essay on effect of coronavirus

How to Write About Coronavirus / COVID-19 In Your College Essay & Application

Option 2: the slightly more creative way, how to use narrative structure to describe your pandemic experience if you want it to be all of your essay, should i write about coronavirus/ covid-19 in my college essay.

This year, the Common App is including a special 250-word section allowing students to describe the impacts of COVID-19 on their lives. Here’s the official word from the Common App website:

We want to provide colleges with the information they need, with the goal of having students answer COVID-19 questions only once while using the rest of the application as they would have before to share their interests and perspectives beyond COVID-19.

Below is the question applicants will see:

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.

Do you wish to share anything on this topic? Y/N

Please use this space to describe how these events have impacted you.

The question will be optional and will appear in the Additional Information section of the application. The response length will be limited to 250 words.

It’s worth reading from the Common App website directly , which also notes that counselors will have 500 words to detail impacts that their schools have experienced based on the pandemic.

Note: If you’re applying via the Coalition Application, you’ll also have an opportunity to add information. Learn the details here . And the advice below will apply!

So should you write about coronavirus?

On this webinar at the 14:00 mark, I asked Rick Clark, Director of Admission at Georgia Tech, this very question. His response: “How could they not!” In other words: You totally have permission to write about this.

But it also kinda’ depends on your pandemic experience.

Which of the following best describes what the pandemic has been like for you?

It’s been okay . Online school wasn’t as good as real school, but I adapted, played video games maybe a little more than usual (so my sleeping schedule was weird), and hung out with my family a little more. TBH, though, things haven’t changed (or didn’t change) too much for me.

Very negative. Coronavirus rocked my world—and not in a good way. The pandemic has led to serious hardships for my family and me. It’s been incredibly stressful, and we’re still living with some uncertainty.

Very positive. And I feel weird saying that because I know so many people have been negatively impacted. But I’ve learned some new things/felt inspired/maybe even started a new project and (maybe even) I’ve even shifted the way I’m thinking about my future!

It’s been a roller coaster (so 2 and 3). In some ways, it’s been really difficult, but in other ways, it’s been productive, and I’m learning a lot.

Do a quick self-scan: Which feels most like your experience?

And if your experience has been way too complex to fit into one of these (admittedly) overly-simplistic and reductive categories, read on.

But based on these broad categories, I’d say ...

If your life hasn’t changed too much (so A), no need to write about it.

If the pandemic has been either very negative (B), very positive (C), or like a roller coaster (D), maybe do write about it.

The questions are: Where should you write about it in your application, and how?

You’ve got options.

Where to Write About COVID-19/ Coronavirus on Your College Application?

If the school you’re applying to is on the Common App, your options include:

The special COVID-19 question (250 words)

The Additional Information section (650 words)

Your main personal statement (650 words)

Below, I’ll offer tips on how to write each one. And if the school you’re applying to is not on the Common App, check out that school’s particular application.

There’s an old saying in the musical theater world that goes something like this: If what you want to say is so important that mere words can’t capture it, you sing it. And if not even singing can capture those feelings, you dance it. (More commonly: “If you can’t say it, sing it. If you can’t sing it, dance it.”)

That’s pretty much my advice when it comes to writing about coronavirus/COVID-19 on your college application.

How to Write About COVID-19/ Coronavirus on Your College Application

More specifically, if you feel as though you need to address your pandemic experience in your college application, I’d say:

If you can fit your pandemic experiences into the 250-word COVID-19 section, do it.

If you need more space, use the 650-word Additional Information section.

If a) your pandemic experience was one of the most important things that’s ever happened to you and there’s no way it could fit in both of the sections named above, b) you believe that describing your pandemic experience is the best way to demonstrate the values/skills/qualities that you’ll bring with you to a college campus, and c) you’ve spent at least an hour exploring other topics using high-quality brainstorming exercises with a partner and still haven’t come up with any other ideas, then you might consider using the 650-word personal statement.

But keep in mind that if you do write about the pandemic in your personal statement, then you can’t use the 250-word COVID-specific section for anything else. On the other hand, if you write about the pandemic in the COVID-specific space, you can use your personal statement for …. whatever you want.

Also note that the Common App is kind of hinting that you should use the 250-word COVID-19 section so that you can use the rest of your application for other things: “ We want to provide colleges with the information they need, with the goal of having students answer COVID-19 questions only once while using the rest of the application as they would have before to share their interests and perspectives beyond COVID-19.”

Again, I’m going to show you how to write something in each section, but can you sense which way I’m nudging you?

And btw, if you’re unsure what else to write your personal statement on, keep reading—I’ll share brainstorming exercises below.

How to Write About Coronavirus Using the Special COVID-19 (250-Word) Section on the Common App

Here again is the question you’ll see on the Common App:

Option 1: The Straightforward Way

If you did face significant challenges during the pandemic, one way to write about your pandemic experience is by using this structure:

a) Challenges Faced + Impacts on Me

b) What I Did about It

c) What I Learned

Below is an example of what this might look like. (It’s not an actual example, but was written by a former student to illustrate how you can write yours)

Example 1 (faced significant challenges):

Living in rural North Carolina, I have limited access to a consistent, high-speed internet connection. During the pandemic, my family did not have the means to upgrade to a higher internet speed and were working hard around the house trying to make ends meet. This meant I was often unable to access the internet in time to turn in assignments when they were due. It was also difficult to concentrate because our house is very small and everyone was working in close proximity.

Although I found it hard to focus on schoolwork, I communicated these problems to my family so that we could work together. I organized a rotating schedule for my parents and my older sister. We marked off the blocks of time during which we would need to be online and created a system in which only two family members would be on the internet at the same time. The people who were not busy would stay quiet indoors or go outside to talk. This made it so that the internet was faster and there was less noise inside the house.

I am proud to say that I used what I had at my disposal to make the best out of a difficult situation. The unusual conditions instilled in me the value of organization and clear communication. I found ways of adapting my work to fit new time constraints and will bring this knowledge with me to college. (240 words)

Quick Notes + Tips:

This kind of straightforward and factual tone is fine. In fact, some readers will prefer it.

Notice how the example above devotes one bullet point to each of the elements I mentioned: a) Challenges Faced + Impacts on Me, b) What I Did about It, c) What I Learned. And yes, bullet points are OK in this section.

Notice how, in the third bullet point, the author demonstrates a few values that will serve them in college and beyond: adaptability, organization, communication. For a list of values, click here .

Example 2 (did not face significant challenges):

I live in Marfa, Texas, where an important part of the local economy is the restaurant industry. Many businesses in the area were forced to shut down or operate in a more limited capacity. To support these people and their contributions to our community, I started an online blog to write reviews about the takeout my family and I ate during quarantine. I made sure to include details about how food could be ordered and what options they had for different dietary restrictions. As someone who has a very restrictive diet, I understand the importance of finding food that is healthy, delicious, and conscious of different dietary needs. I also wanted to encourage people to support their local businesses.

In addition, to keep myself physically active despite limited mobility, I created a makeshift gym in my house. I fashioned “dumbbells” out of old milk cartons filled with dirt and took an online class about weight training to build a balanced workout schedule. I even got my parents to join me once a week!

I stayed connected with friends during weekly sessions on Zoom and Discord. We often spent hours playing online board games like Bananagrams and Codenames. Because I enjoyed bonding over these games and being intellectually stimulated by the puzzles they posed, I ended up taking an online course in Python and am working on coding my first video game. (231 words)

Quick Notes + Tips:

Notice how in this example, which is not a real example either but was written for illustrative purposes, the author chooses three specific aspects of the pandemic and devotes one bullet point to each.

The author begins by describing a particular need (supporting local businesses) and what they did about it (started a blog). This demonstrates the values of leadership and entrepreneurialism—even without naming the values explicitly, which is fine.

The second bullet point addresses a separate value (health), and the author gives evidence that the impact went beyond themselves—to their parents!

Finally, the author demonstrates the value of what I like to call “curiosity with legs” (i.e., being interested in something—then doing something about it). Again, the tone is straightforward, which works well.

If this kind of straightforward, factual tone isn’t your thing, you could start with something that grabs our attention. Like this:

Example 3 (faced significant challenges):

“Jose, turn down the TV. MOM, THE STOVE WON’T TURN ON! Be quiet, I’m on a call. Zuli, have you seen the scissors anywhere?!” Life in quarantine was actually four lives squished together. The pandemic forced my parents, my older sister, and I into a space that wasn’t built for all of our preferences and professions. Living in a small, one-bedroom apartment in Los Angeles meant that internet speed was often slow and privacy was minimal. We were constantly yelling, stepping on each other’s toes. Although I was discouraged, I knew that the tension in our house came mostly from fear of uncertainty, not a lack of love. I kept a level head and called a family meeting. Together, we organized a rotating schedule, marking off when we needed to be online. With this information, we created a system in which only two family members would be on the internet at any time. The people who were not busy would keep quiet or go outside to talk. In a matter of days, the internet was faster and the noise had gone down. I did what I could to make the best out of a difficult situation. The unusual conditions instilled in me the value of organization and clear communication. And I learned how to hit pause when things got intense. We’re still squished, but our love is louder than our yelling. (231 words)

Quick Notes + Tips:

Using a slightly more creative approach is also fine. In fact, some readers may find it refreshing. But note that the “slightly more creative” opening is really just 24 words long. The rest is pretty straightforward. So don’t spend too much time obsessing over this. The information you share is what’s most important here.

Notice how, in this example, the author takes the framework of the first example essay and bends it into a more cohesive narrative. It still follows the same path (i.e., identifying the challenges/effects, how you dealt with them, what you learned), but smooths the edges between those sections. It also gets a bit more creative with the intro, hooking readers with some intriguing sentence fragments. If you want to do something a little unconventional, this is a good framework you can use.

Also notice that the author still keeps all the relevant information here. It’s still crucial for her to communicate that the internet speed was slow and the house was crowded because that’s essentially the answer to the prompt. Those are challenges that will help admissions officers contextualize the author’s transcript. Remember, important information like that should be included no matter which of these formats you use.

How to Brainstorm Content for Your Own COVID-19 Response:

Use this Values List to identify 3-5 values you gained (or strengthened) during the pandemic.

Brainstorm examples to demonstrate each value (e.g., to show the value of “health” the example might be “I built a makeshift gym and designed a workout schedule”).

Write one bullet point per value. Keep it succinct, as in the examples above.

Here’s a simple Google doc template where you can brainstorm the ideas above.

How to Write About Coronavirus Using the (650-Word) Additional Information Section

First, here’s a comprehensive guide that describes what students typically use this section for. Know that writing about coronavirus in this section is also totally fine.

Next, ask yourself, “Am I sure I can’t fit everything into the 250-word Coronavirus/COVID-19 section described above?” The reason I ask that is that it’s tough for me to imagine a scenario in which your pandemic experience(s) would not fit into the space above. I suppose if you created a project that was so large in scope that you have lots of details that wouldn’t fit into 250 words, but I imagine this will apply to fewer than 5% of students. But if that’s you, then by all means, use this section.

If you do use this section, here are some general tips:

When you’re ready to brainstorm content for that section, use the simple three-step process described above where it says, “How to Brainstorm Content for Your Own COVID-19 Response.”

Probably keep the tone straightforward and factual. Value content over poetry. This is, after all, the Additional Information section.

Probably don’t write a whole 650-word essay on your coronavirus experience. Why?

a) What can be communicated in a 650-word essay can probably be communicated in 250 words in the coronavirus-specific section (see above).

b) It’s likely to be a very common essay topic (more on that below), so writing a full-length essay may lead to blending in more than standing out.

c) Again, this is the additional information (and not the additional essay) section.

Note that I say probably in the bullet points above. Could there be an exception to these tips? Something I’m not thinking about? Absolutely. If you are that exception, rock on. (In fact, email me and let me know if you feel you’re the exception, and please share with me what you wrote: [email protected] )

Again, here’s some guidance on how to use the Additional Information section in general.

How to Write About Coronavirus in Your College Essay (i.e., Your 650-Word Personal Statement)

Quick recap in case you skipped straight to this section:

Probably use the coronavirus-specific 250-word section on the Common App. That may be enough space to say what you want to say. Read the section above to see if that might be true for you.

Whatever doesn’t fit there, you can probably fit into the Additional Info section.

If you’ve read both of the sections above and you’re still feeling like you want to write about your pandemic experience in your personal statement, ask yourself if you want to devote:

Part of your personal statement to your pandemic experience (maybe because it connects to a topic you were considering anyway) or

All of your personal statement to your pandemic experience (maybe because you’ve faced extraordinary challenges)

If the answer is part (because you don’t want to potentially be defined by your pandemic experience in your reader’s eyes), I’d recommend using the Montage Structure and devoting a paragraph of your essay to your pandemic experience.

In other words, think of it as a chapter in your life as opposed to the whole book.

If the answer is all (maybe because you’ve faced significant challenges), I’d recommend the Narrative Structure .

Here’s how to write both of these, beginning with ...

How to Use Montage Structure to Describe Your Pandemic Experience in Part of Your Essay

Before you start writing about the pandemic, I’d recommend first brainstorming a variety of topics that might show different values/skills/qualities that you’ll bring with you to a college campus. You can do that using the exercises on this page in the section called “My favorite resources for brainstorming everything you'll need for your college application.” Each exercise will take you 5-20 minutes but will set you up for your entire application. In fact, you may want to bookmark that link because a) I’ll refer to it a couple of times below, plus b) the resources on that page will probably answer a lot of other college application questions you’ll have.

Once you’ve found a great non-pandemic-related topic that captures some of the magic of who you are, ask yourself ...

What was my main take-away from the pandemic?

A simple way to figure that out is to look at this List of Needs and identify 1-2 main needs that became more apparent to you during the pandemic.

Example: Maybe you realized how much you needed community . Or structure . Or contribution .

Whatever need(s) you identify, next answer: How did I work to meet that need during the pandemic?

In other words: How did you meet your need for community? Or structure? Or contribution? (Or whatever value you’ve picked.) What did you actually do ?

Once you’ve identified that, answer: What did I learn? Or how did I grow?

A great way to figure out what you learned or how you grew is to pick from this List of Values .

Try to identify 1-3 values you connected with more deeply as a result of your work to meet your needs.

Example Brainstorm:

Needs: Community + contribution

How I tried to meet these needs: Hosted a virtual open mic with my class where my peers took turns reading and sharing their pandemic experiences

What I learned: Some of my friends are really creative (or) that vulnerability can create closeness even when we can’t be together in person (or) you get the idea ...

Again, here’s a simple Google doc template where you can brainstorm the ideas above.

A Quick Word of Advice on How to Stand Out If You’re Writing About Coronavirus

Once you’ve identified a few potential (ideally, uncommon!) values, ask yourself: How could I work this idea or these ideas into the topic I’ve already thought of?

Again, make this just one part of the larger story of your life.

First, as I mentioned above, COVID-19 is likely to be a common topic this year. And while that doesn’t mean that you shouldn’t write about it, I do think it’s going to be a lot harder to stand out with this topic. So, if possible, brainstorm other possible ideas using the resources above before you commit to this as your topic.

Second, check in with yourself: Are you choosing this because some part of you believes, or someone told you, that it’s “better” to write about a challenge for your college essay? BECAUSE IT’S NOT TRUE. :) You’ll find many examples of amazing essays written by students who do not discuss significant challenges. (To see some, click this link and scroll down to the “Personal Statement Examples” link.)

Having said all this, if you still feel that describing your pandemic experience is The Best Way to Show Who You Are, then I recommend this structure:

Challenge(s) I faced based on the pandemic + their impact on me

What I did about it/them

What I learned/How I grew from the experience

Important: Make sure that only the start of your essay describes the challenges and their impact on you, then most of your essay is devoted to describing what you did about it and what you learned from the experience. Why? Because your goal with the personal statement is to demonstrate skills, qualities, values, and interests. If you’re committing to COVID-19 as a topic, you’re basically saying that you feel this is the best way to show the many sides of who you are. Is that true? Is this your deepest story?

If you’re not sure, complete this Feelings and Needs exercise . You’ll find out in about 15 minutes.

If you’re certain if this is your deepest story, still do the Feelings and Needs exercise . It’ll help you create an outline that you can use to write your personal statement.

That’s what I’ve got.

Feel free to email to share examples of what you’re working on with [email protected] , as I’ll likely publish a follow-up once we get deeper into the fall.

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Covid 19 Essay in English

Essay on Covid -19: In a very short amount of time, coronavirus has spread globally. It has had an enormous impact on people's lives, economy, and societies all around the world, affecting every country. Governments have had to take severe measures to try and contain the pandemic. The virus has altered our way of life in many ways, including its effects on our health and our economy. Here are a few sample essays on ‘CoronaVirus’.

100 Words Essay on Covid 19

200 words essay on covid 19, 500 words essay on covid 19.

COVID-19 or Corona Virus is a novel coronavirus that was first identified in 2019. It is similar to other coronaviruses, such as SARS-CoV and MERS-CoV, but it is more contagious and has caused more severe respiratory illness in people who have been infected. The novel coronavirus became a global pandemic in a very short period of time. It has affected lives, economies and societies across the world, leaving no country untouched. The virus has caused governments to take drastic measures to try and contain it. From health implications to economic and social ramifications, COVID-19 impacted every part of our lives. It has been more than 2 years since the pandemic hit and the world is still recovering from its effects.

Since the outbreak of COVID-19, the world has been impacted in a number of ways. For one, the global economy has taken a hit as businesses have been forced to close their doors. This has led to widespread job losses and an increase in poverty levels around the world. Additionally, countries have had to impose strict travel restrictions in an attempt to contain the virus, which has resulted in a decrease in tourism and international trade. Furthermore, the pandemic has put immense pressure on healthcare systems globally, as hospitals have been overwhelmed with patients suffering from the virus. Lastly, the outbreak has led to a general feeling of anxiety and uncertainty, as people are fearful of contracting the disease.

My Experience of COVID-19

I still remember how abruptly colleges and schools shut down in March 2020. I was a college student at that time and I was under the impression that everything would go back to normal in a few weeks. I could not have been more wrong. The situation only got worse every week and the government had to impose a lockdown. There were so many restrictions in place. For example, we had to wear face masks whenever we left the house, and we could only go out for essential errands. Restaurants and shops were only allowed to operate at take-out capacity, and many businesses were shut down.

In the current scenario, coronavirus is dominating all aspects of our lives. The coronavirus pandemic has wreaked havoc upon people’s lives, altering the way we live and work in a very short amount of time. It has revolutionised how we think about health care, education, and even social interaction. This virus has had long-term implications on our society, including its impact on mental health, economic stability, and global politics. But we as individuals can help to mitigate these effects by taking personal responsibility to protect themselves and those around them from infection.

Effects of CoronaVirus on Education

The outbreak of coronavirus has had a significant impact on education systems around the world. In China, where the virus originated, all schools and universities were closed for several weeks in an effort to contain the spread of the disease. Many other countries have followed suit, either closing schools altogether or suspending classes for a period of time.

This has resulted in a major disruption to the education of millions of students. Some have been able to continue their studies online, but many have not had access to the internet or have not been able to afford the costs associated with it. This has led to a widening of the digital divide between those who can afford to continue their education online and those who cannot.

The closure of schools has also had a negative impact on the mental health of many students. With no face-to-face contact with friends and teachers, some students have felt isolated and anxious. This has been compounded by the worry and uncertainty surrounding the virus itself.

The situation with coronavirus has improved and schools have been reopened but students are still catching up with the gap of 2 years that the pandemic created. In the meantime, governments and educational institutions are working together to find ways to support students and ensure that they are able to continue their education despite these difficult circumstances.

Effects of CoronaVirus on Economy

The outbreak of the coronavirus has had a significant impact on the global economy. The virus, which originated in China, has spread to over two hundred countries, resulting in widespread panic and a decrease in global trade. As a result of the outbreak, many businesses have been forced to close their doors, leading to a rise in unemployment. In addition, the stock market has taken a severe hit.

Effects of CoronaVirus on Health

The effects that coronavirus has on one's health are still being studied and researched as the virus continues to spread throughout the world. However, some of the potential effects on health that have been observed thus far include respiratory problems, fever, and coughing. In severe cases, pneumonia, kidney failure, and death can occur. It is important for people who think they may have been exposed to the virus to seek medical attention immediately so that they can be treated properly and avoid any serious complications. There is no specific cure or treatment for coronavirus at this time, but there are ways to help ease symptoms and prevent the virus from spreading.

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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?

A syllabus for the end of the world

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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Table Of Contents

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.

Writing about COVID-19 in a college admission essay

by: Venkates Swaminathan | Updated: September 14, 2020

Print article

Writing about COVID-19 in your college admission essay

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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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

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

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Coronavirus Pandemic

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.

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Kimberly Chriscaden

Communications Officer World Health Organization

Nutrition and Food Safety (NFS) and COVID-19

Here’s How the Coronavirus Pandemic Has Changed Our Lives

Results from a survey conducted with PARADE magazine

A curly-haired person with a surgical face mask wearing a black tank top and holding a yoga mat

To say that the novel coronavirus (COVID-19) pandemic has changed the world would be an understatement. In less than a year since the virus emerged — and just over 6 months since tracking began in the United States — it’s upended day-to-day lives across the globe.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

The pandemic has changed how we work , learn and interact as social distancing guidelines have led to a more virtual existence, both personally and professionally.

But a new survey, commissioned by Parade magazine and Cleveland Clinic, reveals the pandemic has also changed how Americans approach their health and health care in ways both positive and negative.

Conducted by Ipsos, the survey was given to a nationally representative sample of 1000 American adults 18 years of age & older, living in the U.S.

Here’s what the survey found.

Mental health challenges

Unsurprisingly, the pandemic has triggered a wave of mental health issues. Whether it’s managing addiction , depression , social isolation or just the general stress that’s resulted from COVID-19, we’re all feeling it.

It seems to especially be hitting younger people. Of those surveyed, 55% reported experiencing mental health issues since the onset of the pandemic, including 74% of respondents in the 18-to-34-year-old age range.

Of those respondents, four of the most common issues were:

Stress (33% overall; 42% of 18-to-34-year-olds)
Anxiety (30% overall; 40% of 18-to-34-year-olds)
Depression (24% overall; 31% of 18-to-34-year-olds)
Loneliness or isolation (24% overall; 31% of 18-to-34-year-olds)

Many are also feeling overwhelmed by the constant, sometimes shifting and conflicting flow of information around the virus and the pandemic. Overall, 41% of those surveyed claimed that they were so overwhelmed by COVID-19 news and information that they weren’t paying attention.

Pandemic-induced hesitation

While much of the world has come to a stop at times during the pandemic, the need for health care has not. Yet, 38% of respondents said they skipped or delayed preventive health care visits because of the pandemic even though health care providers have gone to great lengths to ensure that keeping those appointments are safe for everyone.

Women are more likely to skip these appointments than men, 46% to 29%, and as many as 15% of total respondents avoided visits for more serious issues like injury or even chest pain.

“In a time when we need to be able to focus on keeping ourselves as healthy as we can, we must not skip preventive visits to our healthcare providers. When we miss early signs of disease, we allow it to grow into a serious or even life-threatening illness,” says infectious disease expert Kristin Englund, MD.

“Our clinics and hospitals are taking every precaution available to assure patients are safe from COVID-19 within our walls. We cannot let fear of one disease keep us from doing what we need to do to stay healthy,” she continues.

This is especially true for children who need to continue their routine immunizations . As pediatrician Skyler Kalady, MD, points out, “We can’t lose sight of other diseases that children will be at high risk for contracting, like measles and pertussis (whooping cough), without those regular vaccinations.”

Staying healthy during the pandemic

But there is good news as far as respondents’ health is concerned. From lifestyle changes to better eating habits, people are using this time to get healthier in many areas.

Since the pandemic started, nearly two-thirds of the survey’s participants (62%) say they’ve made a significant lifestyle change, including:

More time outdoors or experiencing nature .
Improved sleep patterns.
Starting or modifying an exercise program .
Other healthy dietary changes .

Eating and exercise are new areas of focus for many respondents. One-third of the participants (34%) say they’re eating more healthy food and most (a whopping 87%) say they’ll keep the habit up.

Meanwhile over a quarter of respondents (28%) say they’ve increased their exercise frequency during the pandemic, perhaps a sign that more people are embracing the advantages of working out at home while gyms remain a risky venture .

Better health awareness

There’s more to healthy living than just exercising and food, though. And 68% of respondents said that the pandemic has them paying more attention to certain risk factors for other health issues. That number is even higher (77%) for those younger respondents, 18-to-34 years old. Some of those risk factors include:

Stress, anxiety, depression and mental health (37%).
Risk factors for chronic diseases, autoimmune or other chronic diseases (36%).
Weight (32%).
Physical fitness (28%).
Lung health (15%).

Additionally, the pandemic is motivating people to take better care of more serious issues with 41% of respondents who already have a chronic condition saying they’ll now be even more likely to comply with treatment.

Family and the pandemic

Throughout the pandemic, we’ve seen both benefits and drawbacks of being cooped up with family for long periods of time. And there’s certainly been added stress for families who have had to deal with remote learning situations for school-aged children.

Some, though, reported positive experiences with their families in such close quarters. Overall, 34% of those who responded said that they feel closer to their family and, in households with kids, 52% reported feeling like they’ve forged new connections. Additionally, 78% agreed that quarantine made them value their relationships.

As for that stress with kids, 27% of those surveyed who have kids in their households say their children have benefited from being able to spend more time with family.

Vaccinations

As flu season looms and the coronavirus pandemic stretches on, it’s especially important that everyone get a flu shot this year. According to the survey, 26% of respondents said they’re now more likely to get a flu shot. And among adults 18-to-34-years old, 35% are more likely to get vaccinated against the flu.

As for receiving a COVID-19 vaccine , 60% of respondents said that yes, they absolutely would get that vaccine when available. Of those who answered no or that they weren’t sure if they’d get the COVID-19 vaccine, the top reasons given were concerns about potential side effects (61%) and concerns about the efficacy of the vaccine (53%).

In the short term, those who took the survey show a dedication to being safe and following guidelines for the foreseeable future. And that’s where their concerns remain, too.

Staying vigilant

Of those surveyed, 78% say they won’t spend the holidays as they normally do with only 9% planning to attend holiday church services and only 12% planning to attend holiday parades or New Year’s Eve firework celebrations.

Respondents are also putting common personal interactions on hold with 78% saying they won’t shake hands with people through the end of the year and only 13% saying they will hug a non-family member.

Perhaps it’s not surprising, then, that a resurgence of COVID-19 is a big concern among those surveyed. Over half (59%) said they were concerned about another surge of cases while 44% said they’re worried about another round of quarantine.

It’s also not a surprise to see that two-thirds (68%) of respondents aged 55 years or older, the group with the highest risk of serious illness or death from COVID-19, are concerned about another surge of cases.

Staying positive

Despite these concerns and the difficulties faced throughout the pandemic, those who responded to the survey also showed that they’ve managed to find positives in their experiences.

Overall, 78% of those surveyed said that while quarantine and social distancing was difficult, it’s made them value their relationships. Meanwhile, 65% said the pandemic has made them reevaluate how they spend their time and 58% said it’s made them reevaluate their life goals.

And while 58% say that the pandemic has changed their way of life forever, nearly three-quarters (72%) said that they still have hope for the future.

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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.

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.

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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How Is the Coronavirus Outbreak Affecting Your Life?

How are you staying connected and sane in a time of social distancing?

By Jeremy Engle

Find all our Student Opinion questions here.

Note: The Times Opinion section is working on an article about how the coronavirus outbreak has disrupted the lives of high school students. To share your story, fill out this form .

The coronavirus has changed how we work , play and learn : Schools are closing, sports leagues have been canceled, and many people have been asked to work from home.

On March 16, the Trump administration released new guidelines to slow the spread of the coronavirus, including closing schools and avoiding groups of more than 10 people, discretionary travel, bars, restaurants and food courts.

How are you dealing with these sudden and dramatic changes to how we live? Are you practicing social distancing — and are you even sure what that really means?

In “ Wondering About Social Distancing? ” Apoorva Mandavilli explains the term and offers practical guidance from experts:

What is social distancing? Put simply, the idea is to maintain a distance between you and other people — in this case, at least six feet. That also means minimizing contact with people. Avoid public transportation whenever possible, limit nonessential travel, work from home and skip social gatherings — and definitely do not go to crowded bars and sporting arenas. “Every single reduction in the number of contacts you have per day with relatives, with friends, co-workers, in school will have a significant impact on the ability of the virus to spread in the population,” said Dr. Gerardo Chowell, chair of population health sciences at Georgia State University. This strategy saved thousands of lives both during the Spanish flu pandemic of 1918 and, more recently, in Mexico City during the 2009 flu pandemic.

The article continues with expert responses to some common questions about social distancing. Here are excerpts from three:

I’m young and don’t have any risk factors. Can I continue to socialize? Please don’t. There is no question that older people and those with underlying health conditions are most vulnerable to the virus, but young people are by no means immune. And there is a greater public health imperative. Even people who show only mild symptoms may pass the virus to many, many others — particularly in the early course of the infection, before they even realize they are sick. So you might keep the chain of infection going right to your own older or high-risk relatives. You may also contribute to the number of people infected, causing the pandemic to grow rapidly and overwhelm the health care system. If you ignore the guidance on social distancing, you will essentially put yourself and everyone else at much higher risk. Experts acknowledged that social distancing is tough, especially for young people who are used to gathering in groups. But even cutting down the number of gatherings, and the number of people in any group, will help. Can I leave my house? Absolutely. The experts were unanimous in their answer to this question. It’s O.K. to go outdoors for fresh air and exercise — to walk your dog, go for a hike or ride your bicycle, for example. The point is not to remain indoors, but to avoid being in close contact with people. You may also need to leave the house for medicines or other essential resources. But there are things you can do to keep yourself and others safe during and after these excursions. When you do leave your home, wipe down any surfaces you come into contact with, disinfect your hands with an alcohol-based sanitizer and avoid touching your face. Above all, frequently wash your hands — especially whenever you come in from outside, before you eat or before you’re in contact with the very old or very young. How long will we need to practice social distancing? That is a big unknown, experts said. A lot will depend on how well the social distancing measures in place work and how much we can slow the pandemic down. But prepare to hunker down for at least a month, and possibly much longer. In Seattle, the recommendations on social distancing have continued to escalate with the number of infections and deaths, and as the health system has become increasingly strained. “For now, it’s probably indefinite,” Dr. Marrazzo said. “We’re in uncharted territory.”

Abdullah Shihipar writes in an Opinion essay, “ Coronavirus and the Isolation Paradox ,” that while social distancing is required to prevent infection, loneliness can make us sick:

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COVID-19 and Chronic Disease: The Impact Now and in the Future

ESSAY — Volume 18 — June 17, 2021

Karen A. Hacker, MD, MPH 1 ; Peter A. Briss, MD, MPH 1 ; Lisa Richardson, MD, MPH 1 ; Janet Wright, MD 1 ; Ruth Petersen, MD, MPH 1 ( View author affiliations )

Suggested citation for this article: Hacker KA, Briss PA, Richardson L, Wright J, Petersen R. COVID-19 and Chronic Disease: The Impact Now and in the Future. Prev Chronic Dis 2021;18:210086. DOI: http://dx.doi.org/10.5888/pcd18.210086 .

PEER REVIEWED

The Problem of COVID-19 and Chronic Disease

Raise awareness, collaborate on solutions and build trust, address long-term covid-19 sequelae, how will the national center for chronic disease prevention and health promotion contribute, acknowledgments, author information.

Chronic diseases represent 7 of the top 10 causes of death in the United States (1). Six in 10 Americans live with at least 1 chronic condition, such as heart disease, stroke, cancer, or diabetes (2). Chronic diseases are also the leading causes of disability in the US and the leading drivers of the nation’s $3.8 trillion annual health care costs (2,3).

The COVID-19 pandemic has resulted in enormous personal and societal losses, with more than half a million lives lost (4). COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can result in respiratory distress. In addition to the physical toll, the emotional impact has yet to be fully understood. For those with chronic disease, the impact has been particularly profound (5,6). Heart disease, diabetes, cancer, chronic obstructive pulmonary disease, chronic kidney disease, and obesity are all conditions that increase the risk for severe illness from COVID-19 (7). Other factors, including smoking and pregnancy, also increase the risk (7). Finally, in addition to COVID-19–related deaths since February 1, 2020, an increase in deaths has been observed among people with dementia, circulatory diseases, and diabetes among other causes (8). This increase could reflect undercounting COVID-19 deaths or indirect effects of the virus, such as underutilization of, or stresses on, the health care system (8).

Some populations, including those with low socioeconomic status and those of certain racial and ethnic groups, including African American, Hispanic, and Native American, have a disproportionate burden of chronic disease, SARS-CoV-2 infection, and COVID-19 diagnosis, hospitalization, and mortality (9). These populations are at higher risk because of exposure to suboptimal social determinants of health (SDoH). SDoH are factors that influence health where people live, work, and play, and can create obstacles that contribute to inequities. Education, type of employment, poor or no access to health care, lack of safe and affordable housing, lack of access to healthy food, structural racism, and other conditions all affect a wide range of health outcomes (10–12). The COVID-19 pandemic has exacerbated existing health inequities and laid bare underlying root causes.

The COVID-19 pandemic has had direct and indirect effects on people with chronic disease. In addition to morbidity and mortality, high rates of community spread and various mitigation efforts, including stay-at-home recommendations, have disrupted lives and created social and economic hardships (13). This pandemic has also raised concerns about safely accessing health care (14) and has reduced the ability to prevent or control chronic disease. This essay discusses the impact that these challenges have or could have on people with chronic disease now and in the future. Exploring the impact of COVID-19 should help the public health and health care communities effectively improve health outcomes.

The challenges we face as public health professionals are divided into 3 categories. The first category involves the current effects of COVID-19 on those with, or at risk for, chronic diseases and those at higher risk for severe COVID-19 illness. Inherent in this category is the need for balance between protecting people with chronic diseases from COVID-19 while assuring they can engage in disease prevention, manage their conditions effectively, and safely receive needed health care.

The second category is the postpandemic impact of COVID-19 on the prevention, identification, and management of chronic disease. COVID-19 has resulted in decreases of many types of health care utilization (15), ranging from preventive care to chronic disease management and even emergency care (16). As of June 2020, 4 in 10 adults surveyed reported delaying or avoiding routine or emergent medical care because of the pandemic (14). Cancer screenings, for example, dropped during the pandemic (17). Decreases in screening have resulted in the diagnoses of fewer cancers and precancers (18), and modeling studies have estimated that delayed screening and treatment for breast and colorectal cancer could result in almost 10,000 preventable deaths in the United States (19). We have lost ground in prevention across the chronic disease spectrum and in other areas, including pediatric immunization (20), mental health (21,22), and substance abuse (21,22).

Some challenges with health care utilization may be improving, but improvement has not been consistent across all health care visit types, providers, patients, or communities (15). Questions about the impact of the pandemic on chronic disease include:

What diseases have been missed or allowed to worsen?

What is the status of prevention and disease management efforts?

Have prevention and disease management efforts been affected by concerns such as job loss, loss of insurance, lack of access to healthy food, or loss of places and opportunities to be physically active?

How have effects of the pandemic on health care systems (staff reductions, health practice closures, disrupted services) (23) and public health organizations’ deployment of personnel away from ongoing chronic disease prevention efforts been experienced nationally?

The effects of COVID-19, whether negative or positive, on health care and public health systems will certainly affect those with chronic disease. To fully understand the consequences of the pandemic, we need to assess its overall impact on incidence, management, and outcomes of chronic disease. This is particularly salient in communities where health inequities are already rampant or communities that are remote or underserved. Will our postpandemic response be strong enough to mitigate the exacerbation of inequities that have occurred? Can public health agencies effectively build trust in science and community health care systems where trust might never have been fully established or where it has been lost?

The third category relates to the long-term COVID-19 sequelae, both as a disease entity and from a population perspective. Has COVID-19 created a new group of patients with chronic diseases, neurologic or psychiatric conditions, diabetes, or effects on the heart, lungs, kidneys, or other organs (24)? Has it worsened existing conditions or caused additional chronic disease? And, at the population level, have the incidence and prevalence of chronic diseases increased because of pandemic-related health behaviors or other challenges, such as decreased food and nutrition security?

Given the rollout of COVID-19 vaccines and the coming end of the pandemic, this is an important time to examine the impact of COVID-19. Solutions at all levels are needed to improve health outcomes and lessen health inequities among people with or at risk for chronic disease. Solutions are likely to include increasing awareness about prevention and care during and after the pandemic, building or enhancing cross-organizational and cross-sector partnerships, innovating to address identified gaps, and addressing SDoH to improve health and achieve equity. So, what can be done?

Additional focus is required on several aspects of awareness about the impact of COVID-19. First, public health and health care practitioners need to allay people’s fears and help them safely return to health care. We need to reemphasize chronic disease prevention and care, explain how to safely access care, and convey the host of mitigation efforts made by health care systems, providers, and public health to ensure that environments are safe (eg, mask requirements, social distancing). Emphasis on safety and mitigation applies to both disease prevention (such as encouraging healthy nutrition and physical activity, screening for cancer and other conditions, and getting oral health care) and disease management (eg, educating patients about medications to control hypertension, diabetes, asthma, and other chronic conditions). Efforts must also include helping those with chronic diseases obtain access to and gain confidence in the COVID-19 vaccine. Given current community rates of COVID-19 and the need to reenter care after the height of the pandemic, information can help patients make informed choices about the need for in-person care, communication at a distance, or temporary delays in care that is more discretionary.

To garner support to help affected communities, there is a need to build awareness about how COVID-19 has disproportionately affected particular communities, including the unequal distribution of disease, morbidity, mortality, and resources, such as access to vaccines. Awareness is dependent on access to data at the granular geographic level, including information on the burden of chronic disease and the status of SDoH. Communities need data to effectively address health inequities in the aftermath of the pandemic.

Public health plays a significant role in addressing health behaviors (healthy eating, physical activity, avoiding tobacco and other substance use) and community solutions to address SDoH that impact prevention and control of chronic disease. Collaborations at both the individual and system levels, however, are required for success. Collaborative partners include other government and nongovernmental organizations, health care organizations, insurers, nonprofit organizations, community and faith-based groups, schools, businesses, and others. Coalitions and community groups are critical change agents. They have worked with local health departments and others to identify solutions, bring residents into discussions, and implement action. We can learn from them about how best to build trust and foster the innovation they are leading. Solutions must also include direct discussions with residents in affected communities to understand their priorities and effectively address their concerns. These relationships are particularly salient to address SDoH. These factors have been amplified as a direct consequence of COVID-19 and will require a multisector approach to problem solving.

To achieve this will require building trust in both the health care system and the public health system. The pandemic has taken a toll on an already fragile relationship between communities and public health and health care institutions where trust has been absent or insufficient. To begin to address the trust challenge will require investments in outreach, engagement, and transparency. Conversations need to be bidirectional, long-term, and conducted by people who are trusted, who are respectful, and who can identify with affected populations.

Creative solutions are needed to engage populations and promote resiliency among those who are disproportionately affected by COVID-19. Efforts that need to be further developed and brought to scale include the following:

Leveraging technology to expand the reach of health care and health promotion (eg, telemedicine, virtual program delivery, wearables, mobile device applications).

Providing more services in community settings, as is increasingly modeled in the National Diabetes Prevention Program (25).

Using community health workers to assist in assessing current conditions and connecting to community resources.

Further enhancing approaches to increase access to and convenience of services (eg, increasing access to home screenings, such as cancer screening) or monitoring (eg, home blood pressure monitoring) where appropriate.

Health care approaches, such as telemedicine, have expanded greatly during the pandemic and seem likely to continue expansion over time. As these and related efforts grow, practitioners will need to ensure that existing disparities are not magnified. Care is needed to ensure that those with the highest health needs can access services. For example, are technological solutions easily accessible, available in multiple languages, compatible with readily available hardware options, such as telephones rather than laptops? Are culturally appropriate resources available to help people use and value these technologies? In addition, computer availability and internet access will need to be expanded. Challenges such as unemployment, food insecurity, limited transportation, substance abuse, and social isolation will require a multisector effort uniquely adapted to local contexts. To begin, health equity–focused policy analyses and health impact assessments will help policy makers understand better how proposed SDoH-related action might either exacerbate or mitigate chronic disease inequities. These actions will help us develop a deeper understanding of what individual communities need to mobilize and build resilience for the future. We face serious public health and population health concerns that should be the focus in the near term — particularly as equitable access to COVID-19 vaccines is a consideration in every community across the nation. We clearly have an enormous amount of work to do as we enter recovery from the pandemic, but with recovery comes enormous opportunity.

A challenge related to long-term COVID-19 sequelae is that we do not know yet the extent that COVID-19 exacerbates chronic disease, causes chronic disease, or will be determined a chronic disease unto itself. Those interested in chronic disease prevention and management need to follow the research to understand better the role they will play with this emerging situation. Long-term studies and longitudinal surveillance will help clarify these issues, and there is much research to be done. The duty of the public health community is to help ensure that the most important issues from the perspectives of patients, providers, health care, and public health systems are addressed; that potential solutions are developed and tested; and that eventual solutions are delivered where they are needed most.

As the US enters the next phase of pandemic response, the work of National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) of the Centers for Disease Control and Prevention is evolving to address health inequities and drive toward health equity with a multipronged approach. This approach includes enhanced access to data at the local level, a focus on SDoH including a shift in the Notice of Funding Opportunity process that emphasizes a health equity lens, and an expansion of partnerships and communications.

Placing data in the hands of communities is critical for local coalitions to determine their burden of chronic disease and COVID-19, their access to resources, and the best policies and practices to implement. Data will be useful for local public health, governments, and health care systems, but can also help human services, planning, and economic development organizations. An initial step is making available data from the PLACES Project (26), which provides data on 27 chronic disease measures at the census tract level, allowing communities to understand their own chronic disease burden. In addition, modules on SDoH are in development to enhance NCCDPHP data surveillance systems. This will increase the ability to overlay chronic disease data and SDoH data at the community level. The need is also a great for core SDoH measures that allow comparisons of related outcomes across communities. NCCDPHP can augment this effort by contributing to and amplifying the SDoH measures identified for Healthy People 2030 (27).

NCCDPHP is focusing on supporting and stimulating SDoH efforts by concentrating on 5 major areas: built environment, social connectedness, food and nutrition security, tobacco policies, and connections to clinical care. For example, SDoH are the foci of recent Notices of Funding Opportunities (available at https://www.grants.gov). NCCDPHP supports multisector partnerships in numerous funding announcements and launched a joint effort with the Association of State and Territorial Health Officials and the National Association of County and City Health Officials to identify best practices in multisector collaboration to address SDoH (28). Evidence will help build a standard for success to support local coalitions in their work. States and local communities are sites of innovation, and promoting lessons learned can help build broader efforts. To address urgent needs and facilitate change, NCCDPHP must link with other sectors outside of public health and health care. The work to evaluate these efforts and determine the most effective strategies to address SDoH, therefore, will be integrated fully into NCCDPHP.

An expansion of the Racial and Ethnic Approaches to Community Health (REACH) Program (29) and other programs that address health inequities will help to target resources where they are needed most. REACH and a recently released investment in community health workers (30) demonstrate NCCDPHP’s commitment to connecting with populations that are disproportionately affected by chronic disease at the local level. These efforts are aimed at addressing the ramifications of COVID-19 while also amplifying chronic disease prevention efforts. NCCDPHP also intends to enhance the use of a health equity lens, among other approaches, to determine the best use of resources and to help assess outcomes in all programmatic activities.

Finally, communication about the impact of COVID-19 on chronic disease, returning to care, and the extent of health inequities is critical to building trust. Efforts under way include a television and digital media campaign aiming to encourage those with chronic disease to return safely to care (31). In addition to expanding work with partner organizations, both external and internal to government, NCCDPHP will embrace new ways of garnering input from affected communities. Successes and failures experienced by communities during the pandemic will continue to be of the utmost importance to NCCDPHP. In addition, important insights gained from working closely with affected communities will help NCCDPHP continually refine its national chronic disease prevention and control goals and objectives. Activities related to SDoH and health equity, data, and communication will address difficult questions now and into the future. These efforts can only be successful with collaboration and partnerships across multiple sectors.

The impact of SARS-CoV-2, the virus that causes COVID-19, on people with or at risk for chronic disease cannot be overstated. COVID-19 has impeded chronic disease prevention and disrupted disease management. The problems and solutions outlined here are critically important to help those committed to chronic disease prevention and intervention to identify ways forward.

NCCDPHP is adjusting, preparing, and implementing multiple strategies to address the future. Although the work will be challenging, opportunities abound. NCCDPHP is committed to working with the health care community and a variety of partners at federal, state, and local levels to help address the realities of the post-COVID era.

The authors have no conflicts of interest to report. No copyrighted materials were used in the preparation of this essay.

Corresponding Author: Karen A. Hacker, MD, MPH, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway NE, Atlanta, GA 30341. Telephone: 404-632-5062. Email: [email protected] .

Author Affiliations: 1 National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

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Czeisler MÉ, Lane RI, Petrosky E, Wiley JF, Christensen A, Njai R, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep . 2020;69:1049–1057. CrossRef
Czeisler MÉ, Lane RI, Wiley JF, Czeisler CA, Howard ME, Rajaratnam SMW. Follow-up survey of US adult reports of mental health, substance use, and suicidal ideation during the COVID-19 pandemic, September 2020. JAMA Netw Open 2021;4(2):e2037665. CrossRef
Song Z, Giuriato M, Lillehaugen T, Altman W, Horn DM, Phillips RS, et al. Economic and clinical impact of COVID-19 on provider practices in Massachusetts. New England Journal of Medicine Catalyst Innovations in Care Delivery . Published online September 11, 2020. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0441. Accessed May 19, 2021.
Rubin R. As their numbers grow, COVID-19 long haulers stump experts. JAMA 2020;324(14):1381–3. CrossRef
Centers for Disease Control and Prevention. National Diabetes Prevention Program: working together to prevent diabetes. Updated August 10, 2019. https://www.cdc.gov/diabetes/prevention/index.html. Accessed April 8, 2021.
Centers for Disease Control and Prevention, Division of Population Health. PLACES: local data for better health. Updated December 8, 2020. https://www.cdc.gov/places/about/index.html. Accessed April 8, 2021.
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy people 2030: social determinants of health. https://health.gov/healthypeople/objectives-and-data/social-determinants-health. Accessed April 29, 2021.
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Social determinants of health community pilots. Updated March 17, 2021. https://www.cdc.gov/chronicdisease/programs-impact/SDoH/community-pilots.htm. Accessed April 8, 2021.
Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity. Racial and ethnic approaches to community health. Updated October 16, 2020. https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm. Accessed April 8, 2021.
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Community health workers for COVID response and resilient communities (CCR) CDC-RFA-DP21-2109. Updated April 28, 2021. https://www.cdc.gov/chronicdisease/programs-impact/nofo/covid-response.htm. Accessed April 29, 2021.
The National Association of Chronic Disease Directors. Your health beyond COVID-19 matters! https://yourhealthbeyondcovid.org. Accessed April 29, 2021.

The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

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The positive effects...

The positive effects of covid-19

Read our latest coverage of the coronavirus pandemic.

Related content
Peer review
Bryn Nelson , science journalist
Seattle, WA, USA
bdnelson{at}nasw.org

As the coronavirus pandemic continues its deadly path, dramatic changes in how people live are reducing some instances of other medical problems. Bryn Nelson writes that the irony may hold valuable lessons for public health

Doctors and researchers are noticing some curious and unexpectedly positive side effects of the abrupt shifts in human behaviour in response to the covid-19 pandemic. Skies are bluer, fewer cars are crashing, crime is falling, and some other infectious diseases are fading from hospital emergency departments.

Other changes are unquestionably troubling. American doctors have expressed alarm over a nosedive in patients presenting to emergency departments with heart attacks, strokes, and other conditions, leading to fears that patients are too afraid of contracting covid-19 to seek necessary medical care. 1 Calls to poison control centres are up by around 20%, attributed to a rise in accidents with cleaners and disinfectants even before President Trump questioned whether injected disinfectants might stop the virus. 2 Calls to suicide prevention lines are skyrocketing, while health experts are fretting about signs of rising alcohol and drug use, poorer diets, and a lack of exercise among those cooped-up at home. 3 Millions of people are hungry and unemployed.

But doctors, researchers, and public health officials say the pandemic is also providing a unique window through which to view some positive health effects from major changes in human behaviour. And the pandemic may lead to a public more willing to accept and act on public health messages.

Alice Pong, a paediatric infectious disease physician and the medical director for infection control at Rady Children’s Hospital in San Diego, California, said the hospital has seen a sharp decline in paediatric admissions for respiratory illnesses. These include diseases such as influenza, parainfluenza, respiratory syncytial virus, and human metapneumovirus.

“We track positive viral tests through our hospital lab and those numbers have gone down dramatically since everybody went into quarantine,” Pong told The BMJ . “We do think that’s a reflection of kids not being in day care or school.” The hospital is testing fewer patients, she said, which could be because more children might be staying home with respiratory symptoms. But more serious cases and intensive care unit admissions are down as well, suggesting a true decline in life threatening illnesses.

Beyond the disease reducing effects of social distancing, Pong said she believes children and families are taking advice on hand washing, personal hygiene, and other prevention measures seriously. “I think this is going to be a good lesson for everybody,” she said. ‘‘The public is seeing why public health officials have advised them stay home when they feel sick, for example, and why they’ve emphasised hand washing and covering a cough or sneeze. Kids growing up now will know this is how germs are spread,” Pong said. That message could spread to their families and broaden awareness.

Fewer cars, blue skies

With covid-19 shutting down economic activity in most parts of the world and people staying closer to home, street crimes like assault and robbery are down significantly, though domestic violence has increased. 4 Traffic has plummeted as well. As a result, NASA satellites have documented significant reductions in air pollution—20-30% in many cases—in major cities around the world. 5 Based on those declines, Marshall Burke, an environmental economist at Stanford University, predicted in a blog post that two months’ worth of improved air quality in China alone might save the lives of 4000 children under the age of 5 and 73 000 adults over the age of 70 (a more conservative calculation estimated about 50 000 saved lives). 6

Although baseline pollution levels in the US are lower, Burke said a similar 20-30% reduction in pollution would still likely yield significant health benefits. “A pandemic is a terrible way to improve environmental health,” he emphasised. It may, however, provide an unexpected vantage to help understand how environmental health can be altered. “It may help bring into focus the effect of business as usual on health outcomes that we care about,” he told The BMJ . “In some sense, it helps us imagine the future.” Getting there, he says, could instead come through better regulation and technology.

A separate report coauthored by Fraser Shilling, director of the Road Ecology Center at the University of California at Davis, found that highway accidents—including those involving an injury or fatality—fell by half after the state’s shelter-in-place order on 19 March. 7 “The reduction in traffic accidents is unparalleled,” and yielded an estimated $40m (£32m; €37m) in public savings every day, the report asserted.

Whereas average traffic speeds increased by only a few miles per hour, traffic volume fell by 55%. Hospitals in the Sacramento region reported fewer trauma related admissions while other reports indicated fewer car collisions with pedestrians and cyclists.

In Washington, collisions on state highways fell even further—by 62%—in the month after the state’s stay-at-home order went into effect on 23 March, compared with the previous year, according to the Washington State Patrol. The question, Shilling said, is whether researchers can learn from the information to design safer transportation patterns. “We’re not going to be guessing anymore about what happens when you take half the cars away,” he said.

Emptier highways, though, may be triggering reckless driving that could undo the mortality reductions. Washington State Patrol spokesperson Darren Wright said that troopers are seeing a “scary trend” of more drivers travelling at extreme speeds—a phenomenon also observed in Missouri. “We’re seeing speeds in the 120 and 130 miles per hour range,” Wright said. One motorcyclist was clocked at more than 150 miles per hour.

Reassessing priorities

If the pandemic has prompted risky behaviour for some, it has encouraged others to embrace preventive measures. Randy Mayer, chief of the Bureau of HIV, STD, and Hepatitis at the Iowa Department of Public Health, said the public has become more responsive to calls from the department’s partner services, which perform contact tracing for people who test positive for HIV, gonorrhoea, and syphilis. “People are really interested in calling us back and finding out what information we have for them,” he said. That increased cooperation, Mayer said, may be a benefit of people associating public health departments with trying to keep them safe from covid-19.

Even so, he worries that a noticeable reduction in the number of new HIV diagnoses may partially reflect a reduction in available testing with many clinics open for limited hours, if not completely closed. But growing evidence suggests that more people are also heeding recent pleas by public health officials and even dating apps to reduce the risk of covid-19 infection by avoiding casual sex with new partners. Researchers in Portugal and the UK told The BMJ that they were beginning to see shifts in the incidence of sexually transmitted infections but were still collecting data to support their observations.

Miguel Duarte Botas Alpalhão, a dermatovenereologist and invited lecturer in the Faculty of Medicine at the University of Lisbon, said that he expects to see a lower rate of sexually transmitted infections during the lockdown. The crisis has caused people to question their priorities “and how much they are willing to give up to protect their lives and those of their loved ones,” he said. “People are now more aware that nothing really matters when health is lacking, and this raised awareness may be the driving force towards healthier habits. We will have to wait and see.”

Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

↵ Grady D. The pandemic’s hidden victims: sick or dying, but not from the virus. New York Times. 20 April 2020. www.nytimes.com/2020/04/20/health/treatment-delays-coronavirus.html .
Schnall AH ,
↵ Bharath D. Suicide, help hotline calls soar in Southern California over coronavirus anxieties. Orange County Register. 19 April 2020. www.ocregister.com/2020/04/19/suicide-help-hotline-calls-soar-in-southern-california-over-coronavirus-anxieties .
↵ Dazio S, Briceno F, Tarm M. Crime drops around the world as covid-19 keeps people inside. Associated Press. 11 April 2020. https://apnews.com/bbb7adc88d3fa067c5c1b5c72a1a8aa6 .
↵ NASA. Airborne nitrogen dioxide plummets over China. 2 March 2020. www.earthobservatory.nasa.gov/images/146362/airborne-nitrogen-dioxide-plummets-over-china .
↵ Burke M. Covid-19 reduces economic activity, which reduces pollution, which saves lives. G-FEED.org. 8 March 2020. www.g-feed.com/2020/03/covid-19-reduces-economic-activity.html .
↵ Shilling F, Waetjen D. Special report (update): impact of covid-19 mitigation on numbers and costs of California traffic crashes. 15 April 2020. https://roadecology.ucdavis.edu/files/content/projects/COVID_CHIPs_Impacts_updated_415.pdf .

Pandemics Don’t Really End—They Echo

T he public health emergency related to the COVID-19 pandemic officially ended on May 11, 2023. It was a purely administrative step. Viruses do not answer to government decrees. Reported numbers were declining, but then started coming up again during the summer. By August, hospital admissions climbed to more than 10,000 a week. This was nowhere near the 150,000 weekly admissions recorded at the peak of the pandemic in January 2022.

The new variant is more contagious. It is not yet clear whether it is more lethal. Nor is it clear whether the recent rise is a mere uptick or foreshadows a more serious surge. More than 50,000 COVID-19 deaths have been reported in the U.S. in 2023. Somehow, this has come to be seen as almost normal.

Even while health authorities are keeping their eyes on new “variables of concern,” for much of the public COVID has been cancelled. The news media have largely moved on to other calamities. The pandemic is over. Is it?

History shows that pandemics have ragged endings. Some return again and again. The Justinian Plague that swept through the Roman Empire in the 6 th century returned in waves over the next 200 years. The Black Death that killed half the population of Europe between 1347 and 1351 came back more than 40 times over the next 400 years.

Read More: Will the New Vaccine Work Against the Latest Variant?

The effect of the COVID-19 pandemic will be felt long after the last rapid test comes back positive. Millions today are still suffering from “ long COVID ”—a range of medical conditions that can appear long after the initial infection. This concept can be applied to the whole of society.

Pandemics have always frayed the social fabric, disrupted economies, deepened social divides, and intensified prejudices, leaving behind psychological scars—all of which have lasting political repercussions.

Angered by the British crown’s attempt to restore the inequalities of the pre-pandemic feudal system, which had been weakened by the massive depopulation caused by the plague, English peasants marched on London and nearly brought down the king. Repeated waves of cholera in Europe during the 19 th century increased social tensions and contributed to growing class warfare. A sharp increase in labor strife followed the 1918 flu pandemic.

Today, society seems similarly on edge and quick to violence, an observation that was also made about medieval society following the plague. The U.S. homicide rate in 2020 and 2021 increased by nearly 40 percent. It appears to have come down in some cities, but violent crime remains above pre-pandemic levels. Mass shootings have hit an all-time high, while random unprovoked aggression has increased in public spaces. The pandemic is not entirely to blame, but it has likely been a contributing factor.

Many Americans quit their jobs after the pandemic. Others are refusing to give up working from home . The so-called great resignation appears to be ending, but the labor militancy that featured in post-pandemic societies continues.

While the COVID-19 pandemic comes nowhere near the depopulation effects of the plague, it emptied the sidewalks in many major American cities. Office buildings have fewer workers. Restaurants have lost business. It is not uncommon to see rows of boarded up retail shops. COVID does not get all the blame. The rise in crime in many city centers keeps many away. Urban geography may be permanently altered.

As it often did after past pandemics, pessimism pervades the post-pandemic moodscape. Its explanation lies beyond the pathogens. A Biblical host of natural and man-made disasters—pestilence, war, famine, floods, drought, fire, contribute to a sense of foreboding.

The 1918 flu pandemic left a legacy of distrust in institutions and each other, which was passed down to children and grandchildren, COVID may have similar long-term effects.

Americans are a cantankerous lot, increasingly suspicious of malevolent motives behind anything government does. Partisan news outlets look for conflict and stoke outrage. In past pandemics, conspiracy theories flourished, often blaming immigrants and Jews. So too, some COVID conspiracy theories suggest that the virus was designed to kill Whites or Blacks, while sparing Asians and Jews. Nothing changes.

Some believe the government created the pandemic hoax or deliberately misled the public about the seriousness of the situation. They argue that needless lockdown orders and business shutdown ruined the economy; providing financial relief to businesses and families opened the way for massive corruption and left the country with insupportable debt; mask and vaccine mandates were assaults on personal liberty for the benefit of big Pharma profits. Some still claim that the vaccines themselves rivaled the virus in their lethality. Defiance has been elevated to patriotism.

Owing to response measures, improved medications, life-saving procedures for treating critically-ill patients, and the rapid availability of a vaccine, the outbreak did not replicate the death tolls of previous pandemics.

Although it sounds perverse, saving lives ended up contributing to the controversy. Simply put: The pandemic was not deadly enough . The 2 nd century Antonine Plague killed a quarter of the Roman Empire’s population. The 6 th century Justinian plague killed half the population of Europe. According to some historians, the first wave of the plague in the 14 th century again wiped out half of Europe’s inhabitants.

COVID has killed more than a million Americans, roughly a third of one percent—or about the same percentage of the population killed in World War II. As a percentage of the total population, the 1918 flu was twice as deadly.

The demographics of the death toll are important. The 1918 flu killed many younger people—those 25-40 years old accounted for 40% of the fatalities—while COVID killed mainly older Americans, as three-quarters of the dead were 65 or older. Those under 40 accounted for just 2.5% of the fatalities.

Some questioned why the country’s well-being should be jeopardized to save the elderly, many of whom already had other afflictions anyway. Expressed in the cruelest terms, nature was culling the herd. Indeed, some of the same groups that during earlier debates about national health care expressed outrage at the prospect of death panels “pulling the plug on grandma” suggested during the pandemic that the elderly would be willing to die to save the economy.

The COVID pandemic lacked visual impact. Except for those directly affected, COVID’s toll remained abstract. There was no modern equivalent of town criers calling “Bring out your dead” accompanied by carts making the rounds to collect corpses. Had COVID led to bodies piled in the streets, shared dread might have outweighed our differences. As it turned out, we had the science to address the pandemic. What we lacked was the social accord.

Discord continues in the political arena. The tradeoffs between preserving individual rights and protecting the public are legitimate areas to explore, but rather than looking for lessons to be learned, some politicians appear determined to settle scores. Pandemic disputes will almost certainly feature in the 2024 presidential election.

Any future outbreak of disease will likely again see cable news, the internet, and social media play major roles in shaping the information individuals choose in their decision making. This will inevitably make emergency control measures more difficult to impose. COVID’s biggest political casualty may be governability itself.

We are unable to join hands to remember the more than a million Americans that have succumbed to the virus—that are succumbing still. We cannot express a nation’s gratitude to the scientists, public health officials, and heroic frontline health workers, thousands of whom died saving lives during the pandemic. Stuck in the well-worn paths of previous pandemic prejudices and conspiracy theory re-runs, we cannot come together to mourn our losses and celebrate our survival.

There will be no collective thanksgiving, no elegies, no closure. As we have seen time and time again throughout human history, pandemics do not end—they echo.

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Paragraph Writing on Covid 19 - Check Samples with Various Word Counts

Examples of Short Paragraph Writing On Covid 19 with Different Word Limits

The Covid-19 pandemic has been a severe global crisis, impacting almost everyone. It is a viral infection that has spread widely, affecting people in various ways. As a virus , it continues to evolve, leading to new variants. The pandemic has changed many aspects of daily life , including education and the economy. Many have lost their lives, jobs, and loved ones.

In this challenging time , Vedantu offers valuable support with online learning resources, helping students continue their education despite disruptions. By providing accessible and effective learning tools, Vedantu plays an important role in supporting students through these difficult times, ensuring they remain on track with their studies. Here, students can find short paragraph writing on Covid 19 in different word limits .

Do You Know?

drives. Mention key responses and their effects in a concise manner.

Read the article to learn how to write a Paragraph Writing on Covid 19.

Sample Paragraph Writing on COVID-19: How to Write Your Paragraph

To write a paragraph on Covid-19, start by introducing what the pandemic is and its global impact. Explain that Covid-19 is a viral infection that has affected millions of people around the world. Describe how it changed daily life, such as by disrupting the economy, education, and personal routines. Include specific examples, like the shift to online learning and the increase in remote work . Mention how the pandemic led to new health measures, such as social distancing and vaccinations. Conclude by summarising the overall impact and highlighting the importance of understanding these changes for future reference. Keep your sentences short and straightforward to ensure clarity.

Writing a 100-word Paragraph on COVID-19: A Simple Guide

Covid-19, caused by the novel coronavirus, greatly impacted the world. It spread rapidly, leading to a global health crisis. To control the virus, many countries implemented lockdowns, travel restrictions, and social distancing measures. These actions affected daily life, with people losing jobs, facing financial hardships, and schools shifting to online learning. The pandemic also overwhelmed healthcare systems. Despite these challenges, the global effort to combat the virus, including vaccination drives and medical research, aimed to bring an end to the crisis. Understanding these points helps us understand the wide-reaching effects of Covid-19 on our lives.

Paragraph Writing on Covid 19 in 150 Words

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, began in late 2019 and rapidly spread across the globe, becoming one of the most challenging public health crises in recent history. This virus has led to a wide range of health issues, from mild symptoms to severe illness, causing significant loss of life. In response, countries introduced lockdowns, social distancing guidelines, and mask mandates, profoundly changing daily life and impacting various sectors. Educational institutions shifted to online learning, and many businesses adopted remote work or faced closures, leading to widespread economic difficulties. However, the swift development and distribution of vaccines have been crucial in managing the spread of the virus, significantly reducing severe cases and fatalities. The pandemic has underscored the importance of following public health guidelines, staying updated on health information, and supporting each other during these trying times. By understanding the pandemic's effects on health, society, and the economy, we can better navigate current challenges and prepare for future health crises. To conclude, Paragraph Writing On Covid 19 In 150 Words understanding the impact of COVID-19 helps us appreciate the importance of staying informed and prepared for future challenges.

Writing a 200-word Paragraph on COVID-19: A Simple Guide

COVID-19, caused by the SARS-CoV-2 virus, emerged in late 2019 and quickly escalated into a global pandemic. This virus spreads primarily through respiratory droplets when an infected person coughs or sneezes. It can lead to symptoms ranging from mild, such as a sore throat and fever , to severe conditions, including pneumonia and respiratory failure, which can be fatal. The pandemic has profoundly impacted every aspect of daily life, prompting governments worldwide to implement measures such as lockdowns, travel restrictions, and social distancing. These interventions, while essential for controlling the spread of the virus, have led to significant changes in how people live and work. Many businesses and schools shut down, shifting to remote work and online learning as the new norm. The pandemic has highlighted the importance of adhering to public health practices like regular handwashing, wearing masks, and maintaining physical distance .

Vaccines, developed at unprecedented speed, have played a crucial role in mitigating the severity of the disease and reducing mortality rates. Despite these advances, the pandemic has exposed and often exacerbated existing health inequalities and underscored the need for global cooperation in health emergencies. By understanding the impacts of COVID-19, we can better appreciate the importance of preparedness and resilience in addressing future health crises. Adhering to health guidelines remains crucial for safeguarding ourselves and our communities.

Writing a 250-word Paragraph on COVID-19: A Simple Guide

COVID-19, caused by the coronavirus SARS-CoV-2, emerged in December 2019 in Wuhan, China. It quickly evolved into a global pandemic, significantly altering daily life across the world. The virus spreads mainly through respiratory droplets from coughing, sneezing, or talking, but it can also be transmitted by touching surfaces contaminated with the virus and then touching the face. Symptoms range from mild, such as cough and fever, to severe, including pneumonia and difficulty breathing. The pandemic triggered unprecedented global responses, including lockdowns, travel restrictions, and social distancing measures. These actions, aimed at limiting the virus's spread, caused widespread disruptions to economies and education systems. Many businesses faced closures, and educational institutions shifted to remote learning, highlighting the need for digital infrastructure and adaptability. Healthcare systems worldwide faced immense pressure, revealing both strengths and weaknesses in pandemic preparedness. The rapid development and distribution of vaccines have been crucial in reducing severe illness and deaths. However, challenges remain, such as ensuring equitable vaccine distribution, managing public health compliance, and addressing the economic fallout. COVID-19 has underscored the importance of global collaboration and timely health interventions. It has shown the need for robust healthcare systems, effective communication , and individual responsibility in combating health crises. The pandemic has also emphasized the significance of science and technology in addressing global challenges and the importance of being prepared for future health emergencies. Continued vigilance, effective health strategies, and community solidarity are essential for overcoming the pandemic and mitigating its long-term impacts. Additionally, COVID-19 has highlighted the resilience and adaptability of communities around the world in the face of unprecedented challenges.

Examples for Paragraph Writing on Covid 19

Example 1: how covid-19 ended and vaccination’s role.

The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, significantly impacted global health and daily life since late 2019. To combat the virus, countries introduced lockdowns, social distancing, and travel restrictions. The end of the pandemic began with the development and distribution of effective vaccines, which reduced severe cases and deaths. Mass vaccination campaigns worldwide, combined with public health measures, helped control the virus's spread. As more people were vaccinated and natural immunity developed, the number of new cases declined. By late 2021 and into 2022, many countries started easing restrictions, although the virus continued to circulate in various forms. Global cooperation and adherence to health guidelines played crucial roles in bringing the pandemic under control, though it remains important to monitor and manage ongoing cases.

Example 2: How COVID-19 Affected Everyone’s Daily Life

The COVID-19 pandemic affected everyone in profound ways. Individuals experienced disruptions in daily routines, with many facing job losses, financial difficulties, and isolation from loved ones due to lockdowns and social distancing. Schools shifted to online learning, creating challenges for students and parents alike. Healthcare systems were overwhelmed, with hospitals struggling to manage the surge in patients. Businesses faced closures and reduced operations, impacting economies globally. The pandemic also highlighted disparities in healthcare access and resources. Communities had to adapt to new ways of living, from wearing masks to changing work environments. Despite the difficulties, the pandemic showed the resilience of people worldwide and the importance of community support and public health measures in navigating such crises.

Test Your Knowledge of Paragraph Writing on Covid 19

Here are some engaging tasks for students to help them learn how to write a Paragraph on Covid 19:

Task 1 : Describe the Impact of COVID-19 on Daily Life.

Task 2 : Write a Paragraph on How Different Countries Handled the Pandemic.

Now Check Out if You Got them All Right from the Answers Below.

Task 1: describe the impact of covid-19 on daily life.

The COVID-19 pandemic drastically changed people's daily lives around the world. With lockdowns and social distancing measures, many people had to adapt to working from home. Schools shifted to online learning, which presented challenges for both students and teachers in maintaining engagement and managing resources. Social interactions were limited to virtual meetings and phone calls, reducing face-to-face contact with friends and family. Many people adopted new habits, such as wearing masks and using hand sanitiser regularly, to stay safe. The pandemic also highlighted the importance of health and hygiene , influencing daily routines in profound ways.

Task 2: Write a Paragraph on How Different Countries Handled the Pandemic

During the COVID-19 pandemic, different countries adopted various strategies to manage the crisis. For example, New Zealand implemented early and strict lockdown measures, along with comprehensive testing and contact tracing, which effectively controlled the spread of the virus and allowed for quicker economic reopening. In contrast, the United States initially struggled with inconsistent lockdowns and testing shortages, leading to a higher number of cases. While the U.S. eventually increased vaccine distribution, the delayed response in the early months contributed to a more prolonged impact on public health. This comparison shows that early intervention and consistent measures can significantly influence the outcome of pandemic management.

Takeaways from this Page

This page on Paragraph Writing about COVID-19 gives a clear guide on how to write about the pandemic. It explains how to create well-structured paragraphs, using examples and tasks to make learning easier. Students will learn how to describe the impact of COVID-19, including its effects on daily life and the global response. The page also shows how to include important details and write clearly about the topic. By following the tips and examples provided, students will be able to write effective paragraphs on COVID-19 and understand its broader effects.

FAQs on Paragraph Writing on Covid 19 - Check Samples with Various Word Counts

1. What is the main focus of a paragraph writing on Covid 19?

The main focus is to describe the impact of the COVID-19 pandemic. This includes its effects on health, daily life, and the global response. Keep your details clear and relevant.

2. How should I start a paragraph about COVID-19?

Begin with a clear topic sentence that introduces the main point about COVID-19. This could be about its spread, impact, or measures taken. Make sure it's engaging and informative.

3. What details should be included in the body of the paragraph writing on Covid 19?

Include key facts like how COVID-19 spread, its effects on people’s lives, and the response from governments. Use simple, direct language and relevant examples to explain these points.

4. How do I keep the short paragraph writing on Covid 19 focused?

Stick to the topic by focusing on specific aspects of COVID-19, such as its impact on daily routines or health. Avoid adding unrelated information to keep the paragraph clear and relevant.

5. What is a good way to end a paragraph writing on Covid 19?

End with a concluding sentence that sums up the main points. You might reflect on the overall impact of COVID-19 or mention ongoing changes and future outlooks.

6. How can I make my paragraph writing on Covid 19 interesting?

Use engaging examples and personal anecdotes if relevant. Describe how COVID-19 has specifically affected different aspects of life to make the paragraph more relatable and interesting.

7. Should I use technical terms in my paragraph writing on Covid 19?

Avoid using too many technical terms. Instead, use simple language that anyone can understand. Explain any necessary terms briefly to ensure clarity.

8. How do I organise my short paragraph writing on Covid 19?

Start with an introduction sentence, follow with detailed sentences about COVID-19’s impact, and end with a concluding sentence. This structure helps in presenting information.

9. How can I add depth to my short paragraph writing on Covid 19?

Include various perspectives, such as how COVID-19 affected different groups of people. Providing specific examples and detailed explanations adds depth and richness to your writing.

10. What should I avoid in my paragraph writing on Covid 19?

Avoid including personal opinions or speculative information. Stick to factual, relevant details about COVID-19 to maintain objectivity and accuracy.

11. How can I check if my paragraph writing on Covid 19 is clear?

Read your paragraph out loud to see if it flows well. Ask someone else to read it and provide feedback on clarity and understanding. Make sure each sentence contributes to the main point.

12. Can I use quotes or statistics in my short paragraph writing on Covid 19?

Yes, using quotes or statistics can add credibility to your paragraph. Just make sure to explain them clearly and relate them directly to the main points about COVID-19.

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Favorable Antiviral Effect of Metformin on SARS-CoV-2 Viral Load in a Randomized, Placebo-Controlled Clinical Trial of COVID-19

D. R. B. and J. D. H. contributed equally to this work.

Potential conflicts of interest. J. B. B. reports contracted fees and travel support for contracted activities for consulting work paid to the University of North Carolina by Novo Nordisk; grant support by NIH, PCORI, Bayer, Boehringer-Ingelheim, Carmot, Corcept, Dexcom, Eli Lilly, Insulet, MannKind, Novo Nordisk, and vTv Therapeutics; personal compensation for consultation from Alkahest, Altimmune, Anji, Aqua Medical Inc, AstraZeneca, Boehringer-Ingelheim, CeQur, Corcept Therapeutics, Eli Lilly, embecta, GentiBio, Glyscend, Insulet, Mellitus Health, Metsera, Moderna, Novo Nordisk, Pendulum Therapeutics, Praetego, Stability Health, Tandem, Terns Inc, and Vertex.; personal compensation for expert testimony from Medtronic MiniMed; participation on advisory boards for Altimmune, AstraZeneca, and Insulet; a leadership role for the Association of Clinical and Translational Science; and stock/options in Glyscend, Mellitus Health, Pendulum Therapeutics, Praetego, and Stability Health. M. A. P. receives consulting fees from Opticyte and Cytovale. A. B. K. has served as an external consultant for Roche Diagnostics; received speaker honoraria from Siemens Healthcare Diagnostics, the American Kidney Fund, the National Kidney Foundation, the American Society of Nephrology, and Yale University Department of Laboratory Medicine; research support unrelated to this work from Siemens Healthcare Diagnostics, Kyowa Kirin Pharmaceutical Development, the Juvenile Diabetes Research Foundation, and the NIH; support for travel from College of American Pathologists Point-Of-Care Testing Committee; participation on an advisory board for the Minnesota Newborn Screening Advisory Committee; grants from NIH and JDRF for multiple unrelated clinical research projects and Kyowa Kirin Pharmaceutical Development and Siemens Healthcare Diagnostics for unrelated clinical research studies; and leadership roles for the American Board of Clinical Chemistry, Association for Diagnostics and Laboratory Medicine (ADLM) Evidence-Based Laboratory Medicine Subcommittee, and ADLM Academy Test Utilization Committee. M. R. R. reports consulting fees from 20/20 Gene Systems for coronavirus disease 2019 testing. D. B. R. reports grants from the NIH NCATS ACTIV-6 Steering Committee Chair. K. C. reports stock or stock options for United Health Group. C. T. B. reports consulting fees from NCATS/DCRI and the ACTIV-6 Executive Committee and support for travel from Academic Medical Education. All other authors report no potential conflicts.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Article contents
Figures & tables

Carolyn T Bramante, Kenneth B Beckman, Tanvi Mehta, Amy B Karger, David J Odde, Christopher J Tignanelli, John B Buse, Darrell M Johnson, Ray H B Watson, Jerry J Daniel, David M Liebovitz, Jacinda M Nicklas, Ken Cohen, Michael A Puskarich, Hrishikesh K Belani, Lianne K Siegel, Nichole R Klatt, Blake Anderson, Katrina M Hartman, Via Rao, Aubrey A Hagen, Barkha Patel, Sarah L Fenno, Nandini Avula, Neha V Reddy, Spencer M Erickson, Regina D Fricton, Samuel Lee, Gwendolyn Griffiths, Matthew F Pullen, Jennifer L Thompson, Nancy E Sherwood, Thomas A Murray, Michael R Rose, David R Boulware, Jared D Huling, COVID-OUT Study Team , Favorable Antiviral Effect of Metformin on SARS-CoV-2 Viral Load in a Randomized, Placebo-Controlled Clinical Trial of COVID-19, Clinical Infectious Diseases , Volume 79, Issue 2, 15 August 2024, Pages 354–363, https://doi.org/10.1093/cid/ciae159

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Metformin has antiviral activity against RNA viruses including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The mechanism appears to be suppression of protein translation via targeting the host mechanistic target of rapamycin pathway. In the COVID-OUT randomized trial for outpatient coronavirus disease 2019 (COVID-19), metformin reduced the odds of hospitalizations/death through 28 days by 58%, of emergency department visits/hospitalizations/death through 14 days by 42%, and of long COVID through 10 months by 42%.

COVID-OUT was a 2 × 3 randomized, placebo-controlled, double-blind trial that assessed metformin, fluvoxamine, and ivermectin; 999 participants self-collected anterior nasal swabs on day 1 (n = 945), day 5 (n = 871), and day 10 (n = 775). Viral load was quantified using reverse-transcription quantitative polymerase chain reaction.

The mean SARS-CoV-2 viral load was reduced 3.6-fold with metformin relative to placebo (−0.56 log 10 copies/mL; 95% confidence interval [CI], −1.05 to −.06; P = .027). Those who received metformin were less likely to have a detectable viral load than placebo at day 5 or day 10 (odds ratio [OR], 0.72; 95% CI, .55 to .94). Viral rebound, defined as a higher viral load at day 10 than day 5, was less frequent with metformin (3.28%) than placebo (5.95%; OR, 0.68; 95% CI, .36 to 1.29). The metformin effect was consistent across subgroups and increased over time. Neither ivermectin nor fluvoxamine showed effect over placebo.

In this randomized, placebo-controlled trial of outpatient treatment of SARS-CoV-2, metformin significantly reduced SARS-CoV-2 viral load, which may explain the clinical benefits in this trial. Metformin is pleiotropic with other actions that are relevant to COVID-19 pathophysiology.

NCT04510194.

(See the Invited Commentary by Siedner and Sax on pages 292–4.)

COVID-OUT was a multisite, phase 3, quadruple-blinded, placebo-controlled, randomized clinical trial to test whether outpatient treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevented severe coronavirus disease 2019 (COVID-19) [ 1 ].

The selection of metformin was motivated by in silico modeling, in vitro data, and human lung tissue data that showed that metformin decreased SARS-CoV-2 viral growth and improved cell viability [ 2–4 ]. The in silico modeling identified protein translation as a key process in SARS-CoV-2 replication, similar to protein mapping of SARS-CoV-2 [ 3 ]. Metformin inhibits the mechanistic target of rapamycin (mTOR) [ 5 ], which controls protein translation [ 6 , 7 ]. Metformin has shown in vitro antiviral actions against the Zika virus and against hepatitis C via mTOR inhibition [ 8–11 ].

Severe COVID-19 was defined using a binary, 4-part composite outcome (1 reading <94% SpO 2 on a home oximeter/emergency department visit/hospitalization/death) through 14 days and was not significant. After removing the 1 oxygen reading <94% component per the prespecified statistical analysis plan (SAP), metformin reduced the odds of emergency department visits/hospitalizations/death by day 14 by 42%, of hospitalization/death by day 28 by 58%, and of long COVID diagnoses by day 300 by 42% [ 1 , 12 ].

Here, we present the viral load quantification from samples obtained during the COVID-OUT trial. The trial used a 2 × 3 factorial design of parallel treatments to efficiently assess 3 medications: immediate-release metformin, ivermectin, and fluvoxamine at doses not previously studied in COVID-19 trials.

Study Design, Sample, and Oversight

COVID-OUT was an investigator-initiated, multisite, phase 3, quadruple-blinded, placebo-controlled randomized clinical trial ( Supplementary Tables 1 and 2 ) [ 1 ] that enrolled from 30 December 2020 to 28 January 2022. COVID-OUT was decentralized to prevent SARS-CoV-2 spread. The participants, care providers, investigators, and outcomes assessors remained blinded to treatment allocation.

Institutional review boards (IRBs) at each site and the Advarra Central IRB approved the protocol. An independent data and safety monitoring board (DSMB) monitored safety and efficacy. All analyses and covariates were prespecified in the SAP, which was submitted to the DSMB before enrollment ended and submitted in February 2022 with the primary outcome manuscript and then published [ 1 ]. An independent monitor oversaw study conduct per the Declaration of Helsinki, Good Clinical Practice Guidelines, and local requirements.

COVID-OUT excluded low-risk individuals, limiting enrollment to standard-risk adults aged 30 to 85 years with a body mass index (BMI) in the overweight or obesity categories, documented + SARS-CoV-2 within 3 days, and no prior confirmed SARS-CoV-2 infection. Pregnant women were randomized to metformin or placebo and not to ivermectin or fluvoxamine. Exclusion criteria included hospitalized, symptom onset >7 days prior, and unstable heart, liver, or kidney failure [ 1 ].

Metformin dosing was as follows: 500 mg on day 1, 500 mg twice daily on days 2–5, and 500 mg in the morning and 1000 mg in the evening on days 6–14. Fluvoxamine dosing was as follows: 50 mg on day 1 and 50 mg twice daily on days 2–14. Ivermectin dosing was as follows: a median of 430 µg/kg/day (range, 390 to 470 µg/kg/day) for 3 days.

Clinical and Virologic End Points

The primary end point was severe COVID-19 by day 14, defined using a binary, 4-part composite end point: 1 reading <94% SpO 2 on home oximeter/emergency department visit/hospitalization/death due to COVID-19. Secondary end points included hospitalization or death by day 28 and long COVID over the 10-month follow-up. The virologic secondary end point was overall viral load in follow-up, adjusted for baseline viral load as prespecified in the SAP.

Self-collection of anterior nares samples was an optional component of the randomized trial. Supply chain shortages caused administrative censoring of 78 participants who did not receive materials for collecting day 1, day 5, or day 10 samples; 3 did not receive materials for day 5 or day 10 samples ( Supplementary Figure 1, Supplementary Tables 3–6 ).

Laboratory Procedures

Participants received written instructions with pictures on self-collecting from the anterior mid-turbinate, which has excellent concordance with professionally collected nasal swabs [ 13 ]. Viral load was measured via reverse-transcription quantitative polymerase chain reaction using N1 and N2 targets in the SARS-CoV-2 nucleocapsid protein, with relative cycle threshold values converted to absolute copy number via calibration to droplet digital polymerase chain reaction. Detailed methods can be found in Supplementary Table 7 .

While participant self-collection may vary between participants, self-collection of samples is done by the same individual at baseline and follow-up. Thus, participant self-collection may have less variability between baseline and follow-up than when study or clinical staff obtain samples.

Statistical Analyses

We evaluated randomized study drug assignment on the impact of log 10 -transformed viral load on day 5 and day 10 with a linear Tobit regression model where the effect of study drugs was allowed to differ on day 5 and day 10. This was decided a priori as a rigorous analytic approach to account for left censoring due to the viral load limit of quantification. Repeated measures were accounted for using clustered standard errors within participants. Analyses of viral loads estimated the adjusted mean reduction averaged over time and the adjusted mean reduction at day 5 and day 10. We evaluated impact over time on the probability of viral load being undetectable using generalized estimating equations with a logistic link; estimates are reported as adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

The COVID-OUT trial was a 2 × 3 factorial design of parallel distinct treatments ( Supplementary Table 2 ). All analyses were adjusted for baseline viral load, vaccination status, time since last vaccination for those vaccinated before enrollment, receipt of other study medications within factorial trial, laboratory that processed the nasal swabs, and exact time and date of specimen collection. Additional details and the results of the analyses with dropping of adjustment variables are presented in Supplementary Tables 8 and 9 .

To handle missing values, we used multiple imputation with chained equations to multiply impute missing viral load outcomes and vaccination status. Missing covariate information was jointly imputed along with missing outcomes using random forests for the univariate imputation models. Along with outcome and vaccination status information, imputation models were informed by sex, BMI, symptom duration, race/ethnicity, baseline comorbidities, clinical outcomes, and enrollment time categorized by the dominant pandemic variant. Complete case analysis without imputation of missing data is presented in Supplementary Figures 2–4 . Heterogeneity of effect was assessed across a priori subgroups of baseline characteristics. Starting metformin in <4 days of symptom onset is a subgroup that aligns with antiviral trials and reflects real-world use, as metformin is widely available.

Among 1323 randomized participants in the COVID-OUT trial, 999 (76%) chose to participate in the optional substudy and provided at least 1 nasal swab sample ( Table 1 , Supplementary Figure 1 ). The demographics of the participants who submitted swabs were similar to those who did not submit nasal swabs ( Supplementary Tables 3–5 ). Day 1 samples were provided by 945 participants, 871 provided day 5 samples, and 775 provided day 10 samples ( Supplementary Table 6 ). The overall viral load was a median of 4.88 log 10 copies/mL (interquartile range [IQR], 2.99 to 6.18) on day 1, 1.90 (IQR, 0 to 3.93) on day 5, and 0 (IQR, 0 to 1.90 with 0 representing the limit of quantification) on day 10.

Baseline Characteristics of Participants Who Submitted Any Nasal Swab

Characteristic .	Overall n = 999 .	Placebo n = 495 .	Metformin n = 504 .
Age	46 (38–55)	45 (38–54)	46 (38–55)
Biologic sex, female	56% (559)	57% (282)	55% (277)
Race Native American	2.2% (22)	2.6% (13)	1.8% (9)
Asian	3.6% (36)	3.8% (19)	3.4% (17)
Hawaiian, Pacific Islander	0.7% (7)	0.4% (2)	1.0% (5)
Black or African American	6.2% (62)	6.1% (30)	6.3% (32)
White	85% (849)	85% (420)	85% (429)
Other, missing, declined	5.0% (50)	4.4% (22)	5.6% (28)
Ethnicity, Hispanic	12% (118)	13% (63)	11% (55)
Medical history
BMI	30.0 (27.1–34.3)	30.0 (26.9–34.7)	29.8 (27.2–34.0)
BMI ≥30 kg/m	50% (496)	51% (250)	49% (246)
Cardiovascular disease	28% (282)	28% (140)	28% (142)
Diabetes	2.0% (20)	2.6% (13)	1.4% (7)
Vaccination status at baseline
No vaccine	46% (457)	48% (240)	43% (217)
Primary series only	50% (495)	47% (232)	52% (263)
Monovalent booster	4.7% (47)	4.6% (23)	4.8% (24)
Days since last vaccine dose	194 (132–240)	195 (132–235)	192 (132–245)
Time from symptom onset to first dose
Days, mean (± standard deviation)	4.7 (±1.9)	4.7 (±1.8)	4.7 (±1.9)
≤4 days	46% (453)	48% (230)	45% (223)
Severe acute respiratory syndrome coronavirus 2 variant period
Alpha (before 19 June 2021)	13% (132)	13% (65)	13% (67)
Delta (2021 June 19 2021 to 2021 December 12)	65% (645)	65% (320)	64% (325)
Omicron (after 2021 December 12,)	22% (222)	22% (110)	22% (112)
Insurance status
Private	65% (652)	65% (324)	65% (328)
Medicare	7.5% (75)	6.9% (34)	8.1% (41)
Medicaid	14% (136)	14% (69)	13% (67)
No insurance	12% (123)	12% (60)	12% (63)
Unknown	1.3% (13)	1.6% (8)	1.0% (5)

Characteristic .	Overall n = 999 .	Placebo n = 495 .	Metformin n = 504 .
Age	46 (38–55)	45 (38–54)	46 (38–55)
Biologic sex, female	56% (559)	57% (282)	55% (277)
Race Native American	2.2% (22)	2.6% (13)	1.8% (9)
Asian	3.6% (36)	3.8% (19)	3.4% (17)
Hawaiian, Pacific Islander	0.7% (7)	0.4% (2)	1.0% (5)
Black or African American	6.2% (62)	6.1% (30)	6.3% (32)
White	85% (849)	85% (420)	85% (429)
Other, missing, declined	5.0% (50)	4.4% (22)	5.6% (28)
Ethnicity, Hispanic	12% (118)	13% (63)	11% (55)
Medical history
BMI	30.0 (27.1–34.3)	30.0 (26.9–34.7)	29.8 (27.2–34.0)
BMI ≥30 kg/m	50% (496)	51% (250)	49% (246)
Cardiovascular disease	28% (282)	28% (140)	28% (142)
Diabetes	2.0% (20)	2.6% (13)	1.4% (7)
Vaccination status at baseline
No vaccine	46% (457)	48% (240)	43% (217)
Primary series only	50% (495)	47% (232)	52% (263)
Monovalent booster	4.7% (47)	4.6% (23)	4.8% (24)
Days since last vaccine dose	194 (132–240)	195 (132–235)	192 (132–245)
Time from symptom onset to first dose
Days, mean (± standard deviation)	4.7 (±1.9)	4.7 (±1.8)	4.7 (±1.9)
≤4 days	46% (453)	48% (230)	45% (223)
Severe acute respiratory syndrome coronavirus 2 variant period
Alpha (before 19 June 2021)	13% (132)	13% (65)	13% (67)
Delta (2021 June 19 2021 to 2021 December 12)	65% (645)	65% (320)	64% (325)
Omicron (after 2021 December 12,)	22% (222)	22% (110)	22% (112)
Insurance status
Private	65% (652)	65% (324)	65% (328)
Medicare	7.5% (75)	6.9% (34)	8.1% (41)
Medicaid	14% (136)	14% (69)	13% (67)
No insurance	12% (123)	12% (60)	12% (63)
Unknown	1.3% (13)	1.6% (8)	1.0% (5)

Values are percent (n) or median (interquartile range) unless specified. Cardiovascular disease defined as hypertension, hyperlipidemia, coronary artery disease, past myocardial infarction, congestive heart failure, pacemaker, arrhythmias, or pulmonary hypertension.

Abbreviation: BMI, body mass index.

a Unknown n = 22.

The overall mean SARS-CoV-2 viral load reduction with metformin was −0.56 log 10 copies/mL (95% CI, −1.05 to −0.06) greater than placebo across all follow-up ( P = .027). The antiviral effect of metformin compared with placebo was −0.47 log 10 copies/mL (95% CI, −0.93 to −0.014) on day 5 and −0.64 log 10 copies/mL (95% CI, −1.42 to 0.13) on day 10 ( Figure 1 ). Neither ivermectin nor fluvoxamine had virologic effect ( Figure 2 , Supplementary Figure 2 , Supplementary Tables 8–10 ).

Effect of metformin versus placebo on viral load over time, detectable viral load, and rebound viral load. A , Adjusted mean change in log10 copies per milliliter (viral load) from baseline (day 1) to day 5 and day 10 for metformin (lower line) and placebo (upper line). Mean change estimates are based on the adjusted, multiply imputed Tobit analysis (the primary analytic approach) that corresponds to the overall metformin analysis presented in Figure 2 . B , Adjusted percent of viral load samples that were detectable at day 1, day 5, and day 10. The percent viral load detected estimates were based on the adjusted, multiply imputed logistic generalized estimating equations (GEE) analysis corresponding to the overall metformin analysis depicted in Figure 3 . Odds ratios correspond to adjusted effects on the odds ratio scale. C , Bar chart depicting the percent of participants whose day 10 viral load was greater than the day 5 viral load and the odds ratio for having viral load rebound using the multiply imputed logistic GEE. Abbreviation: CI, confidence interval.

Overall results for metformin, ivermectin, and fluvoxamine on viral load; heterogeneity of treatment effect of metformin versus placebo. This is a forest plot that depicts the effect of active medication compared with control on log10 copies per milliliter (viral load), overall, and at day 5 and day 10. Viral Effect* denotes the adjusted mean change in viral load in log10 copies per milliliter with 95% confidence intervals for the adjusted mean change. Analyses were conducted using the primary analytic approach, a multiply imputed Tobit model. The vertical dashed line indicates the value for a null effect. The top 3 rows show ivermectin, the next 3 rows show fluvoxamine, and the following 3 rows show metformin. Below these, the effect of metformin compared with placebo is shown by a priori subgroups of baseline characteristics. Abbreviation: CI, confidence interval.

When the adjustment covariates were dropped one at a time—baseline viral load, vaccination status, time since last vaccination, other study medications within the factorial trial, and the laboratory processing the nasal swabs—in addition to dropping all adjustment covariates, the results were similar. The range in the estimated average effect was −0.51 log 10 copies/mL (95% CI, −1.04 to 0.01; P = .056) to −0.66 log 10 copies/mL (95% CI, −1.215 to −0.097; P = .021) with the latter arising from the unadjusted model ( Supplementary Table 9 ).

Those in the metformin group were less likely to have a detectable viral load than those in the placebo group (OR, 0.72; 95% CI, .55 to .94; Figure 1) . This effect was higher at day 10 (OR, 0.65; 95% CI, .43 to .98) when 1500 mg/d of metformin was being prescribed than at day 5 (OR, 0.79; 95% CI, .60 to 1.05) when 1000 mg/d was prescribed. Viral rebound was defined as having a higher viral load at day 10 than day 5. In the placebo group, 5.95% (22 of 370) of participants had viral rebound compared with 3.28% (12 of 366) in the metformin group (adjusted OR, .68; 95% CI, .36 to 1.29) for metformin compared with placebo ( Figure 1) .

Metformin's effect on continuous viral load and conversion to undetectable viral load was consistent across a priori identified subgroups of baseline characteristics ( Figures 2 and 3 ). Subgroups should be interpreted with caution because of low power, risk of making multiple comparisons without correction, and sparse data bias. One subgroup warrants additional detail for interpretation. The antiviral effect on geometric log 10 scale was greater among those with baseline viral loads <100 000 copies/mL (mean −1.17 log 10 copies/mL reduction) than among those with >100 000 copies/mL (mean −0.49 log 10 copies/mL reduction); although the reduction in absolute copies per milliliter would be greater among those with higher viral loads ( Figures 2 and 3 ). Mean, median viral load levels are presented in Supplementary Table 11 ; sensitivity analyses are presented in Supplementary Figures 5–7 and Supplementary Table 12 .

Overall results for metformin, ivermectin, and fluvoxamine on detectability of viral load; heterogeneity of treatment effect of metformin versus placebo. This is a forest plot that depicts the effect of active medication compared with control on the proportion of participants with a detectable viral load, overall and at days 5 and 10. Estimate* denotes the adjusted mean risk difference in the percent of samples with detected viral load with 95% confidence intervals for the adjusted risk difference. The vertical dashed line indicates the value for a null effect. The estimated risk differences are derived from the adjusted, multiply imputed logistic generalized estimating equations (GEE) analytic approach. The top 3 rows show ivermectin, the next 3 rows show fluvoxamine, and the following 3 rows show metformin. Below these, the effect of metformin compared with placebo is shown by a priori subgroups of baseline characteristics. Abbreviation: CI, confidence interval.

In the virologic end point of the COVID-OUT phase 3, randomized trial, metformin significantly reduced SARS-CoV-2 viral load over 10 days [ 1 ]. The mean reduction was −0.56 log 10 copies/mL greater than placebo. The antiviral response is consistent with the statistically significant and clinically relevant effects of metformin in preventing clinical outcomes: severe COVID-19 (emergency department visit, hospitalization, or death) through day 14, hospitalization or death by day 28, and the diagnosis of long COVID [ 1 , 12 ]. The magnitude of effect on clinical outcomes was larger when metformin was started earlier in the course of infection at <4 days from symptom onset, with metformin reducing the odds of severe COVID-19 by 55% (OR, 0.45; 95% CI, .22 to .93) and of long COVID by 65% (hazard ratio = 0.35; 95% CI, .15 to .95; Figure 4) . An improved effect size for clinical outcomes when therapies are started earlier in the course of infection is consistent with an antiviral action [ 14 ].

Overview of results from the COVID-OUT trial. This is a forest plot that combines the severe, acute coronavirus disease 2019 outcome as well as the long-term follow-up outcome from the COVID-OUT trial [ 1 , 12 ]. Two a priori subgroups from the COVID-OUT trial are also presented: pregnant individuals and those who started the study drug within 4 days of symptom onset, to match the primary analytic sample of other antivirals. Abbreviations: COVID-19, coronavirus disease 2019; ITT, intention to treat; mITT, modified intention to treat; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

The objective of the COVID-OUT trial was to determine whether metformin prevented severe COVID-19. Severe COVID-19 was defined with a binary, 4-part composite outcome (<94% SpO 2 on a home oximeter/emergency department visit/hospitalization/death) at a time when the implications of “silent hypoxia” were unknown and fears of overwhelmed emergency services caused concern that deaths would occur at home before patients reached the emergency department. As a scientific community, we now understand that 1 reading below 94% is not severe COVID-19. An accurate definition of severe COVID-19 (emergency department visit/hospitalization/death) was ascertained within the same data-generation process. In such situations, recommendations are sometimes made based on the totality of evidence from a single randomized trial [ 15–17 ].

The antiviral effect in this phase 3, randomized trial is also consistent with emerging data from other trials. In a phase 2, randomized trial with 20 participants, the metformin group had better clinical outcomes, achieved an undetectable viral load 2.3 days faster than placebo ( P = .03), and had a larger proportion of patients with an undetectable viral load at 3.3 days in the metformin group ( P = .04) [ 18 ]. A recent in vitro study showed that metformin decreased infectious SARS-CoV-2 titers and viral RNA in 2 cell lines, Caco2 and Calu3, at a clinically appropriate concentration [ 19 ].

Conversely, an abandoned randomized trial testing extended-release metformin 1500 mg/d without a dose titration did not report improved SARS-CoV-2 viral clearance at day 7 [ 20 ]. Several differences between the Together Trial and the COVID-OUT trial are important for understanding the data. First, the Together Trial allowed individuals already taking metformin to enroll and be randomized to placebo or more metformin [ 20 , 21 ]. To compare starting metformin versus placebo, the authors excluded those already taking metformin at baseline and reported that emergency department visit or hospitalization occurred in 9.2% (17 of 185) randomized to metformin compared with 14.8% (27 of 183) randomized to placebo (relative risk, 0.63; 95% confidence interval, .35 to 1.10, Probability of superiority = 0.949) [ 22 ]. Thus, the Together Trial results for starting metformin versus placebo are similar. Second, 1500 mg/day without escalating the dose over 6 days would cause side effects, especially if the study participant was already taking metformin [ 23 ]. Third, extended-release and immediate-release metformin have different pharmacokinetic properties. Immediate-release metformin has higher systemic exposure than extended-release metformin, which may improve antiviral actions, but this is not known [ 24 , 25 ]. Given the similar clinical outcomes between immediate and extended-release, a direct comparison of the 2 may be important for understanding pharmacokinetics against SARS-CoV-2.

In comparison with other SARS-CoV-2 antivirals, when considering all enrolled participants, at day 5, the antiviral effect over placebo was 0.47 log 10 copies/mL for metformin, 0.30 log 10 copies/mL for molnupiravir, and 0.80 log 10 copies/mL for nirmatrelvir/ritonavir [ 26 , 27 ]. At day 10, the viral load reduction over blinded placebo was 0.64 log 10 copies/mL for metformin, 0.35 log 10 copies/mL for nirmatrelvir, and 0.19 log 10 copies/mL for molnupiravir [ 26 , 27 ]. We note that the 3 trials enrolled different populations and at different times and locations during the pandemic. In the COVID-OUT metformin trial, half were vaccinated [ 1 , 12 ].

The magnitude of metformin's antiviral effect was larger at day 10 than at day 5 overall and across subgroups, which correlates with the dose titration from 1000 mg on days 2–5 to 1500 mg on days 6–14. The dose titration to 1500 mg over 6 days used in the COVID-OUT trial was faster than typical use. When used chronically, that is, for diabetes, prediabetes, or weight loss, metformin is slowly titrated to 2000 mg daily over 4–8 weeks. While metformin's effect on diabetes control is not consistently dose-dependent, metformin's gastrointestinal side effects are known to be dose-dependent [ 25 ]. Thus, despite what appears to be dose-dependent antiviral effects, a faster dose titration should likely only be considered in individuals with no gastrointestinal side effects from metformin.

When assessing for heterogeneity of effect, metformin was consistent across subgroups. Metformin's antiviral effect in vaccinated versus unvaccinated of −0.48 versus −0.86 log 10 copies/mL at day 10 mirrors nirmatrelvir, for which the effect in seropositive participants was smaller than in the overall trial population, −0.13 versus −0.35 log 10 copies/mL at day 10 [ 26 ]. Effective primed memory B- and T-cell anamnestic immunity prompting effective response by day 5 in vaccinated persons may account for this trend in both trials. Subgroups should be interpreted with caution because of low power and multiple comparisons [ 28 ].

Both nirmatrelvir and molnupiravir are pathogen-directed antiviral agents. Therapeutics may have an important role in targeting host factors rather than viral factors, as targeting the host may be less likely to induce drug-resistant viral variants through mutation–selection [ 11 , 29 ]. We did not study the mechanism for the antiviral activity or an antiinflammatory action in this trial. Previous work has shown that metformin's inhibition of mTOR complex 1 may depend on AMP-activated protein kinase (AMPK) at low doses but not high doses [ 5 ]. An AMPK-independent inhibition of mTOR may be more efficient. Additionally, metformin demonstrates a dose-dependent ability to inhibit interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha in the presence of lipopolysaccharide, inflammatory products that correlate with COVID-19 severity [ 30 , 31 ].

In addition to antiviral activity, metformin appears to have relevant antiinflammatory actions. In mice without diabetes, metformin inhibited mitochondrial ATP and DNA synthesis to evade NLRP3 inflammasome activation [ 32 ]. In macrophages of mice without diabetes infected with SARS-CoV-2, metformin inhibited inflammasome activation, IL-1 production, and IL-6 secretion and also increased the IL-10 antiinflammatory response to lipopolysaccharide, thereby attenuating lipopolysaccharide-induced lung injury [ 32 ]. In a recent assay of human lung epithelial cell lines, metformin inhibited the cleavage of caspase-1 by NSP6, inhibiting the maturation and release of IL-1, a key factor that mediates inflammatory responses [ 7 ]. The idea of pleiotropic effects is being embraced in novel therapeutics being developed for both antiviral and anti-inflammatory actions [ 33 ].

Strengths of our study include the large sample size and detailed participant information collected, including the exact time and date of specimen collection. One limitation was the sampling time frame of only day 1, day 5, and day 10 due to limited resources. By day 10 post-randomization, 77% of participants in the placebo group and 86% in the metformin group had an undetectable viral load. As viral load is lower in vaccinated persons [ 34 ], this degree of undetectable viral loads differs from findings from earlier clinical trials conducted in unvaccinated participants without known prior infection [ 26 , 27 ]. Sampling earlier and more frequently, that is, day 1, day 3, day 6, and day 9 in future trials, may better characterize differences in viral shedding earlier in the infection and over time, dependent on the duration of therapy and timing of enrollment.

Future work could assess whether synergy exists between metformin and direct SARS-CoV-2 antivirals, as previous work showed that metformin improved sustained virologic clearance of hepatitis C virus and improved outcomes in other respiratory infections [ 35–37 ]. The biophysical modeling that motivated this trial predicts additive/cooperative effects in combination with transcription inhibitors. Combination therapy might decrease selective pressure, and metformin has few medication interactions, so treatment with metformin could continue beyond 5 days while home medications are restarted. Additionally, continuing metformin could reduce symptom rebound, given its effects on T-cell immunity [ 38 , 39 ]. Further data are needed to understand whether decreased viral load and faster viral clearance decrease onward transmission of SARS-CoV-2.

Metformin is safe in children and pregnant individuals with and without preexisting diabetes [ 40–42 ]. Individuals with or without diabetes do not need to check blood sugar when taking metformin. Historical concerns about lactic acidosis were driven by other biguanides; metformin does not increase risk of lactic acidosis [ 43 ]. Metformin improves outcomes in patients with heart, liver, and kidney failure, as well as during hospitalizations and perioperatively [ 44–48 ].

In a large randomized, controlled trial conducted in nonhospitalized, standard-risk adults, metformin reduced the incidence of severe COVID-19 by day 14, of hospitalizations by day 28, and of long COVID diagnosis by day 300. In this virologic analysis, we found a corresponding significant reduction in viral load with metformin compared with placebo and a lower likelihood of viral load rebound. While 22% of participants in the trial were enrolled during the Omicron era, metformin has not been assessed in individuals with a history of prior infection and thus should be trialed in the current state of the pandemic. Metformin is currently being trialed in low-risk adults [ 49 ].

Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author.

Disclaimer. The funders had no influence on the design or conduct of the trial and were not involved in data collection or analysis, writing of the manuscript, or decision to submit for publication. The authors assume responsibility for trial fidelity and the accuracy and completeness of the data and analyses.

Financial support . The fluvoxamine placebo tablets were donated by the Apotex Pharmacy. The ivermectin placebo and active tablets were donated by the Edenbridge Pharmacy. The trial was funded by the Parsemus Foundation, Rainwater Charitable Foundation, Fast Grants, and the UnitedHealth Group Foundation. C. T. B. was supported by grants (KL2TR002492 and UL1TR002494) from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) and by a grant (K23 DK124654) from the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH. J. B. B. was supported by a grant (UL1TR002489) from NCATS. J. M. N. was supported by a grant (K23HL133604) from the National Heart, Lung, and Blood Institute (NHLBI) of the NIH. D. J. O. was supported by the Institute for Engineering in Medicine, University of Minnesota Office of Academic and Clinical Affairs COVID-19 Rapid Response Grant, the Earl E. Bakken Professorship for Engineering in Medicine, and by grants (U54 CA210190 and P01 CA254849) from the National Cancer Institute of the NIH. D. M. L. receives funding from NIH RECOVER (OT2HL161847). L. K. S. was supported by NIH grants (18X107CF6 and 18X107CF5) through a contract with Leidos Biomedical and by grants from the HLBI of the NIH (T32HL129956) and the NIH (R01LM012982 and R21LM012744). M. A. P. receives grants from the Bill and Melinda Gates Foundation (INV-017069), Minnesota Partnership for Biotechnology and Medical Genomics (00086722) and NHLBI (OT2HL156812).

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Author notes

coronavirus
antiviral agents
outpatients
viral load result
severe acute respiratory syndrome
post-acute covid-19 syndrome

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DOI: 10.1111/coep.12670
Corpus ID: 272103107

The effect of expansion of nurse practitioner scope of practice on early COVID‐19 deaths

Bobby W. Chung , Noah J. Trudeau
Published in Contemporary economic policy 24 August 2024

35 References

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Pregnancy and COVID-19: What are the risks?

You may wonder how coronavirus disease 2019 (COVID-19) could affect your risk of illness, birth plan or time bonding with your baby. You also might have questions about the safety of the COVID-19 vaccines. Here's what you need to know.

COVID-19 risks during pregnancy

Pregnant people seem to catch the virus that causes COVID-19 at about the same rate as people who aren't pregnant. Also, pregnant people usually get better without needing care in the hospital. But pregnancy is a factor that raises the risk of severe COVID-19. That risk stays higher for at least a month after giving birth.

And the risk continues to go up if a pregnant person has other health issues linked to severe COVID-19. Examples of these health issues are obesity, diabetes, high blood pressure or lung disease.

Being very sick with COVID-19 means that a person's lungs don't work as well as they should. Severe or critical COVID-19 is treated in the hospital with oxygen and other medical help to treat damage throughout the body. Severe COVID-19 can lead to death.

Pregnant people with severe COVID-19 also may be more likely to develop other health problems as a result of COVID-19. They include heart damage, blood clots and kidney damage. Moderate to severe symptoms from COVID-19 have also been linked to higher rates of preterm birth, high blood pressure or preeclampsia.

These risks may shift as the virus that causes COVID-19 changes. Risks also may change as disease prevention and treatment evolve. But risks are lowered significantly when a pregnant person gets the COVID-19 vaccine.

Preventing COVID-19 during pregnancy and breastfeeding

The Centers for Disease Control and Prevention recommends getting a 2023-2024 COVID-19 vaccine if:

You are planning or trying to get pregnant.
You are pregnant now.
You are breastfeeding.

Staying up to date on your COVID-19 vaccine helps prevent severe COVID-19 illness. It also may help a newborn avoid getting COVID-19 if you are vaccinated during pregnancy.

People at higher risk of serious illness can talk to a healthcare professional about additional COVID-19 vaccines or other precautions. It also can help to ask about what to do if you get sick so you can quickly start treatment.

While you’re pregnant, it’s important for you and those in your household to:

Test for COVID-19. If you have COVID-19 symptoms, test for the infection. If you are exposed, test five days after you came in contact with the virus. In the United States, the Food and Drug Administration, also known as the FDA, approves or authorizes the tests. On the FDA website, you can find a list of the tests that are validated and their expiration dates. You also can check with your healthcare professional before buying a test if you have any concerns.
Keep some distance. Avoid close contact with anyone who is sick or has symptoms, if possible.
Wash your hands. Wash your hands well and often with soap and water for at least 20 seconds. Or use an alcohol-based hand sanitizer with at least 60% alcohol.
Cover your coughs and sneezes. Cough or sneeze into a tissue or your elbow. Then wash your hands.
Clean and disinfect high-touch surfaces. For example, clean doorknobs, light switches, electronics and counters regularly.

Try to spread out in crowded public areas, especially in places with poor airflow. This is important if you have a higher risk of serious illness.

The CDC recommends that people wear a mask in indoor public spaces if you're in an area with a high number of people with COVID-19 in the hospital. They suggest wearing the most protective mask possible that you'll wear regularly, that fits well and is comfortable.

COVID-19 and prenatal care

Unlike earlier in the pandemic, in-person prenatal visits typically are not disrupted by COVID-19.

If you test positive for COVID-19, your healthcare professional will want to discuss your options with you. That might mean a virtual or in-person appointment to figure out how to best keep track of your health. It may help to know that in most cases, the COVID-19 infection doesn't spread to the unborn baby.

If you test positive for COVID-19 and have symptoms, your healthcare team will monitor you closely. A healthcare professional may ask about your symptoms, review your other medical conditions and determine your risk of serious illness. You may be offered medicine to block the infection from getting worse. Treatment with these medicines may be a pill that you swallow, or a liquid given through a needle into a vein.

You also may be asked to use a device to monitor your oxygen level, called a pulse oximeter.

After the infection, your healthcare professional may plan on extra imaging tests to make sure the unborn baby is growing as expected.

COVID-19 and giving birth

If you test positive for COVID-19 close to when you give birth, you may not need to change your birth plan.

But it's also possible that your healthcare professional will suggest a change in timing or delivery options for your safety. People who also are managing high blood pressure linked to pregnancy or preeclampsia are more likely to be monitored in the hospital if they get COVID-19.

After the baby is born, research suggests it's safe for your baby to stay with you even if you have COVID-19. If you are too ill to care for your baby, your healthcare professional may suggest the baby stay in another hospital area.

To limit your baby's exposure to the virus, wear a well-fitting face mask and have clean hands when caring for your newborn. Stay a reasonable distance from your baby when not feeding, if possible.

Breastfeeding and COVID-19

If you have COVID-19 but feel well enough, there is no need to stop breastfeeding or stay separate from your baby. To avoid spreading the infection, wash your hands before breastfeeding. Also, wear a well-fitting face mask whenever you are in close contact with your baby.

If you're pumping breast milk, wash your hands before touching any pump or bottle parts and follow instructions for pump cleaning. If you need care in the hospital, you may be able to keep pumping.

COVID-19 concerns after giving birth

Staying healthy can be a big concern for new parents. Worry about COVID-19 illness for yourself or your newborn may be an added burden. But it is typical for newborns to get their first illness during their first year of life. In fact, your baby may have mild illness regularly during this first year as the baby comes in contact with the world.

If you find that worry over COVID-19 or other illness is affecting your or your baby's health, talk to your healthcare professional.

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Berghella V, et al. COVID-19: Overview of pregnancy issues. https://www.uptodate.com/contents/search. Accessed March 18, 2024.
COVID-19: People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed March 18, 2024.
Goldman L, et al., eds. COVID-19: Epidemiology, clinical manifestations, diagnosis, community prevention, and prognosis. In: Goldman-Cecil Medicine. 27th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed March 20, 2024.
Smith, ER. Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: A sequential, prospective meta-analysis. American Journal of Obstetrics and Gynecology. 2023; doi:10.1016/j.ajog.2022.08.038.
COVID-19 vaccines while pregnant or breastfeeding. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html. Accessed March 18, 2024.
Barros, FC. Maternal vaccination against COVID-19 and neonatal outcomes during omicron: INTERCOVID-2022 study. American Journal of Obstetrics and Gynecology. 2024; doi: 10.1016/j.ajog.2024.02.008.
Interim clinical considerations for use of COVID-19 vaccines in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. Accessed March 20, 2024.
How to protect yourself and others. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed March 20, 2024.
COVID-19 overview and infection prevention and control priorities in non-U.S. healthcare settings. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/overview/index.html. Accessed March 20, 2024.
Use and care of masks. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html. Accessed March 20, 2024.
Hughes BL, et al. COVID-19: Antepartum care of pregnant patients with symptomatic infection. https://www.uptodate.com/contents/search. Accessed March 18, 2024.
AskMayoExpert. COVID-19: Pregnancy. Mayo Clinic; 2024.
CDER scientific review documents supporting emergency use authorizations for drug and biological therapeutic products, COVID-19. U.S. Food and Drug Administration. https://www.fda.gov/drugs/coronavirus-covid-19-drugs/cder-scientific-review-documents-supporting-emergency-use-authorizations-drug-and-biological. Accessed March 18, 2024.
AskMayoExpert. COVID-19: Drug regimens and other treatment options. Mayo Clinic; 2023.
COVID-19 testing: What you need to know. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html. Accessed March 18, 2024.
At-home OTC COVID-19 diagnostic tests. U.S. Food and Drug Administration. https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/home-otc-covid-19-diagnostic-tests. Accessed March 20, 2024.
COVID-19, Pregnancy, childbirth, and breastfeeding: Answers from Ob-Gyns. The American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/coronavirus-covid-19-pregnancy-and-breastfeeding. Accessed March 19, 2024.
Cook WJ, et al., eds. Mayo Clinic Guide to Your Baby's First Years: Newborn to Age 3. Mayo Clinic Press; 2020.
COVID data tracker. Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#datatracker-home. Accessed March 26, 2024.

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New Study Provides Insight on Health Effects for Troops Who Got Myocarditis After the COVID Vaccine

COVID-19 vaccine shots at Dover Air Force Base

New research has found that patients who developed inflammation of the heart, or myocarditis, after receiving an mRNA vaccine for COVID-19 had fewer complications in the 18 months after hospitalization than those who developed it from contracting COVID-19 or some other cause.

The population study, conducted in France and published online Monday in JAMA , found that hospital readmission rates, diagnoses of other heart-related conditions, or instances of death were significantly lower in the group that received the vaccine.

The long-term effects of COVID-19 and COVID-19 vaccines are a concern for the U.S. military, which saw nearly 500,000 cases of the coronavirus in the first two years of the pandemic and required all members to get the vaccine .

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The study findings were the same regardless of age, according to the research, although the authors noted that post-vaccine myocarditis patients, who were mainly healthy young men, "may require medical management up to several months after hospital discharge."

"Although patients with myocarditis after COVID-19 mRNA vaccination appear to have a good prognosis near hospital discharge, their longer-term prognosis and management remain unknown," wrote the researchers, led by Laura Semenzato, a statistician with EPI-PHARE Scientific Interest Group.

The Defense Department vaccinated more than 2 million service members from December 2020, when the U.S. Food and Drug Administration issued an emergency use authorization for the Pfizer and Moderna COVID-19 vaccines, through December 2022, according to the Pentagon.

The vaccines used a novel mRNA technology to stimulate the body's immune response to the illness, using messenger RNA to instruct cells to make pieces of the virus' spike protein to trigger an immune response.

As early as February 2021, the U.S. military began seeing patients who developed myocarditis after receiving their COVID-19 vaccine series.

Military.com began tracking the cases shortly after a civilian member of the Pentagon press corps and a Military.com reporter who serves in the National Guard developed the condition, although the Pentagon did not confirm it had additional cases until April.

In a report to Congress last September on troop health following the Defense Department's COVID-19 vaccine mandate, which went into effect in August 2021, a Pentagon official said 25 service members developed myocarditis in early 2021 but did not give a total number of cases for the force over the years.

The report said the rate for service members developing myocarditis was 57 cases per 100,000 "person years," which measures the number of people across the observation time, versus 98 cases per 100,000 person years among those who contracted COVID-19 in 2021.

The Department of Veterans Affairs , which could be asked to provide disability compensation for veterans who have long-term health effects from COVID-19 contracted on active duty or from the vaccine, has 11 ongoing studies on long-term coronavirus.

"The VA research program remains tightly focused on understanding the long-term impacts

of COVID-19," wrote VA Under Secretary for Health Dr. Shereef Elnahal in an article in Federal Practitioner last November. "At the same time, the VA is committed to using lessons learned during the crisis in addressing high priorities in veterans' health care."

Dr. Harlan Krumholz, a cardiologist at Yale School of Medicine who was not involved in the French study, said the latest research provides reassurance to patients and doctors about the possible long-term effects on the heart and body of post-vaccine myocarditis.

But, he noted, while the study focuses on the outcomes at 18 months after hospitalization -- what Krumholz described as "meaningful follow-up," it does not provide insight into longer-term outcomes.

"In general, myocarditis at a young age can potentially lead to chronic heart issues like arrhythmias or heart failure in some patients, though many recover fully. Ongoing monitoring is important," Krumholz wrote in an email Tuesday to Military.com.

For the study, researchers examined 4,635 patients ages 12 to 49 who were hospitalized for myocarditis in France from Dec. 27, 2020, to June 30, 2022.

Of those, 12% developed post-vaccine myocarditis within seven days of getting the immunization while 6% developed post COVID-19 myocarditis and 82% had a conventional form of the condition.

While the number of patients who developed myocarditis after contracting the illness was smaller than the vaccine group, they were hospitalized and had rates of complications or death similar to those who developed regular myocarditis.

The study noted, however, that one patient with post-vaccine myocarditis required extensive medical interventions and died after leaving the hospital, with myocarditis likely the cause of death.

"While outcomes were generally favorable, some patients required ongoing medical management for several months after discharge. Also, 3% of those who had post-vaccine myocarditis were rehospitalized ... over the subsequent 18 months," noted Krumholz after reviewing the study.

Myocarditis can result from a viral infection or an overactive immune response to an illness. The reason why some people, especially young men, develop myocarditis after getting a COVID-19 mRNA vaccine is not well understood. Krumholz said it likely involves an "exaggerated immune response," occurring in roughly 1 to 10 of every 100,000 vaccinated individuals.

The JAMA study has its limitations, as researchers were able to look only at hospitalizations for myocarditis and not all potential cases during the time frame. They also did not include details on the severity of cases and based their research on medical diagnoses, relying on the accuracy of medical providers.

The researchers noted that the American Heart Association and the American College of Cardiology guidelines advise patients with myocarditis to refrain from competitive sports for 3 to 6 months and to have their health condition assessed prior to the resumption of sports.

They also said that, while several studies have reported "reassuring results" for the prognosis of post-vaccine myocarditis, patients with the low likelihood of poor outcomes, residual symptoms and cardiac abnormalities have been detected up to a year after illness.

The study, the researchers said, should be "taken into account for ongoing and future mRNA vaccine recommendations."

"Overall, this study provides important data on medium-term outcomes, but continued research on longer-term prognosis is still needed," Krumholz added.

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The Impact of COVID-19 Pandemic on Family Well-Being: A Literature Review

Maria gayatri.

1 Directorate for Development of Service Quality of Family Planning, National Population and Family Planning Board (BKKBN), Jakarta, Indonesia

Mardiana Dwi Puspitasari

2 Research Center for Population, National Research and Innovation Agency (BRIN), Jakarta, Indonesia

Background: COVID-19 has changed family life, including employment status, financial security, the mental health of individual family members, children's education, family well-being, and family resilience. The aim of this study is to analyze the previous studies in relation to family well-being during the COVID-19 pandemic. Methods: A literature review was conducted on PubMed, Medline, Web of Science, and Scopus for studies using a cross-sectional or quasi-experimental design published from their inception to October 15, 2020, using the keywords “COVID-19,” “pandemic,” “coronavirus,” “family,” “welfare,” “well-being,” and “resilience.” A manual search on Google Scholar was used to find relevant articles based on the eligibility criteria in this study. The presented conceptual framework is based on the family stress model to link the inherent pandemic hardships and the family well-being. Results: The results show that family income loss/economic difficulties, job loss, worsening mental health, and illness were reported in some families during the COVID-19 pandemic. Family life has been influenced since the early stage of the pandemic by the implementation of physical distancing, quarantine, and staying at home to curb the spread of coronavirus. During the pandemic, it is important to maintain family well-being by staying connected with communication, managing conflict, and making quality time within family. Conclusion: The government should take action to mitigate the social, economic, and health impacts of the pandemic on families, especially those who are vulnerable to losing household income. Promoting family resilience through shared beliefs and close relationships within families is needed during the COVID-19 pandemic.

Introduction

Coronavirus disease 2019 (COVID-19) is a form of pneumonia caused by the severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2) ( Lai et al., 2020 ). The appearance of COVID-19 becomes an outbreak in December 2019 in China. The coronavirus disease can be transmitted through the respiratory tract, digestive system, and also mucosal surface ( Ye et al., 2020 ). Fever, cough, shortness of breath, and diarrhea are the symptoms of COVID-19 infection at the onset. The pandemic of COVID-19 has brought many changes to all the communities, workers, and families to reduce the spread of the coronavirus and limit its impact on health, societal, and economic consequences. This pandemic had a powerful impact on family life. Mental resilience is required for coping strategies during the pandemic ( Barzilay et al., 2020 ).

COVID-19 has changed family life, including employment, financial instability, the mental health of family members, children's education, family well-being, and family resilience. People start to protect themselves from the spread of the coronavirus by physical and social distancing, sheltering-in-place, restricting travel, and implementing health protocols. Some public places are abrupt closures, such as schools, childcare centers, community programs, religious places, and workplaces. This change impacts social life, such as isolation, psychological distress, substantial economic distress, depression, and also domestic violence, including child abuse ( Campbell, 2020 ; Patrick et al., 2020 ). The Internet has become the most important thing to support all activities while staying at home and staying connected with others.

Families are forced to maintain a work–life balance in the same place with all family members during the pandemic ( Fisher et al., 2020 ). Parents are working from home while children are in school. Therefore, parents and children should share the space for their activities at home. On the one hand, parents should focus on their job to maintain their working target in order to avoid losing their job, heighten their financial concerns, sustain their food security, maintain healthy habits, and keep their family members safe from COVID-19. Balancing life during the pandemic is challenging ( Fisher et al., 2020 ). Fathers and mothers should work together not only on the paid job but also on domestic chores, childcare, and teaching their children.

The aim of this literature review is to identify the impact of the COVID-19 pandemic on family well-being based on the previously published articles.

Literature Review

The coronavirus pandemic has become a public health crisis or disaster that has had an impact on family well-being both directly and indirectly. An infectious disease outbreak has spread rapidly, severely disrupted the world, and resulted in morbidity and mortality. This pandemic produced not only a health crisis, but also a social crisis among the population ( Murthy, 2020 ).

The conceptual framework was adapted from McCubbin and Patterson's family stress model. Using McCubbin and Patterson's family stress model, stressful life events (external stressors) had an impact on family life. During the COVID-19 pandemic, there was a profound impact on Indonesian economic growth and labor market, indicating that more people were living in poverty ( Gandasari & Dwidienawati, 2020 ; Olivia et al., 2020 ; Suryahadi et al., 2020 ). Stress-frustration theory indicates that diminished economic resources in the family could add to stress, frustration, and conflict in interpersonal interactions, which might increase the risk of men committing violence against women ( Kaukinen, 2020 ). It means that unemployment and economic instability contributed to the family stress. Furthermore, the underlying pandemic difficulties posed a threat to Indonesian people's mental health ( Abdullah, 2020 ; Megatsari et al., 2020 ). A higher risk of stress could lead to domestic violence. Domestic violence was defined as a coping mechanism for stress induced by social-systemic variables, such as poverty, unemployment, homelessness, loneliness, and ecological characteristics ( Zhang, 2020 ). Individual stress and other factors (such as job loss, lower income, limited resources and support, and hazardous and harmful alcohol use) were associated with domestic violence during the COVID-19 pandemic ( Campbell, 2020 ). Indonesian children were also affected. A recent study found that the financial burden within the family constituted a risk to Indonesian child competency and adjustment ( Riany & Morawska, 2021 ). The well-being of children might be dependent on the well-being of their parents ( Dahl et al., 2014 ). As a result, the inherent pandemic hardships posed a risk to family well-being.

According to the family stress model, the family must engage in an active process to balance external stressors with personal and family resources and a positive outlook on COVID-19 in order to develop and sustain an adaptive coping strategy to face the inherent pandemic hardships and eventually reach a level of family well-being. Mental health and prevention from the risk of mental disorders were required by incorporating individuals, families, communities, and government during and after pandemic events, so that family well-being and resilience could be achieved and improved ( Murthy, 2020 ). Resilience was characterized as a process that encompassed not just successfully adapting and functioning after experiencing adversity or crisis, but also the possibility of personal and relationship transformation and positive growth as a result of adversity ( Walsh, 1996 ). There were three fundamental processes to becoming resilient: shared belief systems, organizational patterns, and communication processes within the family ( Walsh, 1996 ).

A literature review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines ( Moher et al., 2009 ). This study was conducted from the beginning of March 2020, when the first positive case occurred in Indonesia, to October 1, 2020.

In order to meet the research objective, the authors carried out the literature review by searching various databases. The present study uses an integrative review to summarize the existing evidence to obtain a comprehensive understanding of the impact of the COVID-19 pandemic on family welfare. PubMed, Medline, Web of Science, and Scopus are selected as the main sources of the article's database. A manual search on Google Scholar is also conducted to find relevant articles based on the study’s eligibility criteria. The following keywords are used to perform the search, such as “COVID-19,” “pandemic,” “coronavirus,” “family,” “welfare,” “resilience,” and “mental health.” A total of 67 articles with the matching keywords were primarily retrieved.

Studies were eligible for inclusion if the studies are cross-sectional, experimental designs, or cohort studies describing the impact of the pandemics on family well-being both physical and mental well-being. Studies had to be published from the inception of the pandemic to October 15, 2020, in a journal with impact factors, English-language studies, and related to the COVID-19 pandemic. However, some articles are excluded because they are duplicate articles or studies in non-English language. We also excluded opinions, letters to the editor, and systematic reviews or meta-analyses. Moreover, unpublished articles and reports are also excluded from this study. Finally, based on the inclusion and exclusion criteria, eight articles met the inclusion criteria, and the data were extracted for the next analysis.

Based on eight articles, the data were extracted to include some important information, such as (1) Country/Region, (2) The purpose of the study, (3) Methods of the study, (4) The respondents (sample size and sample characteristics), (5) the main result of the study. The data extraction is done using a form on Microsoft Excel. All articles in this study were evaluated using narrative synthesis and presented data in the table forms.

A total of eight articles were selected for this study, with various subjects consisting of children, adolescents, adults, and parents. The literature review in this study is based on previous studies in the United States, Canada, Brazil, the United Kingdom, Germany, Ireland, Israel, China, Taiwan, Japan, and Bangladesh. Common impacts are physiological stress, anxiety, depression, income loss, fear, economic hardship, food insecurity, and family violence. Higher resilience is associated with fewer COVID-19-related worries, lower anxiety, and lower depression. Greater parental control is associated with lower stress and a lower risk of child abuse. Positive children were infected by the household contact. The results of the review are shown in Table 1 .

Table 1.

Characteristics of the Studies.

Reference	Country	Purpose	Method	Respondents	Main result
)	The United States	To determine how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in the United States through early June 2020	Online research panel created by using probability-based address sampling of U.S. households. National survey of parents using the Ipsos Knowledge Panel. Households without Internet at the time of recruitment are provided with an Internet-enabled tablet	1,011 parents with at least one child under the age of 18 years old in the household	27% of parents reported worsening mental health themselves, and 14% reported worsening behavioral health of their children. The proportion of families with moderate or severe food insecurity increased. Employer-sponsored insurance coverage for children decreased, and parents reported a loss of regular childcare
)	Bangladesh	To investigate the relationships between human COVID-19 stress with basic demographic, fear of infection, and insecurity-related variables, which can be helpful in facilitating mental health policies and strategies during the COVID-19 crisis period	Online-based survey	340 Bangladeshi adult populations (65.9% male)	About 85.60% of the participants are in COVID-19-related stress, which results in sleep shortness, short temper, and chaos in family. Fear of COVID-19 infection (i.e., self and/or family member(s), and/or relatives), hampering scheduled study plans and future career, and financial difficulties are identified as the main causes of human stress Economic hardship and food shortages are linked together and cause stress for millions of people, while hamper of formal education and future plan create stress for job seekers
)	Israel	To investigate the extent to which individual resilience, well-being, and demographic characteristics may predict two indicators of the coronavirus pandemic: distress symptoms and perceived danger	Online survey: an Internet panel company and an Internet survey through social media by using snowball sampling	605 Jewish Israelis from the Internet survey company and 741 respondents from the Internet sample	Individual resilience and well-being were the strongest predictors of distress symptoms and a sense of danger
)	The United States, Israel, and other countries (the United Kingdom, Canada, Brazil, Germany, Ireland, etc.)	To measure resilience using self-reported surveys and explore differences in COVID-19-related stress and resilience	Online survey on a crowdsourcing research website	3,042 participants of healthcare providers and non-healthcare providers (engineering, computers, finance, research, legal, government, administration, student, teaching).	Respondents were more distressed about family members contracting COVID-19 and unknowingly infecting others than they were about contracting COVID-19 themselves Higher resilience scores were associated with fewer COVID-19-related worries. Increasing resilience score was associated with a reduced rate of anxiety and depression
)	United States	To examine the impacts of the COVID-19 pandemic in relation to parental perceived stress and child abuse potential	Online survey via Qualtrics	183 parents with a child under the age of 18 years old in the western United States	Greater COVID-19-related stressors and high anxiety and depressive symptoms are associated with higher parental perceived stress. Receipt of financial assistance and high anxiety and depressive symptoms are associated with higher child abuse potential. Conversely, greater parental support and perceived control during the pandemic are associated with lower perceived stress and child abuse potential. The results also indicate racial and ethnic differences in COVID-19-related stressors
)	China	To analyze the different clinical characteristics between children and their families infected with severe acute respiratory syndrome coronavirus 2	Retrospective review of the clinical, laboratory, and radiologic tests	9 children and their 14 families	All the children were diagnosed with positive results after their family's onset, which indicated that they were infected by the household contact. A positive PCR among children may relate to mental health after discharge. The duration of positive PCR among children is longer compared with their adult families
)	Taiwan	To explore family members’ concerns for their relatives during the lockdown period, assess their level of acceptance of the visiting restriction policy, and determine the associated factors	Telephone interviews of family members of residents in long-term care facilities comprising 186 beds	156 family members	The most common concerns of the family members for their relatives were psychological stress (such as feelings of loneliness among residents), followed by nursing care, and daily activity. More than 80% of respondents accepted the visiting restriction policy, and a higher satisfaction rating was independently associated with acceptance of the visiting restriction policy
)	Japan	To examine the relationship between the presence or absence of a COVID-19 patient in a close setting and psychological distress levels	Administrative survey using social networking service (SNS): chatbot on LINE	16,402 people aged 15 years and older	In the groups under the age of 60 years old, respondents with COVID-19 patients in a close setting had higher psychological stress

Coronavirus diseases put families in uncertain conditions without clarity on how long the pandemic situation will last. The pandemic has caused many challenges that impact on family unit and the functions of the family unit, including distraction in family relationships ( Luttik et al., 2020 ). These challenges will have an influence on family well-being in many aspects, such as loss of community, loss of income, resources, planned activities, and travel due to quarantine. The concern about nuclear family members increased because they did not want their family to become ill from the coronavirus. It is suggested to not visit the older members or those with serious illnesses who are more vulnerable to the virus.

Family life has been influenced since the early stage of the pandemic by the implementation of physical distancing, quarantine, and staying at home to curb the spread of coronavirus. Physical and social distancing are effective mitigations to reduce the spread of the coronavirus during the outbreak. However, distancing requires adaptation among family members to improve family well-being. Sheltering-in-place makes more frequent interactions among family members because they have limited opportunities to have a leisure time into the outside world. This condition, on the one hand, can create a quality time and intimate interactions among family members, but on the other hand, it may lead to long-standing high conflicts, occasionally domestic violence, and divorce ( Lebow, 2020b ). In this condition, a home can be described as a place of warmth, love, and safety or as a place of intimidation, abuse, and fear ( Hitchings & Maclean, 2020 ). Other studies found a positive outlook on the COVID-19 pandemic regarding the necessity of focusing on and enjoying family relationships, especially taking advantage of the pandemic's gift of extended time together ( Evans et al., 2020 ; Holmberg et al., 2021 ). This optimistic attitude could function as a shared belief system within the family, resulting in family resilience. Working life balance at home during the time of COVID-19 provides a new chance for internal conflicts, disagreements, and arguments in which parents try to play their multi-roles with all family members to mitigate some problems such as unemployment and financial instability ( Lebow, 2020b ). Family income loss/economic difficulties, job loss, experienced hardships during the pandemic, worsening mental and behavioral health, stress, high anxiety, distress about family contracting COVID-19, and illness are reported in some families during the COVID-19 pandemic.

Domestic violence related to mental and physical health may happen during the COVID-19 quarantine. Family members lived in complex situations during the pandemic, which increased the risk of overexposure by increasing the levels of stress, anxiety, and instability. The increase in domestic violence during the pandemic is reported in many countries, such as China, Brazil, the United States, and Italy, which may represent as “tip of the iceberg” since many victims do not have the freedom to report the abuse ( Campbell, 2020 ). Domestic violence is reported as physical harm, emotional harm, and abuse. Intimate partner violence is a common form of family violence during the COVID-19 pandemic ( Kaukinen, 2020 ; Zhang, 2020 ). There are three factors of family violence, such as the opportunities of family violence during lockdown and isolation at home, the economic crisis in the households, and insufficient social support for the victims of domestic violence ( Zhang, 2020 ). Individual resilience is a strong predictor of the willingness of people to cope with emergencies and challenges of different kinds, including the COVID-19 pandemic ( Kimhi et al., 2020 ). Individual resilience and well-being are significant factors influencing distress symptoms and a sense of danger ( Kimhi et al., 2020 ). Physical abuse, emotional abuse, and stalking are kinds of intimate partner violence that are experienced by some women during the COVID-19 quarantine ( Mazza et al., 2020 ).

Family violence is one of the causes of divorce. Family violence has become a serious social problem. During the pandemic in China, some couples decide to divorce due to family violence in their spousal relationship ( Zhang, 2020 ). Divorcing partners in the wake of COVID-19 have more complex issues because they should physically and emotionally separate in their households. It is suggested to involve family therapy so they can share their problems that arise readily to prevent anger, contempt, and other problematic conflicts ( Lebow, 2020b ). A good cooperation and communication among divorced parents may help children achieve their goals through this hard time. A recent study found that communication between two single parents discussing the impact of the COVID-19 epidemic on their family life could acquire something considerably more significant than just support and self-discovery ( Abdellatif & Gatto, 2020 ).

Financial distress, economic depression, unemployment, poverty, and added stressors such as the care and homeschooling of children, social distancing, and family isolation have increased the opportunities for family violence ( Kaukinen, 2020 ; Zhang, 2020 ). Family members with lower financial income, lower education status, and lower occupational status are more likely to experience family violence, including family conflicts, economic distress, high tension, lower mental well-being, and insufficient support during physical distancing or lockdown ( Zhang, 2020 ). Families have been dealing with threats from COVID-19 pandemics, both direct and indirect effects ( Lebow, 2020a ). The direct effects are the loss of family members, anxiety feelings related to family loss, increased unemployment, limited physical and social contact, family stress, conflict, and financial vulnerability. During the pandemic, families may have a virtual connection to maintain their communication. Therefore, geographic challenges are becoming less important due to virtual interconnection. Furthermore, a recent study found that virtual communication during the COVID-19 pandemic could improve family well-being and happiness ( Gong et al., 2021 ). At this time, digital technology, which needs digital literacy, becomes essential ( Hitchings & Maclean, 2020 ).

The coronavirus pandemic has increased the risk of mental health problems (such as mood disorders, fear, anxiety, depression, alcohol and smoking abuse) as well as physical health problems (such as sleep disturbance, gastrointestinal problems, poorer health condition) ( Mazza et al., 2020 ). The mental problems are caused by work stress, financial stress, and changes in the social life. The coronavirus pandemic has increased the risk of mental disorders (such as mood disorders, anger, anxiety, depression, alcohol and smoking abuse) as well as physical disorders (such as sleep disturbance, gastrointestinal problems, poorer health condition). Children’s health and well-being are also in danger during the pandemic, because most of the children may get the transmission of the virus from their adult family members who were previously infected ( Su et al., 2020 ). Therefore, individual resilience and well-being as a part of family resilience and well-being should be maintained to cope with the threat of the coronavirus pandemic.

Homeschooling during the pandemic makes parental responsibilities extended to include being teachers, coaches, trainers, and mentors for their children's school from home and other extracurricular activities ( Lebow, 2020b ). The condition of staying at home may increase parental stressors, particularly for working parents who are responsible for their multi-task dealing with other stressful conditions as paid workers and also doing domestic tasks. Moreover, violence may increase among children during homeschooling. During this time, parents and children are similarly living with stress, fear, and many challenges because they share their activities in the same place for uncertain time. Some factors influence the home learning as a distance learning, such as poverty, the educational levels of parents, mental health, the availability of gadget, and Internet access. During the pandemic, however, parental involvement in their children's activities provided an opportunity to develop and preserve family well-being ( Evans et al., 2020 ).

During the pandemic, it should be more widely focused on helping family members generate their individual space. A good and intensive family communication is needed to deal with the uncertainty of the COVID-19 pandemic. Some interventions are needed to improve maternal and child health and nutrition, such as strengthening the food supply chain, reducing food insecurity, building a net social security program, and a cash support program for the disadvantaged families during the COVID-19 pandemic. Based on the literature review, it is recommended to increase public awareness to staying connected and reporting if they find any family violence. Improving the readiness and knowledge of healthcare providers and counselors is needed to provide counseling services to help families who have physical and mental health problems. Fulfilling parents with updated information and guidance is important to deal with pandemic especially how to have working life balance and quality of life between working, guiding children in their homeschooling and other activities. Providing parenting resources during COVID-19 including conflict management is needed to have positive relationship and manage parenting stress. The government should take action to mitigate the social, economic, and health impacts of the pandemic on families, especially those who are vulnerable to losing household income. During the pandemic, it is important to maintain family well-being by staying connected with communication, managing conflict, and making quality time within family. Promoting family resilience through shared beliefs and close relationships within families is needed during the COVID-19 pandemic.

This study has some limitations. The limitation of this article is the possibility of omission of the potential article related to the family welfare during the COVID-19 pandemic. Moreover, the exclusion of unpublished articles will become another limitation. The findings of this literature review were mostly conducted in higher-income countries, which limits the generalization of the findings to low- and middle-income countries. The future research is required regarding family welfare as responses to women’s empowerment during the COVID-19 pandemic with homogenous family’s samples or with a large sample size with heterogeneity of welfare's status. The future research can be conducted by mixed methods between qualitative and quantitative methods.

COVID-19 outbreak around the world has become a public health concern. The coronavirus pandemic has had a substantial impact on the family's life. Physical and mental health problems, economic instability, and family violence are social issues during the pandemic that should be dealt with. The government should take action to mitigate the social, economic, and health impacts of the pandemic on families especially those who are vulnerable to losing household income. Promoting family welfare and resilience through shared beliefs and close relationships within families is needed during the COVID-19 pandemic.

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs: Maria Gayatri https://orcid.org/0000-0002-2792-5586

Mardiana Dwi Puspitasari https://orcid.org/0000-0002-6827-3350

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100 Words Essay on Covid 19. COVID-19 or Corona Virus is a novel coronavirus that was first identified in 2019. It is similar to other coronaviruses, such as SARS-CoV and MERS-CoV, but it is more contagious and has caused more severe respiratory illness in people who have been infected. The novel coronavirus became a global pandemic in a very ...
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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.
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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 ...
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experienced an average decrease of 11.5 hours of work per week and a 21% decrease in weekly earnings, arnings for 52% of the sample, which again re ects s. variation in the e ects of COVID-19 across students. In terms of labor market expectations, on average, students foresee a 13 percentage points decrease in.
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Reading time: 3 min (864 words) 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 ...
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The magnitude of effect on clinical outcomes was larger when metformin was started earlier in the course of infection at <4 days from symptom onset, with metformin reducing the odds of severe COVID-19 by 55% (OR, 0.45; 95% CI, .22 to .93) and of long COVID by 65% (hazard ratio = 0.35; 95% CI, .15 to .95; Figure 4).
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The Impact of COVID-19 Pandemic on Family Well-Being: A Literature
Background: COVID-19 has changed family life, including employment status, financial security, the mental health of individual family members, children's education, family well-being, and family resilience. The aim of this study is to analyze the previous studies in relation to family well-being during the COVID-19 pandemic. Methods: A literature review was conducted on PubMed, Medline, Web of ...

How to Write About Coronavirus / COVID-19 In Your College Essay & Application

TABLE OF CONTENTS

Where to Write About COVID-19/ Coronavirus on Your College Application?

How to Write About COVID-19/ Coronavirus on Your College Application

How to Write About Coronavirus Using the Special COVID-19 (250-Word) Section on the Common App

Option 1: The Straightforward Way

How to Write About Coronavirus Using the (650-Word) Additional Information Section

How to Write About Coronavirus in Your College Essay (i.e., Your 650-Word Personal Statement)

How to Use Montage Structure to Describe Your Pandemic Experience in Part of Your Essay

A Quick Word of Advice on How to Stand Out If You’re Writing About Coronavirus

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Introduction

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Social support

Social and interactional norms

Recommendations and conclusions

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

Recommendation 2: intelligently balance online and offline ways of relating

Recommendation 3: build stronger and sustainable localised communities

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

Related Content

Part of the series

Coronavirus Pandemic

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

Here’s How the Coronavirus Pandemic Has Changed Our Lives

Mental health challenges

Pandemic-induced hesitation