and insufficient.” Id . at 608.

[52] . Id . at 609 (emphasis omitted).

[53] . See, e.g. , Cameron Peters, A Detailed Timeline of All the Ways Trump Failed to Respond to the Coronavirus , VOX (June 8, 2020), https://www.vox.com/2020/6/8/21242003/trump-failed- coronavirus-response [https://perma.cc/9WBX-3WFH].

[54] . Pozen & Scheppele, supra note 51, at 613.

[55] . Daniel Wolfe & Daniel Dale, ‘It’s Going to Disappear’: A Timeline of Trump’s Claims That COVID -19 Will Vanish , CNN (Oct. 31, 2020), https://www.cnn.com/interactive/ 2020/10/politics/covid-disappearing-trump-comment-tracker [https://perma.cc/84R5- HH73 ] (quoting Trump’s February 10, 2020 statement). The first likely COVID -19 death in the United States was on February 6, 2020. Thomas Fuller & Mike Baker, Coronavirus Death in California Came Weeks Before First Known U.S. Death , N.Y. Times (May 7, 2020), https://www.nytimes.com/2020/04/22/us/coronavirus-first-united-states-death.html [https://perma.cc/BWP6-CXQN].

[56] . Wolfe & Dale supra note 55 (“Since February [2020], the President has declared at least 38 times that Covid-19 is either going to disappear or is currently disappearing.”).

[57] . Pozen & Scheppele, supra note 51 at 613 (citing Gavin Bade, Despite Expanded DPA , Confusion Reigns Over Coronavirus Industrial Response , Politico (Apr. 3, 2020), https://www.politico.com/news/2020/04/03/trump-dpa-medical-goods-164036 [https://perma.cc/RA52-UMFA]).

[58] . Pozen & Scheppele, supra note 51, at 613 (citing Aaron Rupar, How Trump Turned Ventilators Into a Form of Patronage , VOX (Apr. 10, 2020), https://www.vox.com/2020/4/10/21215578/trump-ventilators-coronavirus-cory-gardner-colorado-jared- polispatronage [https://perma.cc/3BSS-BST7]).

[59] . Pozen & Scheppele, supra note 51, at 613.

[60] . Baker, supra note 39 (noting the sluggish response of the Trump administration to act, despite a Trump executive order invoking the DPA ).

[61] . Memorandum from President Donald J. Trump to the Secretary of Health and Human Services, Memorandum on Order Under the Defense Production Act Regarding General Motors Company (Mar. 27, 2020), https://trumpwhitehouse.archives.gov/presidential- actions/memorandum-order-defense-production-act-regarding-general-motors- company [https://perma.cc/6SPG-FSXN]; Memorandum from President Donald J. Trump to the Secretary of Homeland Security, Memorandum on Order Under the Defense Production Act Regarding 3M Company (Apr. 2, 2020), https://trumpwhitehouse. archives.gov/presidential-actions/memorandum-order-defense-production-act- regarding-3m-company [https://perma.cc/2JNX-96ZB].

[62] . Exec. Order No. 13,910, 85 Fed. Reg. 17,001 (Mar. 26, 2020).

[63] . Exec. Order No. 13,911, 85 Fed. Reg. 18,403 (Apr. 1, 2020).

[64] . Memorandum from President Donald J. Trump to the Secretary of Health and Human Services, Memorandum on Allocating Certain Scarce or Threatened Health and Medical Resources to Domestic Use (Apr. 3, 2020), https://web.archive.org/web/2020040 4011508/https://www.whitehouse.gov/presidential-actions/memorandum-allocating-certain- scarce-threatened-health-medical-resources-domestic-use [https://perma.cc/ J8MK -JCWB].

[65] . Siripurapu, supra note 38 (quoting CFR Senior Fellow Jennifer Hillman).

[66] . Exec. Order No. 13,917, 85 Fed. Reg. 26,313 (May 1, 2020) (citing emergency powers under the Defense Production Act).

[67] . Powell, Color of Covid and Gender of Covid , supra note 17, at 13–14.

[68] . Exec. Order No. 13,917, supra note 66 (noting that closures of these plants “threaten the continued functioning of the national meat poultry supply chain, undermining critical infrastructure during the national emergency”).

[69] . Jane Mayer, How Trump is Helping Tycoons Exploit the Pandemic , New Yorker (July 13, 2020), https://www.newyorker.com/magazine/2020/07/20/how-trump-is-helping-tycoons- exploit-the-pandemic [https://perma.cc/SU4L-VK3K] (documenting how one of Trump’s top donors—the owner of one of America’s largest poultry plants—leveraged the COVID -19 crisis to force poultry workers to continue working, even while stripping them of protections).

[70] Public Health Services Act, 42 U.S.C. § 265 (2012).

[71] . See Priscilla Alvarez, Biden Administration Announces Official End of Title 42, the Trump-Era Pandemic Restrictions at the US Border , CNN (Apr. 1, 2022), https://www.cnn.com/2022/04/01/politics/immigration-title-42-repeal-cdc/ index.html [https://perma.cc/QV34-TYQU] (“Former President Donald Trump invoked a public health authority, known as Title 42, at the onset of the coronavirus pandemic, a move that was immediately met with skepticism by immigrant advocates, public health experts, and even officials within the administration who believed it to be driven by political motivations.”).

[72] . Lucas Guttentag, Coronavirus Border Expulsions: CDC ’s Assault on Asylum Seekers and Unaccompanied Minors , Just Sec. (Apr. 13, 2020), https://www.justsecurity.org/ 69640/coronavirus-border-expulsions-cdcs-assault-on-asylum-seekers-and- unaccompanied-minors [https://perma.cc/K8NP-Y8GW].

[73] . Jaya Ramji-Nogales, How an Internal State Department Memo Exposes “Title 42” Expulsions of Refugees as Violations of Law , Just Sec. (Oct. 5, 2021), https://www.justsecurity.org/ 78476/how-an-internal-state-department-memo-exposes-title-42-expulsions-of- refugees-as-violations-of-law [https://perma.cc/VQV2-9TQB].

[74] . Id .

[75] . Fiona Harrigan, Opinion, Trump’s COVID -19 Border Logic Doesn’t Check Out , S. Fla. Sun Sentinel (June 16, 2020), https://www.sun-sentinel.com/opinion/commentary/fl-op-com- coronavirus-border-wall-20200616-funstjpenfhwpitdyrpoaswvyy-story.html [https://perma.cc/585L-STN8] (discussing Trump’s effort to use diverted defense funds for his Southern border wall as misguided and based on incorrect information); see also Brakkton Booker, Trump Administration Diverts $3.8 Billion In Pentagon Funding To Border Wall , NPR (Feb. 13, 2020), https://www.npr.org/2020/02/13/805796618/trump- administration-diverts-3–8-billion-in-pentagon-funding-to-border-wall [https://perma.cc/TY63-XFLK] (reporting on Trump’s effort to divert military funding for his Southern border wall).

[76] . Catherine Powell, Race, Gender and Nation in an Age of Shifting Borders , 24 UCLA J. Int’l L. FOREIGN AFF . 133 (2020) [hereinafter Powell, Race, Gender and Nation ].

[77] . Cf. Emily Cochrane, House Votes to Block Trump’s Emergency Declaration About the Border , N.Y. Times (Feb. 26, 2019), https://www.nytimes.com/2019/02/26/us/ politics/national- emergency-vote.html [https://perma.cc/T2B8-7FNK].

[78] . See Harrigan, supra note 75. Harrigan notes: Simply put, many Mexicans worry that the coronavirus is crossing the border from the U.S. As early as March, in an ironic twist of fate, Mexicans demanded that their government crackdown on Americans crossing the border. It’s no wonder that the number of Mexican crossers stopped at the southwest border has dwindled so precipitously as the coronavirus pandemic persists. Id .

[79] . See id .

[80] . Bennet & Berenson, supra note 25.

[81] . Exec. Order No. 14,001, 86 Fed. Reg. 7,219 (Jan. 26, 2021).

[84] See President Joesph R. Biden, Remarks on the Administration’s COVID -19 Vaccination Efforts , The White House (Mar. 2, 2021), https://www.whitehouse.gov/briefing- room/speeches-remarks/2021/03/02/remarks-by-president-biden-on-the- administrations-covid-19-vaccination-efforts [https://perma.cc/6R2S-Z748]; see also Siripurapu, supra note 38; Sydney Lupkin, Defense Production Act Speeds Up Vaccine Production , NPR (Mar. 13, 2021), https://www.npr.org/sections/health-shots/ 2021/03/13/976531488/defense-production-act-speeds-up-vaccine-production [perma.cc/3SKM-VN8N] (discussing Biden’s use of DPA to address reasons underlying shortages, including supply chain issues).

[85] . See, e.g. , Exec. Order No. 13,996, 86 Fed. Reg. 7,197 (Jan. 26, 2021); see also Siripurapu, supra note 38.

[86] . See Fact Sheet: President Biden Announces New Actions to Protect Americans and Help Communities and Hospitals Battle Omicron , White House (Dec. 21, 2021), https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/21/fact-sheet- president-biden-announces-new-actions-to-protect-americans-and-help- communities-and-hospitals-battle-omicron [perma.cc/N9JP-YMM5]; see also Siripurapu, supra note 38.

[87] . Public Health Services Act, 42 U.S.C. § 265 (2012).

[88] See Alvarez, supra note 71.

[89] . See id .

[90] . Monvak, supra note 46.

[91] . Pricilla Alvarez & Ariane de Vogue, Biden Administration Tells Supreme Court Title 42 Will End When Public Health Emergency Expires , CNN (Feb. 7, 2023), https://www.cnn.com/ 2023/02/07/politics/title-42-biden-administration-public-health-emergency-expire [https://perma.cc/5ALX-8NMR].

[92] . Biden Administration Ends Title 42. What Now? NPR : Consider This (May 14, 2023), https://www.npr.org/2023/05/12/1175865631/biden-administration-ends-title- 42-what-now [https://perma.cc/F2PL-ENFV].

[93] . Shafer, supra note 2 (“Calling his crusade ‘our big war’ and directly enlisting the military in the fight allows Trump to frame a public health crisis as a military operation: He is the commander in chief, we are his foot soldiers, our patriotic duty is to obey him, and the entire planet is his battleground.”).

[94] . See, e.g. , Nevitt, supra note 34.

[95] . See Biden, supra note 1 and accompanying text. Biden’s own reference to Americans being “frontline troops” in the “war” on COVID -19 enlists all Americans to rally around the flag.

[96] See, e.g. , Nevitt, supra note 34.

[97]   See supra notes 58–63 and accompanying text.

[98] . See supra notes 30, 81–86 and accompanying text.

[99] . Siripurapu, supra note 38.

[100] . 50 U.S.C. § 4502(a)(1).

[101] . Siripurapu, supra note 38.

[102] . See Elizabeth Hinton, From The War On Poverty To The War On Crime: The Making Of Mass Incarceration In America (2016).

[103] . See supra notes 66–79 and accompanying text.

[104] . See supra notes 75–79 and accompanying text.

[105] . See supra notes 66–69 and accompanying text.

[106] . Laura Kurtzman, Trump’s ‘Chinese Virus’ Tweet Linked to Rise of Anti-Asian Hashtags on Twitter , UCSF , Special Notice About Covid-19 (Mar. 18, 2021) https://www.ucsf.edu/news/2021/03/420081/trumps-chinese-virus-tweet-linked-rise-anti- asian-hashtags-twitter [https://perma.cc/6L2E-YYYC] (discussing study published in March 18, 2021 in the American Journal of Public Health).

[107] . Id . (quoting the tweet and noting that “the number of anti-Asian hashtags associated with #chinesevirus grew much faster” after [Trump’s] March 16[, 2020] tweet”).

[108] . Id .; see ADL , Reports of Anti-Asian Assaults, Harassment and Hate Crimes Rise as Coronavirus Spreads , ADL Blog (June 18, 2020), https://www.adl.org/blog/reports-of-anti-asian-assaults- harassment-and-hate-crimes-rise-as-coronavirus-spreads [https://perma.cc/6XC7-8GEQ] (noting incidents of “being told to ‘Go back to China,’ being blamed for ‘bringing the virus’ to the United States, being referred to with racial slurs, spat on, or physically assaulted” and that “[s]tatements by public officials referring to COVID -19 as the ‘Chinese virus,’ ‘Kung Flu’ or ‘Wu Flu’ may be exacerbating the scapegoating and targeting of the [Asian American Pacific Islander] community”); Cady Lang, Hate Crimes Against Asian Americans Are on the Rise. Many Say More Policing Isn’t the Answer , Time (Feb. 18, 2021), https://time.com/5938482/asian-american-attacks [https://perma.cc/G8J5-SZVQ]; Kimmy Yam, There Were 3,800 Anti-Asian Racist Incidents, Mostly Against Women, In Past Year , NBC News (Mar. 16, 2021); https://www.nbcnews.com/news/asian- america/there-were-3-800-anti-asian-racist-incidents-mostly-against-n1261257 [https://perma.cc/55MU-574Q] (noting the targeting of female and elderly Asian Americans, indicating “the coalescence of racism and sexism, including the stereotype that Asian women are meek and subservient, likely factors into this disparity,” and quoting Russell Jeung, Professor of Asian American studies at San Francisco State University, who points out, “[t]here is an intersectional dynamic going on that others may perceive both Asians and women and Asian women as easier targets’”); Nicole Chavez, A Woman’s Brutal Attack Exposed a Torrent of Anti-Asian Violence After the Atlanta Shootings , CNN (Apr. 1, 2021), https://www.cnn.com/2021/04/01/us/asian-americans-attacks/index.html [https://perma.cc/CDE7-5BEU] (discussing the recent shooting of Asian American women in Atlanta-based spas as well as the stereotype of Asian American women being fetishized and hypersexualized).

[109] . David Wallechinsky, What is the Real Reason George Bush Invaded Iraq? , Huffington Post (Nov. 23, 2005), https://www.huffpost.com/entry/what-is-the-real-reason-g_b_11116 [https://perma.cc/99NF-T8Y6] (discussing President George W. Bush’s ill–advised decision to invade Iraq).

[110] . See Mary L. Dudziak, “You Didn’t See Him Lying . . . Beside the Gravel Road in France”: Death, Distance, and American War Politics , 42 Diplomatic Hist. 1 (2018) (critiquing lengthy conflicts following the September 11, 2021 terror attacks); DUDZIAK , supra note 12 (same); Rosa Brooks, How Everything Became War And The Military Became Everything: Tales From The Pentagon (2016) (critiquing overbreadth of powers by the Defense Department).

[111] . See, e.g. , Viet Thanh Nguyen, The MLK Speech We Need Today Is Not the One We Remember Most , Time (Jan. 17, 2019), https://time.com/5505453/martin-luther-king-beyond-vietnam [https://perma.cc/AG6Z-3YDJ] (“King’s prophecy connects the war in Vietnam with our forever wars today, spread across multiple countries and continents, waged without end from global military bases numbering around 800.”).

[112] . See< Kaine, Young, Lee, Roy, Spanberger, & Cole Introduce Bill to Repeal 1991 & 2002 AUMFs, Formally Ending Gulf & Iraq Wars , Tim Kaine (Feb. 9, 2023) https://www.kaine. senate.gov/press-releases/kaine-young-lee-roy-spanberger-and-cole-introduce-bill-to- repeal-1991_2002-aumfs-formally-ending-gulf--iraq-wars?utm_campaign=wp_the_daily_202&utm_medium=email&utm_source=newsletter&wpisrc=nl_daily202 [https://perma.cc/W7XA-GUWC] (noting the risk of allowing presidents to use zombie Authorizations for the Use of Military Force (AUMF) to justify actions never envisioned by the AUMF and lamenting, “The 1991 and 2002 AUMFs—which passed 32 and 20 years ago, respectively—authorized the use of force for the Gulf and Iraq wars, but Congress has failed to repeal these AUMFs to prevent potential misuse by future presidents.”).

[113] . See discussion supra notes 82–86, 100–107; Ramji-Nogales, supra note 73; see also Alex Thompson & Alexander Ward, Top State Adviser Leaves Post, Rips Biden’s Use of Trump-era Title 42 , Politico (Oct. 4, 2021), https://www.politico.com/news/2021/10/04/top-state- adviser-leaves-post-title-42-515029 [https://perma.cc/7RAS-UQ4B] (quoting Biden administration senior State Department advisor, Harold Koh, who criticized “the continuing use of Title 42 to rebuff the pleas of thousands of Haitians and myriad others arriving at the Southern Border who are fleeing violence, persecution, or torture”).

[114] . Powell, Color of Covid and Gender of Covid , supra note 17, at 5.

[115] . Id . (citing sources comparing the violent arrests of people in communities of color for failure to wear face masks while predominantly white crowds sunbathed in Central Park and other “white spaces”). My Yale article also notes the disparate response to Black Lives Matter protesters (and curfew violators) and the armed protesters who demonstrated against face masks, quarantine measures, and other COVID -19 restrictions from which we ostensibly needed to be “liberate[d],” according to Trump tweets. Powell, Color of Covid and Gender of Covid , supra note 17, at n.13. See Mary McCord, Trump’s ‘LIBERATE MICHIGAN !’ Tweets Incite Insurrection. That’s Illegal. , Wash. Post (Apr. 17, 2020), https://www.washingtonpost.com/outlook/2020/04/17/liberate-michigan-trump- constitution [https://perma.cc/FMT8-5JKH].

[116] . Powell, Viral Convergence , supra note 7; Catherine Powell, Introductory Remarks, Interlocking Pandemics, 114 Am. Soc’y Int’l L. 371 (2021) (outlining the notion of the interlocking pandemics of COVID -19, economic devastation, and inequality in introductory remarks for a panel on “COVID‐19: Understanding the Disparate Impact on Marginalized Communities” at the 113th Annual Meeting of the 2020 American Society of International Law).

[117] . Arundhati Roy, The Pandemic is a Portal , Fin. Times (Apr. 3, 2020), https://www.ft.com/ content/10d8f5e8–74eb-11ea-95fe-fcd274e920ca [https://perma.cc/VNA2-25DT] [hereinafter Roy, The Pandemic is a Portal , Fin. Times ]; see also Arundhati Roy, The Pandemic Is a Portal , Yes! Mag. (Apr. 17, 2020), https://www.yesmagazine.org/ video/coronavirus-pandemic-arundhati-roy [https://perma.cc/LC3Q-LV8Q]; Rahm Emanuel, Opinion, Let’s Make Sure This Crisis Doesn’t Go to Waste , Wash. Post (Mar. 25, 2020, 8:00 AM), https://www.washingtonpost.com/opinions/2020/03/25/lets-make-sure- this-crisis-doesnt-go-waste [https://perma.cc/X5E7-KXPV].

[118] . These Reconstruction Amendments are, of course, the Thirteenth, Fourteenth, and Fifteenth Amendments. U.S. Const. amends. XIII , XIV , XV.

[119] . Henry Louis Gates, Jr., Stony The Road: Reconstruction, White Supremacy, And The Rise Of Jim Crow (2019).

[120] . Rebecca E. Zietlow, It’s Time for a Third Reconstruction , Hill (June 17, 2020), https://thehill.com/opinion/civil-rights/503182-its-time-for-a-third-reconstruction [https://perma.cc/E7JV-AAW2] (providing a historical overview of these first and second Reconstruction periods and calling for a third Reconstruction).

[121] . Id .; Adam Serwer, The New Reconstruction , Atlantic (Oct. 2020), https://www.the atlantic.com/magazine/archive/2020/10/the-next-reconstruction/615475 [https:// perma.cc/A42D-3HK9]; Richard Rothstein & Valerie Wilson, Reconstruction 2020 Panel , Econ. Pol’y Inst. (July 9, 2020), https://www.epi.org/event/reconstruction-2020- valuing-black-lives-and-economic-opportunities-for-all [perma.cc/5LK7-W6ML] (calling for new Reconstruction akin to the period following the Civil War).

[122] . Powell, Viral Convergence , supra note 7.

[123] . See, e.g. , Gates , supra note 119 (discussing the roll back of voting rights for Black Americans and the rise of Jim Crow segregation in the aftermath of Reconstruction).

[124] . Kimberlé Williams Crenshaw, Race, Reform and Retrenchment: Transformation and Legitimation in Antidiscrimination Law , 101 Harv. L. Rev. 1331 (1988); Terry Smith, Whitewash: Unmasking White Grievance At The Ballot Box 16 (2020) (exploring how white identity contributed to the 2016 election of President Trump by analogizing voting to a jury deliberation, in that like the jury, voting is a collective decisionmaking process undertaken on behalf of the democratic body politic, not on behalf of the individual voter); Catherine Powell & Camille Gear Rich, The ‘Welfare Queen’ Goes to the Polls: Race-Based Fractures in Gender Politics and Opportunities for Intersectional Coalitions , 19 Geo. L.J. 105 (2020) (exploring how raced and gendered narratives are mobilized to roll back voting rights against the backdrop of the current retrenchment of civil rights).

[125] . See Adam Liptak & Jason Kao, The Majority Supreme Court Decisions in 2022 , N.Y. Times (June 30, 2022), https://www.nytimes.com/interactive/2022/06/21/us/major-supreme- court-cases-2022.html [https://perma.cc/KH5X-52JM] (noting cases trimming the federal government’s regulatory authority, including, inter alia, in the contest of vaccine mandates in the workplace, per NFIB v. Dept. of Labor ) (citing Nat’l Fed’n of Indep. Bus. v. Dep’t of Lab., Occupational Safety and Health Admin., 595 U.S. (2022)).

[126] . See, e.g. , discussion supra note 71 and accompanying text. The more ambitious “Build Back Better” bill was narrowed in the ultimately adopted Inflation Reduction Act. Proposals to address police violence and misconduct have also stalled in Congress, such as The George Floyd Justice in Policing Act of 2020. See, e.g. , Felicia Sonmez & Mike DeBonis, No Deal on Bill to Overhaul Policing in the Aftermath of Protests over Killing of Black Americans , Wash. Post (Sept. 22, 2021, 7:35 PM) https://www.washingtonpost.com/powerpost/policing-george-floyd-congress- legislation/2021/09/22/36324a34-1bc9-11ec-a99a-5fea2b2da34b_story.html [https://perma.cc/7452-ZV6X] (explaining the collapse of efforts to overhaul policing in the aftermath of large-scale protests).

[127] . Michelle Goldberg, Opinion, The New Great Depression is Coming. Will There Be a New New Deal? , N.Y. Times (May 2, 2020), https://www.nytimes.com/2020/05/02/ opinion/sunday/coronavirus-new-deal-ubi.html [https://perma.cc/NVD8-UQH9].

[128] . Eric Rauchway, Why The New Deal Matters (Yale Univ. Press 2021).

[129] . J.R. Vernon, World War II Fiscal Policies and the End of the Great Depression , 54 J. Econ. Hist. 850, 850 (1994) (arguing that World War II fiscal policies were in fact a major contributor to the recovery from the Depression, not merely a topping-off of the recovery after it had been substantially completed).

[130] . Minor League Pay , RevealL (Mar. 27, 2021), https://revealnews.org/podcast/minor-league-pay [https://perma.cc/R9N9-S3QV] (discussing the history behind the exclusion of certain employees from the New Deal era labor laws).

[131] . James Roosevelt, Jr. & Henry Scott Wallace, A 21st Century New Deal , Hill (July 22, 2020), https://thehill.com/opinion/campaign/508585-a-21st-century-new-deal [https://perma.cc/JT6T-LEYC]; Jennifer Rubin, Opinion, Joe Biden’s New New Deal , Wash. Post (Mar. 15, 2021), https://www.washingtonpost.com/opinions/2021/03/15/joe-bidens- new-new-deal [https://perma.cc/T3RT-DB8G]. It is important to note also the earlier discussion of the Obama-Biden administration’s New “New Deal” in Michael Grunwald, The New New Deal: The Hidden Story Of Change In The Obama Era (2012).

[132] . See Unemployment Rates During the COVID -19 Pandemic, Cong. Rich. Serv. (Apr. 14, 2021), https://crsreports.congress.gov/product/pdf/R/R46554/12 [https://perma.cc/2ULP-9VEE] (discussing unemployment trends prompted by quarantine measures and other COVID -19 restrictions that necessitated a largely stay-at-home pandemic economy during the first year of the pandemic).

[133] . Aamer Baig, Bryce Hall, Paul Jenkins, Eric Lamarre, & Brian McCarthy, The COVID -19 recovery will be digital: A plan for the first 90 days , Mckinsey Digit. (May 14, 2020), https://www.mckinsey.com/capabilities/mckinsey-digital/our-insights/the-covid-19- recovery-will-be-digital-a-plan-for-the-first-90-days [https://perma.cc/CSR2-H6FJ] (proposing efforts to reskill those who lost jobs for the digital economy).

[134] . Powell, Color of Covid and Gender of Covid , supra note 17, at 16–17, 36.

[135] . Rubin, supra note 131.

[136] . Infrastructure Investment and Jobs Act, Pub. L. No. 117–58, 135 Stat. 429. The Infrastructure Act supported, among other things: roads, bridges, and other infrastructure projects; modernizing public transit; improving nationwide broadband access and infrastructure; rebuilding the U.S. national electric grid; and upgrading national water infrastructure. See Katie Lobosco & Tami Luhby, Here’s What’s in the Bipartisan Infrastructure Package , CNN (Nov. 15, 2021, 5:47 PM), https://www.cnn.com/2021/07/28/politics/infrastructure- bill-explained/index.html [https://perma.cc/25RU-ZQX6].

[137] . See National Industrial Recovery Act (NIRA) of 1933, Pub. L. No. 73-67, 48 Stat. 195.

[138] . Rubin, supra note 131. Jim Tankersley, Biden Signs Infrastructure Bill, Promoting Benefits for Americans. , N.Y. TIMES (Nov. 15, 2021), https://www.nytimes.com/2021/11/ 15/us/politics/biden-signs-infrastructure-bill.html [https://perma.cc/8S6S-YJAZ] (noting that spending in the infrastructure legislation “nearly on par” with FDR ’s New Deal).

[139] . For further discussion, see Powell, Color of Covid and Gender of Covid , supra note 17, at 39.

[140] . President Biden’s initial, more ambitious “human infrastructure bill” (or “Build Back Better” bill) as passed by the House, would have supported, inter alia: climate change through clean energy and technology; free universal preschool nationwide; a one-year extension of the child tax credit; a permanent national paid leave program; affordable in-home care through Medicaid; in-home care workers; and affordable housing. See Nik Popli & Abby Vesoulis, The House Just Passed Biden’s Build Back Better Bill. Here’s What’s in It , Time (Nov. 19, 2021, 9:48 AM), https://time.com/6121415/build-back-better-spending-bill-summary [https://perma.cc/BS7J-LK4S]; see also Susan Milligan, Biden Sells ‘Human Infrastructure’ Plan Despite Imperiled Bipartisan Package , U.S. News & World Rep. (June 29, 2021), https://www.usnews.com/news/politics/articles/2021-06-29/biden-sells-human- infrastructure-plan-despite-imperiled-bipartisan-package [https://perma.cc/7EFR-E8YC].

[141] . While not as robust, nonetheless, the Inflation Reduction Act, authorizes $370 billion in spending on energy and climate change, $300 billion in deficit reduction, three years of Affordable Care Act subsidies, prescription drug reform, and tax reform. Inflation Reduction Act of 2022, Pub. L. No. 117-169; see also Fact Sheet: The Inflation Reduction Act Supports Workers and Families , White House (Aug. 19, 2022), https://www.whitehouse.gov/briefing-room/statements-releases/2022/08/19/fact-sheet- the-inflation-reduction-act-supports-workers-and-families [https://perma. cc/JA4K-3ZZT].

[142] . President Joseph R. Biden, Remarks on the Anniversary of the COVID -19 Shutdown , The White House (Mar. 11, 2021), https://www.whitehouse.gov/briefing-room/speeches- remarks/2021/03/11/remarks-by-president-biden-on-the-anniversary-of-the-covid-19- shutdown [perma.cc/9Y8Y-6W4Y].

[143] . American Rescue Plan Act of 2021, Pub. L. No. 117–2, 135 Stat. 4.

[144] . President Joseph R. Biden, supra note 142.

[145] . Mary Anne Glendon, A World Made New: Eleanor Roosevelt And The Universal Declaration Of Human Rights (2002).

[146] . Catherine Powell, Human Rights at Home: A Domestic Policy Blueprint for a New Administration , Am. Const. Soc’y L. Pol’y (2008).

[147] . See Legal Defense Fund, supra note 18 (calling for “a (Thurgood) Marshall Plan,” Sherilynn Ifill stresses the urgent need to redress the disproportionate impact of COVID -19 on communities of color).

[148] . Stephanie Ruhle, Girls Who Code Founder: Any economic recovery plan should have moms at center , MSNBC at 2:40 (Jan. 27, 2021), https://www.msnbc.com/stephanie- ruhle/watch/girls-who-code-founder-any-economic-recovery-plan-should-have- moms-at-center-100097605912 [https://perma.cc/8M2S-69KW]. Saujani notes, “[Moms] are not America’s social safety net. Id . at 3:40.

[149] . See Mom’s First News , Moms F1rst , https://momsfirst.us/news [https://perma.cc/XL7U- G2RK ] (discussing “Marshall Plan for Moms” ad in the New York Times); Veronica Stracqualursi, 50 Prominent Men Join Push for ‘Marshall Plan for Moms’ Proposal , CNN Pol. (Feb. 26, 2021), https://www.cnn.com/2021/02/26/politics/marshall-plan-for-moms-male- allies/index.html [https://perma.cc/63WF-98DN] (discussing “Marshall Plan for Moms” ad in the Washington Post as well as the New York Times).

[150] . For example, instead of continuing to focus primarily on economic growth through Gross National Product (GNP), over time, the United Nations began to issue the Human Development Report (HDI), following Nobel laureate and Harvard economist Amartya Sen's capacities approach to development by measuring other indicators of well-being, such as access to health and education. See, e.g. , Amartya K. Sen, Foreword, Readings In Human Development: Concepts, Measures And Policies For A Development Paradigm , vii-xiii (Sakiko Fukuda-Parr & A.K. Shiva Kumar eds., 2005); see generally Amartya K. Sen, Development As Freedom (1999) (laying the groundwork for development economics to move beyond essentially exclusive reliance on economic growth as a way to measure progress).

[151] . See Mary Dudziak, Cold War Civil Rights: Race And The Image Of American Democracy (2011) (discussing U.S. foreign policy underpinnings of Brown v. Bd of Ed. ).

[152] . President Franklin Delano Roosevelt, Annual Address to Congress: The “Four Freedoms” (Jan. 6, 1941).

[153] . Mary Dudziak, Desegregation as Cold War Imperative , 41 Stan. L. Rev. 61, 110–11 (1988) (discussing the Justice Department’s amicus brief in Brown v. Bd of Ed. ).

[154] . Id . (quoting Brief of Department of Justice Attorney General of the United States, James P. McGraner Amicus Curiae at 6, Brown v. Board of Educ. , 347 U.S. 483 (1954), supplemented sub nom. Brown v. Board of Educ., 349 U.S. 294 (1955)).

[155] . Id . at 111, n. 287 (quoting Brief for Appellants on Reargument at 194, Brown v. Board of Educ. , 347 U.S. 483 (1954)).

[156] See supra notes 103–116 and accompanying text (discussing the law and order approach embedded in the wartime and emergency powers approach).

[157] See also Amy Kapczynski & Gregg Gonsalves, The New Politics of Care , Bos. Rev. (Apr. 27, 2020), https://bostonreview.net/articles/gregg-gonsalves-amy-kapczynski-new-deal-public- health-we-need [https://perma.cc/Z9DH-QEB7] (arguing for “a new politics of care, one organized around a commitment to universal provision for human needs; countervailing power for workers, people of color, and the vulnerable; and a rejection of carceral approaches to social problems). As suggested in the discussion that follows, infra Part IV.A, an ethics of care is a philosophical framework and a politics of care is a political strategy based on an ethic sof care. A law of care refers to a legal framework grounded in an ethics of care philosophy.

[158] See discussion in the Introduction of this Article. As I have discussed elsewhere, President Obama’s National Security Strategy also sought to broaden the idea of “security.” See Powell, Viral Convergence , supra note 7 (“When I worked for the White House National Security Council, I saw first-hand how elements of Obama’s foreign policy sought to promote economic and other forms of justice as cornerstones of our national interests in a secure and prosperous world.”).

[159] What Is Human Security? , United Nations Trust Fund Human Security , https://www.un.org/humansecurity/what-is-human-security [https://perma.cc/3Y6H- 88GP] (“As noted in General Assembly resolution 66/290, ‘human security is an approach to assist Member States in identifying and addressing widespread and cross-cutting challenges to the survival, livelihood and dignity of their people.’ It calls for ‘people-centered, comprehensive, context-specific and prevention-oriented responses that strengthen the protection and empowerment of all people.’”).

[160] See supra , note 20 (discussing how activist are offering alternative visions of security).

[161] See, e.g. , Nel Noddings, Caring: A Relational Approach to Ethics and Moral Education (2d ed. 1984) (noting gender neutral application of an ethics of care); Carol Gilligan, In A Different Voice (1982) (same) .

[162] Gilligan , supra note 161 .

[163] See, e.g., Noddings , supra note 161; Gilligan , supra note 161. .

[164] Walter E. Conn, Book Review for Nel Noddings, Caring: A Relational Approach to Ethics and Moral Education , 12 Horizons 209 (2014).

[169] Powell, Color of Covid and Gender of Covid, supra note 17, at 15 and accompanying text .

[170] Catharine MacKinnon, Feminism Unmodified: Discourses on Life and Law (1987) (articulating the feminist theory of dominance and subordination) .

[171] Martha Albertson Fineman, Universality, Vulnerability, and Collective Responsibility , 16 Etjics F. 103, 108 (2021) [hereinafter Fineman, Universality ] .

[172] Martha A. Fineman, The Vulnerable Subject: Anchoring Equality in the Human Condition , 20 Yale J. L. & Feminism 1, 11 (2008) [hereinafter Fineman, Vulnerable Subject ] .

[173] Fineman, Universality , supra note 171 .

[174] Id. at 114 n.6 .

[175]   See Powell, Color of Covid and Gender of Covid , supra note 17, at 35 (relying on Fineman, Vulnerable Subject, supra note 171, at 1). Noting: While observers point to the tech and green economies as the “future of work,” the pandemic reveals that another large component of the future of work is care work—jobs where women (particularly women of color) are already well- represented (in fact, disproportionately so). Thus, even while creating ladders of opportunity for women and people of color into the digital economy, green economy, and other expanding sectors, lawmakers should imagine ways to support less visible, but critical important, expanding sectors, such as the care economy Id .

[178] See Derrick A. Bell, Jr., Comment, Brown v. Board of Education and the Interest-Convergence Dilemma , 93 Harv. L. Rev 518 (1980) .

[179] See Powell, Color of Covid and Gender of Covid, supra note 17, at 37–39 .

[180] Ruha Benjamin, Harvard Carr Center for Human Rights Policy, Viral Justice: Pandemics, Policing, and Portals , Harvard Carr Center for Human Rights Policy (Jul. 16, 2020) (as heard live and paraphrased by author) .

[181] Id. (arguing for the transformative potential of the COVID -19 crisis) .

[182] Zachary B. Wolf, Biden Declares the Pandemic is Over. People Are Acting Like It Too , CNN Pol. (Sept. 19, 2022), https://www.cnn.com/2022/09/19/politics/biden-covid- pandemic-over-what-matters/index.html [https://perma.cc/SB9G-RN3P] (discussing shift from the pandemic to endemic phase of COVID -19) .

[183] Guidance for COVID -19 , Ctr. Diseases Control (Mar. 2021), https://www.cdc.gov/ coronavirus/2019-ncov/communication/guidance.html [https://perma.cc/6AP3- YCCQ ] .

[184] By “care economy,” I am referring to the sector of the economy for the provision of various forms of care-by-care providers. See Heather McCulloch & Ai-jen Poo, Opinion, The Care Economy as an Infrastructure Investment , Hill (Feb. 2, 2021), https://thehill.com/opinion/white- house/536924-the-care-economy-as-an-infrastructure-investment?rl=1 [https://perma.cc/V8HX-UTJ5] (discussing the importance of the care economy and legislative proposals to support it).

[185] See Powell, Color of Covid and Gender of Covid , supra note 17, at 41; McCulloch & Poo, supra note 184 .

[186] Andrew Osterland, Aging Baby Boomers Raise the Risk of a Long-Term-Care Crisis in the U.S. , CNBC (Nov. 8, 2021), https://www.cnbc.com/2021/11/08/aging-baby-boomers-raise-the-risk- of-a-long-term-care-crisis-in-the-us.html [https://perma.cc/4DE7-6GVX].

[188] McCulloch & Poo, supra note 184.

[189] See id .

[190] See Bobo Diallo, Seemin Qayum & Silke Staab, UN Women, COVID -19 and the Care Economy: Immediate Action and Structural Transformation For a Gedner-Responsive Recovery 3 (2020) (“With COVID -19, many of these workers have been dismissed with no compensation or access to social protection. Those who continue to work report difficulties commuting to workplaces in contexts of lockdown, heavier workloads and limited protection from infection.”). The impact of the pandemic has also been particularly harsh on other domestic workers, particularly housekeepers. See David Segal, Housekeepers Face a Disaster Generations in the Making , N.Y. Times (Sept. 18, 2020) https://www.nytimes.com/2020/09/18/business/housekeepers-covid.html [https://perma.cc/K5P6-J4YX] (“Ghosted by their employers, members of the profession are facing ‘a full-blown humanitarian crisis—a Depression-level situation.’”) .

[191] The Brian Lehrer Show, Looking Back at COVID Strategies , WNYC at 16:50, https://www.wnyc.org/story/the-brian-lehrer-show-2023-03-10 [https://perma.cc/YX2P- PGYJ ] (quoting interview in which Dr. Dhruv Kullar notes that at points during the pandemic, 30 to 40 percent of COVID -19 deaths were in nursing homes, and the nursing home population is only 1 percent of the U.S. population); Covid-19 Nursing Home Data , Ctrs. Medicare & Medicaid Servs., https://data.cms.gov/covid-19/covid-19-nursing-home-data [https://perma.cc/LA4A-DAPU] (containing data of COVID -19 rates among both staff and those who live in assisted living facilities); Sarah True, Nancy Ochieng, Juliette Cubanski, Priya Chidambaram, & Tricia Neuman, Overlooked and Undercounted: The Growing Impact of COVID -19 on Assisted Living Facilities , Kaiser Fam. Found. (Sept. 1, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/overlooked-and-undercounted- the-growing-impact-of-covid-19-on-assisted-living-facilities [https://perma.cc/53T8- YL8A ] (noting the high rates of COVID -19 transmission and deaths in assisted living and nursing home facilities) .

[192] See McCulloch & Poo, supra note 184 .

[193] For example, while the National Labor Relations Act (NLRA) is the primary guarantor of the rights of U.S. workers to organize, it excludes domestic workers. See ‘You’re mostly isolated and alone.’ Why some domestic workers are vulnerable to exploitation , Pbs News Weekend (Aug. 12, 2018) (noting “farm workers and domestic workers are excluded from the National Labor Relations Act”), https://www.pbs.org/newshour/nation/ai-jen-poo-domestic-workers- exploitation [https://perma.cc/6GNM-FHH2] .

[194] Minor League Pay, supra note 130 .

[195] See Bell, supra note 178, at 523.

[196] See Caring Across Generations , https://caringacross.org [https://perma.cc/LLB2-YZGG] .

[197] See McCulloch & Poo, supra note 184 .

[198] See id .

[199] There are, however, a few indications that the parts of Biden’s Build Back Better bill related to the care economy, such as the enhanced child tax credit, can be implemented by Biden or congressional Democrats without the broader support of Republicans. See Carmen Reinicke, Biden ‘Not Sure’ Enhanced Child Tax Credit, Free Community College Will Stay in Build Back Better , CNBC (Jan. 20, 2022, 1:25 PM), https://www.cnbc.com/2022/01/20/biden- not-sure-child-tax-credit-free-community-college-will-stay-in-bill-.html [https://perma.cc/7TWW-GRZH]. Some U.S. Senate Republicans have proposed legislation that would provide more limited support for parents—such as Senator Mitt Romney’s proposal to send $350 per month, per child, to families making more than $10,000 per year. See Joseph Zeballos-Roig, Mitt Romney Introduces New Plan to Send Most Parents up to $350 Monthly Checks Per Kid , Bus. Insider (Jun. 15, 2022, 11:55 AM), https://www.businessinsider.com/mitt-romney-child-allowance-monthly-checks- 2022-6?op=1 [https://perma.cc/E29K-7F52]. But particularly troubling is one Republican-sponsored bill claiming to provide support only to reinforce the anti-abortion fetal personhood theory. See Child Tax Credit for Pregnant Moms Act of 2022, S. 3537, 117th Cong. § 2(a) (2022) (proposing a child tax credit that pregnant women could claim for “unborn child[ren],” beginning at fertilization); Lois M. Collins, Should Pregnant Women Get a Child Tax Credit Before Their Baby is Born? , Desert News (Feb. 1, 2022, 5:17 PM), https://www.deseret.com/2022/2/1/22911345/should-pregnant-women-get-a-child-tax- credit-before-their-baby-is-born-romney-lee-daines-pregnancy [https://perma.cc/QX9E- AA3F ]. Such developments have gained renewed significance in the aftermath of the Supreme Court’s reversal of the landmark abortion rights case, Roe v. Wade . See Dobbs v. Jackson Women’s Health Org., 142 U.S. 2228 (2022). Note the Republicans’ ostensible renewed interest in supporting pro-natalist policies, including presumed concern for economically disadvantaged children, following the reversal of Roe v. Wade in Dobbs v. Jackson’s Women’s Health Org . See, e.g., Jessica Chasmar, Republicans Push Pro-Family, Pro-Mother Policies in the Wake of Dobbs Ruling , Fox News (July 18, 2022), https://www.foxnews.com/politics/republicans-push-pro-family-pro-mother-policies- dobbs-ruling [https://perma.cc/UVG6-R5NX].

[200] See McCulloch & Poo, supra note 184.

[201] See Bell, supra note 178, at 523.

[202] See Powell, Color of Covid and Gender of Covid , supra note 17 (discussing the contrast between universal and differential vulnerability).

[203] Fineman, Vulnerable Subject, supra note 172; Fineman, Universality, supra note 171.

[204] Carol Rasmussen, Local Lockdowns Brought Fast Global Ozone Reductions, NASA Finds, NASA (June 9, 2021), https://climate.nasa.gov/news/3089/local-lockdowns-brought-fast- global-ozone-reductions-nasa-finds [https://perma.cc/92SK-6G23]. In demonstrating that it is actually possible to address the climate crisis, the pandemic helped us realize that rethinking our commitments to each other applies not only across space (i.e., across the globe), but across time (i.e., for future generations).

[205] David Roberts, The Green New Deal, Explained , Vox (Mar. 30, 2019), https://www.vox.com/energy-and-environment/2018/12/21/18144138/green-new-deal- alexandria-ocasio-cortez [https://perma.cc/Y667-45CQ]. .

[206] Henry Louis Gates Jr. Points to Reconstruction as the Genesis of White Supremacy , NPR (Apr. 3, 2019), https://www.npr.org/2019/04/03/709094399/henry-louis-gates-jr-points-to- reconstruction-as-the-genesis-of-white-supremacy [perma.cc/DP8B-L632] .

[210] Minor League Pay, supra note 130.

[211] Byron Pitts, “Harvest of Shame” Fifty Years Later , CBS Evening News (Nov. 24, 2010), https://www.cbsnews.com/news/harvest-of-shame-50-years-later [https://perma.cc/ AR7B - B4CS ] (exposing the poor pay and working conditions of the farm workers).

[213] As for the collapse of care economy during the initial phase of the COVID shut down, see supra note 135 and accompanying text (discussing how many in the care economy lost jobs). For food security during the pandemic, see supra notes 66-69 and accompanying text (discussing how Trump mischaracterized the threat COVID -19 posed to the nation’s food supply as a basis to force meat and poultry plants to continue production even in the absence of social distancing protocols and protective equipment for the workers).

[214] David Martin, Many Black Veterans were Denied G.I. Bill benefits After World War II. Some Lawmakers Want to Correct that Historical Error , CBS News (Dec. 27, 2022, 7:38 PM), https://www.cbsnews.com/news/g-i-bill-revival-black-veterans-congress [https://perma.cc/6BNS-6KFT] (omitting internal quotation marks).

[216] Powell, Color of Covid and Gender of Covid, supra note 17. While the G.I. Bill entrenched race inequality, American women were, in some ways, liberated by work during WWII (as the symbol of “Rosie the Riveter” illustrated). With the entry of women into the workforce continued after the war, parents increasingly turned to care workers, paid family leave, and other infrastructures of care. See Mike Konczal, Freedom From the Market: America's Fight to Liberate Itself From the Grip of the Invisible Hand (2021) (discussing how women fought for daycares to be established in domestic factories during WWII , which were some of the first free daycare centers in the United States). Thus, even as the war effort sought security abroad, it paved the way for economic security and greater independence for at least some women at home. As discussed above, caregivers have been essential for allowing parents to outsource care work responsibilities, illustrating how the care economy has been indispensable for gender equality. See discussion supra Part IV.B.1 (discuss how care work is job-enabling for working parents, particularly women, who bear disproportionate care work).

[217] See Roy, The Pandemic is a Portal , Fin. Times supra note 117 .

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What was the impact of COVID-19?

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On February 25, 2020, a top official at the Centers for Disease Control and Prevention decided it was time to level with the U.S. public about the COVID-19 outbreak. At the time, there were just 57 people in the country confirmed to have the infection, all but 14 having been repatriated from Hubei province in China and the Diamond Princess cruise ship , docked off Yokohama , Japan .

The infected were in quarantine. But Nancy Messonnier, then head of the CDC’s National Center for Immunization and Respiratory Diseases, knew what was coming. “It’s not so much a question of if this will happen anymore but rather more a question of exactly when this will happen and how many people in this country will have severe illness,” Messonnier said at a news briefing.

“I understand this whole situation may seem overwhelming and that disruption to everyday life may be severe,” she continued. “But these are things that people need to start thinking about now.”

Looking back, the COVID-19 pandemic stands as arguably the most disruptive event of the 21st century, surpassing wars, the September 11, 2001, terrorist attacks , the effects of climate change , and the Great Recession . It has killed more than seven million people to date and reshaped the world economy, public health , education, work, social interaction, family life, medicine, and mental health—leaving no corner of the globe untouched in some way. Now endemic in many societies, the consistently mutating virus remains one of the leading annual causes of death, especially among people older than 65 and the immunosuppressed.

“The coronavirus outbreak, historically, beyond a doubt, has been the most devastating pandemic of an infectious disease that global society has experienced in well over 100 years, since the 1918 influenza pandemic ,” Anthony Fauci , who helped lead the U.S. government’s health response to the pandemic under Pres. Donald Trump and became Pres. Joe Biden ’s chief medical adviser, told Encyclopædia Britannica in 2024.

“I think the impact of this outbreak on the world in general, on the United States , is really historic. Fifty years from now, 100 years from now, when they talk about the history of what we’ve been through, this is going to go down equally with the 1918 influenza pandemic , with the stock market crash of 1929 , with World War II —all the things that were profoundly disruptive of the social order.”

What few could imagine in the first days of the pandemic was the extent of the disruption the disease would bring to the everyday lives of just about everyone around the globe.

Within weeks, schools and child-care centers began shuttering, businesses sent their workforces home, public gatherings were canceled, stores and restaurants closed, and cruise ships were barred from sailing. On March 11, actor Tom Hanks announced that he had COVID-19, and the NBA suspended its season. (It was ultimately completed in a closed “bubble” at Walt Disney World .) On March 12, as college basketball players left courts mid-game during conference tournaments, the NCAA announced that it would not hold its wildly popular season-ending national competition, known as March Madness , for the first time since 1939. Three days later, the New York City public school system, the country’s largest, with 1.1 million students, closed. On March 19, all 40 million Californians were placed under a stay-at-home order.

By mid-April, with hospital beds and ventilators in critically short supply, workers were burying the coffins of COVID-19 victims in mass graves on Hart Island, off the Bronx . At first, the public embraced caregivers. New Yorkers applauded them from windows and balconies, and individuals sewed masks for them. But that spirit soon gave way to the crushing long-term reality of the pandemic and the national division that followed.

Around the world, it was worse. On the day Messonnier spoke, the virus had spread from its origin point in Wuhan , China, to at least two dozen countries, sickening thousands and killing dozens. By April 4, more than one million cases had been confirmed worldwide. Some countries, including China and Italy, imposed strict lockdowns on their citizens. Paris restricted movement, with certain exceptions, including an hour a day for exercise, within 1 km (0.62 mile) of home.

In the United States, the threat posed by the virus did not keep large crowds from gathering to protest the May 25 slaying of George Floyd , a 46-year-old Black man, by a white police officer, Derek Chauvin. The murder, taped by a bystander in Minneapolis , Minnesota , sparked raucous and sometimes violent street protests for racial justice around the world that contributed to an overall sense of societal instability.

The official World Health Organization total of more than seven million deaths as of March 2024 is widely considered a serious undercount of the actual toll. In some countries there was limited testing for the virus and difficulty attributing fatalities to it. Others suppressed total counts or were not able to devote resources to compiling their totals. In May 2021, a panel of experts consulted by The New York Times estimated that India ’s actual COVID-19 death toll was likely 1.6 million, more than five times the reported total of 307,231.

An average of 3,100 people—one every 28 seconds—died of COVID-19 every day in the United States in January 2021.

When “excess mortality”—COVID and non-COVID deaths that likely would not have occurred under normal, pre-outbreak conditions—are included in the worldwide tally, the number of pandemic victims was about 15 million by the end of 2021, WHO estimated.

Not long after the pandemic took hold, the United States, which spends more per capita on medical care than any other country, became the epicenter of COVID-19 fatalities. The country fell victim to a fractured health care system that is inequitable to poor and rural patients and people of color, as well as a deep ideological divide over its political leadership and public health policies, such as wearing protective face masks. By early 2024, the U.S. had recorded nearly 1.2 million COVID-19 deaths.

Life expectancy at birth plunged from 78.8 years in 2019 to 76.4 in 2021, a staggering decline in a barometer of a country’s health that typically changes by only a tenth or two annually. An average of 3,100 people—one every 28 seconds—died of COVID-19 every day in the United States in January 2021, before vaccines for the virus became widely available, The Washington Post reported.

The impact on those caring for the sick and dying was profound. “The second week of December [2020] was probably the worst week of my career,” said Brad Butcher, director of the medical-surgical intensive care unit at UPMC Mercy hospital in Pittsburgh , Pennsylvania. “The first day I was on service, five patients died in a shift. And then I came back the next day, and three patients died. And I came back the next day, and three more patients died. And it was completely defeating,” he told The Washington Post on January 11, 2021.

“We can’t get the graves dug fast enough,” a Maryland funeral home operator told The Washington Post that same day.

As the pandemic surged in waves around the world, country after country was plunged into economic recession , the inevitable damage caused by layoffs, business closures, lockdowns, deaths, reduced trade, debt repayment moratoriums , the cost to governments of responding to the crisis, and other factors. Overall, the virus triggered the greatest economic calamity in more than a century, according to a 2022 report by the World Bank .

“Economic activity contracted in 2020 in about 90 percent of countries, exceeding the number of countries seeing such declines during two world wars, the Great Depression of the 1930s, the emerging economy debt crises of the 1980s, and the 2007–09 global financial crisis,” the report noted. “In 2020, the first year of the COVID-19 pandemic, the global economy shrank by approximately 3 percent, and global poverty increased for the first time in a generation.”

A 2020 study that attempted to aggregate the costs of lost gross domestic product (GDP) estimated that premature deaths and health-related losses in the United States totaled more than $16 trillion, or roughly “90% of the annual GDP of the United States. For a family of 4, the estimated loss would be nearly $200,000.”

In April 2020, the U.S. unemployment rate stood at 14.7 percent, higher than at any point since the Great Depression. There were 23.1 million people out of work. The hospitality, leisure, and health care industries were especially hard hit. Consumer spending, which accounts for about two-thirds of the U.S. economy, plunged.

With workers at home, many businesses turned to telework, a development that would persist beyond the pandemic and radically change working conditions for millions. In 2023, 12.7 percent of full-time U.S. employees worked from home and 28.2 percent worked a hybrid office-home schedule, according to Forbes Advisor . Urban centers accustomed to large daily influxes of workers have suffered. Office vacancies are up, and small businesses have closed. The national office vacancy rate rose to a record 19.6 percent in the fourth quarter of 2023, according to Moody’s Analytics , which has been tracking the statistic since 1979.

Many hospitals were overwhelmed during COVID-19 surges, with too few beds for the flood of patients. But many also demonstrated their resilience and “surge capacity,” dramatically expanding bed counts in very short periods of time and finding other ways to treat patients in swamped medical centers. Triage units and COVID-19 wards were hastily erected in temporary structures on hospital grounds.

Still, U.S. hospitals suffered severe shortages of nurses and found themselves lacking basic necessities such as N95 masks and personal protective garb for the doctors, nurses, and other workers who risked their lives against the new pathogen at the start of the outbreak. Mortuaries and first responders were overwhelmed as well. The dead were kept in refrigerated trucks outside hospitals.

The country’s fragmented public health system proved inadequate to the task of coping with the outbreak, sparking calls for major reform of the CDC and other agencies. The CDC botched its initial attempt to create tests for the virus, leaving the United States almost blind to its spread during the early stages of the pandemic.

Beyond the physical dangers, mental health became a serious issue for overburdened health care personnel, other “essential” workers who continued to labor in crucial jobs, and many millions of isolated, stressed, fearful, locked-down people in the United States and elsewhere. Parents struggled to care for children kept at home by the pandemic while also attending to their jobs.

In a June 2020 survey, the CDC found that 41 percent of respondents said they were struggling with mental health and 11 percent had seriously considered suicide recently. Essential workers, unpaid caregivers , young adults, and members of racial and ethnic minority groups were found to be at a higher risk for experiencing mental health struggles, with 31 percent of unpaid caregivers reporting that they were considering suicide. WHO reported two years later that the pandemic had caused a 25 percent increase in anxiety and depression worldwide, young people and women being at the highest risk.

The rate of homicides by firearm in the United States rose by 35 percent during the pandemic to the highest rate in more than a quarter century.

A silver lining in the chaos of the pandemic’s opening year was the development in just 11 months of highly effective vaccines for the virus, a process that normally had taken 7–10 years. The U.S. government’s bet on unproven messenger RNA technology under the Trump administration’s Operation Warp Speed paid off, and the result validated the billions of dollars that the government pours into basic research every year.

On December 14, 2020, New York nurse Sandra Lindsay capped the tumultuous year by receiving the first shot of the vaccine that eventually would help end the public health crisis caused by COVID-19 pandemic.

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Coronavirus: The world has come together to flatten the curve. Can we stay united to tackle other crises?

Watching the world come together gives me hope for the future, writes mira patel, a high school junior..

Mira Patel and her sister Veda. (Courtesy of Dee Patel)

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Before the pandemic, I had often heard adults say that young people would lose the ability to connect in-person with others due to our growing dependence on technology and social media. However, this stay-at-home experience has proven to me that our elders’ worry is unnecessary. Because isolation isn’t in human nature, and no advancement in technology could replace our need to meet in person, especially when it comes to learning.

As the weather gets warmer and we approach summertime, it’s going to be more and more tempting for us teenagers to go out and do what we have always done: hang out and have fun. Even though the decision-makers are adults, everyone has a role to play and we teens can help the world move forward by continuing to self-isolate. It’s incredibly important that in the coming weeks, we respect the government’s effort to contain the spread of the coronavirus.

In the meantime, we can find creative ways to stay connected and continue to do what we love. Personally, I see many 6-feet-apart bike rides and Zoom calls in my future.

If there is anything that this pandemic has made me realize, it’s how connected we all are. At first, the infamous coronavirus seemed to be a problem in China, which is worlds away. But slowly, it steadily made its way through various countries in Europe, and inevitably reached us in America. What was once framed as a foreign virus has now hit home.

Watching the global community come together, gives me hope, as a teenager, that in the future we can use this cooperation to combat climate change and other catastrophes.

As COVID-19 continues to creep its way into each of our communities and impact the way we live and communicate, I find solace in the fact that we face what comes next together, as humanity.

When the day comes that my generation is responsible for dealing with another crisis, I hope we can use this experience to remind us that moving forward requires a joint effort.

Mira Patel is a junior at Strath Haven High School and is an education intern at the Foreign Policy Research Institute in Philadelphia. Follow her on Instagram here.  

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Coronavirus Pandemic

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

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

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

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

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Read More: The Family Time the Pandemic Stole

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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COVID‑19 Pandemic

By: History.com Editors

Updated: March 11, 2024 | Original: April 25, 2023

The outbreak of the infectious respiratory disease known as COVID-19 triggered one of the deadliest pandemics in modern history. COVID-19 claimed nearly 7 million lives worldwide. In the United States, deaths from COVID-19 exceeded 1.1 million, nearly twice the American death toll from the 1918 flu pandemic . The COVID-19 pandemic also took a heavy toll economically, politically and psychologically, revealing deep divisions in the way that Americans viewed the role of government in a public health crisis, particularly vaccine mandates. While the United States downgraded its “national emergency” status over the pandemic on May 11, 2023, the full effects of the COVID-19 pandemic will reverberate for decades.

A New Virus Breaks Out in Wuhan, China

In December 2019, the China office of the World Health Organization (WHO) received news of an isolated outbreak of a pneumonia-like virus in the city of Wuhan. The virus caused high fevers and shortness of breath, and the cases seemed connected to the Huanan Seafood Wholesale Market in Wuhan, which was closed by an emergency order on January 1, 2020.

After testing samples of the unknown virus, the WHO identified it as a novel type of coronavirus similar to the deadly SARS virus that swept through Asia from 2002-2004. The WHO named this new strain SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). The first Chinese victim of SARS-CoV-2 died on January 11, 2020.

Where, exactly, the novel virus originated has been hotly debated. There are two leading theories. One is that the virus jumped from animals to humans, possibly carried by infected animals sold at the Wuhan market in late 2019. A second theory claims the virus escaped from the Wuhan Institute of Virology, a research lab that was studying coronaviruses. U.S. intelligence agencies maintain that both origin stories are “plausible.”

The First COVID-19 Cases in America

The WHO hoped that the virus outbreak would be contained to Wuhan, but by mid-January 2020, infections were reported in Thailand, Japan and Korea, all from people who had traveled to China.

On January 18, 2020, a 35-year-old man checked into an urgent care center near Seattle, Washington. He had just returned from Wuhan and was experiencing a fever, nausea and vomiting. On January 21, he was identified as the first American infected with SARS-CoV-2.

In reality, dozens of Americans had contracted SARS-CoV-2 weeks earlier, but doctors didn’t think to test for a new type of virus. One of those unknowingly infected patients died on February 6, 2020, but her death wasn’t confirmed as the first American casualty until April 21.

On February 11, 2020, the WHO released a new name for the disease causing the deadly outbreak: Coronavirus Disease 2019 or COVID-19. By mid-March 2020, all 50 U.S. states had reported at least one positive case of COVID-19, and nearly all of the new infections were caused by “community spread,” not by people who contracted the disease while traveling abroad. 

At the same time, COVID-19 had spread to 114 countries worldwide, killing more than 4,000 people and infecting hundreds of thousands more. On March 11, the WHO made it official and declared COVID-19 a pandemic.

The World Shuts Down

Pandemics are expected in a globally interconnected world, so emergency plans were in place. In the United States, health officials at the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) set in motion a national response plan developed for flu pandemics.

State by state and city by city, government officials took emergency measures to encourage “ social distancing ,” one of the many new terms that became part of the COVID-19 vocabulary. Travel was restricted. Schools and churches were closed. With the exception of “essential workers,” all offices and businesses were shuttered. By early April 2020, more than 316 million Americans were under a shelter-in-place or stay-at-home order.

With more than 1,000 deaths and nearly 100,000 cases, it was clear by April 2020 that COVID-19 was highly contagious and virulent. What wasn’t clear, even to public health officials, was how individuals could best protect themselves from COVID-19. In the early weeks of the outbreak, the CDC discouraged people from buying face masks, because officials feared a shortage of masks for doctors and hospital workers.

By April 2020, the CDC revised its recommendations, encouraging people to wear masks in public, to socially distance and to wash hands frequently. President Donald Trump undercut the CDC recommendations by emphasizing that masking was voluntary and vowing not to wear a mask himself. This was just the beginning of the political divisions that hobbled the COVID-19 response in America.

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Why the 1918 Flu Pandemic Never Really Ended

After infecting millions of people worldwide, the 1918 flu strain shifted—and then stuck around.

When Mask‑Wearing Rules in the 1918 Pandemic Faced Resistance

Most people complied, but some resisted (or poked holes in their masks to smoke).

Global Financial Markets Collapse

In the early months of the COVID-19 pandemic, with billions of people worldwide out of work, stuck at home, and fretting over shortages of essential items like toilet paper , global financial markets went into a tailspin.

In the United States, share prices on the New York Stock Exchange plummeted so quickly that the exchange had to shut down trading three separate times. The Dow Jones Industrial Average eventually lost 37 percent of its value, and the S&P 500 was down 34 percent.

Business closures and stay-at-home orders gutted the U.S. economy. The unemployment rate skyrocketed, particularly in the service sector (restaurant and other retail workers). By May 2020, the U.S. unemployment rate reached 14.7 percent, the highest jobless rate since the Great Depression . 

All across America, households felt the pinch of lost jobs and lower wages. Food insecurity reached a peak by December 2020 with 30 million American adults—a full 14 percent—reporting that their families didn’t get enough to eat in the past week.

The economic effects of the COVID-19 pandemic, like its health effects, weren’t experienced equally. Black, Hispanic and Native Americans suffered from unemployment and food insecurity at significantly higher rates than white Americans. 

Congress tried to avoid a complete economic collapse by authorizing a series of COVID-19 relief packages in 2020 and 2021, which included direct stimulus checks for all American families.

The Race for a Vaccine

A new vaccine typically takes 10 to 15 years to develop and test, but the world couldn’t wait that long for a COVID-19 vaccine. The U.S. Department of Health and Human Services (HHS) under the Trump administration launched “ Operation Warp Speed ,” a public-private partnership which provided billions of dollars in upfront funding to pharmaceutical companies to rapidly develop vaccines and conduct clinical trials.

The first clinical trial for a COVID-19 vaccine was announced on March 16, 2020, only days after the WHO officially classified COVID-19 as a pandemic. The vaccines developed by Moderna and Pfizer were the first ever to employ messenger RNA, a breakthrough technology. After large-scale clinical trials, both vaccines were found to be greater than 95 percent effective against infection with COVID-19.

A nurse from New York officially became the first American to receive a COVID-19 vaccine on December 14, 2020. Ten days later, more than 1 million vaccines had been administered, starting with healthcare workers and elderly residents of nursing homes. As the months rolled on, vaccine availability was expanded to all American adults, and then to teenagers and all school-age children.

By the end of the pandemic in early 2023, more than 670 million doses of COVID-19 vaccines had been administered in the United States at a rate of 203 doses per 100 people. Approximately 80 percent of the U.S. population received at least one COVID-19 shot, but vaccination rates were markedly lower among Black, Hispanic and Native Americans.

The First ‘Vaccine Passports’ Were Scars from Smallpox Vaccinations

When smallpox ravaged the United States at the turn of the 20th century, many public spaces required people to show their vaccine scars for entry.

When the Supreme Court Ruled a Vaccine Could Be Mandatory

A 1905 decision provided a powerful and controversial precedent for the flexing of government authority.

4 Diseases You’ve Probably Forgotten About Because of Vaccines

Vaccines are so effective at fighting disease that sometimes it’s easy to forget their impact.

COVID-19 Deaths Heaviest Among Elderly and People of Color

In America, the COVID-19 pandemic impacted everyone’s lives, but those who died from the disease were far more likely to be older and people of color.

Of the more than 1.1 million COVID deaths in the United States, 75 percent were individuals who were 65 or older. A full 93 percent of American COVID-19 victims were 50 or older. Throughout the emergence of COVID-19 variants and the vaccine rollouts, older Americans remained the most at-risk for being hospitalized and ultimately dying from the disease.

Black, Hispanic and Native Americans were also at a statistically higher risk of developing life-threatening COVID-19 systems and succumbing to the disease. For example, Black and Hispanic Americans were twice as likely to be hospitalized from COVID-19 than white Americans. The COVID-19 pandemic shined light on the health disparities between racial and ethnic groups driven by systemic racism and lower access to healthcare.

Mental health also worsened during the COVID-19 pandemic. The anxiety of contracting the disease, and the stresses of being unemployed or confined at home, led to unprecedented numbers of Americans reporting feelings of depression and suicidal ideation.

A Time of Social & Political Upheaval

In the United States, the three long years of the COVID-19 pandemic paralleled a time of heightened political contention and social upheaval.

When George Floyd was killed by Minneapolis police on May 25, 2020, it sparked nationwide protests against police brutality and energized the Black Lives Matter movement. Because so many Americans were out of work or home from school due to COVID-19 shutdowns, unprecedented numbers of people from all walks of life took to the streets to demand reforms.

Instead of banding together to slow the spread of the disease, Americans became sharply divided along political lines in their opinions of masking requirements, vaccines and social distancing.

By March 2024, in signs that the pandemic was waning, the CDC issued new guidelines for people who were recovering from COVID-19. The agency said those infected with the virus no longer needed to remain isolated for five days after symptoms. And on March 10, 2024, the Johns Hopkins Coronavirus Resource Center stopped collecting data for its highly referenced COVID-19 dashboard.

Still, an estimated 17 percent of U.S. adults reported having experienced symptoms of long COVID, according to the Household Pulse Survey. The medical community is still working to understand the causes behind long COVID, which can afflict a patient for weeks, months or even years.

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“CDC Museum COVID Timeline.” Centers for Disease Control and Prevention . “Coronavirus: Timeline.” U.S. Department of Defense . “COVID-19 and Related Vaccine Development and Research.” Mayo Clinic . “COVID-19 Cases and Deaths by Race/Ethnicity: Current Data and Changes Over Time.” Kaiser Family Foundation . “Number of COVID-19 Deaths in the U.S. by Age.” Statista . “The Pandemic Deepened Fault Lines in American Society.” Scientific American . “Tracking the COVID-19 Economy’s Effects on Food, Housing, and Employment Hardships.” Center on Budget and Policy Priorities . “U.S. Confirmed Country’s First Case of COVID-19 3 Years Ago.” CNN .

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• Calling time on the...

Calling time on the use of war metaphors in covid-19

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• Katherine A.A. Clark , clinical fellow cardiovascular medicine 1 ,
• S. Elissa Altin , assistant professor of medicine , cardiovascular medicine 1
• 1 Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven

More than two years since the covid-19 pandemic started, Katherine Clark and S. Elissa Altin, consider the impact that war metaphors have had on patient and physician wellbeing

In 2020, as cases rose, health systems scrambled to adapt, and the economy was shut down—our entire world changed to flatten the curve. During these early days, the language used to describe the pandemic was that of an armed battle. Patients were “struck with illness,” and physicians were the “warriors deployed to the front lines.” The federal government was “mobilising supply chains” to pull the “ammunition” of personal protective equipment (PPE) and ventilators from the “national stockpile.” The administration employed the Defence Production Act to produce additional medical supplies.

Daily task force briefings and the popular press were flooded with this militarisation of the US pandemic response. There was a massive rollout of military resources, including the USS Comfort docked in the Hudson River and “field hospitals” across the country. Given the unprecedented magnitude and morbidity of the pandemic, the logistical power of the government and military was needed to deploy resources in this time of national crisis, and at many other points over the past two years. However, alongside the literal deployment of the military into this public health crisis came the entry of metaphoric, militaristic language. While for some these metaphors could enhance morale and unite society, this language also resulted in frustration. 1

The use of biomilitary metaphors in medicine is not novel. Similar language dates back to the 2nd century BCE in Traditional Chinese medical texts. Twentieth-century titles such as Victory with Vaccines , The Battle Against Bacteria , and Crusading Doctor demonstrate how language around illness has often been likened to battle. 2 President Nixon declared a “war on cancer” with the National Cancer Act of 1971 to discover a “magic bullet.”

There are unintended consequences of the biomilitarisation of the language of disease—as the HIV/AIDS epidemic demonstrates. In the widely cited New England Journal of Medicine article, “Time to Hit HIV, Early and Hard,” HIV was depicted as a “relentless” attacker that must be met with therapeutic “weapons” to “annihilate” the virus. 3 Such language was stigmatising as it erased patients’ narratives of suffering and their personal experiences, and given the lack of understanding about transmission and morbidity at the time, generated fear and shame. 4

Susan Sontag, an American literary critic and cancer survivor, argued against the biomilitarisation of language: “We are not being invaded. The body is not a battlefield. The ill are neither unavoidable casualties nor the enemy.” 5 She wrote that such language “over-mobilises, it over-describes, and it powerfully contributes to the excommunicating and stigmatising of the ill.” 6

She demonstrates how metaphors of illness are deeply embedded within the complex cultural and societal milieu and identifies a potential danger implicit to metaphorical thinking: a shift from fighting the disease to fighting the patient. 4

Military metaphors are not simply ornamental; instead, they provide a structured framework from which we understand illness. 7 In short, language matters, and metaphors that stigmatise the patient compound disparities that reduce equitable access to care. 8 Given the profound impact of this pandemic, the impact of the metaphors used to describe it will be equally profound. Health organisations are beginning to recognise the resulting social stigma of covid. 9 The stigma of covid may perpetuate inequality of care and drive patients away from testing and treatment. 9 The relentless nature of the pandemic no doubt continues to take its toll on providers’ wellbeing, as continuing to serve on the front lines causes them to shoulder incomprehensible amounts of death and grief, resulting in stress, anxiety and depressive symptoms. 10 11

Importantly, as healthcare providers, we must be conscious that our language does not inadvertently weaponise our approach and further propagate inequality, doffing this rhetoric at the doors of the hospital to don our best practice as care givers and scientists.

Competing interests: none declared

Provenance and peer review: not commissioned, not peer reviewed

• Gilbertson A ,
• de Roubaix M ,
• Thibodeau PH ,
• Boroditsky L
• Sayles JN ,
• Kinsler JJ ,
• Martins D ,
• Cunningham WE
• Social Stigma Associated with COVID-19
• ↵ Physician Well-being and COVID-19. https://www.aafp.org/family-physician/patient-care/current-hot-topics/recent-outbreaks/covid-19/covid-19-physician-wellbeing.html . Published 2022. Updated 2022. Accessed March 30, 2022.
• Shreffler J ,

How Science Beat the Virus

And what it lost in the process

Listen to more stories on audm

This article was published online on December 14, 2020.

In fall of 2019, exactly zero scientists were studying COVID‑19, because no one knew the disease existed. The coronavirus that causes it, SARS‑CoV‑2, had only recently jumped into humans and had been neither identified nor named. But by the end of March 2020, it had spread to more than 170 countries, sickened more than 750,000 people, and triggered the biggest pivot in the history of modern science. Thousands of researchers dropped whatever intellectual puzzles had previously consumed their curiosity and began working on the pandemic instead. In mere months, science became thoroughly COVID-ized.

As of this writing, the biomedical library PubMed lists more than 74,000 COVID-related scientific papers—more than twice as many as there are about polio, measles, cholera, dengue, or other diseases that have plagued humanity for centuries. Only 9,700 Ebola-related papers have been published since its discovery in 1976; last year, at least one journal received more COVID‑19 papers than that for consideration. By September, the prestigious New England Journal of Medicine had received 30,000 submissions—16,000 more than in all of 2019. “All that difference is COVID‑19,” Eric Rubin, NEJM ’s editor in chief, says. Francis Collins, the director of the National Institutes of Health, told me, “The way this has resulted in a shift in scientific priorities has been unprecedented.”

Much like famous initiatives such as the Manhattan Project and the Apollo program, epidemics focus the energies of large groups of scientists. In the U.S., the influenza pandemic of 1918, the threat of malaria in the tropical battlegrounds of World War II, and the rise of polio in the postwar years all triggered large pivots. Recent epidemics of Ebola and Zika each prompted a temporary burst of funding and publications . But “nothing in history was even close to the level of pivoting that’s happening right now,” Madhukar Pai of McGill University told me.

That’s partly because there are just more scientists: From 1960 to 2010, the number of biological or medical researchers in the U.S. increased sevenfold , from just 30,000 to more than 220,000. But SARS-CoV-2 has also spread farther and faster than any new virus in a century. For Western scientists, it wasn’t a faraway threat like Ebola. It threatened to inflame their lungs. It shut down their labs. “It hit us at home,” Pai said.

In a survey of 2,500 researchers in the U.S., Canada, and Europe, Kyle Myers from Harvard and his team found that 32 percent had shifted their focus toward the pandemic. Neuroscientists who study the sense of smell started investigating why COVID‑19 patients tend to lose theirs. Physicists who had previously experienced infectious diseases only by contracting them found themselves creating models to inform policy makers. Michael D. L. Johnson at the University of Arizona normally studies copper’s toxic effects on bacteria. But when he learned that SARS‑CoV‑2 persists for less time on copper surfaces than on other materials, he partially pivoted to see how the virus might be vulnerable to the metal. No other disease has been scrutinized so intensely, by so much combined intellect, in so brief a time.

These efforts have already paid off. New diagnostic tests can detect the virus within minutes. Massive open data sets of viral genomes and COVID‑19 cases have produced the most detailed picture yet of a new disease’s evolution. Vaccines are being developed with record-breaking speed. SARS‑CoV‑2 will be one of the most thoroughly characterized of all pathogens, and the secrets it yields will deepen our understanding of other viruses, leaving the world better prepared to face the next pandemic.

But the COVID‑19 pivot has also revealed the all-too-human frailties of the scientific enterprise . Flawed research made the pandemic more confusing, influencing misguided policies. Clinicians wasted millions of dollars on trials that were so sloppy as to be pointless. Overconfident poseurs published misleading work on topics in which they had no expertise. Racial and gender inequalities in the scientific field widened.

Amid a long winter of sickness , it’s hard not to focus on the political failures that led us to a third surge. But when people look back on this period, decades from now, they will also tell stories, both good and bad, about this extraordinary moment for science. At its best, science is a self-correcting march toward greater knowledge for the betterment of humanity. At its worst, it is a self-interested pursuit of greater prestige at the cost of truth and rigor. The pandemic brought both aspects to the fore. Humanity will benefit from the products of the COVID‑19 pivot. Science itself will too, if it learns from the experience.

In February, Jennifer Doudna, one of America’s most prominent scientists, was still focused on CRISPR—the gene-editing tool that she’d co-discovered and that won her a Nobel Prize in October. But when her son’s high school shut down and UC Berkeley, her university, closed its campus, the severity of the impending pandemic became clear. “In three weeks, I went from thinking we’re still okay to thinking that my whole life is going to change,” she told me. On March 13, she and dozens of colleagues at the Innovative Genomics Institute, which she leads, agreed to pause most of their ongoing projects and redirect their skills to addressing COVID‑19. They worked on CRISPR-based diagnostic tests. Because existing tests were in short supply, they converted lab space into a pop-up testing facility to serve the local community. “We need to make our expertise relevant to whatever is happening right now,” she said.

Scientists who’d already been studying other emerging diseases were even quicker off the mark. Lauren Gardner, an engineering professor at Johns Hopkins University who has studied dengue and Zika, knew that new epidemics are accompanied by a dearth of real-time data. So she and one of her students created an online global dashboard to map and tally all publicly reported COVID‑19 cases and deaths. After one night of work, they released it, on January 22. The dashboard has since been accessed daily by governments, public-health agencies, news organizations, and anxious citizens.

Studying deadly viruses is challenging at the best of times, and was especially so this past year. To handle SARS‑CoV‑2, scientists must work in “biosafety level 3” labs, fitted with special airflow systems and other extreme measures; although the actual number is not known, an estimated 200 such facilities exist in the U.S. Researchers often test new drugs and vaccines on monkeys before proceeding to human trials, but the U.S. is facing a monkey shortage after China stopped exporting the animals, possibly because it needed them for research. And other biomedical research is now more difficult because of physical-distancing requirements. “Usually we had people packed in, but with COVID, we do shift work,” Akiko Iwasaki, a Yale immunologist, told me. “People are coming in at ridiculous hours” to protect themselves from the very virus they are trying to study.

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Experts on emerging diseases are scarce: These threats go neglected by the public in the lulls between epidemics. “Just a year ago I had to explain to people why I was studying coronaviruses,” says Lisa Gralinski of the University of North Carolina at Chapel Hill. “That’s never going to be a concern again.” Stressed and stretched, she and other emerging-disease researchers were also conscripted into unfamiliar roles. They’re acting as makeshift advisers to businesses, schools, and local governments. They’re barraged by interview requests from journalists. They’re explaining the nuances of the pandemic on Twitter, to huge new follower counts. “It’s often the same person who’s helping the Namibian government to manage malaria outbreaks and is now being pulled into helping Maryland manage COVID‑19,” Gardner told me.

But the newfound global interest in viruses also means “you have a lot more people you can talk through problems with,” Pardis Sabeti, a computational geneticist at the Broad Institute of MIT and Harvard, told me. Indeed, COVID‑19 papers are more likely than typical biomedical studies to have authors who had never published together before, according to a team led by Ying Ding, who works at the University of Texas at Austin.

Fast-forming alliances could work at breakneck speed because many researchers had spent the past few decades transforming science from a plodding, cloistered endeavor into something nimbler and more transparent. Traditionally, a scientist submits her paper to a journal, which sends it to a (surprisingly small) group of peers for (several rounds of usually anonymous) comments; if the paper passes this (typically months-long) peer-review gantlet, it is published (often behind an expensive paywall). Languid and opaque, this system is ill-suited to a fast-moving outbreak. But biomedical scientists can now upload preliminary versions of their papers, or “preprints,” to freely accessible websites, allowing others to immediately dissect and build upon their results. This practice had been slowly gaining popularity before 2020, but proved so vital for sharing information about COVID‑19 that it will likely become a mainstay of modern biomedical research. Preprints accelerate science, and the pandemic accelerated the use of preprints. At the start of the year, one repository, medRxiv (pronounced “med archive”), held about 1,000 preprints. By the end of October, it had more than 12,000.

Open data sets and sophisticated new tools to manipulate them have likewise made today’s researchers more flexible. SARS‑CoV‑2’s genome was decoded and shared by Chinese scientists just 10 days after the first cases were reported. By November, more than 197,000 SARS‑CoV‑2 genomes had been sequenced. About 90 years ago, no one had even seen an individual virus; today, scientists have reconstructed the shape of SARS‑CoV‑2 down to the position of individual atoms. Researchers have begun to uncover how SARS‑CoV‑2 compares with other coronaviruses in wild bats, the likely reservoir; how it infiltrates and co-opts our cells; how the immune system overreacts to it, creating the symptoms of COVID‑19. “We’re learning about this virus faster than we’ve ever learned about any virus in history,” Sabeti said.

By March, the odds of quickly eradicating the new coronavirus looked slim. A vaccine became the likeliest endgame, and the race to create one was a resounding success. The process normally takes years, but as I write this, 54 different vaccines are being tested for safety and efficacy, and 12 have entered Phase 3 clinical trials—the final checkpoint. As of this writing, Pfizer/BioNTech and Moderna have announced that, based on preliminary results from these trials, their respective vaccines are roughly 95 percent effective at preventing COVID‑19. * “We went from a virus whose sequence was only known in January, and now in the fall, we’re finishing— finishing —a Phase 3 trial,” Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and a member of the White House’s coronavirus task force, told me. “Holy mackerel.”

Most vaccines comprise dead, weakened, or fragmented pathogens, and must be made from scratch whenever a new threat emerges. But over the past decade, the U.S. and other countries have moved away from this slow “one bug, one drug” approach. Instead, they’ve invested in so-called platform technologies, in which a standard chassis can be easily customized with different payloads that target new viruses. For example, the Pfizer/BioNTech and Moderna vaccines both consist of nanoparticles that contain pieces of SARS‑CoV‑2’s genetic material—its mRNA. When volunteers are injected with these particles, their cells use the mRNA to reconstruct a noninfectious fragment of the virus, allowing their immune system to prepare antibodies that neutralize it. No company has ever brought an mRNA vaccine to market before, but because the basic platform had already been refined, researchers could quickly repurpose it with SARS‑CoV‑2’s mRNA. Moderna got its vaccine into Phase 1 clinical trials on March 16, just 66 days after the new virus’s genome was first uploaded—far faster than any pre-COVID vaccine.

Meanwhile, companies compressed the process of vaccine development by running what would normally be sequential steps in parallel, while still checking for safety and efficacy. The federal government’s Operation Warp Speed, an effort to accelerate vaccine distribution, funded several companies at once—an unusual move. It preordered doses and invested in manufacturing facilities before trials were complete, reducing the risk for pharmaceutical companies looking to participate. Ironically, federal ineptitude at containing SARS‑CoV‑2 helped too. In the U.S., “the fact that the virus is everywhere makes it easier to gauge the performance of a vaccine,” says Natalie Dean of the University of Florida, who studies vaccine trials. “You can’t do a [Phase 3] vaccine trial in South Korea,” because the outbreak there is under control.

Read: How the pandemic will end

Vaccines will not immediately end the pandemic . Millions of doses will have to be manufactured, allocated, and distributed ; large numbers of Americans could refuse the vaccine ; and how long vaccine-induced immunity will last is still unclear. In the rosiest scenario, the Pfizer/BioNTech and Moderna vaccines are approved and smoothly rolled out over the next 12 months. By the end of the year, the U.S. achieves herd immunity, after which the virus struggles to find susceptible hosts. It still circulates, but outbreaks are sporadic and short-lived. Schools and businesses reopen. Families hug tightly and celebrate joyously over Thanksgiving and Christmas.

And the next time a mystery pathogen emerges, scientists hope to quickly slot its genetic material into proven platforms, and move the resulting vaccines through the same speedy pipelines that were developed during this pandemic. “I don’t think the world of vaccine development will ever be the same again,” says Nicole Lurie of the Coalition for Epidemic Preparedness Innovations.

As fast as the vaccine-development process was, it could have been faster. Despite the stakes, some pharmaceutical companies with relevant expertise chose not to enter the race, perhaps dissuaded by intense competition. Instead, from February to May, the sector roughly tripled its efforts to develop drugs to treat COVID‑19, according to Kevin Bryan, an economist at the University of Toronto. The decades-old steroid dexamethasone turned out to reduce death rates among severely ill patients on ventilators by more than 12 percent. Early hints suggest that newer treatments such as the monoclonal-antibody therapy bamlanivimab, which was just approved for emergency use by the FDA, could help newly infected patients who have not yet been hospitalized. But although these wins are significant, they are scarce. Most drugs haven’t been effective. Health-care workers became better at saving hospitalized patients more through improvements in basic medical care than through pharmaceutical panaceas—a predictable outcome, because antiviral drugs tend to offer only modest benefits.

The quest for COVID‑19 treatments was slowed by a torrent of shoddy studies whose results were meaningless at best and misleading at worst. Many of the thousands of clinical trials that were launched were too small to produce statistically solid results. Some lacked a control group—a set of comparable patients who received a placebo, and who provided a baseline against which the effects of a drug could be judged. Other trials needlessly overlapped. At least 227 involved hydroxychloroquine—the antimalarial drug that Donald Trump hyped for months. A few large trials eventually confirmed that hydroxychloroquine does nothing for COVID‑19 patients, but not before hundreds of thousands of people were recruited into pointlessly small studies . More than 100,000 Americans have also received convalescent plasma—another treatment that Trump touted. But because most were not enrolled in rigorous trials, “we still don’t know if it works—and it likely doesn’t,” says Luciana Borio, the former director for medical and biodefense preparedness at the National Security Council. “What a waste of time and resources.”

Read: How we survive the winter

In the heat of a disaster, when emergency rooms are filling and patients are dying, it is hard to set up one careful study, let alone coordinate several across a country. But coordination is not impossible. During World War II , federal agencies unified private companies, universities, the military, and other entities in a carefully orchestrated effort to speed pharmaceutical development from benchtop to battlefield. The results—revolutionary malaria treatments, new ways of mass-producing antibiotics, and at least 10 new or improved vaccines for influenza and other diseases—represented “not a triumph of scientific genius but rather of organizational purpose and efficiency,” Kendall Hoyt of Dartmouth College has written.

Similar triumphs occurred last year—in other countries. In March, taking advantage of the United Kingdom’s nationalized health system, British researchers launched a nationwide study called Recovery, which has since enrolled more than 17,600 COVID‑19 patients across 176 institutions. Recovery offered conclusive answers about dexamethasone and hydroxychloroquine and is set to weigh in on several other treatments. No other study has done more to shape the treatment of COVID‑19. The U.S. is now catching up. In April, the NIH launched a partnership called ACTIV , in which academic and industry scientists prioritized the most promising drugs and coordinated trial plans across the country. Since August, several such trials have started. This model was late, but is likely to outlast the pandemic itself, allowing future researchers to rapidly sort medical wheat from pharmaceutical chaff. “I can’t imagine we’ll go back to doing clinical research in the future the way we did in the past,” the NIH’s Francis Collins said.

Even after the COVID‑19 pandemic, the fruits of the pivot will leave us better equipped for our long and intensifying war against harmful viruses. The last time a virus caused this much devastation—the flu pandemic of 1918—scientists were only just learning about viruses, and spent time looking for a bacterial culprit. This one is different. With so many scientists observing intently as a virus wreaks its horrible work upon millions of bodies, the world is learning lessons that could change the way we think about these pathogens forevermore.

Consider the long-term consequences of viral infections. Years after the original SARS virus hit Hong Kong in 2003, about a quarter of survivors still had myalgic encephalomyelitis—a chronic illness whose symptoms, such as extreme fatigue and brain fogs, can worsen dramatically after mild exertion. ME cases are thought to be linked to viral infections, and clusters sometimes follow big outbreaks. So when SARS‑CoV‑2 started spreading, people with ME were unsurprised to hear that tens of thousands of COVID‑19 “long-haulers” were experiencing incapacitating symptoms that rolled on for months . “Everyone in my community has been thinking about this since the start of the pandemic,” says Jennifer Brea, the executive director of the advocacy group #MEAction.

ME and sister illnesses such as dysautonomia, fibromyalgia, and mast cell activation syndrome have long been neglected, their symptoms dismissed as imaginary or psychiatric. Research is poorly funded, so few scientists study them. Little is known about how to prevent and treat them. This negligence has left COVID‑19 long-haulers with few answers or options, and they initially endured the same dismissal as the larger ME community. But their sheer numbers have forced a degree of recognition. They started researching, cataloging their own symptoms. They gained audiences with the NIH and the World Health Organization. Patients who are themselves experts in infectious disease or public health published their stories in top journals. “Long COVID” is being taken seriously, and Brea hopes it might drag all post-infection illnesses into the spotlight. ME never experienced a pivot. COVID‑19 might inadvertently create one.

Anthony Fauci hopes so. His career was defined by HIV, and in 2019 he said in a paper he co-wrote that “the collateral advantages of” studying HIV “have been profound.” Research into HIV/AIDS revolutionized our understanding of the immune system and how diseases subvert it. It produced techniques for developing antiviral drugs that led to treatments for hepatitis C. Inactivated versions of HIV have been used to treat cancers and genetic disorders. From one disease came a cascade of benefits. COVID‑19 will be no different. Fauci had personally seen cases of prolonged symptoms after other viral infections, but “I didn’t really have a good scientific handle on it,” he told me. Such cases are hard to study, because it’s usually impossible to identify the instigating pathogen. But COVID‑19 has created “the most unusual situation imaginable,” Fauci said—a massive cohort of people with long-haul symptoms that are almost certainly caused by one known virus. “It’s an opportunity we cannot lose,” he said.

Read: The core lesson of the COVID-19 heart debate

COVID‑19 has developed a terrifying mystique because it seems to behave in unusual ways. It causes mild symptoms in some but critical illness in others. It is a respiratory virus and yet seems to attack the heart, brain, kidneys, and other organs. It has reinfected a small number of people who had recently recovered. But many other viruses share similar abilities; they just don’t infect millions of people in a matter of months or grab the attention of the entire scientific community. Thanks to COVID‑19, more researchers are looking for these rarer sides of viral infections, and spotting them.

At least 20 known viruses, including influenza and measles, can trigger myocarditis—inflammation of the heart. Some of these cases resolve on their own, but others cause persistent scarring, and still others rapidly progress into lethal problems. No one knows what proportion of people with viral myocarditis experience the most mild fate, because doctors typically notice only those who seek medical attention. But now researchers are also intently scrutinizing the hearts of people with mild or asymptomatic COVID‑19 infections, including college athletes, given concerns about sudden cardiac arrest during strenuous workouts. The lessons from these efforts could ultimately avert deaths from other infections.

Respiratory viruses, though extremely common, are often neglected. Respiratory syncytial virus, parainfluenza viruses, rhinoviruses, adenoviruses, bocaviruses, a quartet of other human coronaviruses—they mostly cause mild coldlike illnesses, but those can be severe. How often? Why? It’s hard to say, because, influenza aside, such viruses attract little funding or interest. “There’s a perception that they’re just colds and there’s nothing much to learn,” says Emily Martin of the University of Michigan, who has long struggled to get funding to study them. Such reasoning is shortsighted folly. Respiratory viruses are the pathogens most likely to cause pandemics, and those outbreaks could potentially be far worse than COVID‑19’s.

Read: We need to talk about ventilation

Their movements through the air have been poorly studied, too. “There’s this very entrenched idea,” says Linsey Marr at Virginia Tech, that viruses mostly spread through droplets (short-range globs of snot and spit) rather than aerosols (smaller, dustlike flecks that travel farther). That idea dates back to the 1930s, when scientists were upending outdated notions that disease was caused by “bad air,” or miasma. But the evidence that SARS‑CoV‑2 can spread through aerosols “is now overwhelming,” says Marr, one of the few scientists who, before the pandemic, studied how viruses spread through air. “I’ve seen more acceptance in the last six months than over the 12 years I’ve been working on this.”

Another pandemic is inevitable, but it will find a very different community of scientists than COVID‑19 did. They will immediately work to determine whether the pathogen—most likely another respiratory virus—moves through aerosols, and whether it spreads from infected people before causing symptoms. They might call for masks and better ventilation from the earliest moments, not after months of debate. They will anticipate the possibility of an imminent wave of long-haul symptoms, and hopefully discover ways of preventing them. They might set up research groups to prioritize the most promising drugs and coordinate large clinical trials. They might take vaccine platforms that worked best against COVID‑19, slot in the genetic material of the new pathogen, and have a vaccine ready within months.

For all its benefits, the single-minded focus on COVID‑19 will also leave a slew of negative legacies. Science is mostly a zero-sum game, and when one topic monopolizes attention and money, others lose out. Last year, between physical-distancing restrictions, redirected funds, and distracted scientists, many lines of research slowed to a crawl. Long-term studies that monitored bird migrations or the changing climate will forever have holes in their data because field research had to be canceled. Conservationists who worked to protect monkeys and apes kept their distance for fear of passing COVID‑19 to already endangered species. Roughly 80 percent of non-COVID‑19 clinical trials in the U.S.—likely worth billions of dollars—were interrupted or stopped because hospitals were overwhelmed and volunteers were stuck at home. Even research on other infectious diseases was back-burnered. “All the non-COVID work that I was working on before the pandemic started is now piling up and gathering dust,” says Angela Rasmussen of Georgetown University, who normally studies Ebola and MERS. “Those are still problems.”

The COVID‑19 pandemic is a singular disaster, and it is reasonable for society—and scientists—to prioritize it. But the pivot was driven by opportunism as much as altruism. Governments, philanthropies, and universities channeled huge sums toward COVID‑19 research. The NIH alone received nearly $3.6 billion from Congress. The Bill & Melinda Gates Foundation apportioned $350 million for COVID‑19 work. “Whenever there’s a big pot of money, there’s a feeding frenzy,” Madhukar Pai told me. He works on tuberculosis, which causes 1.5 million deaths a year—comparable to COVID‑19’s toll in 2020. Yet tuberculosis research has been mostly paused. None of Pai’s colleagues pivoted when Ebola or Zika struck, but “half of us have now swung to working on COVID‑19,” he said. “It’s a black hole, sucking us all in.”

While the most qualified experts became quickly immersed in the pandemic response, others were stuck at home looking for ways to contribute. Using the same systems that made science faster, they could download data from free databases, run quick analyses with intuitive tools, publish their work on preprint servers, and publicize it on Twitter. Often, they made things worse by swerving out of their scholarly lanes and plowing into unfamiliar territory. Nathan Ballantyne, a philosopher at Fordham University, calls this “ epistemic trespassing .” It can be a good thing: Continental drift was championed by Alfred Wegener, a meteorologist; microbes were first documented by Antonie van Leeuwenhoek, a draper. But more often than not, epistemic trespassing just creates a mess, especially when inexperience couples with overconfidence.

On March 28, a preprint noted that countries that universally use a tuberculosis vaccine called BCG had lower COVID‑19 mortality rates. But such cross-country comparisons are infamously treacherous. For example, countries with higher cigarette-usage rates have longer life expectancies, not because smoking prolongs life but because it is more popular in wealthier nations. This tendency to draw faulty conclusions about individual health using data about large geographical regions is called the ecological fallacy. Epidemiologists know to avoid it. The BCG-preprint authors, who were from an osteopathic college in New York, didn’t seem to . But their paper was covered by more than 70 news outlets, and dozens of inexperienced teams offered similarly specious analyses. “People who don’t know how to spell tuberculosis have told me they can solve the link between BCG and COVID‑19,” Pai said. “Someone told me they can do it in 48 hours with a hackathon.”

Other epistemic trespassers spent their time reinventing the wheel. One new study, published in NEJM , used lasers to show that when people speak, they release aerosols. But as the authors themselves note, the same result—sans lasers—was published in 1946, Marr says. I asked her whether any papers from the 2020 batch had taught her something new. After an uncomfortably long pause, she mentioned just one.

In some cases, bad papers helped shape the public narrative of the pandemic. On March 16, two biogeographers published a preprint arguing that COVID‑19 will “marginally affect the tropics” because it fares poorly in warm, humid conditions. Disease experts quickly noted that techniques like the ones the duo used are meant for modeling the geographic ranges of animal and plant species or vector-borne pathogens, and are ill-suited to simulating the spread of viruses like SARS-CoV-2. But their claim was picked up by more than 50 news outlets and echoed by the United Nations World Food Program. COVID‑19 has since run rampant in many tropical countries, including Brazil, Indonesia, and Colombia—and the preprint’s authors have qualified their conclusions in later versions of the paper. “It takes a certain type of person to think that weeks of reading papers gives them more perspective than someone with a Ph.D. on that subject, and that type of person has gotten a lot of airtime in this pandemic,” says Colin Carlson of Georgetown.

The incentives to trespass are substantial. Academia is a pyramid scheme: Each biomedical professor trains an average of six doctoral students across her career, but only 16 percent of the students get tenure-track positions . Competition is ferocious, and success hinges on getting published—a feat made easier by dramatic results. These factors pull researchers toward speed, short-termism, and hype at the expense of rigor—and the pandemic intensified that pull. With an anxious world crying out for information, any new paper could immediately draw international press coverage—and hundreds of citations.

The tsunami of rushed but dubious work made life harder for actual experts, who struggled to sift the signal from the noise. They also felt obliged to debunk spurious research in long Twitter threads and relentless media interviews—acts of public service that are rarely rewarded in academia. And they were overwhelmed by requests to peer-review new papers. Kristian Andersen, an infectious-disease researcher at Scripps Research, told me that journals used to send him two or three such requests a month. Now “I’m getting three or five a day,” he said in September.

The pandemic’s opportunities also fell inequitably upon the scientific community. In March, Congress awarded $75 million to the National Science Foundation to fast-track studies that could quickly contribute to the pandemic response. “That money just went ,” says Cassidy Sugimoto of Indiana University, who was on rotation at the agency at the time. “It was a first-come, first-served environment. It advantaged people who were aware of the system and could act upon it quickly.” But not all scientists could pivot to COVID‑19, or pivot with equal speed.

Among scientists, as in other fields, women do more child care, domestic work, and teaching than men, and are more often asked for emotional support by their students. These burdens increased as the pandemic took hold, leaving women scientists “less able to commit their time to learning about a new area of study, and less able to start a whole new research project,” says Molly M. King, a sociologist at Santa Clara University. Women’s research hours fell by nine percentage points more than did men’s because of the pressures of COVID‑19. And when COVID‑19 created new opportunities, men grabbed them more quickly. In the spring, the proportion of papers with women as first authors fell almost 44 percent in the preprint repository medRxiv, relative to 2019. And published COVID‑19 papers had 19 percent fewer women as first authors compared with papers from the same journals in the previous year. Men led more than 80 percent of national COVID‑19 task forces in 87 countries . Male scientists were quoted four times as frequently as female scientists in American news stories about the pandemic.

American scientists of color also found it harder to pivot than their white peers, because of unique challenges that sapped their time and energy. Black, Latino, and Indigenous scientists were most likely to have lost loved ones, adding mourning to their list of duties. Many grieved, too, after the killings of Breonna Taylor, George Floyd, Ahmaud Arbery, and others. They often faced questions from relatives who were mistrustful of the medical system, or were experiencing discriminatory care. They were suddenly tasked with helping their predominantly white institutions fight racism. Neil Lewis Jr. at Cornell, who studies racial health disparities, told me that many psychologists had long deemed his work irrelevant. “All of a sudden my inbox is drowning,” he said, while some of his own relatives have become ill and one has died.

Science suffers from the so-called Matthew effect, whereby small successes snowball into ever greater advantages, irrespective of merit. Similarly, early hindrances linger. Young researchers who could not pivot because they were too busy caring or grieving for others might suffer lasting consequences from an unproductive year. COVID‑19 “has really put the clock back in terms of closing the gap for women and underrepresented minorities,” Yale’s Akiko Iwasaki says. “Once we’re over the pandemic, we’ll need to fix it all again.”

COVID-19 has already changed science immensely, but if scientists are savvy, the most profound pivot is still to come—a grand reimagining of what medicine should be. In 1848, the Prussian government sent a young physician named Rudolf Virchow to investigate a typhus epidemic in Upper Silesia. Virchow didn’t know what caused the devastating disease, but he realized its spread was possible because of malnutrition, hazardous working conditions, crowded housing, poor sanitation, and the inattention of civil servants and aristocrats—problems that require social and political reforms. “Medicine is a social science,” Virchow said, “and politics is nothing but medicine in larger scale.”

This viewpoint fell by the wayside after germ theory became mainstream in the late 19th century. When scientists discovered the microbes responsible for tuberculosis, plague, cholera, dysentery, and syphilis, most fixated on these newly identified nemeses. Societal factors were seen as overly political distractions for researchers who sought to “be as ‘objective’ as possible,” says Elaine Hernandez, a medical sociologist at Indiana University. In the U.S., medicine fractured. New departments of sociology and cultural anthropology kept their eye on the societal side of health, while the nation’s first schools of public health focused instead on fights between germs and individuals. This rift widened as improvements in hygiene, living standards, nutrition, and sanitation lengthened life spans: The more social conditions improved, the more readily they could be ignored.

The ideological pivot away from social medicine began to reverse in the second half of the 20th century. The women’s-rights and civil-rights movements, the rise of environmentalism, and anti-war protests created a generation of scholars who questioned “the legitimacy, ideology, and practice of any science … that disregards social and economic inequality,” wrote Nancy Krieger of Harvard . Beginning in the 1980s, this new wave of social epidemiologists once again studied how poverty, privilege, and living conditions affect a person’s health—to a degree even Virchow hadn’t imagined. But as COVID‑19 has shown, the reintegration is not yet complete.

Politicians initially described COVID‑19 as a “great equalizer,” but when states began releasing demographic data, it was immediately clear that the disease was disproportionately infecting and killing people of color . These disparities aren’t biological. They stem from decades of discrimination and segregation that left minority communities in poorer neighborhoods with low-paying jobs, more health problems, and less access to health care—the same kind of problems that Virchow identified more than 170 years ago.

From the September 2020 issue: How the pandemic defeated America

Simple acts like wearing a mask and staying at home, which rely on people tolerating discomfort for the collective good, became society’s main defenses against the virus in the many months without effective drugs or vaccines. These are known as nonpharmaceutical interventions—a name that betrays medicine’s biological bias. For most of 2020, these were the only interventions on offer, but they were nonetheless defined in opposition to the more highly prized drugs and vaccines.

In March, when the U.S. started shutting down, one of the biggest questions on the mind of Whitney Robinson of UNC at Chapel Hill was: Are our kids going to be out of school for two years? While biomedical scientists tend to focus on sickness and recovery, social epidemiologists like her “think about critical periods that can affect the trajectory of your life,” she told me. Disrupting a child’s schooling at the wrong time can affect their entire career, so scientists should have prioritized research to figure out whether and how schools could reopen safely. But most studies on the spread of COVID‑19 in schools were neither large in scope nor well-designed enough to be conclusive. No federal agency funded a large, nationwide study, even though the federal government had months to do so. The NIH received billions for COVID‑19 research , but the National Institute of Child Health and Human Development—one of its 27 constituent institutes and centers—got nothing.

The horrors that Rudolf Virchow saw in Upper Silesia radicalized him, pushing the future “father of modern pathology” to advocate for social reforms. The current pandemic has affected scientists in the same way. Calm researchers became incensed as potentially game-changing innovations like cheap diagnostic tests were squandered by a negligent administration and a muzzled Centers for Disease Control and Prevention. Austere publications like NEJM and Nature published explicitly political editorials castigating the Trump administration for its failures and encouraging voters to hold the president accountable. COVID‑19 could be the catalyst that fully reunifies the social and biological sides of medicine, bridging disciplines that have been separated for too long.

“To study COVID‑19 is not only to study the disease itself as a biological entity,” says Alondra Nelson, the president of the Social Science Research Council. “What looks like a single problem is actually all things, all at once. So what we’re actually studying is literally everything in society, at every scale, from supply chains to individual relationships.”

The scientific community spent the pre-pandemic years designing faster ways of doing experiments, sharing data, and developing vaccines, allowing it to mobilize quickly when COVID‑19 emerged. Its goal now should be to address its many lingering weaknesses. Warped incentives, wasteful practices, overconfidence, inequality, a biomedical bias—COVID‑19 has exposed them all. And in doing so, it offers the world of science a chance to practice one of its most important qualities: self-correction.

* The print version of this article stated that the Moderna and Pfizer/BioNTech vaccines were reported to be 95 percent effective at preventing COVID-19 infections. In fact, the vaccines prevent disease, not infection.

This article appears in the January/February 2021 print edition with the headline “The COVID-19 Manhattan Project.”

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Read these 12 moving essays about life during coronavirus

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

by Alissa Wilkinson

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.

• The Vox guide to navigating the coronavirus crisis

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?

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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.

• What day is it today?

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.

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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.

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

February 16, 2021

• 15 min read

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

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

Restore institutional trust

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

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

Fortify early alert frameworks

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

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

Threat-based resource allocation

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

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

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

Science in the war room

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

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

Privacy preserving technology

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

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

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

Mass casualty surge capacity

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

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

Public-private accelerator

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

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

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

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

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

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Essay On Covid-19: 100, 200 and 300 Words

• Updated on  
• Apr 30, 2024

COVID-19, also known as the Coronavirus, is a global pandemic that has affected people all around the world. It first emerged in a lab in Wuhan, China, in late 2019 and quickly spread to countries around the world. This virus was reportedly caused by SARS-CoV-2. Since then, it has spread rapidly to many countries, causing widespread illness and impacting our lives in numerous ways. This blog talks about the details of this virus and also drafts an essay on COVID-19 in 100, 200 and 300 words for students and professionals. 

Table of Contents

• 1 Essay On COVID-19 in English 100 Words
• 2 Essay On COVID-19 in 200 Words
• 3 Essay On COVID-19 in 300 Words
• 4 Short Essay on Covid-19

Essay On COVID-19 in English 100 Words

COVID-19, also known as the coronavirus, is a global pandemic. It started in late 2019 and has affected people all around the world. The virus spreads very quickly through someone’s sneeze and respiratory issues.

COVID-19 has had a significant impact on our lives, with lockdowns, travel restrictions, and changes in daily routines. To prevent the spread of COVID-19, we should wear masks, practice social distancing, and wash our hands frequently. 

People should follow social distancing and other safety guidelines and also learn the tricks to be safe stay healthy and work the whole challenging time. 

Also Read: National Safe Motherhood Day 2023

Essay On COVID-19 in 200 Words

COVID-19 also known as coronavirus, became a global health crisis in early 2020 and impacted mankind around the world. This virus is said to have originated in Wuhan, China in late 2019. It belongs to the coronavirus family and causes flu-like symptoms. It impacted the healthcare systems, economies and the daily lives of people all over the world. 

The most crucial aspect of COVID-19 is its highly spreadable nature. It is a communicable disease that spreads through various means such as coughs from infected persons, sneezes and communication. Due to its easy transmission leading to its outbreaks, there were many measures taken by the government from all over the world such as Lockdowns, Social Distancing, and wearing masks. 

There are many changes throughout the economic systems, and also in daily routines. Other measures such as schools opting for Online schooling, Remote work options available and restrictions on travel throughout the country and internationally. Subsequently, to cure and top its outbreak, the government started its vaccine campaigns, and other preventive measures. 

In conclusion, COVID-19 tested the patience and resilience of the mankind. This pandemic has taught people the importance of patience, effort and humbleness. 

Also Read : Essay on My Best Friend

Essay On COVID-19 in 300 Words

COVID-19, also known as the coronavirus, is a serious and contagious disease that has affected people worldwide. It was first discovered in late 2019 in Cina and then got spread in the whole world. It had a major impact on people’s life, their school, work and daily lives. 

COVID-19 is primarily transmitted from person to person through respiratory droplets produced and through sneezes, and coughs of an infected person. It can spread to thousands of people because of its highly contagious nature. To cure the widespread of this virus, there are thousands of steps taken by the people and the government. 

Wearing masks is one of the essential precautions to prevent the virus from spreading. Social distancing is another vital practice, which involves maintaining a safe distance from others to minimize close contact.

Very frequent handwashing is also very important to stop the spread of this virus. Proper hand hygiene can help remove any potential virus particles from our hands, reducing the risk of infection. 

In conclusion, the Coronavirus has changed people’s perspective on living. It has also changed people’s way of interacting and how to live. To deal with this virus, it is very important to follow the important guidelines such as masks, social distancing and techniques to wash your hands. Getting vaccinated is also very important to go back to normal life and cure this virus completely.

Also Read: Essay on Abortion in English in 650 Words

Short Essay on Covid-19

Please find below a sample of a short essay on Covid-19 for school students:

Also Read: Essay on Women’s Day in 200 and 500 words

to write an essay on COVID-19, understand your word limit and make sure to cover all the stages and symptoms of this disease. You need to highlight all the challenges and impacts of COVID-19. Do not forget to conclude your essay with positive precautionary measures.

Writing an essay on COVID-19 in 200 words requires you to cover all the challenges, impacts and precautions of this disease. You don’t need to describe all of these factors in brief, but make sure to add as many options as your word limit allows.

The full form for COVID-19 is Corona Virus Disease of 2019.

Related Reads

Hence, we hope that this blog has assisted you in comprehending with an essay on COVID-19. For more information on such interesting topics, visit our essay writing page and follow Leverage Edu.

Simran Popli

An avid writer and a creative person. With an experience of 1.5 years content writing, Simran has worked with different areas. From medical to working in a marketing agency with different clients to Ed-tech company, the journey has been diverse. Creative, vivacious and patient are the words that describe her personality.

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Impact of COVID-19 on people's livelihoods, their health and our food systems

Joint statement by ilo, fao, ifad and who.

The COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge to public health, food systems and the world of work. The economic and social disruption caused by the pandemic is devastating: tens of millions of people are at risk of falling into extreme poverty, while the number of undernourished people, currently estimated at nearly 690 million, could increase by up to 132 million by the end of the year.

Millions of enterprises face an existential threat. Nearly half of the world’s 3.3 billion global workforce are at risk of losing their livelihoods. Informal economy workers are particularly vulnerable because the majority lack social protection and access to quality health care and have lost access to productive assets. Without the means to earn an income during lockdowns, many are unable to feed themselves and their families. For most, no income means no food, or, at best, less food and less nutritious food. 

The pandemic has been affecting the entire food system and has laid bare its fragility. Border closures, trade restrictions and confinement measures have been preventing farmers from accessing markets, including for buying inputs and selling their produce, and agricultural workers from harvesting crops, thus disrupting domestic and international food supply chains and reducing access to healthy, safe and diverse diets. The pandemic has decimated jobs and placed millions of livelihoods at risk. As breadwinners lose jobs, fall ill and die, the food security and nutrition of millions of women and men are under threat, with those in low-income countries, particularly the most marginalized populations, which include small-scale farmers and indigenous peoples, being hardest hit.

Millions of agricultural workers – waged and self-employed – while feeding the world, regularly face high levels of working poverty, malnutrition and poor health, and suffer from a lack of safety and labour protection as well as other types of abuse. With low and irregular incomes and a lack of social support, many of them are spurred to continue working, often in unsafe conditions, thus exposing themselves and their families to additional risks. Further, when experiencing income losses, they may resort to negative coping strategies, such as distress sale of assets, predatory loans or child labour. Migrant agricultural workers are particularly vulnerable, because they face risks in their transport, working and living conditions and struggle to access support measures put in place by governments. Guaranteeing the safety and health of all agri-food workers – from primary producers to those involved in food processing, transport and retail, including street food vendors – as well as better incomes and protection, will be critical to saving lives and protecting public health, people’s livelihoods and food security.

In the COVID-19 crisis food security, public health, and employment and labour issues, in particular workers’ health and safety, converge. Adhering to workplace safety and health practices and ensuring access to decent work and the protection of labour rights in all industries will be crucial in addressing the human dimension of the crisis. Immediate and purposeful action to save lives and livelihoods should include extending social protection towards universal health coverage and income support for those most affected. These include workers in the informal economy and in poorly protected and low-paid jobs, including youth, older workers, and migrants. Particular attention must be paid to the situation of women, who are over-represented in low-paid jobs and care roles. Different forms of support are key, including cash transfers, child allowances and healthy school meals, shelter and food relief initiatives, support for employment retention and recovery, and financial relief for businesses, including micro, small and medium-sized enterprises. In designing and implementing such measures it is essential that governments work closely with employers and workers.

Countries dealing with existing humanitarian crises or emergencies are particularly exposed to the effects of COVID-19. Responding swiftly to the pandemic, while ensuring that humanitarian and recovery assistance reaches those most in need, is critical.

Now is the time for global solidarity and support, especially with the most vulnerable in our societies, particularly in the emerging and developing world. Only together can we overcome the intertwined health and social and economic impacts of the pandemic and prevent its escalation into a protracted humanitarian and food security catastrophe, with the potential loss of already achieved development gains.

We must recognize this opportunity to build back better, as noted in the Policy Brief issued by the United Nations Secretary-General. We are committed to pooling our expertise and experience to support countries in their crisis response measures and efforts to achieve the Sustainable Development Goals. We need to develop long-term sustainable strategies to address the challenges facing the health and agri-food sectors. Priority should be given to addressing underlying food security and malnutrition challenges, tackling rural poverty, in particular through more and better jobs in the rural economy, extending social protection to all, facilitating safe migration pathways and promoting the formalization of the informal economy.

We must rethink the future of our environment and tackle climate change and environmental degradation with ambition and urgency. Only then can we protect the health, livelihoods, food security and nutrition of all people, and ensure that our ‘new normal’ is a better one.

Media Contacts

Kimberly Chriscaden

Communications Officer World Health Organization

Nutrition and Food Safety (NFS) and COVID-19

Writing about COVID-19 in a college admission essay

by: Venkates Swaminathan | Updated: September 14, 2020

Print article

For students applying to college using the CommonApp, there are several different places where students and counselors can address the pandemic’s impact. The different sections have differing goals. You must understand how to use each section for its appropriate use.

The CommonApp COVID-19 question

First, the CommonApp this year has an additional question specifically about COVID-19 :

Community disruptions such as COVID-19 and natural disasters can have deep and long-lasting impacts. If you need it, this space is yours to describe those impacts. Colleges care about the effects on your health and well-being, safety, family circumstances, future plans, and education, including access to reliable technology and quiet study spaces. Please use this space to describe how these events have impacted you.

This question seeks to understand the adversity that students may have had to face due to the pandemic, the move to online education, or the shelter-in-place rules. You don’t have to answer this question if the impact on you wasn’t particularly severe. Some examples of things students should discuss include:

• The student or a family member had COVID-19 or suffered other illnesses due to confinement during the pandemic.
• The candidate had to deal with personal or family issues, such as abusive living situations or other safety concerns
• The student suffered from a lack of internet access and other online learning challenges.
• Students who dealt with problems registering for or taking standardized tests and AP exams.

Jeff Schiffman of the Tulane University admissions office has a blog about this section. He recommends students ask themselves several questions as they go about answering this section:

• Are my experiences different from others’?
• Are there noticeable changes on my transcript?
• Am I aware of my privilege?
• Am I specific? Am I explaining rather than complaining?
• Is this information being included elsewhere on my application?

If you do answer this section, be brief and to-the-point.

Counselor recommendations and school profiles

Second, counselors will, in their counselor forms and school profiles on the CommonApp, address how the school handled the pandemic and how it might have affected students, specifically as it relates to:

• Grading scales and policies
• Graduation requirements
• Instructional methods
• Schedules and course offerings
• Testing requirements
• Your academic calendar
• Other extenuating circumstances

Students don’t have to mention these matters in their application unless something unusual happened.

Writing about COVID-19 in your main essay

Write about your experiences during the pandemic in your main college essay if your experience is personal, relevant, and the most important thing to discuss in your college admission essay. That you had to stay home and study online isn’t sufficient, as millions of other students faced the same situation. But sometimes, it can be appropriate and helpful to write about something related to the pandemic in your essay. For example:

• One student developed a website for a local comic book store. The store might not have survived without the ability for people to order comic books online. The student had a long-standing relationship with the store, and it was an institution that created a community for students who otherwise felt left out.
• One student started a YouTube channel to help other students with academic subjects he was very familiar with and began tutoring others.
• Some students used their extra time that was the result of the stay-at-home orders to take online courses pursuing topics they are genuinely interested in or developing new interests, like a foreign language or music.

Experiences like this can be good topics for the CommonApp essay as long as they reflect something genuinely important about the student. For many students whose lives have been shaped by this pandemic, it can be a critical part of their college application.

Want more? Read 6 ways to improve a college essay , What the &%$! should I write about in my college essay , and Just how important is a college admissions essay? .

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An Introduction to COVID-19

Simon james fong.

4 Department of Computer and Information Science, University of Macau, Taipa, Macau, China

Nilanjan Dey

5 Department of Information Technology, Techno International New Town, Kolkata, West Bengal India

Jyotismita Chaki

6 School of Information Technology and Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu India

A novel coronavirus (CoV) named ‘2019-nCoV’ or ‘2019 novel coronavirus’ or ‘COVID-19’ by the World Health Organization (WHO) is in charge of the current outbreak of pneumonia that began at the beginning of December 2019 near in Wuhan City, Hubei Province, China [1–4]. COVID-19 is a pathogenic virus. From the phylogenetic analysis carried out with obtainable full genome sequences, bats occur to be the COVID-19 virus reservoir, but the intermediate host(s) has not been detected till now.

A Brief History of the Coronavirus Outbreak

A novel coronavirus (CoV) named ‘2019-nCoV’ or ‘2019 novel coronavirus’ or ‘COVID-19’ by the World Health Organization (WHO) is in charge of the current outbreak of pneumonia that began at the beginning of December 2019 near in Wuhan City, Hubei Province, China [ 1 – 4 ]. COVID-19 is a pathogenic virus. From the phylogenetic analysis carried out with obtainable full genome sequences, bats occur to be the COVID-19 virus reservoir, but the intermediate host(s) has not been detected till now. Though three major areas of work already are ongoing in China to advise our awareness of the pathogenic origin of the outbreak. These include early inquiries of cases with symptoms occurring near in Wuhan during December 2019, ecological sampling from the Huanan Wholesale Seafood Market as well as other area markets, and the collection of detailed reports of the point of origin and type of wildlife species marketed on the Huanan market and the destination of those animals after the market has been closed [ 5 – 8 ].

Coronaviruses mostly cause gastrointestinal and respiratory tract infections and are inherently categorized into four major types: Gammacoronavirus, Deltacoronavirus, Betacoronavirus and Alphacoronavirus [ 9 – 11 ]. The first two types mainly infect birds, while the last two mostly infect mammals. Six types of human CoVs have been formally recognized. These comprise HCoVHKU1, HCoV-OC43, Middle East Respiratory Syndrome coronavirus (MERS-CoV), Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) which is the type of the Betacoronavirus, HCoV229E and HCoV-NL63, which are the member of the Alphacoronavirus. Coronaviruses did not draw global concern until the 2003 SARS pandemic [ 12 – 14 ], preceded by the 2012 MERS [ 15 – 17 ] and most recently by the COVID-19 outbreaks. SARS-CoV and MERS-CoV are known to be extremely pathogenic and spread from bats to palm civets or dromedary camels and eventually to humans.

COVID-19 is spread by dust particles and fomites while close unsafe touch between the infector and the infected individual. Airborne distribution has not been recorded for COVID-19 and is not known to be a significant transmission engine based on empirical evidence; although it can be imagined if such aerosol-generating practices are carried out in medical facilities. Faecal spreading has been seen in certain patients, and the active virus has been reported in a small number of clinical studies [ 18 – 20 ]. Furthermore, the faecal-oral route does not seem to be a COVID-19 transmission engine; its function and relevance for COVID-19 need to be identified.

For about 18,738,58 laboratory-confirmed cases recorded as of 2nd week of April 2020, the maximum number of cases (77.8%) was between 30 and 69 years of age. Among the recorded cases, 21.6% are farmers or employees by profession, 51.1% are male and 77.0% are Hubei.

However, there are already many concerns regarding the latest coronavirus. Although it seems to be transferred to humans by animals, it is important to recognize individual animals and other sources, the path of transmission, the incubation cycle, and the features of the susceptible community and the survival rate. Nonetheless, very little clinical knowledge on COVID-19 disease is currently accessible and details on age span, the animal origin of the virus, incubation time, outbreak curve, viral spectroscopy, dissemination pathogenesis, autopsy observations, and any clinical responses to antivirals are lacking among the serious cases.

How Different and Deadly COVID-19 is Compared to Plagues in History

COVID-19 has reached to more than 150 nations, including China, and has caused WHO to call the disease a worldwide pandemic. By the time of 2nd week of April 2020, this COVID-19 cases exceeded 18,738,58, although more than 1,160,45 deaths were recorded worldwide and United States of America became the global epicentre of coronavirus. More than one-third of the COVID-19 instances are outside of China. Past pandemics that have existed in the past decade or so, like bird flu, swine flu, and SARS, it is hard to find out the comparison between those pandemics and this coronavirus. Following is a guide to compare coronavirus with such diseases and recent pandemics that have reformed the world community.

Coronavirus Versus Seasonal Influenza

Influenza, or seasonal flu, occurs globally every year–usually between December and February. It is impossible to determine the number of reports per year because it is not a reportable infection (so no need to be recorded to municipality), so often patients with minor symptoms do not go to a physician. Recent figures placed the Rate of Case Fatality at 0.1% [ 21 – 23 ].

There are approximately 3–5 million reports of serious influenza a year, and about 250,000–500,000 deaths globally. In most developed nations, the majority of deaths arise in persons over 65 years of age. Moreover, it is unsafe for pregnant mothers, children under 59 months of age and individuals with serious illnesses.

The annual vaccination eliminates infection and severe risks in most developing countries but is nevertheless a recognized yet uncomfortable aspect of the season.

In contrast to the seasonal influenza, coronavirus is not so common, has led to fewer cases till now, has a higher rate of case fatality and has no antidote.

Coronavirus Versus Bird Flu (H5N1 and H7N9)

Several cases of bird flu have existed over the years, with the most severe in 2013 and 2016. This is usually from two separate strains—H5N1 and H7N9 [ 24 – 26 ].

The H7N9 outbreak in 2016 accounted for one-third of all confirmed human cases but remained confined relative to both coronavirus and other pandemics/outbreak cases. After the first outbreak, about 1,233 laboratory-confirmed reports of bird flu have occurred. The disease has a Rate of Case Fatality of 20–40%.

Although the percentage is very high, the blowout from individual to individual is restricted, which, in effect, has minimized the number of related deaths. It is also impossible to monitor as birds do not necessarily expire from sickness.

In contrast to the bird flu, coronavirus becomes more common, travels more quickly through human to human interaction, has an inferior cardiothoracic ratio, resulting in further total fatalities and spread from the initial source.

Coronavirus Versus Ebola Epidemic

The Ebola epidemic of 2013 was primarily centred in 10 nations, including Sierra Leone, Guinea and Liberia have the greatest effects, but the extremely high Case Fatality Rate of 40% has created this as a significant problem for health professionals nationwide [ 27 – 29 ].

Around 2013 and 2016, there were about 28,646 suspicious incidents and about 11,323 fatalities, although these are expected to be overlooked. Those who survived from the original epidemic may still become sick months or even years later, because the infection may stay inactive for prolonged periods. Thankfully, a vaccination was launched in December 2016 and is perceived to be effective.

In contrast to the Ebola, coronavirus is more common globally, has caused in fewer fatalities, has a lesser case fatality rate, has no reported problems during treatment and after recovery, does not have an appropriate vaccination.

Coronavirus Versus Camel Flu (MERS)

Camel flu is a misnomer–though camels have MERS antibodies and may have been included in the transmission of the disease; it was originally transmitted to humans through bats [ 30 – 32 ]. Like Ebola, it infected only a limited number of nations, i.e. about 27, but about 858 fatalities from about 2,494 laboratory-confirmed reports suggested that it was a significant threat if no steps were taken in place to control it.

In contrast to the camel flu, coronavirus is more common globally, has occurred more fatalities, has a lesser case fatality rate, and spreads more easily among humans.

Coronavirus Versus Swine Flu (H1N1)

Swine flu is the same form of influenza that wiped 1.7% of the world population in 1918. This was deemed a pandemic again in June 2009 an approximately-21% of the global population infected by this [ 33 – 35 ].

Thankfully, the case fatality rate is substantially lower than in the last pandemic, with 0.1%–0.5% of events ending in death. About 18,500 of these fatalities have been laboratory-confirmed, but statistics range as high as 151,700–575,400 worldwide. 50–80% of severe occurrences have been reported in individuals with chronic illnesses like asthma, obesity, cardiovascular diseases and diabetes.

In contrast to the swine flu, coronavirus is not so common, has caused fewer fatalities, has more case fatality rate, has a longer growth time and less impact on young people.

Coronavirus Versus Severe Acute Respiratory Syndrome (SARS)

SARS was discovered in 2003 as it spread from bats to humans resulted in about 774 fatalities. By May there were eventually about 8,100 reports across 17 countries, with a 15% case fatality rate. The number is estimated to be closer to 9.6% as confirmed cases are counted, with 0.9% cardiothoracic ratio for people aged 20–29, rising to 28% for people aged 70–79. Similar to coronavirus, SARS had bad results for males than females in all age categories [ 36 – 38 ].

Coronavirus is more common relative to SARS, which ended in more overall fatalities, lower case fatality rate, the even higher case fatality rate in older ages, and poorer results for males.

Coronavirus Versus Hong Kong Flu (H3N2)

The Hong Kong flu pandemic erupted on 13 July 1968, with 1–4 million deaths globally by 1969. It was one of the greatest flu pandemics of the twentieth century, but thankfully the case fatality rate was smaller than the epidemic of 1918, resulting in fewer fatalities overall. That may have been attributed to the fact that citizens had generated immunity owing to a previous epidemic in 1957 and to better medical treatment [ 39 ].

In contrast to the Hong Kong flu, coronavirus is not so common, has caused in fewer fatalities and has a higher case fatality rate.

Coronavirus Versus Spanish Flu (H1N1)

The 1918 Spanish flu pandemic was one of the greatest occurrences of recorded history. During the first year of the pandemic, lifespan in the US dropped by 12 years, with more civilians killed than HIV/AIDS in 24 h [ 40 – 42 ].

Regardless of the name, the epidemic did not necessarily arise in Spain; wartime censors in Germany, the United States, the United Kingdom and France blocked news of the disease, but Spain did not, creating the misleading perception that more cases and fatalities had occurred relative to its neighbours

This strain of H1N1 eventually affected more than 500 million men, or 27% of the world’s population at the moment, and had deaths of between 40 and 50 million. At the end of 1920, 1.7% of the world’s people had expired of this illness, including an exceptionally high death rate for young adults aged between 20 and 40 years.

In contrast to the Spanish flu, coronavirus is not so common, has caused in fewer fatalities, has a higher case fatality rate, is more harmful to older ages and is less risky for individuals aged 20–40 years.

Coronavirus Versus Common Cold (Typically Rhinovirus)

Common cold is the most common illness impacting people—Typically, a person suffers from 2–3 colds each year and the average kid will catch 6–8 during the similar time span. Although there are more than 200 cold-associated virus types, infections are uncommon and fatalities are very rare and typically arise mainly in extremely old, extremely young or immunosuppressed cases [ 43 , 44 ].

In contrast to the common cold, coronavirus is not so prevalent, causes more fatalities, has more case fatality rate, is less infectious and is less likely to impact small children.

Reviews of Online Portals and Social Media for Epidemic Information Dissemination

As COVID-19 started to propagate across the globe, the outbreak contributed to a significant change in the broad technology platforms. Where they once declined to engage in the affairs of their systems, except though the possible danger to public safety became obvious, the advent of a novel coronavirus placed them in a different interventionist way of thought. Big tech firms and social media are taking concrete steps to guide users to relevant, credible details on the virus [ 45 – 48 ]. And some of the measures they’re doing proactively. Below are a few of them.

Facebook started adding a box in the news feed that led users to the Centers for Disease Control website regarding COVID-19. It reflects a significant departure from the company’s normal strategy of placing items in the News Feed. The purpose of the update, after all, is personalization—Facebook tries to give the posts you’re going to care about, whether it is because you’re connected with a person or like a post. In the virus package, Facebook has placed a remarkable algorithmic thumb on the scale, potentially pushing millions of people to accurate, authenticated knowledge from a reputable source.

Similar initiatives have been adopted by Twitter. Searching for COVID-19 will carry you to a page highlighting the latest reports from public health groups and credible national news outlets. The search also allows for common misspellings. Twitter has stated that although Russian-style initiatives to cause discontent by large-scale intelligence operations have not yet been observed, a zero-tolerance approach to network exploitation and all other attempts to exploit their service at this crucial juncture will be expected. The problem has the attention of the organization. It also offers promotional support to public service agencies and other non-profit groups.

Google has made a step in making it better for those who choose to operate or research from home, offering specialized streaming services to all paying G Suite customers. Google also confirmed that free access to ‘advanced’ Hangouts Meet apps will be rolled out to both G Suite and G Suite for Education clients worldwide through 1st July. It ensures that companies can hold meetings of up to 250 people, broadcast live to up to about 100,000 users within a single network, and archive and export meetings to Google Drive. Usually, Google pays an additional $13 per person per month for these services in comparison to G Suite’s ‘enterprise’ membership, which adds up to a total of about $25 per client each month.

Microsoft took a similar move, introducing the software ‘Chat Device’ to help public health and protection in the coronavirus epidemic, which enables collaborative collaboration via video and text messaging. There’s an aspect of self-interest in this. Tech firms are offering out their goods free of charge during periods of emergency for the same purpose as newspapers are reducing their paywalls: it’s nice to draw more paying consumers.

Pinterest, which has introduced much of the anti-misinformation strategies that Facebook and Twitter are already embracing, is now restricting the search results for ‘coronavirus’, ‘COVID-19’ and similar words for ‘internationally recognized health organizations’.

Google-owned YouTube, traditionally the most conspiratorial website, has recently introduced a connection to the World Health Organization virus epidemic page to the top of the search results. In the early days of the epidemic, BuzzFeed found famous coronavirus conspiratorial videos on YouTube—especially in India, where one ‘explain’ with a false interpretation of the sources of the disease racketeered 13 million views before YouTube deleted it. Yet in the United States, conspiratorial posts regarding the illness have failed to gain only 1 million views.

That’s not to suggest that misinformation doesn’t propagate on digital platforms—just as it travels through the broader Internet, even though interaction with friends and relatives. When there’s a site that appears to be under-performing in the global epidemic, it’s Facebook-owned WhatsApp, where the Washington Post reported ‘a torrent of disinformation’ in places like Nigeria, Indonesia, Peru, Pakistan and Ireland. Given the encrypted existence of the app, it is difficult to measure the severity of the problem. Misinformation is also spread in WhatsApp communities, where participation is restricted to about 250 individuals. Knowledge of one category may be readily exchanged with another; however, there is a considerable amount of complexity of rotating several groups to peddle affected healing remedies or propagate false rumours.

Preventative Measures and Policies Enforced by the World Health Organization (WHO) and Different Countries

Coronavirus is already an ongoing epidemic, so it is necessary to take precautions to minimize both the risk of being sick and the transmission of the disease.

WHO Advice [ 49 ]

• Wash hands regularly with alcohol-based hand wash or soap and water.
• Preserve contact space (at least 1 m/3 feet between you and someone who sneezes or coughs).
• Don’t touch your nose, head and ears.
• Cover your nose and mouth as you sneeze or cough, preferably with your bent elbow or tissue.
• Try to find early medical attention if you have fatigue, cough and trouble breathing.
• Take preventive precautions if you are in or have recently go to places where coronavirus spreads.

The first person believed to have become sick because of the latest virus was near in Wuhan on 1 December 2019. A formal warning of the epidemic was released on 31 December. The World Health Organization was informed of the epidemic on the same day. Through 7 January, the Chinese Government addressed the avoidance and regulation of COVID-19. A curfew was declared on 23 January to prohibit flying in and out of Wuhan. Private usage of cars has been banned in the region. Chinese New Year (25 January) festivities have been cancelled in many locations [ 50 ].

On 26 January, the Communist Party and the Government adopted more steps to contain the COVID-19 epidemic, including safety warnings for travellers and improvements to national holidays. The leading party has agreed to prolong the Spring Festival holiday to control the outbreak. Universities and schools across the world have already been locked down. Many steps have been taken by the Hong Kong and Macau governments, in particular concerning schools and colleges. Remote job initiatives have been placed in effect in many regions of China. Several immigration limits have been enforced.

Certain counties and cities outside Hubei also implemented travel limits. Public transit has been changed and museums in China have been partially removed. Some experts challenged the quality of the number of cases announced by the Chinese Government, which constantly modified the way coronavirus cases were recorded.

Italy, a member state of the European Union and a popular tourist attraction, entered the list of coronavirus-affected nations on 30 January, when two positive cases in COVID-19 were identified among Chinese tourists. Italy has the largest number of coronavirus infections both in Europe and outside of China [ 51 ].

Infections, originally limited to northern Italy, gradually spread to all other areas. Many other nations in Asia, Europe and the Americas have tracked their local cases to Italy. Several Italian travellers were even infected with coronavirus-positive in foreign nations.

Late in Italy, the most impacted coronavirus cities and counties are Lombardia, accompanied by Veneto, Emilia-Romagna, Marche and Piedmonte. Milan, the second most populated city in Italy, is situated in Lombardy. Other regions in Italy with coronavirus comprised Campania, Toscana, Liguria, Lazio, Sicilia, Friuli Venezia Giulia, Umbria, Puglia, Trento, Abruzzo, Calabria, Molise, Valle d’Aosta, Sardegna, Bolzano and Basilicata.

Italy ranks 19th of the top 30 nations getting high-risk coronavirus airline passengers in China, as per WorldPop’s provisional study of the spread of COVID-19.

The Italian State has taken steps like the inspection and termination of large cultural activities during the early days of the coronavirus epidemic and has gradually declared the closing of educational establishments and airport hygiene/disinfection initiatives.

The Italian National Institute of Health suggested social distancing and agreed that the broader community of the country’s elderly is a problem. In the meantime, several other nations, including the US, have recommended that travel to Italy should be avoided temporarily, unless necessary.

The Italian government has declared the closing (quarantine) of the impacted areas in the northern region of the nation so as not to spread to the rest of the world. Italy has declared the immediate suspension of all to-and-fro air travel with China following coronavirus discovery by a Chinese tourist to Italy. Italian airlines, like Ryan Air, have begun introducing protective steps and have begun calling for the declaration forms to be submitted by passengers flying to Poland, Slovakia and Lithuania.

The Italian government first declined to permit fans to compete in sporting activities until early April to prevent the potential transmission of coronavirus. The step ensured players of health and stopped event cancellations because of coronavirus fears. Two days of the declaration, the government cancelled all athletic activities owing to the emergence of the outbreak asking for an emergency. Sports activities in Veneto, Lombardy and Emilia-Romagna, which recorded coronavirus-positive infections, were confirmed to be temporarily suspended. Schools and colleges in Italy have also been forced to shut down.

Iran announced the first recorded cases of SARS-CoV-2 infection on 19 February when, as per the Medical Education and Ministry of Health, two persons died later that day. The Ministry of Islamic Culture and Guidance has declared the cancellation of all concerts and other cultural activities for one week. The Medical Education and Ministry of Health has also declared the closing of universities, higher education colleges and schools in many cities and regions. The Department of Sports and Culture has taken action to suspend athletic activities, including football matches [ 52 ].

On 2 March 2020, the government revealed plans to train about 300,000 troops and volunteers to fight the outbreak of the epidemic, and also send robots and water cannons to clean the cities. The State also developed an initiative and a webpage to counter the epidemic. On 9 March 2020, nearly 70,000 inmates were immediately released from jail owing to the epidemic, presumably to prevent the further dissemination of the disease inside jails. The Revolutionary Guards declared a campaign on 13 March 2020 to clear highways, stores and public areas in Iran. President Hassan Rouhani stated on 26 February 2020 that there were no arrangements to quarantine areas impacted by the epidemic and only persons should be quarantined. The temples of Shia in Qom stayed open to pilgrims.

South Korea

On 20 January, South Korea announced its first occurrence. There was a large rise in cases on 20 February, possibly due to the meeting in Daegu of a progressive faith community recognized as the Shincheonji Church of Christ. Any citizens believed that the hospital was propagating the disease. As of 22 February, 1,261 of the 9,336 members of the church registered symptoms. A petition was distributed calling for the abolition of the church. More than 2,000 verified cases were registered on 28 February, increasing to 3,150 on 29 February [ 53 ].

Several educational establishments have been partially closing down, including hundreds of kindergartens in Daegu and many primary schools in Seoul. As of 18 February, several South Korean colleges had confirmed intentions to delay the launch of the spring semester. That included 155 institutions deciding to postpone the start of the semester by two weeks until 16 March, and 22 institutions deciding to delay the start of the semester by one week until 9 March. Also, on 23 February 2020, all primary schools, kindergartens, middle schools and secondary schools were declared to postpone the start of the semester from 2 March to 9 March.

South Korea’s economy is expected to expand by 1.9%, down from 2.1%. The State has given 136.7 billion won funding to local councils. The State has also coordinated the purchase of masks and other sanitary supplies. Entertainment Company SM Entertainment is confirmed to have contributed five hundred million won in attempts to fight the disease.

In the kpop industry, the widespread dissemination of coronavirus within South Korea has contributed to the cancellation or postponement of concerts and other programmes for kpop activities inside and outside South Korea. For instance, circumstances such as the cancellation of the remaining Asian dates and the European leg for the Seventeen’s Ode To You Tour on 9 February 2020 and the cancellation of all Seoul dates for the BTS Soul Tour Map. As of 15 March, a maximum of 136 countries and regions provided entry restrictions and/or expired visas for passengers from South Korea.

The overall reported cases of coronavirus rose significantly in France on 12 March. The areas with reported cases include Paris, Amiens, Bordeaux and Eastern Haute-Savoie. The first coronaviral death happened in France on 15 February, marking it the first death in Europe. The second death of a 60-year-old French national in Paris was announced on 26 February [ 54 ].

On February 28, fashion designer Agnès B. (not to be mistaken with Agnès Buzyn) cancelled fashion shows at the Paris Fashion Week, expected to continue until 3 March. On a subsequent day, the Paris half-marathon, planned for Sunday 1 March with 44,000 entrants, was postponed as one of a series of steps declared by Health Minister Olivier Véran.

On 13 March, the Ligue de Football Professional disbanded Ligue 1 and Ligue 2 (France’s tier two professional divisions) permanently due to safety threats.

Germany has a popular Regional Pandemic Strategy detailing the roles and activities of the health care system participants in the case of a significant outbreak. Epidemic surveillance is carried out by the federal government, like the Robert Koch Center, and by the German governments. The German States have their preparations for an outbreak. The regional strategy for the treatment of the current coronavirus epidemic was expanded by March 2020. Four primary goals are contained in this plan: (1) to minimize mortality and morbidity; (2) to guarantee the safety of sick persons; (3) to protect vital health services and (4) to offer concise and reliable reports to decision-makers, the media and the public [ 55 ].

The programme has three phases that may potentially overlap: (1) isolation (situation of individual cases and clusters), (2) safety (situation of further dissemination of pathogens and suspected causes of infection), (3) prevention (situation of widespread infection). So far, Germany has not set up border controls or common health condition tests at airports. Instead, while at the isolation stage-health officials are concentrating on recognizing contact individuals that are subject to specific quarantine and are tracked and checked. Specific quarantine is regulated by municipal health authorities. By doing so, the officials are seeking to hold the chains of infection small, contributing to decreased clusters. At the safety stage, the policy should shift to prevent susceptible individuals from being harmed by direct action. By the end of the day, the prevention process should aim to prevent cycles of acute treatment to retain emergency facilities.

United States

The very first case of coronavirus in the United States was identified in Washington on 21 January 2020 by an individual who flew to Wuhan and returned to the United States. The second case was recorded in Illinois by another individual who had travelled to Wuhan. Some of the regions with reported novel coronavirus infections in the US are California, Arizona, Connecticut, Illinois, Texas, Wisconsin and Washington [ 56 ].

As the epidemic increased, requests for domestic air travel decreased dramatically. By 4 March, U.S. carriers, like United Airlines and JetBlue Airways, started growing their domestic flight schedules, providing generous unpaid leave to workers and suspending recruits.

A significant number of universities and colleges cancelled classes and reopened dormitories in response to the epidemic, like Cornell University, Harvard University and the University of South Carolina.

On 3 March 2020, the Federal Reserve reduced its goal interest rate from 1.75% to 1.25%, the biggest emergency rate cut following the 2008 global financial crash, in combat the effect of the recession on the American economy. In February 2020, US businesses, including Apple Inc. and Microsoft, started to reduce sales projections due to supply chain delays in China caused by the COVID-19.

The pandemic, together with the subsequent financial market collapse, also contributed to greater criticism of the crisis in the United States. Researchers disagree about when a recession is likely to take effect, with others suggesting that it is not unavoidable, while some claim that the world might already be in recession. On 3 March, Federal Reserve Chairman Jerome Powell reported a 0.5% (50 basis point) interest rate cut from the coronavirus in the context of the evolving threats to economic growth.

When ‘social distance’ penetrated the national lexicon, disaster response officials promoted the cancellation of broad events to slow down the risk of infection. Technical conferences like E3 2020, Apple Inc.’s Worldwide Developers Conference (WWDC), Google I/O, Facebook F8, and Cloud Next and Microsoft’s MVP Conference have been either having replaced or cancelled in-person events with internet streaming events.

On February 29, the American Physical Society postponed its annual March gathering, planned for March 2–6 in Denver, Colorado, even though most of the more than 11,000 physicist attendees already had arrived and engaged in the pre-conference day activities. On March 6, the annual South to Southwest (SXSW) seminar and festival planned to take place from March 13–22 in Austin, Texas, was postponed after the city council announced a local disaster and forced conferences to be shut down for the first time in 34 years.

Four of North America’s major professional sports leagues—the National Hockey League (NHL), National Basketball Association (NBA), Major League Soccer (MLS) and Major League Baseball (MLB) —jointly declared on March 9 that they would all limit the media access to player accommodations (such as locker rooms) to control probable exposure.

Emergency Funding to Fight the COVID-19

COVID-19 pandemic has become a common international concern. Different countries are donating funds to fight against it [ 57 – 60 ]. Some of them are mentioned here.

China has allocated about 110.48 billion yuan ($15.93 billion) in coronavirus-related funding.

Foreign Minister Mohammad Javad Zarif said that Iran has requested the International Monetary Fund (IMF) of about $5 billion in emergency funding to help to tackle the coronavirus epidemic that has struck the Islamic Republic hard.

President Donald Trump approved the Emergency Supplementary Budget Bill to support the US response to a novel coronavirus epidemic. The budget plan would include about $8.3 billion in discretionary funding to local health authorities to promote vaccine research for production. Trump originally requested just about $2 billion to combat the epidemic, but Congress quadrupled the number in its version of the bill. Mr. Trump formally announced a national emergency that he claimed it will give states and territories access to up to about $50 billion in federal funding to tackle the spread of the coronavirus outbreak.

California politicians approved a plan to donate about $1 billion on the state’s emergency medical responses as it readies hospitals to fight an expected attack of patients because of the COVID-19 pandemic. The plans, drawn up rapidly in reaction to the dramatic rise in reported cases of the virus, would include the requisite funds to establish two new hospitals in California, with the assumption that the state may not have the resources to take care of the rise in patients. The bill calls for an immediate response of about $500 million from the State General Fund, with an additional about $500 million possible if requested.

India committed about $10 million to the COVID-19 Emergency Fund and said it was setting up a rapid response team of physicians for the South Asian Association for Regional Cooperation (Saarc) countries.

South Korea unveiled an economic stimulus package of about 11.7 trillion won ($9.8 billion) to soften the effects of the biggest coronavirus epidemic outside China as attempts to curb the disease exacerbate supply shortages and drain demand. Of the 11,7 trillion won expected, about 3.2 trillion won would cover up the budget shortfall, while an additional fiscal infusion of about 8.5 trillion won. An estimated 10.3 trillion won in government bonds will be sold this year to fund the extra expenditure. About 2.3 trillion won will be distributed to medical establishments and would support quarantine operations, with another 3.0 trillion won heading to small and medium-sized companies unable to pay salaries to their employees and child care supports.

The Swedish Parliament announced a set of initiatives costing more than 300 billion Swedish crowns ($30.94 billion) to help the economy in the view of the coronavirus pandemic. The plan contained steps like the central government paying the entire expense of the company’s sick leave during April and May, and also the high cost of compulsory redundancies owing to the crisis.

In consideration of the developing scenario, an updating of this strategy is planned to take place before the end of March and will recognize considerably greater funding demands for the country response, R&D and WHO itself.

Artificial Intelligence, Data Science and Technological Solutions Against COVID-19

These days, Artificial Intelligence (AI) takes a major role in health care. Throughout a worldwide pandemic such as the COVID-19, technology, artificial intelligence and data analytics have been crucial in helping communities cope successfully with the epidemic [ 61 – 65 ]. Through the aid of data mining and analytical modelling, medical practitioners are willing to learn more about several diseases.

Public Health Surveillance

The biggest risk of coronavirus is the level of spreading. That’s why policymakers are introducing steps like quarantines around the world because they can’t adequately monitor local outbreaks. One of the simplest measures to identify ill patients through the study of CCTV images that are still around us and to locate and separate individuals that have serious signs of the disease and who have touched and disinfected the related surfaces. Smartphone applications are often used to keep a watch on people’s activities and to assess whether or not they have come in touch with an infected human.

Remote Biosignal Measurement

Many of the signs such as temperature or heartbeat are very essential to overlook and rely entirely on the visual image that may be misleading. However, of course, we can’t prevent someone from checking their blood pressure, heart or temperature. Also, several advances in computer vision can predict pulse and blood pressure based on facial skin examination. Besides, there are several advances in computer vision that can predict pulse and blood pressure based on facial skin examination.

Access to public records has contributed to the development of dashboards that constantly track the virus. Several companies are designing large data dashboards. Face recognition and infrared temperature monitoring technologies have been mounted in all major cities. Chinese AI companies including Hanwang Technology and SenseTime have reported having established a special facial recognition system that can correctly identify people even though they are covered.

IoT and Wearables

Measurements like pulse are much more natural and easier to obtain from tracking gadgets like activity trackers and smartwatches that nearly everybody has already. Some work suggests that the study of cardiac activity and its variations from the standard will reveal early signs of influenza and, in this case, coronavirus.

Chatbots and Communication

Apart from public screening, people’s knowledge and self-assessment may also be used to track their health. If you can check your temperature and pulse every day and monitor your coughs time-to-time, you can even submit that to your record. If the symptoms are too serious, either an algorithm or a doctor remotely may prescribe a person to stay home, take several other preventive measures, or recommend a visit from the doctor.

Al Jazeera announced that China Mobile had sent text messages to state media departments, telling them about the citizens who had been affected. The communications contained all the specifics of the person’s travel history.

Tencent runs WeChat, and via it, citizens can use free online health consultation services. Chatbots have already become important connectivity platforms for transport and tourism service providers to keep passengers up-to-date with the current transport protocols and disturbances.

Social Media and Open Data

There are several people who post their health diary with total strangers via Facebook or Twitter. Such data becomes helpful for more general research about how far the epidemic has progressed. For consumer knowledge, we may even evaluate the social network group to attempt to predict what specific networks are at risk of being viral.

Canadian company BlueDot analyses far more than just social network data: for instance, global activities of more than four billion passengers on international flights per year; animal, human and insect population data; satellite environment data and relevant knowledge from health professionals and journalists, across 100,000 news posts per day covering 65 languages. This strategy was so successful that the corporation was able to alert clients about coronavirus until the World Health Organization and the Centers for Disease Control and Prevention notified the public.

Automated Diagnostics

COVID-19 has brought up another healthcare issue today: it will not scale when the number of patients increases exponentially (actually stressed doctors are always doing worse) and the rate of false-negative diagnosis remains very high. Machine learning therapies don’t get bored and scale simply by growing computing forces.

Baidu, the Chinese Internet company, has made the Lineatrfold algorithm accessible to the outbreak-fighting teams, according to the MIT Technology Review. Unlike HIV, Ebola and Influenza, COVID-19 has just one strand of RNA and it can mutate easily. The algorithm is also simpler than other algorithms that help to determine the nature of the virus. Baidu has also developed software to efficiently track large populations. It has also developed an Ai-powered infrared device that can detect a difference in the body temperature of a human. This is currently being used in Beijing’s Qinghe Railway Station to classify possibly contaminated travellers where up to 200 individuals may be checked in one minute without affecting traffic movement, reports the MIT Review.

Singapore-based Veredus Laboratories, a supplier of revolutionary molecular diagnostic tools, has currently announced the launch of the VereCoV detector package, a compact Lab-on-Chip device able to detect MERS-CoV, SARS-CoV and COVID-19, i.e. Wuhan Coronavirus, in a single study.

The VereCoV identification package is focused on VereChip technology, a Lab-on-Chip device that incorporates two important molecular biological systems, Polymerase Chain Reaction (PCR) and a microarray, which will be able to classify and distinguish within 2 h MERS-CoV, SARS-CoV and COVID-19 with high precision and responsiveness.

This is not just the medical activities of healthcare facilities that are being charged, but also the corporate and financial departments when they cope with the increase in patients. Ant Financials’ blockchain technology helps speed-up the collection of reports and decreases the number of face-to-face encounters with patients and medical personnel.

Companies like the Israeli company Sonovia are aiming to provide healthcare systems and others with face masks manufactured from their anti-pathogenic, anti-bacterial cloth that depends on metal-oxide nanoparticles.

Drug Development Research

Aside from identifying and stopping the transmission of pathogens, the need to develop vaccinations on a scale is also needed. One of the crucial things to make that possible is to consider the origin and essence of the virus. Google’s DeepMind, with their expertise in protein folding research, has rendered a jump in identifying the protein structure of the virus and making it open-source.

BenevolentAI uses AI technologies to develop medicines that will combat the most dangerous diseases in the world and is also working to promote attempts to cure coronavirus, the first time the organization has based its product on infectious diseases. Within weeks of the epidemic, it used its analytical capability to recommend new medicines that might be beneficial.

Robots are not vulnerable to the infection, and they are used to conduct other activities, like cooking meals in hospitals, doubling up as waiters in hotels, spraying disinfectants and washing, selling rice and hand sanitizers, robots are on the front lines all over to deter coronavirus spread. Robots also conduct diagnostics and thermal imaging in several hospitals. Shenzhen-based firm Multicopter uses robotics to move surgical samples. UVD robots from Blue Ocean Robotics use ultraviolet light to destroy viruses and bacteria separately. In China, Pudu Technology has introduced its robots, which are usually used in the cooking industry, to more than 40 hospitals throughout the region. According to the Reuters article, a tiny robot named Little Peanut is distributing food to passengers who have been on a flight from Singapore to Hangzhou, China, and are presently being quarantined in a hotel.

Colour Coding

Using its advanced and vast public service monitoring network, the Chinese government has collaborated with software companies Alibaba and Tencent to establish a colour-coded health ranking scheme that monitors millions of citizens every day. The mobile device was first introduced in Hangzhou with the cooperation of Alibaba. This applies three colours to people—red, green or yellow—based on their transportation and medical records. Tencent also developed related applications in the manufacturing centre of Shenzhen.

The decision of whether an individual will be quarantined or permitted in public spaces is dependent on the colour code. Citizens will sign into the system using pay wallet systems such as Alibaba’s Alipay and Ant’s wallet. Just those citizens who have been issued a green colour code will be permitted to use the QR code in public spaces at metro stations, workplaces, and other public areas. Checkpoints are in most public areas where the body temperature and the code of individual are tested. This programme is being used by more than 200 Chinese communities and will eventually be expanded nationwide.

In some of the seriously infected regions where people remain at risk of contracting the infection, drones are used to rescue. One of the easiest and quickest ways to bring emergency supplies where they need to go while on an epidemic of disease is by drone transportation. Drones carry all surgical instruments and patient samples. This saves time, improves the pace of distribution and reduces the chance of contamination of medical samples. Drones often operate QR code placards that can be checked to record health records. There are also agricultural drones distributing disinfectants in the farmland. Drones, operated by facial recognition, are often used to warn people not to leave their homes and to chide them for not using face masks. Terra Drone uses its unmanned drones to move patient samples and vaccination content at reduced risk between the Xinchang County Disease Control Center and the People’s Hospital. Drones are often used to monitor public areas, document non-compliance with quarantine laws and thermal imaging.

Autonomous Vehicles

At a period of considerable uncertainty to medical professionals and the danger to people-to-people communication, automated vehicles are proving to be of tremendous benefit in the transport of vital products, such as medications and foodstuffs. Apollo, the Baidu Autonomous Vehicle Project, has joined hands with the Neolix self-driving company to distribute food and supplies to a big hospital in Beijing. Baidu Apollo has also provided its micro-car packages and automated cloud driving systems accessible free of charge to virus-fighting organizations.

Idriverplus, a Chinese self-driving organization that runs electrical street cleaning vehicles, is also part of the project. The company’s signature trucks are used to clean hospitals.

This chapter provides an introduction to the coronavirus outbreak (COVID-19). A brief history of this virus along with the symptoms are reported in this chapter. Then the comparison between COVID-19 and other plagues like seasonal influenza, bird flu (H5N1 and H7N9), Ebola epidemic, camel flu (MERS), swine flu (H1N1), severe acute respiratory syndrome, Hong Kong flu (H3N2), Spanish flu and the common cold are included in this chapter. Reviews of online portal and social media like Facebook, Twitter, Google, Microsoft, Pinterest, YouTube and WhatsApp concerning COVID-19 are reported in this chapter. Also, the preventive measures and policies enforced by WHO and different countries such as China, Italy, Iran, South Korea, France, Germany and the United States for COVID-19 are included in this chapter. Emergency funding provided by different countries to fight the COVID-19 is mentioned in this chapter. Lastly, artificial intelligence, data science and technological solutions like public health surveillance, remote biosignal measurement, IoT and wearables, chatbots and communication, social media and open data, automated diagnostics, drug development research, robotics, colour coding, drones and autonomous vehicles are included in this chapter.

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• http://orcid.org/0000-0003-1512-4471 Emily Long 1 ,
• Susan Patterson 1 ,
• Karen Maxwell 1 ,
• Carolyn Blake 1 ,
• http://orcid.org/0000-0001-7342-4566 Raquel Bosó Pérez 1 ,
• Ruth Lewis 1 ,
• Mark McCann 1 ,
• Julie Riddell 1 ,
• Kathryn Skivington 1 ,
• Rachel Wilson-Lowe 1 ,
• http://orcid.org/0000-0002-4409-6601 Kirstin R Mitchell 2
• 1 MRC/CSO Social and Public Health Sciences Unit , University of Glasgow , Glasgow , UK
• 2 MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing , University of Glasgow , Glasgow , UK
• Correspondence to Dr Emily Long, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR, UK; emily.long{at}glasgow.ac.uk

This essay examines key aspects of social relationships that were disrupted by the COVID-19 pandemic. It focuses explicitly on relational mechanisms of health and brings together theory and emerging evidence on the effects of the COVID-19 pandemic to make recommendations for future public health policy and recovery. We first provide an overview of the pandemic in the UK context, outlining the nature of the public health response. We then introduce four distinct domains of social relationships: social networks, social support, social interaction and intimacy, highlighting the mechanisms through which the pandemic and associated public health response drastically altered social interactions in each domain. Throughout the essay, the lens of health inequalities, and perspective of relationships as interconnecting elements in a broader system, is used to explore the varying impact of these disruptions. The essay concludes by providing recommendations for longer term recovery ensuring that the social relational cost of COVID-19 is adequately considered in efforts to rebuild.

• inequalities

Data availability statement

Data sharing not applicable as no data sets generated and/or analysed for this study. Data sharing not applicable as no data sets generated or analysed for this essay.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ .

https://doi.org/10.1136/jech-2021-216690

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Introduction

Infectious disease pandemics, including SARS and COVID-19, demand intrapersonal behaviour change and present highly complex challenges for public health. 1 A pandemic of an airborne infection, spread easily through social contact, assails human relationships by drastically altering the ways through which humans interact. In this essay, we draw on theories of social relationships to examine specific ways in which relational mechanisms key to health and well-being were disrupted by the COVID-19 pandemic. Relational mechanisms refer to the processes between people that lead to change in health outcomes.

At the time of writing, the future surrounding COVID-19 was uncertain. Vaccine programmes were being rolled out in countries that could afford them, but new and more contagious variants of the virus were also being discovered. The recovery journey looked long, with continued disruption to social relationships. The social cost of COVID-19 was only just beginning to emerge, but the mental health impact was already considerable, 2 3 and the inequality of the health burden stark. 4 Knowledge of the epidemiology of COVID-19 accrued rapidly, but evidence of the most effective policy responses remained uncertain.

The initial response to COVID-19 in the UK was reactive and aimed at reducing mortality, with little time to consider the social implications, including for interpersonal and community relationships. The terminology of ‘social distancing’ quickly became entrenched both in public and policy discourse. This equation of physical distance with social distance was regrettable, since only physical proximity causes viral transmission, whereas many forms of social proximity (eg, conversations while walking outdoors) are minimal risk, and are crucial to maintaining relationships supportive of health and well-being.

The aim of this essay is to explore four key relational mechanisms that were impacted by the pandemic and associated restrictions: social networks, social support, social interaction and intimacy. We use relational theories and emerging research on the effects of the COVID-19 pandemic response to make three key recommendations: one regarding public health responses; and two regarding social recovery. Our understanding of these mechanisms stems from a ‘systems’ perspective which casts social relationships as interdependent elements within a connected whole. 5

Social networks

Social networks characterise the individuals and social connections that compose a system (such as a workplace, community or society). Social relationships range from spouses and partners, to coworkers, friends and acquaintances. They vary across many dimensions, including, for example, frequency of contact and emotional closeness. Social networks can be understood both in terms of the individuals and relationships that compose the network, as well as the overall network structure (eg, how many of your friends know each other).

Social networks show a tendency towards homophily, or a phenomenon of associating with individuals who are similar to self. 6 This is particularly true for ‘core’ network ties (eg, close friends), while more distant, sometimes called ‘weak’ ties tend to show more diversity. During the height of COVID-19 restrictions, face-to-face interactions were often reduced to core network members, such as partners, family members or, potentially, live-in roommates; some ‘weak’ ties were lost, and interactions became more limited to those closest. Given that peripheral, weaker social ties provide a diversity of resources, opinions and support, 7 COVID-19 likely resulted in networks that were smaller and more homogenous.

Such changes were not inevitable nor necessarily enduring, since social networks are also adaptive and responsive to change, in that a disruption to usual ways of interacting can be replaced by new ways of engaging (eg, Zoom). Yet, important inequalities exist, wherein networks and individual relationships within networks are not equally able to adapt to such changes. For example, individuals with a large number of newly established relationships (eg, university students) may have struggled to transfer these relationships online, resulting in lost contacts and a heightened risk of social isolation. This is consistent with research suggesting that young adults were the most likely to report a worsening of relationships during COVID-19, whereas older adults were the least likely to report a change. 8

Lastly, social connections give rise to emergent properties of social systems, 9 where a community-level phenomenon develops that cannot be attributed to any one member or portion of the network. For example, local area-based networks emerged due to geographic restrictions (eg, stay-at-home orders), resulting in increases in neighbourly support and local volunteering. 10 In fact, research suggests that relationships with neighbours displayed the largest net gain in ratings of relationship quality compared with a range of relationship types (eg, partner, colleague, friend). 8 Much of this was built from spontaneous individual interactions within local communities, which together contributed to the ‘community spirit’ that many experienced. 11 COVID-19 restrictions thus impacted the personal social networks and the structure of the larger networks within the society.

Social support

Social support, referring to the psychological and material resources provided through social interaction, is a critical mechanism through which social relationships benefit health. In fact, social support has been shown to be one of the most important resilience factors in the aftermath of stressful events. 12 In the context of COVID-19, the usual ways in which individuals interact and obtain social support have been severely disrupted.

One such disruption has been to opportunities for spontaneous social interactions. For example, conversations with colleagues in a break room offer an opportunity for socialising beyond one’s core social network, and these peripheral conversations can provide a form of social support. 13 14 A chance conversation may lead to advice helpful to coping with situations or seeking formal help. Thus, the absence of these spontaneous interactions may mean the reduction of indirect support-seeking opportunities. While direct support-seeking behaviour is more effective at eliciting support, it also requires significantly more effort and may be perceived as forceful and burdensome. 15 The shift to homeworking and closure of community venues reduced the number of opportunities for these spontaneous interactions to occur, and has, second, focused them locally. Consequently, individuals whose core networks are located elsewhere, or who live in communities where spontaneous interaction is less likely, have less opportunity to benefit from spontaneous in-person supportive interactions.

However, alongside this disruption, new opportunities to interact and obtain social support have arisen. The surge in community social support during the initial lockdown mirrored that often seen in response to adverse events (eg, natural disasters 16 ). COVID-19 restrictions that confined individuals to their local area also compelled them to focus their in-person efforts locally. Commentators on the initial lockdown in the UK remarked on extraordinary acts of generosity between individuals who belonged to the same community but were unknown to each other. However, research on adverse events also tells us that such community support is not necessarily maintained in the longer term. 16

Meanwhile, online forms of social support are not bound by geography, thus enabling interactions and social support to be received from a wider network of people. Formal online social support spaces (eg, support groups) existed well before COVID-19, but have vastly increased since. While online interactions can increase perceived social support, it is unclear whether remote communication technologies provide an effective substitute from in-person interaction during periods of social distancing. 17 18 It makes intuitive sense that the usefulness of online social support will vary by the type of support offered, degree of social interaction and ‘online communication skills’ of those taking part. Youth workers, for instance, have struggled to keep vulnerable youth engaged in online youth clubs, 19 despite others finding a positive association between amount of digital technology used by individuals during lockdown and perceived social support. 20 Other research has found that more frequent face-to-face contact and phone/video contact both related to lower levels of depression during the time period of March to August 2020, but the negative effect of a lack of contact was greater for those with higher levels of usual sociability. 21 Relatedly, important inequalities in social support exist, such that individuals who occupy more socially disadvantaged positions in society (eg, low socioeconomic status, older people) tend to have less access to social support, 22 potentially exacerbated by COVID-19.

Social and interactional norms

Interactional norms are key relational mechanisms which build trust, belonging and identity within and across groups in a system. Individuals in groups and societies apply meaning by ‘approving, arranging and redefining’ symbols of interaction. 23 A handshake, for instance, is a powerful symbol of trust and equality. Depending on context, not shaking hands may symbolise a failure to extend friendship, or a failure to reach agreement. The norms governing these symbols represent shared values and identity; and mutual understanding of these symbols enables individuals to achieve orderly interactions, establish supportive relationship accountability and connect socially. 24 25

Physical distancing measures to contain the spread of COVID-19 radically altered these norms of interaction, particularly those used to convey trust, affinity, empathy and respect (eg, hugging, physical comforting). 26 As epidemic waves rose and fell, the work to negotiate these norms required intense cognitive effort; previously taken-for-granted interactions were re-examined, factoring in current restriction levels, own and (assumed) others’ vulnerability and tolerance of risk. This created awkwardness, and uncertainty, for example, around how to bring closure to an in-person interaction or convey warmth. The instability in scripted ways of interacting created particular strain for individuals who already struggled to encode and decode interactions with others (eg, those who are deaf or have autism spectrum disorder); difficulties often intensified by mask wearing. 27

Large social gatherings—for example, weddings, school assemblies, sporting events—also present key opportunities for affirming and assimilating interactional norms, building cohesion and shared identity and facilitating cooperation across social groups. 28 Online ‘equivalents’ do not easily support ‘social-bonding’ activities such as singing and dancing, and rarely enable chance/spontaneous one-on-one conversations with peripheral/weaker network ties (see the Social networks section) which can help strengthen bonds across a larger network. The loss of large gatherings to celebrate rites of passage (eg, bar mitzvah, weddings) has additional relational costs since these events are performed by and for communities to reinforce belonging, and to assist in transitioning to new phases of life. 29 The loss of interaction with diverse others via community and large group gatherings also reduces intergroup contact, which may then tend towards more prejudiced outgroup attitudes. While online interaction can go some way to mimicking these interaction norms, there are key differences. A sense of anonymity, and lack of in-person emotional cues, tends to support norms of polarisation and aggression in expressing differences of opinion online. And while online platforms have potential to provide intergroup contact, the tendency of much social media to form homogeneous ‘echo chambers’ can serve to further reduce intergroup contact. 30 31

Intimacy relates to the feeling of emotional connection and closeness with other human beings. Emotional connection, through romantic, friendship or familial relationships, fulfils a basic human need 32 and strongly benefits health, including reduced stress levels, improved mental health, lowered blood pressure and reduced risk of heart disease. 32 33 Intimacy can be fostered through familiarity, feeling understood and feeling accepted by close others. 34

Intimacy via companionship and closeness is fundamental to mental well-being. Positively, the COVID-19 pandemic has offered opportunities for individuals to (re)connect and (re)strengthen close relationships within their household via quality time together, following closure of many usual external social activities. Research suggests that the first full UK lockdown period led to a net gain in the quality of steady relationships at a population level, 35 but amplified existing inequalities in relationship quality. 35 36 For some in single-person households, the absence of a companion became more conspicuous, leading to feelings of loneliness and lower mental well-being. 37 38 Additional pandemic-related relational strain 39 40 resulted, for some, in the initiation or intensification of domestic abuse. 41 42

Physical touch is another key aspect of intimacy, a fundamental human need crucial in maintaining and developing intimacy within close relationships. 34 Restrictions on social interactions severely restricted the number and range of people with whom physical affection was possible. The reduction in opportunity to give and receive affectionate physical touch was not experienced equally. Many of those living alone found themselves completely without physical contact for extended periods. The deprivation of physical touch is evidenced to take a heavy emotional toll. 43 Even in future, once physical expressions of affection can resume, new levels of anxiety over germs may introduce hesitancy into previously fluent blending of physical and verbal intimate social connections. 44

The pandemic also led to shifts in practices and norms around sexual relationship building and maintenance, as individuals adapted and sought alternative ways of enacting sexual intimacy. This too is important, given that intimate sexual activity has known benefits for health. 45 46 Given that social restrictions hinged on reducing household mixing, possibilities for partnered sexual activity were primarily guided by living arrangements. While those in cohabiting relationships could potentially continue as before, those who were single or in non-cohabiting relationships generally had restricted opportunities to maintain their sexual relationships. Pornography consumption and digital partners were reported to increase since lockdown. 47 However, online interactions are qualitatively different from in-person interactions and do not provide the same opportunities for physical intimacy.

Recommendations and conclusions

In the sections above we have outlined the ways in which COVID-19 has impacted social relationships, showing how relational mechanisms key to health have been undermined. While some of the damage might well self-repair after the pandemic, there are opportunities inherent in deliberative efforts to build back in ways that facilitate greater resilience in social and community relationships. We conclude by making three recommendations: one regarding public health responses to the pandemic; and two regarding social recovery.

Recommendation 1: explicitly count the relational cost of public health policies to control the pandemic

Effective handling of a pandemic recognises that social, economic and health concerns are intricately interwoven. It is clear that future research and policy attention must focus on the social consequences. As described above, policies which restrict physical mixing across households carry heavy and unequal relational costs. These include for individuals (eg, loss of intimate touch), dyads (eg, loss of warmth, comfort), networks (eg, restricted access to support) and communities (eg, loss of cohesion and identity). Such costs—and their unequal impact—should not be ignored in short-term efforts to control an epidemic. Some public health responses—restrictions on international holiday travel and highly efficient test and trace systems—have relatively small relational costs and should be prioritised. At a national level, an earlier move to proportionate restrictions, and investment in effective test and trace systems, may help prevent escalation of spread to the point where a national lockdown or tight restrictions became an inevitability. Where policies with relational costs are unavoidable, close attention should be paid to the unequal relational impact for those whose personal circumstances differ from normative assumptions of two adult families. This includes consideration of whether expectations are fair (eg, for those who live alone), whether restrictions on social events are equitable across age group, religious/ethnic groupings and social class, and also to ensure that the language promoted by such policies (eg, households; families) is not exclusionary. 48 49 Forethought to unequal impacts on social relationships should thus be integral to the work of epidemic preparedness teams.

Recommendation 2: intelligently balance online and offline ways of relating

A key ingredient for well-being is ‘getting together’ in a physical sense. This is fundamental to a human need for intimate touch, physical comfort, reinforcing interactional norms and providing practical support. Emerging evidence suggests that online ways of relating cannot simply replace physical interactions. But online interaction has many benefits and for some it offers connections that did not exist previously. In particular, online platforms provide new forms of support for those unable to access offline services because of mobility issues (eg, older people) or because they are geographically isolated from their support community (eg, lesbian, gay, bisexual, transgender and queer (LGBTQ) youth). Ultimately, multiple forms of online and offline social interactions are required to meet the needs of varying groups of people (eg, LGBTQ, older people). Future research and practice should aim to establish ways of using offline and online support in complementary and even synergistic ways, rather than veering between them as social restrictions expand and contract. Intelligent balancing of online and offline ways of relating also pertains to future policies on home and flexible working. A decision to switch to wholesale or obligatory homeworking should consider the risk to relational ‘group properties’ of the workplace community and their impact on employees’ well-being, focusing in particular on unequal impacts (eg, new vs established employees). Intelligent blending of online and in-person working is required to achieve flexibility while also nurturing supportive networks at work. Intelligent balance also implies strategies to build digital literacy and minimise digital exclusion, as well as coproducing solutions with intended beneficiaries.

Recommendation 3: build stronger and sustainable localised communities

In balancing offline and online ways of interacting, there is opportunity to capitalise on the potential for more localised, coherent communities due to scaled-down travel, homeworking and local focus that will ideally continue after restrictions end. There are potential economic benefits after the pandemic, such as increased trade as home workers use local resources (eg, coffee shops), but also relational benefits from stronger relationships around the orbit of the home and neighbourhood. Experience from previous crises shows that community volunteer efforts generated early on will wane over time in the absence of deliberate work to maintain them. Adequately funded partnerships between local government, third sector and community groups are required to sustain community assets that began as a direct response to the pandemic. Such partnerships could work to secure green spaces and indoor (non-commercial) meeting spaces that promote community interaction. Green spaces in particular provide a triple benefit in encouraging physical activity and mental health, as well as facilitating social bonding. 50 In building local communities, small community networks—that allow for diversity and break down ingroup/outgroup views—may be more helpful than the concept of ‘support bubbles’, which are exclusionary and less sustainable in the longer term. Rigorously designed intervention and evaluation—taking a systems approach—will be crucial in ensuring scale-up and sustainability.

The dramatic change to social interaction necessitated by efforts to control the spread of COVID-19 created stark challenges but also opportunities. Our essay highlights opportunities for learning, both to ensure the equity and humanity of physical restrictions, and to sustain the salutogenic effects of social relationships going forward. The starting point for capitalising on this learning is recognition of the disruption to relational mechanisms as a key part of the socioeconomic and health impact of the pandemic. In recovery planning, a general rule is that what is good for decreasing health inequalities (such as expanding social protection and public services and pursuing green inclusive growth strategies) 4 will also benefit relationships and safeguard relational mechanisms for future generations. Putting this into action will require political will.

Ethics statements

Patient consent for publication.

Not required.

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Twitter @karenmaxSPHSU, @Mark_McCann, @Rwilsonlowe, @KMitchinGlasgow

Contributors EL and KM led on the manuscript conceptualisation, review and editing. SP, KM, CB, RBP, RL, MM, JR, KS and RW-L contributed to drafting and revising the article. All authors assisted in revising the final draft.

Funding The research reported in this publication was supported by the Medical Research Council (MC_UU_00022/1, MC_UU_00022/3) and the Chief Scientist Office (SPHSU11, SPHSU14). EL is also supported by MRC Skills Development Fellowship Award (MR/S015078/1). KS and MM are also supported by a Medical Research Council Strategic Award (MC_PC_13027).

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

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COVID-19 making worrying comeback WHO warns, amid summertime surge

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COVID-19 infections are surging worldwide - including at the Olympics - and are unlikely to decline anytime soon, the World Health Organization (WHO) warned on Tuesday.

The UN health agency is also concerned that more severe variants of the coronavirus may soon be on the horizon.

“COVID-19 is still very much with us,” and circulating in all countries, Dr. Maria Van Kerkhove of WHO told journalists in Geneva.

Testing positive

“Data from our sentinel-based surveillance system across 84 countries reports that the percent of positive tests for SARS-CoV-2 has been rising over several weeks ,” she said. “ Overall, test positivity is above 10 per cent , but this fluctuates per region. In Europe, percent positivity is above 20 per cent ,” she added.

New waves of infection have been registered in the Americas, Europe and the western Pacific.

Wastewater surveillance suggests the circulation of SARS-CoV-2 is from two to 20 times higher than current figures suggest.

Such high infection circulation rates in the northern hemisphere’s summer months are atypical for respiratory viruses , which tend to spread mostly in cold temperatures.  

“In recent months, regardless of the season, many countries have experienced surges of COVID-19, including at the Olympics",  Dr. Van Kerkhove said. WHO reported that at least 40 athletes had tested positive for COVID-19 or other respiratory illnesses. 

As the virus continues to evolve and spread, there is a growing risk of a more severe strain of the virus that could potentially evade detection systems and be unresponsive to medical intervention.

Boost vaccine awareness

While hospital admissions - including for intensive care - are still much lower than they were during the peak of the pandemic, WHO is urging governments to strengthen vaccination campaigns, making sure that the highest risk groups get shots at least once every 12 months.

“As individuals it is important to take measures to reduce risk of infection and severe disease, including ensuring that you have had a COVID-19 vaccination dose in the last 12 months, especially, if you are in an at-risk group ,” stressed Dr. Van Kerkhove.

Vaccines availability has declined substantially over the last 12 to 18 months, WHO admits, because the number of producers of COVID-19 vaccines has recently decreased.

“It is very difficult for them to maintain the pace,” Dr. Van Kerkhove explained. “And certainly, they don't need to maintain the pace that they had in 2021 and 2022. But let's be very clear, there is a market for COVID-19 vaccines that are [already] out there.”

Nosing ahead

Nasal vaccines are still under development but could potentially address transmission, thereby reducing the risk of further variants, infection and severe disease.

“I am concerned”, the top WHO COVID specialist said.

“With such low coverage and with such large circulation, if we were to have a variant that would be more severe, then the susceptibility of the at-risk populations to develop severe disease is huge ,” Dr. Van Kerkhove warned.

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• America is not ready for a major war, says a bipartisan commission

The country is unaware of the dangers ahead and of the costs to prepare for them

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G ENERAL CHARLES “CQ” BROWN , the chairman of the joint chiefs of staff, America’s top military officer, recently told the Aspen Security Forum, a gathering of the country’s foreign-policy elite, that the nation’s armed forces were the “most lethal, most respected combat force in the world”. Steely-faced, and to jubilant whoops, he declared: “I do not play for second place.”

In truth, America’s military position is eroding. That is the message of a report published on July 29th by a bipartisan commission entrusted by Congress with scrutinising the Biden administration’s National Defence Strategy, a document published two years ago.

The commission was chaired by Jane Harman, a former Democratic congresswoman, with Eric Edelman, an undersecretary of defence in the George W. Bush administration, deputising. In 2018 the previous such commission had warned that America “might struggle to win, or perhaps lose, a war against China or Russia”. This time the language is starker. The threats to America, including “the potential for near-term major war”, are the most serious since 1945, the commission says. The country is both unaware of their extent and unprepared to meet them.

The most serious problem is China . “We’re at least checkmating China now,” boasted Joe Biden, America’s president, on July 6th. In reality, China is “outpacing” America not only in the size but also in the “capability” of its military forces, as well as in defence production, and the country is probably on track to meet its target of being able to invade Taiwan by 2027 , argues the commission. In space and in the cyber realm, the People’s Liberation Army is “peer- or near-peer level”.

Russia is a lesser concern but, despite its quagmire in Ukraine, still poses a serious threat. On July 19th Vipin Narang, a senior Pentagon official, confirmed reports that Russia was seeking to place a nuclear weapon in orbit, describing it as a “threat to all of humanity” and “catastrophic for the entire world”. The report says that America should boost its presence in Europe to a full armoured corps, a much larger commitment than currently exists, accompanied by enablers such as air defence and aviation, with some of today’s rotational forces, which swap in and out, potentially turned into ones that are permanently deployed.

Compounding these threats is the increasing political and military alignment between China, Russia, North Korea and Iran, including the transfer of arms, technology and battlefield lessons. That presents “a real risk, if not likelihood”, in the sombre view of the commission, “that conflict anywhere could become a multi-theatre or global war”.

In 2018 the Trump administration’s National Defence Strategy did away with the previous requirement that the Pentagon be prepared to fight two major wars, including one in Europe and one in Asia, at the same time. Mr Biden’s team stuck to that reduced ambition. The result is that a war in one theatre would stretch America dangerously thin, forcing it to rely on nuclear weapons to compensate.

A conflict would also find America wanting in other respects. “Major war would affect the life of every American in ways we can only begin to imagine,” warns the commission. Cyber-attacks would pound critical infrastructure including power, water and transport. Access to minerals vital for both civilian and military industries “would be completely cut off”, the report concludes.

Casualties would far exceed any Western experience in recent memory. The latest simulations by the army show that, in battles involving corps and divisions—larger formations that the army is prioritising over brigades and battalions—casualties ran to 50,000-55,000, including 10,000-15,000 killed. The commission does not call for a return to the military draft, which America abandoned in 1973, but it hints at it, saying that the country’s all-volunteer force faces “serious questions”.

Military solutions

In response to these problems, the commission makes a number of recommendations. One is to bolster alliances. On July 28th the Biden administration made a big stride in that regard by announcing the creation of a new “warfighting” headquarters in Japan to command all land, sea and air forces in the country. Another recommendation is to reform the Pentagon, whose procurement, research and development practices the commission describes as “byzantine”.

A third is to sharply raise defence spending, which is projected to remain flat in real terms for the next five years, despite the previous commission’s recommendation for 3-5% annual real-terms growth. That particular figure is somewhat arbitrary. Nonetheless, the commission urges Congress to revoke existing spending caps, pass a multi-year supplemental budget to beef up the defence-industrial base and open the fiscal taps to put defence “on a glide path to support efforts commensurate with the US national effort seen during the Cold War”.

There is something here to irritate everyone. To pay for all this, the report proposes additional taxes and cuts to spending on health care and welfare. Both political parties will balk at that. Democrats shy away from more defence spending. Republicans are allergic to more taxes. The defence-policy wonks in Donald Trump’s orbit will like the idea of beefing up the armed forces, but many will recoil at the idea of putting more troops into Europe, rather than Asia.

There is little time to waste, says the commission. “The US public are largely unaware of the dangers the United States faces or the costs…required to adequately prepare,” it says. “They do not appreciate the strength of China and its partnerships or the ramifications to daily life if a conflict were to erupt…They have not internalised the costs of the United States losing its position as a world superpower.” ■

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