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2 Minute Speech on Covid-19 (CoronaVirus) for Students

The year, 2019, saw the discovery of a previously unknown coronavirus illness, Covid-19 . The Coronavirus has affected the way we go about our everyday lives. This pandemic has devastated millions of people, either unwell or passed away due to the sickness. The most common symptoms of this viral illness include a high temperature, a cough, bone pain, and difficulties with the respiratory system. In addition to these symptoms, patients infected with the coronavirus may also feel weariness, a sore throat, muscular discomfort, and a loss of taste or smell.

2 Minute Speech on Covid-19 (CoronaVirus) for Students

10 Lines Speech on Covid-19 for Students

The Coronavirus is a member of a family of viruses that may infect their hosts exceptionally quickly.

Humans created the Coronavirus in the city of Wuhan in China, where it first appeared.

The first confirmed case of the Coronavirus was found in India in January in the year 2020.

Protecting ourselves against the coronavirus is essential by covering our mouths and noses when we cough or sneeze to prevent the infection from spreading.

We must constantly wash our hands with antibacterial soap and face masks to protect ourselves.

To ensure our safety, the government has ordered the whole nation's closure to halt the virus's spread.

The Coronavirus forced all our classes to be taken online, as schools and institutions were shut down.

Due to the coronavirus, everyone was instructed to stay indoors throughout the lockdown.

During this period, I spent a lot of time playing games with family members.

Even though the cases of COVID-19 are a lot less now, we should still take precautions.

Short 2-Minute Speech on Covid 19 for Students

The coronavirus, also known as Covid - 19 , causes a severe illness. Those who are exposed to it become sick in their lungs. A brand-new virus is having a devastating effect throughout the globe. It's being passed from person to person via social interaction.

The first instance of Covid - 19 was discovered in December 2019 in Wuhan, China . The World Health Organization proclaimed the covid - 19 pandemic in March 2020. It has now reached every country in the globe. Droplets produced by an infected person's cough or sneeze might infect those nearby.

The severity of Covid-19 symptoms varies widely. Symptoms aren't always present. The typical symptoms are high temperatures, a dry cough, and difficulty breathing. Covid - 19 individuals also exhibit other symptoms such as weakness, a sore throat, muscular soreness, and a diminished sense of smell and taste.

Vaccination has been produced by many countries but the effectiveness of them is different for every individual. The only treatment then is to avoid contracting in the first place. We can accomplish that by following these protocols—

Put on a mask to hide your face. Use soap and hand sanitiser often to keep germs at bay.

Keep a distance of 5 to 6 feet at all times.

Never put your fingers in your mouth or nose.

Long 2-Minute Speech on Covid 19 for Students

As students, it's important for us to understand the gravity of the situation regarding the Covid-19 pandemic and the impact it has on our communities and the world at large. In this speech, I will discuss the real-world examples of the effects of the pandemic and its impact on various aspects of our lives.

Impact on Economy | The Covid-19 pandemic has had a significant impact on the global economy. We have seen how businesses have been forced to close their doors, leading to widespread job loss and economic hardship. Many individuals and families have been struggling to make ends meet, and this has led to a rise in poverty and inequality.

Impact on Healthcare Systems | The pandemic has also put a strain on healthcare systems around the world. Hospitals have been overwhelmed with patients, and healthcare workers have been stretched to their limits. This has highlighted the importance of investing in healthcare systems and ensuring that they are prepared for future crises.

Impact on Education | The pandemic has also affected the education system, with schools and universities being closed around the world. This has led to a shift towards online learning and the use of technology to continue education remotely. However, it has also highlighted the digital divide, with many students from low-income backgrounds facing difficulties in accessing online learning.

Impact on Mental Health | The pandemic has not only affected our physical health but also our mental health. We have seen how the isolation and uncertainty caused by the pandemic have led to an increase in stress, anxiety, and depression. It's important that we take care of our mental health and support each other during this difficult time.

Real-life Story of a Student

John is a high school student who was determined to succeed despite the struggles brought on by the Covid-19 pandemic.

John's school closed down in the early days of the pandemic, and he quickly found himself struggling to adjust to online learning. Without the structure and support of in-person classes, John found it difficult to stay focused and motivated. He also faced challenges at home, as his parents were both essential workers and were often not available to help him with his schoolwork.

Despite these struggles, John refused to let the pandemic defeat him. He made a schedule for himself, to stay on top of his assignments and set goals for himself. He also reached out to his teachers for additional support, and they were more than happy to help.

John also found ways to stay connected with his classmates and friends, even though they were physically apart. They formed a study group and would meet regularly over Zoom to discuss their assignments and provide each other with support.

Thanks to his hard work and determination, John was able to maintain good grades and even improved in some subjects. He graduated high school on time, and was even accepted into his first-choice college.

John's story is a testament to the resilience and determination of students everywhere. Despite the challenges brought on by the pandemic, he was able to succeed and achieve his goals. He shows us that with hard work, determination, and support, we can overcome even the toughest of obstacles.

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Coronavirus (COVID-19) and society: what matters to people in Scotland?

Findings from an open free text survey taken to understand in greater detail how the pandemic has changed Scotland.

  • This research has captured the diversity and complexity of people’s experiences.
  • People’s experiences of the pandemic and their ability to stay safe has been impacted by a range of factors, including: their geographical environment, their financial situation, profession, their living situation and if they have any physical or mental health conditions.
  • Even though the direct level of threat from COVID-19 has reduced (for some people), there is still concern about the longer term harm and disruption that COVID-19 has caused to people and communities, and worry about the threat of future waves of infection.
  • This report captures a number of specific suggestions for support. For example, support for key workers, creating safer public environments, wide-scale financial support, greater awareness around the experiences of those who are at higher risk to COVID-19 and putting in place robust processes for learning and reflection on the impact of the pandemic.
  • Public engagement in this open and unfiltered format is an essential part of making sense of people’s attitudes and behaviours within the context of their life.

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The White House 1600 Pennsylvania Ave NW Washington, DC 20500

Remarks by President   Biden on the COVID- ⁠ 19 Response and the Vaccination   Program

South Court Auditorium Eisenhower Executive Office Building

1:57 P.M. EDT

THE PRESIDENT:  Good afternoon.  Today, we have hit another milestone — a key milestone — in our nation’s fight against COVID.  The Food and Drug Administration, the FDA, announced that it’s fully concluded its — its now thorough and independent scientific review.

After a strict process, the FDA has reaffirmed its findings that the Pfizer COVID-19 vaccine is safe and effective, and the FDA has given its full and final approval.

So let me say this loudly and clearly: If you have — if you’re one of the millions of Americans who said that they will not get the shot when it’s — until it has full and final approval of the FDA, it has now happened.  The moment you’ve been waiting for is here, and it’s time for you to go get your vaccination and get it today.  Today.  It’s an important moment in our fight against the pandemic.

You know, I want to thank the Acting Commissioner, Janet Woodcock, and the entire team at the FDA for their hard work.

Dr. Woodcock is a true professional.  She’s a career scientist who served under Republican presidents and Democratic presidents.  She’s ensured that the team followed the science above all.

They looked at the mountains of clinical data — clinical trial data and the safety and efficiency [efficacy] data, and concluded, without question, the vaccine was safe and effective for emergency use in December.  That same thing — we’ve got those shots in arms at the time: 350 million in the United States and billions across the world.  They kept pouring over this data.  The FDA approval is the gold standard.

And as I just said, now it has been granted.  Those who have been waiting for full approval should go get your shot now.

Vaccination is free.  It’s easy, it’s safe, and it’s effective.  And it’s convenient.

For 90 percent of Americans, there’s a vaccination site less than five miles from your home, and you can get the shot without an appointment.

So, please, get your shot today.  There’s no time to waste.

The Delta variant is dangerous and spreading, causing a pandemic of the unvaccinated.  That’s the pandemic of the vaccinated.  And while we’re starting to see initial signs that cases may be declining in a few places, nationwide cases are still rising, especially among the unvaccinated.

Across the country, virtually all of the COVID-19 hospitalizations and deaths continue to be among the unvaccinated.  That’s worse in states where vaccination rates are overall low.  But even in states where many people are vaccinated, the unvaccinated are still at risk.

Let me be clear: There are cases where vaccinated people do get COVID-19, but they are far less common than unvaccinated people getting COVID-19.  And most importantly, their conditions are far less severe. 

The overwhelming majority of people in the hospital have COVID-19 are — almost all of those dying from COVID-19 are not vaccinated.  Not vaccinated. 

If you’re fully vaccinated — both shots, plus two weeks — your risk of severe illness from COVID-19 is very, very, very low. 

Now, I know that parents are concerned about COVID-19 cases among their children.  I’ll be addressing this soon with Secretary Cardona to discuss how to get our kids back to school safely.

Cases among children are still rare, and severe cases among children are very, very rare.  But I know that parents are thinking about their own kids, and it’s not as reassuring as anyone would like it to be.

So let me say this as parents — to the parents:  As you have — you have the tools.  You have the tools to keep your child safer, and two of those tools, above all, are available to you.  One, make sure that everyone around your child, who can be vaccinated, is vaccinated: parents, adults, teens.  Two, make sure your child is masked when they leave home.  That’s how we can best keep our kids safe.

As I’ve said before, the pandemic of the unvaccinated is a tragedy that is preventable.  People are dying, and will die, who don’t have to.

So, please, please, if you haven’t gotten your vaccination — if you haven’t gotten vaccinated, do it now.  It could save your life and the lives of those you love.

Now, the good news is that people are getting vaccinated.  For the past several weeks, my administration has imposed new vaccine requirements on federal workers, the armed forces, people who work in federal medical facilities, and nursing home workers.  Governors, mayors, and private sector leaders have done the same. 

We’ve also encouraged new incentives.  For example, in some states, you get $100 if you get vaccinated.

These new requirements and incentives are accelerating vaccinations once again, giving us the hope that we can put this Delta variant behind us in the weeks ahead.

There are three facts everyone should know about where we are in this fight against this pandemic.

First, even as the Delta variant has ravaged the unvaccinated, the deaths have cli- — and deaths have climbed, the death rate is still 70 percent lower than what it was last winter.  Why?  Because we did such a good job vaccinating those most at risk: senior citizens.  America has about 54 million senior citizens.  About 50 million have at lea — have — have gotten at least one shot.  That’s almost 92 percent.

Secondly, overall weekly new vaccinations are up more than 56 percent from where they were a month ago.

Last week, we saw a record of vaccinations — more than 1 million shots a day for three state da- — for three straight days.  This is the first time this has happened since June.

Six million shots in the last seven days –- the highest seven-day total in over a month and a half

Remember — remember when we were trying to get 70 percent of the people over 18 at least one shot?  Well, we’ve not only gotten that done; we’ve gotten 71 percent of everyone age 12 and older their first shot.  That’s over 200 million Americans.  And over 170 million are now fully vaccinated. 

Third, states that had been lagging are seeing their vaccination rates grow faster.  In fact, in Alabama, Arkansas, Louisiana, and Mississippi, more people got new vaccinations in the past month than in the prior two months combined.

The progress we’re making on vaccinations now is going to produce results in the weeks ahead.  The sooner you get fully vaccinated, the sooner you’ll be protected.

According to the experts from the Yale School of Public Health, the pace of our vaccination effort has saved over 100,000 lives and have prevented more than 450,000 hospitalizations.  This is critical progress, but we need to move faster.

As I mentioned before, I’ve imposed vaccination requirements that will reach millions of Americans.

Today, I’m calling on more country — more companies, I should say, in the private sector to step up with vaccine requirements that’ll reach millions more people.

If you’re a business leader, a non-profit leader, a state or local leader who has been waiting for full FDA approval to require vaccinations, I call on you now to do that — require it.  Do what I did last month and require your employees to get vaccinated or face strict requirements.

And as I said last week, vaccination requirements have been around for decades.  Students, healthcare professionals, our troops are typically required to receive vaccination to prevent everything from polio to smallpox, measles, mumps, rubella.

In fact, the reason most people in America don’t worry about polio, smallpox, measles, mumps, and rubella today is because of vaccines.  It only makes sense to require a vaccine to stop the spread of COVID-19.

With today’s FDA full approval, there’s another good reason to get vaccinated.  So, please get vaccinated now.

If you go to Vaccines.com [Vaccines.gov] — Vaccines.com [Vaccines.gov] — or text your ZIP code to 438829 — 438829 — you can find a number of vaccine sites near you, just minutes away, where you can get your shot without an appointment.

All around the world, people want these vaccines.  Here in America, they’re free, convenient, and waiting for you. 

So, please go today — for yourself, for your loved ones, for your neighbors, for your country.

I’ll close with this: We’re in the midst of a wartime effort to beat this pandemic.  It’s one of the biggest and most complicated challenges in our history.  And it’s based on an unparalleled vaccination program that is saving lives and beating this virus.

It’s a vaccination program that’s getting us back to our loved ones and a way of life we were used to.  It’s happening, and it’s going to keep happening if you help — it helps our economy.  It gets everything moving.  It keeps us growing.

Together, we’ve made significant progress in just seven months.

We just have to finish the job with science, facts, and confidence, together — together as a United States of America.  So, please get vaccinated today.

God Bless you all.  And may God protect our troops.  Thank you.

2:08 P.M. EDT

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April 09, 2020

COVID-19 and the Economy

Chair Jerome H. Powell

At the Hutchins Center on Fiscal and Monetary Policy, The Brookings Institution, Washington, D.C. (via webcast)

Good morning. The challenge we face today is different in scope and character from those we have faced before. The coronavirus has spread quickly around the world, leaving a tragic and growing toll of illness and lost lives. This is first and foremost a public health crisis, and the most important response is coming from those on the front lines in hospitals, emergency services, and care facilities. We watch in collective awe and gratitude as these dedicated individuals put themselves at risk in service to others and to our nation.

Like other countries, we are taking forceful measures to control the spread of the virus. Businesses have shuttered, workers are staying home, and we have suspended many basic social interactions. People have been asked to put their lives and livelihoods on hold, at significant economic and personal cost. We are moving with alarming speed from 50-year lows in unemployment to what will likely be very high, although temporary, levels.

All of us are affected, but the burdens are falling most heavily on those least able to carry them. It is worth remembering that the measures we are taking to contain the virus represent an essential investment in our individual and collective health. As a society, we should do everything we can to provide relief to those who are suffering for the public good.

The recently passed Cares Act is an important step in honoring that commitment, providing $2.2 trillion in relief to those who have lost their jobs, to low- and middle-income households, to employers of all sizes, to hospitals and health-care providers, and to state and local governments. And there are reports of additional legislation in the works. The critical task of delivering financial support directly to those most affected falls to elected officials, who use their powers of taxation and spending to make decisions about where we, as a society, should direct our collective resources.

The Fed can also contribute in important ways: by providing a measure of relief and stability during this period of constrained economic activity, and by using our tools to ensure that the eventual recovery is as vigorous as possible.

To those ends, we have lowered interest rates to near zero in order to bring down borrowing costs. We have also committed to keeping rates at this low level until we are confident that the economy has weathered the storm and is on track to achieve our maximum-employment and price-stability goals.

Even more importantly, we have acted to safeguard financial markets in order to provide stability to the financial system and support the flow of credit in the economy. As a result of the economic dislocations caused by the virus, some essential financial markets had begun to sink into dysfunction, and many channels that households, businesses, and state and local governments rely on for credit had simply stopped working. We acted forcefully to get our markets working again, and, as a result, market conditions have generally improved.

Many of the programs we are undertaking to support the flow of credit rely on emergency lending powers that are available only in very unusual circumstances—such as those we find ourselves in today—and only with the consent of the Secretary of the Treasury. We are deploying these lending powers to an unprecedented extent, enabled in large part by the financial backing from Congress and the Treasury. We will continue to use these powers forcefully, proactively, and aggressively until we are confident that we are solidly on the road to recovery.

I would stress that these are lending powers, not spending powers. The Fed is not authorized to grant money to particular beneficiaries. The Fed can only make secured loans to solvent entities with the expectation that the loans will be fully repaid. In the situation we face today, many borrowers will benefit from these programs, as will the overall economy. But there will also be entities of various kinds that need direct fiscal support rather than a loan they would struggle to repay.

Our emergency measures are reserved for truly rare circumstances, such as those we face today. When the economy is well on its way back to recovery, and private markets and institutions are once again able to perform their vital functions of channeling credit and supporting economic growth, we will put these emergency tools away.

None of us has the luxury of choosing our challenges; fate and history provide them for us. Our job is to meet the tests we are presented. At the Fed, we are doing all we can to help shepherd the economy through this difficult time. When the spread of the virus is under control, businesses will reopen, and people will come back to work. There is every reason to believe that the economic rebound, when it comes, can be robust. We entered this turbulent period on a strong economic footing, and that should help support the recovery. In the meantime, we are using our tools to help build a bridge from the solid economic foundation on which we entered this crisis to a position of regained economic strength on the other side.

I want to close by thanking the millions on the front lines: those working in health care, sanitation, transportation, grocery stores, warehouses, deliveries, security—including our own team at the Federal Reserve—and countless others. Day after day, you have put yourselves in harm's way for others: to care for us, to ensure we have access to the things we need, and to help us through this difficult time.

Reversing the Inequality Pandemic: Speech by World Bank Group President David Malpass

World Bank Group President David Malpass

Speech at Frankfurt School of Finance and Management

You can watch the replay of the event  here


Thank you, Jens. And thanks to Frankfurt School and the Bundesbank for hosting me virtually. I look forward to engaging with you and taking questions from students, who will be future business leaders in a post-COVID world. I’m here to set the stage ahead of the IMF and World Bank Group’s Annual Meetings, which will focus primarily on COVID and debt, and will also engage partners in urgent discussions on human capital, climate change, and digital development.

Before I begin, I would be remiss not to mention that this is the first time that the positioning speech for the World Bank Group Annual Meetings is being held in continental Europe. Germany is a major anchor for the World Bank Group and the rest of Europe; it is IBRD’s fourth largest shareholder, and the fourth largest contributor to IDA, and Chancellor Merkel has always been a strong supporter of World Bank Group priorities, including tackling debt and COVID, as well as action on global public goods. I understand that these priorities are also the focus of Germany’s EU Presidency, which runs through the end of 2020.

As Jens said, the COVID-19 pandemic is a crisis like no other. Its toll has been massive and people in the poorest countries are likely to suffer the most and the longest. The pandemic has taken lives and disrupted livelihoods in every corner of the globe. It has knocked more economies into simultaneous recession than at any time since 1870. And it could lead to the first wave of a lost decade burdened by weak growth, a collapse in many health and education systems, and excessive debt.

The pandemic has already changed our world decisively and forced upon the world a painful transformation. It has changed everything : the way we work, the extent to which we travel, and the manner in which we communicate, teach, and learn. It has rapidly elevated some industries—especially the technology sector—while pushing others toward obsolescence.

Our approach has been comprehensive—focused on saving lives, protecting the poor and vulnerable, ensuring sustainable business growth, and rebuilding in better ways. Today, I’m going to focus on four urgent aspects of this work: first, the need to redouble efforts to alleviate poverty and inequality ; second, the associated loss of human capital and what must be done to restore it; third, the urgent need to help the poorest countries make their government debt more transparent and permanently reduce their debt burdens, two necessary steps to attract effective investment; and finally, how we can cooperate to facilitate the changes needed for an inclusive and resilient recovery .

Topic 1: Poverty and Inequality

First, on poverty and inequality, COVID-19 has dealt an unprecedented setback to the worldwide effort to end extreme poverty, raise median incomes and create shared prosperity.

Jens has referred to the World Bank’s new poverty projections, which suggest that by 2021 an additional 110 to 150 million people will have fallen into extreme poverty, living on less than $1.90 per day. This means that the pandemic and global recession may push over 1.4% of the world’s population into extreme poverty.

The current crisis is a sharp contrast from the recession of 2008, which focused much of its damage on financial assets and hit advanced economies harder than developing countries. This time, the economic downturn is broader, much deeper, and has hit informal sector workers and the poor, especially women and children, harder than those with higher incomes or assets.

One reason for the differential impact is the advanced economies’ sweeping expansion of government spending programs. Rich countries have had the resources to protect their citizens to an extent many developing countries have not. Another is central bank asset purchases. The scale of such purchases is unprecedented and has successfully propped up global financial markets. This benefits the well-to-do and those with guaranteed pensions, especially in the rich world, but it is not clear, either in textbook theory or in practice, how 0% interest rates and ever-expanding government asset and liability balances will translate into new jobs, profitable small businesses, or rising median income—key steps in reversing inequality.

Poorer economies have fewer macro-economic tools and stabilizers and suffer from weaker health care systems and social safety nets. For them, there are no fast ways to reverse the sudden reduction in their sales to consumers in advanced economies or the almost overnight collapse in tourism and remittances from family members working abroad. It’s clear that sustainable recoveries will require growth that benefits all people—and not just those in positions of power. In an interconnected world, where people are more informed than ever before, this pandemic of inequality—with rising poverty and declining median incomes—will increasingly be a threat to the maintenance of social order and political stability, and even to the defense of democracy.

Topic 2: Human Capital

Second, on human capital, developing countries were making significant progress before COVID-19—and, notably, starting to close gender gaps. Human capital is what drives sustainable economic growth and poverty reduction. It consists of the knowledge, skills, and quality of health that people gain over their lives. It is associated with higher earnings for people, higher income for countries, and stronger cohesion in societies.

Since the outbreak, however, more than 1.6 billion children in developing countries have been out of school because of COVID-19, implying a potential loss of as much as $10 trillion in lifetime earnings for these students. Gender-based violence is on the rise, and child mortality is also likely to increase in coming years: our early estimates suggest a potential increase of up to 45% in child mortality because of health-service shortfalls and reductions in access to food.

These setbacks imply a long-term hit to productivity, income growth and social cohesion—which is why we’re doing everything we can to bolster health and education in developing countries. In the area of health, the World Bank Group worked with our Board in March to establish a fast-track COVID response that has delivered emergency support to 111 countries so far. Most projects are now in advanced stages of disbursement for the purchase of COVID-related health supplies, such as masks and emergency room equipment.

Our goal was to take broad, fast action early and to provide large net positive flows to the world’s poorest countries. We are making good progress toward our announced 15-month target of $160 billion in surge financing, much of it to the poorest countries and to private sectors for trade finance and working capital. Over $50 billion of that support takes the form of grants or low-rate, long-maturity loans, providing key resources to maintain or expand health care systems and social safety nets. Both are likely to play a key near-term role in survival and health for millions of families.

We are also taking action to help developing countries with COVID vaccines and therapeutics. I announced last week that, by extending and expanding our fast-track approach to address the COVID emergency, we plan to make available up to $12 billion to countries for the purchase and deployment of COVID-19 vaccines once the vaccines have been approved by multiple stringent regulatory agencies around the world. This additional financing will be to low- and middle-income developing countries that don’t have adequate access and will help them alter the course of the pandemic for their people. The approach draws on the World Bank’s significant expertise in supporting public health and vaccination programs and will signal to markets that developing countries will have multiple ways to purchase approved vaccines and will have significant purchasing power.

Our private sector arm—the International Finance Corporation, or IFC—is also investing heavily in vaccine manufacturers through its $4 billion Global Health Platform. The aim is to encourage ramped-up production of COVID-19 vaccines and therapeutics in advanced and developing economies alike—and to ensure that emerging markets gain access to available doses. IFC is also working with the vaccine partnership—CEPI—to map COVID-19 vaccine manufacturing capacity, focusing especially on potential bottlenecks.

To mitigate the impact of the pandemic on education, the Bank is working to help countries reopen primary and secondary schools safely and quickly. Out of school, children tend to backslide in their educational skills; and for children in the poorest countries, physical attendance in school is an important source of food and security, not just the reading and math that provide a critical ladder out of poverty. The Bank is working in 65 countries to implement remote-learning strategies, combining online resources with radio, TV, and social networks, and printed materials for the most vulnerable. We are also partnering with UNICEF and UNESCO on school-reopening frameworks.

In Nigeria, for example, we provided $500 million in new funding for the Adolescent Girls Initiative for Learning and Empowerment (AGILE), which aims to improve secondary education opportunities among girls. The project is expected to benefit more than 6 million girls, using TV, radio, and remote-learning tools.

Topic 3: Debt Burdens

My third urgent topic is debt. A combination of factors has led to a wave of excessive debt in countries where there is no margin for error. Global financial markets are dominated by low interest rates, creating a reach-for-yield fervor that invites excess. This is reinforced by an imbalance in the global debt system that puts sovereign debt in a unique category that favors creditors over the people in the borrowing country—there’s not a sovereign bankruptcy process that allows for partial payment and reduction of claims. As a result, people, even the world’s poorest and most destitute, are required to pay their government’s debts as long as creditors pursue claims—even so-called “vulture” creditors who acquire the distressed claims on secondary markets, exploit litigation, penalty interest clauses and court judgments to ratchet up the value of the claims, and use attachment of assets and payments to enforce debt service. In the worst cases, it’s the modern equivalent of debtor’s prison.

Further, the political incentive and opportunity for government officials to borrow heavily has increased. Their careers benefit from the availability of long-maturity debt because the repayment cycle is often well after the political cycle. This undermines accountability for debt, making transparency much more important than in the past.

An added factor in the current wave of debt is the rapid growth of new official lenders, especially several of China’s well-capitalized creditors. They’ve expanded their portfolios dramatically and are not fully participating in the debt rescheduling processes that were developed to soften previous waves of debt.

To take a first step toward debt relief for the poorest countries, at the World Bank’s Spring Meetings in March, I, along with Kristalina Georgieva of the IMF, proposed a moratorium on debt payments by the poorest countries. It was partly a response to COVID and the need for countries to have fiscal space, and also a recognition that a debt crisis was underway for the poorest countries. With endorsement by the G20, G7 and Paris Club, the Debt Service Suspension Initiative, or DSSI, took effect on May 1. It enabled a fast and coordinated response to provide additional fiscal space for the poorest countries in the world. As of mid-September, 43 countries were benefiting from an estimated $5 billion in debt-service suspension from official bilateral creditors, complementing the scaled-up emergency financing provided by the World Bank and IMF. The DSSI has also enabled us to make significant progress on debt transparency, which will help borrowing countries and their creditors make more informed borrowing and investment decisions. This year’s edition of the World Bank’s International Debt Statistics, to be released next Monday, October 12, will provide more detailed and more disaggregated data on sovereign debt than ever before in its nearly 70-year history.

Many more steps are needed on debt relief. One avenue is to broaden and extend the current debt initiative so that there is time to work out a more permanent solution. The World Bank and the IMF have called on the G20 to extend the DSSI’s relief through the end of 2021, and we are highlighting the need for G20 governments to urge the participation of all their private and bilateral public sector creditors in the DSSI. Private creditors and non-participating bilateral creditors should not be allowed to free-ride on the debt relief of others, and at the expense of the world’s poor.

Debt service suspension is an important stopgap, but it is not enough. First, too many of the creditors are not participating, leaving the debt relief too shallow to meet the fiscal needs of the inequality pandemic around us. Second, debt payments are simply being deferred, not reduced. It doesn’t produce light at the end of the debt tunnel. This is particularly apparent in today’s low-for-long financing environment. The normal time value of money simply isn’t working, so the creditors’ offer of a deferral of payments with a compounding of interest often means that the burden of debt goes up with time, not down. The historical use of net present value equations in debt restructurings has to be scrutinized for fairness to the people in the debtor countries.

The risk is that it will take years or decades for the poorest countries to convince creditors to reduce their debt burdens enough to help restart growth and investment. Given the depth of the pandemic, I believe we need to move with urgency to provide a meaningful reduction in the stock of debt for countries in debt distress. Under the current system, however, each country, no matter how poor, may have to fight it out with each creditor. Creditors are usually better financed with the highest paid lawyers representing them, often in U.S. and UK courts that make debt restructurings difficult. It is surely possible that these countries—two of the biggest contributors to development—can do more to reconcile their public policies toward the poorest countries and their laws protecting the rights of creditors to demand repayments from these countries.

Several steps are needed. First, as I mentioned, full participation in the moratorium by all official bilateral and commercial creditors, to buy time. Second, full transparency of the terms of the existing and new debt and debt-like commitments of the governments of the poorest countries. Both creditors and debtors should embrace this transparency, but neither has done enough in this regard. Third, using this fuller transparency, we need a careful analysis of a country’s long-term debt sustainability to identify sovereign debt levels that would be sustainable and consistent with growth and poverty reduction. This degree of transparency and analysis would also be strongly beneficial for the public commitments of developed countries, such as outlay projections for public pension funds. Fourth, we need new tools to push forward with the reduction of the stock of debt for the poorest countries. The World Bank and IMF are proposing to the Development Committee a joint action plan by the end of 2020 for debt reduction for IDA countries in unsustainable debt situations.

Looking more broadly, since the arrival of COVID-19, the challenge of high debt burdens has expanded to endanger the solvency of many businesses. The Bank for International Settlements has estimated that 50% of businesses do not have enough cash to pay their debt-servicing costs over the coming year.

Rising corporate debt distress has the potential to put otherwise viable firms out of business, exacerbating job losses, depressing entrepreneurship, and slowing growth prospects well into the future. The World Bank and IFC are both working with our client countries to address this issue, helping them bolster and improve insolvency frameworks while shoring up the working capital of systemically important businesses.

Topic 4: Fostering an Inclusive and Resilient Recovery

My fourth topic is on fostering an inclusive and resilient recovery. COVID-19 has demonstrated—with deadly effect—that national borders offer little protection against some calamities. It has underscored the deep connections between economic systems, human health, and global well-being. It has concentrated our minds on building systems that will better protect all countries the next time, especially our poorest and most vulnerable citizens.

It is critical that countries work toward their climate and environmental goals. A high priority for the world is to lower the carbon emissions from electricity generation, meaning the termination of new coal- and oil-dependent power generation projects and the wind-down of existing high-carbon generators. Many of the largest emitters—in the developing world but, I must say, also in the developed world—are still not making sufficient progress in this area.

Amid the pandemic, the World Bank Group has remained the largest multilateral financier of climate action. Over the last five years, we have provided $83 billion in climate-related investments. Our work has helped 120 million people in over 50 countries gain access to weather data and early-warning systems crucial to saving lives in disasters. We have added a total of 34 gigawatts of renewable energy into grids to help communities, businesses and economies thrive. I’m happy to say that, in Fiscal Year 2020, my first full year as President, the World Bank Group made more climate-related investments than at any time in its history.

We intend to step up that work over the next five years. We are helping countries put an economic value on biodiversity—including forests, land, and water resources—so they can better manage these natural assets. We are helping them assess how climate risks affect women and others who are already vulnerable.

We are also working with governments to eliminate or redirect environmentally harmful fuel subsidies and to reduce trade barriers for food and medical supplies. Global progress in this area, however, has remained slow. COVID-19 spending packages could have a decisive effect on promoting more low-carbon energy sources and facilitating a stronger, more resilient recovery.

And on the economy itself, recognizing the severity of the downturn and the likely longevity, a key step in a sustainable recovery will be for economies and people to allow change and embrace it. Countries will need to allow capital, labor, skills, and innovation to shift to a different, post-COVID business environment. This puts a premium on workers and businesses using their skills and innovations in new ways in a commercial environment that is likely to rely more on electronic connections than travel and handshakes.

To speed recovery, countries will need to find a better balance between, on the one hand, maintaining core public and private sector businesses and, on the other, recognizing that many businesses won’t survive the downturn. In many cases, support efforts will be more effective if they aid families rather than propping up pre-COVID business structures.

The business environment needs change and improvement to build a faster, more sustainable recovery. A key part of this process of change is for the ownership and repurposing of distressed assets to be resolved as quickly as possible. This will likely entail a combination of faster bankruptcy proceedings, new legal avenues for settling small claims, and other out-of-court alternatives such as arbitration. These are important building blocks for effective contracts and capital allocation, but only a few developing countries have them in place. The severity of the downturn makes the prompt streamlining and transparency of commercial law as vital for recovery as the availability of new debt and equity capital.

None of these steps will be enough, and the reality is that aid, even from the most generous donors, can’t make ends meet. Just to reverse COVID’s likely increase in extreme poverty in 2020 would require $70 billion per year ($2 per day times 100 million people). That’s well beyond the World Bank Group’s financial capacity or any of the development agencies. My view is that sustainable solutions can only come by embracing change—through innovation, new uses for existing assets, workers and job skills, a reset on excessive debt burdens, and governance systems that create a stable rule of law while also embracing change.

In conclusion, I raised the urgency of addressing poverty, inequality, human capital, debt reduction, climate change, and economic adaptability as elements in ensuring a resilient recovery. This once-in-a-century crisis has demonstrated why history doesn’t exactly repeat itself—because humankind does learn from its mistakes. The pandemic so far has not triggered the devastating side effects of earlier crashes—neither hyperinflation, nor deflation, nor widespread famine. Even though the loss of income and the inequality of the impact have been worse than in most past crises, the global economic response, so far, has been much bigger than we might have expected at the start of this crisis.

The development response will need to be extended and intensified, both in terms of the health emergency and the efforts to help countries find effective support systems and recovery plans. Greater cooperation will enable us to share knowledge and develop and apply effective solutions far more swiftly. It will enable innovators to develop a vaccine that beats the virus and restores people’s confidence in the future. Working through all channels, my hope—and my belief—is that we can shorten the downturn and build a strong foundation for a more durable model of prosperity—one that can lift all countries and all people.

Thank you very much.

Read these 12 moving essays about life during coronavirus

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

by Alissa Wilkinson

A woman wearing a face mask in Miami.

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.
  • Vox is starting a book club. Come read with us!

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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Introduction - Pandemic Preparedness | Lessons From COVID-19


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On December 31, 2019, the World Health Organization (WHO) contacted China about media reports of a cluster of viral pneumonias in Wuhan, later attributed to a coronavirus, now named SARS-CoV-2 . By January 30, 2020, scarcely a month later, WHO declared the virus to be a public health emergency of international concern (PHEIC)—the highest alarm the organization can sound. Thirty days more and the pandemic was well underway; the coronavirus had spread to more than seventy countries and territories on six continents, and there were roughly ninety thousand confirmed cases worldwide of COVID-19, the disease caused by the coronavirus.

The COVID-19 pandemic is far from over and could yet evolve in unanticipated ways, but one of its most important lessons is already clear: preparation and early execution are essential in detecting, containing, and rapidly responding to and mitigating the spread of potentially dangerous emerging infectious diseases. The ability to marshal early action depends on nations and global institutions being prepared for the worst-case scenario of a severe pandemic and ready to execute on that preparedness The COVID-19 pandemic is far from over and could yet evolve in unanticipated ways, but one of its most important lessons is already clear: preparation and early execution are essential in detecting, containing, and rapidly responding to and mitigating the spread of potentially dangerous emerging infectious diseases. The ability to marshal early action depends on nations and global institutions being prepared for the worst-case scenario of a severe pandemic and ready to execute on that preparedness before that worst-case outcome is certain.

The rapid spread of the coronavirus and its devastating death toll and economic harm have revealed a failure of global and U.S. domestic preparedness and implementation, a lack of cooperation and coordination across nations, a breakdown of compliance with established norms and international agreements, and a patchwork of partial and mishandled responses. This pandemic has demonstrated the difficulty of responding effectively to emerging outbreaks in a context of growing geopolitical rivalry abroad and intense political partisanship at home.

Pandemic preparedness is a global public good. Infectious disease threats know no borders, and dangerous pathogens that circulate unabated anywhere are a risk everywhere. As the pandemic continues to unfold across the United States and world, the consequences of inadequate preparation and implementation are abundantly clear. Despite decades of various commissions highlighting the threat of global pandemics and international planning for their inevitability, neither the United States nor the broader international system were ready to execute those plans and respond to a severe pandemic. The result is the worst global catastrophe since World War II.

The lessons of this pandemic could go unheeded once life returns to a semblance of normalcy and COVID-19 ceases to menace nations around the globe. The United States and the world risk repeating many of the same mistakes that exacerbated this crisis, most prominently the failure to prioritize global health security, to invest in the essential domestic and international institutions and infrastructure required to achieve it, and to act quickly in executing a coherent response at both the national and the global level.

The goal of this report is to curtail that possibility by identifying what went wrong in the early national and international responses to the coronavirus pandemic and by providing a road map for the United States and the multilateral system to better prepare and execute in future waves of the current pandemic and when the next pandemic threat inevitably emerges. This report endeavors to preempt the next global health challenge before it becomes a disaster.

A Rapid Spread, a Grim Toll, and an Economic Disaster

On January 23, 2020, China’s government began to undertake drastic measures against the coronavirus, imposing a lockdown on Wuhan, a city of ten million people, aggressively testing, and forcibly rounding up potential carriers in makeshift quarantine centers. 1 In the subsequent days and weeks, the Chinese government extended containment to most of the country, sealing off cities and villages and mobilizing tens of thousands of health workers to contain and treat the disease. By the time those interventions began, however, the disease had already spread well beyond the country’s borders.

SARS-CoV-2 is a highly transmissible emerging infectious disease for which no highly effective treatments or vaccines currently exist and against which people have no preexisting immunity. Some nations have been successful so far in containing its spread through public health measures such as testing, contact tracing, and isolation of confirmed and suspected cases. Those nations have managed to keep the number of cases and deaths within their territories low.

More than one hundred countries implemented either a full or a partial shutdown in an effort to contain the spread of the virus and reduce pressure on their health systems. Although these measures to enforce physical distancing slowed the pace of infection, the societal and economic consequences in many nations have been grim. The supply chain for personal protective equipment (PPE), testing kits, and medical equipment such as oxygen treatment equipment and ventilators remains under immense pressure to meet global demand.

If international cooperation in response to COVID-19 has been occurring at the top levels of government, evidence of it has been scant, though technical areas such as data sharing have witnessed some notable successes. Countries have mostly gone their own ways, closing borders and often hoarding medical equipment. More than a dozen nations are competing in a biotechnology arms race to find a vaccine. A proposed international arrangement to ensure timely equitable access to the products of that biomedical innovation has yet to attract the necessary support from many vaccine-manufacturing nations, and many governments are now racing to cut deals with pharmaceutical firms and secure their own supplies.

As of August 31, 2020, the pandemic had infected at least twenty-five million people worldwide and killed at least 850,000 (both likely gross undercounts), including at least six million reported cases and 183,000 deaths in the United States. Meanwhile, the world economy had collapsed into a slump rivaling or surpassing the Great Depression, with unemployment rates averaging 8.4 percent in high-income economies. In the second quarter of 2020, the U.S gross domestic product (GDP) fell 9.5 percent, the largest quarterly decline in the nation’s history. 2

Already in May 2020, the Asia Development Bank estimated that the pandemic would cost the world $5.8 to 8.8 trillion, reducing global GDP in 2020 by 6.4 to 9.7 percent. The ultimate financial cost could be far higher. 3

The United States is among the countries most affected by the coronavirus, with about 24 percent of global cases (as of August 31) but just 4 percent of the world’s population. While many countries in Europe and Asia succeeded in driving down the rate of transmission in spring 2020, the United States experienced new spikes in infections in the summer because the absence of a national strategy left it to individual U.S. states to go their own way on reopening their economies. In the hardest-hit areas, U.S. hospitals with limited spare beds and intensive care unit capacity have struggled to accommodate the surge in COVID-19 patients. Resource-starved local and state public health departments have been unable to keep up with the staggering demand for case identification, contract tracing, and isolation required to contain the coronavirus’s spread.

A Failure to Heed Warnings

  • Institute of Medicine, Microbial Threats to Health (1992)
  • National Intelligence Estimate, The Global Infectious Disease Threat and Its Implications ...

This failing was not for any lack of warning of the dangers of pandemics. Indeed, many had sounded the alarm over the years. For nearly three decades, countless epidemiologists, public health specialists, intelligence community professionals, national security officials, and think tank experts have underscored the inevitability of a global pandemic of an emerging infectious disease. Starting with the Bill Clinton administration, successive administrations, including the current one, have included pandemic preparedness and response in their national security strategies. The U.S. government, foreign counterparts, and international agencies commissioned multiple scenarios and tabletop exercises that anticipated with uncanny accuracy the trajectory that a major outbreak could take, the complex national and global challenges it would create, and the glaring gaps and limitations in national and international capacity it would reveal.

The global health security community was almost uniformly in agreement that the most significant natural threat to population health and global security would be a respiratory virus—either a novel strain of influenza or a coronavirus that jumped from animals to humans. 4 Yet, for all this foresight and planning, national and international institutions alike have failed to rise to the occasion.

  • National Intelligence Estimate, The Global Infectious Disease Threat and Its Implications for the United States (2000)
  • Launch of the U.S. Global Health Security Initiative (2001)
  • Institute of Medicine, Microbial Threats to Health: Emergence, Detection, and Response (2003)
  • Revision of the International Health Regulations (2005)
  • World Health Organization, Global Influenza Preparedness Plan (2005)
  • Homeland Security Council, National Strategy for Pandemic Influenza (2005)
  • U.S. Department of Health and Human Services, National Health Security Strategy of the United States of America (2009)
  • U.S. Director of National Intelligence, Worldwide Threat Assessments (2009–2019)
  • World Health Organization, Report of Review Committee on the Functioning of the International Health Regulations (2005) in Relation to Pandemic (H1N1) 2009 (2011)
  • Pandemic and All-Hazards Preparedness Reauthorization Act of 2013
  • Launch of the Global Health Security Agenda (2014)
  • Blue Ribbon Study Panel on Biodefense (now Bipartisan Commission on Biodefense) (2015)
  • National Security Strategy (2017)
  • National Biodefense Strategy (2018)
  • Crimson Contagion Simulation (2019)
  • Global Preparedness Monitoring Board, A Work at Risk: Annual Report on Global Preparedness for Health Emergencies (2019)
  • CSIS Commission, Ending the Cycle of Crisis and Complacency in U.S. Global Health Security (2019)
  • U.S. National Health Security Strategy, 2019–2022 (2019)
  • Global Health Security Index (2019)

Further Reading

Health-Systems Strengthening in the Age of COVID-19

By Angela E. Micah , Katherine Leach-Kemon , Joseph L Dieleman August 25, 2020

What Is the World Doing to Create a COVID-19 Vaccine?

By Claire Felter Aug 26, 2020

What Does the World Health Organization Do?

By CFR.org Editors Jun 1, 2020

The pandemic changed the way we understand speech

A new study examines how certain now-common words influence what we expect to hear.

Our brains are great at filling in the blanks.

During the COVID-19 pandemic, we’ve been inundated with words and situations that were uncommon to many people before then. We’ve been in lockdowns, maintained social distance, worn masks, and taken vaccines and boosters, and have been talking about these topics seemingly nonstop. Life has looked very different for most people since the start of the pandemic, and new research suggests it has even altered the way we understand certain words.

Our study , 1 recently published in PLOS ONE, shows how likely we are to perceive these newly common words as a result of the pandemic — to the point that we expect to hear words like “mask” and “isolation,” even when a different but similar-sounding word is actually spoken. What word do you hear in these clips?

Now that we’ve lived through multiple years of the pandemic, you probably thought that the speaker is saying “lockdown,” “infection,” and “testing.” In reality, each recording is only a partial word: “--ockdown,” “in--ection” and “te--ing,” with a cough replacing the missing sound in each word.

The pandemic presented a once-in-a-generation opportunity to study rapid changes in the way we process language, as those changes were in the process of occurring. The abrupt change to everyone’s lives, and to the words that were on everyone’s lips, gave us a naturalistic way to study how the human brain understands speech and engages in statistical language learning. It also allowed us to study how the brain perceives words in noisy situations — like in a bar or on a train — where it’s not always clear exactly what word someone is saying. This research both helps us understand how our brains perform the highly complex task of understanding language, and may also help to better train AI models tasked with understanding human speech.

From April 2020 through February 2021, a total of 899 subjects participated in four experiments, conducted on Amazon Mechanical Turk, testing how they understood words like “mask” and “isolation” — words that did not feature prominently in our speech before COVID, but have now become extremely common. We found drastic, long-lasting cognitive effects in the way our brains understand these words.

What was that you said? What our 10-minute experiments taught us over 10 months

As cognitive psychologists, we love thinking about language and human interaction, and what happens in the brain when we talk to one another. As it became obvious that the sudden, massive societal shift caused by COVID was also changing the frequency with which we heard certain words, we wondered if it would cause any lasting changes to how our brains process language — a critical component of what makes us human.

At the time, we had no idea how the pandemic would unfold or that it would still be with us two and a half years later. This made the fact that we ran our first experiment just weeks after the start of the soon-to-be-commonly referenced “lockdowns” all the more prescient.

First, we decided on a set of 28 words which had become much more frequent after the onset of COVID – words such as “mask” and “lockdown.” To determine both the pre-pandemic frequency of these words (how often they were spoken between January and December 2019), and the post-pandemic-onset frequency of those same words (how often they were used between January and December 2020), we used the News on the Web ( NOW ) corpus — a dataset of thousands of newspaper and magazine articles containing billions of words, which, critically, includes when the articles were published and thus the date that each word was used. It was striking to see how much the frequency of individual words changed in such a short period of time: COVID-related words like “mask” were used three times as frequently during 2020 as they had been during 2019, even though similar-sounding words, like “map”, didn’t change at all.

Our experiments used the phonemic restoration task to test what words listeners understand when they hear something ambiguous. This works by recording a full word — for example, “knockdown” — and then removing one sound from the recording (here, the initial “kn” sound). Then, we replaced the deleted “kn” sound with a noise, as you can hear in the sound clip at the top of the post. We asked participants what word they heard when they listened to this now-incomplete and ambiguous recording. All the words we recorded were one sound away from a COVID-related word, such as "knockdown" instead of “lockdown,” and “task” instead of “mask.” And all of the recorded words were equally common in English as their COVID-related counterparts in 2019, but were much less commonly spoken in 2020.

The roughly 10-minute-long experiments presented each qualified participant with ambiguous auditory inputs. For example, a participant would hear a spoken word accompanied by an overlapping cough, much in the same way we might hear a word spoken in a crowd.

The pandemic changed the ranking of certain words we perceive

We ran a set of four experiments over the course of 10 months, and found that people now understand a slew of spoken words differently. For example, now that “mask” is more common, an ambiguous recording of a similar-sounding word “task” is misunderstood as “mask” three times as often as an ambiguous recording of the word “tap” is misunderstood as “map.” Our study is the first to demonstrate the presence of long-lasting changes in lexical accessibility induced by rapid changes in real-world linguistic input.

More research will be needed over time to confirm whether these pandemic-related words will recede to their pre-pandemic frequencies in our mental lexicons. But the implications are clear: Our brains rapidly adapt to the changing linguistic statistics of the world around us, and we predict and expect more common words compared to less common ones.

This research helps us to better understand how the brain processes language input, and adds to a growing body of research – including from our IBM Research colleagues studying other forms of sensory input – which may eventually inform the building of new AI models structured like our own brains. For example, this understanding of the brain's ability to rapidly adapt to changing word frequencies in real-world input could be applied to help digital assistants adapt to individual users' speech more effectively as well.

  • Rachel Ostrand

Kleinman, D., Morgan, A.M., Ostrand, R., Wittenberg, E. Lasting effects of the COVID-19 pandemic on language processing . PLOS ONE. June 15, 2022. ↩

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COVID-19 Pandemic: Knowledge and Perceptions of the Public and Healthcare Professionals

Priyanka a parikh.

1 Department of Pediatrics, Pramukhswami Medical College, Karamsad, IND

Binoy V Shah

Ajay g phatak.

2 Central Research Services, Bhaikaka University, Karamsad, IND

Amruta C Vadnerkar

3 Department of Public Health, Child Health Foundation, Gandhidham, IND

Shraddha Uttekar

4 Department of Public Health, International Pediatric Association, Gandhidham, IND

Naveen Thacker

5 Department of Pediatrics, Deep Children Hospital, Gandhidham, IND

Somashekhar M Nimbalkar

Background and objective

The recent pandemic due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a major concern for the people and governments across the world due to its impact on individuals as well as on public health. The infectiousness and the quick spread across the world make it an important event in everyone’s life, often evoking fear. Our study aims at assessing the overall knowledge and perceptions, and identifying the trusted sources of information for both the general public and healthcare personnel.

Materials and methods

This is a questionnaire-based survey taken by a total of 1,246 respondents, out of which 744 belonged to the healthcare personnel and 502 were laypersons/general public. There were two different questionnaires for both groups. The questions were framed using information from the World Health Organization (WHO), UpToDate, Indian Council of Medical Research (ICMR), Center for Disease Control (CDC), National Institute of Health (NIH), and New England Journal of Medicine (NEJM) website resources. The questions assessed awareness, attitude, and possible practices towards ensuring safety for themselves as well as breaking the chain of transmission. A convenient sampling method was used for data collection. Descriptive statistics [mean(SD), frequency(%)] were used to portray the characteristics of the participants as well as their awareness, sources of information, attitudes, and practices related to SARS-CoV-2.

The majority (94.3%) of the respondents were Indians. About 80% of the healthcare professionals and 82% of the general public were worried about being infected. Various websites such as ICMR, WHO, CDC, etc., were a major source of information for the healthcare professional while the general public relied on television. Almost 98% of healthcare professionals and 97% of the general public, respectively, identified ‘Difficulty in breathing” as the main symptom. More than 90% of the respondents in both groups knew and practiced different precautionary measures. A minority of the respondents (28.9% of healthcare professionals and 26.5% of the general public) knew that there was no known cure yet. Almost all respondents from both the groups agreed on seeking medical help if breathing difficulty is involved and self-quarantine if required.

Most healthcare professionals and the general public that we surveyed were well informed about SARS-CoV-2 and have been taking adequate measures in preventing the spread of the same. There is a high trust of the public in the government. There are common trusted sources of information and these need to be optimally utilized to spread accurate information.


In December 2019, the 2019 novel coronavirus disease (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China, followed by a rapid spread all over the world. On March 11, 2020, the World Health Organization (WHO) raised its pandemic alert. As of April 11, 2020, COVID-19 had caused over 95,269 deaths in 189 countries and overseas territories or communities [ 1 ].

In a connected world, fake news and rumor-mongering are common due to a surge in the use of the internet and social media. A confused comprehension in an emerging communicable disease of which even the experts have inadequate knowledge can lead to fear and chaos, even excessive panic, which has the probability to aggravate the disease epidemic [ 2 ]. During the SARS epidemic from 2002 to 2004, there were misconceptions and hence excessive panic in the general public concerning SARS. This led them to be resistant to comply with suggested preventive measures such as avoiding public transportation, going to a hospital when sick, etc. This contributed to the rapid spread of SARS and resulted in a more serious epidemic situation [ 3 ]. A similar experience occurred during the Ebola outbreak in 2009 in Africa. These experiences underscore the vital role of engaging with the general public and healthcare professionals and the importance of monitoring their perception of disease epidemic control, which may affect the compliance of community to the precautionary strategies. Understanding related factors affecting and influencing people to undertake precautionary behavior may also help decision-makers take appropriate measures to promote individual or community health. Hence, it is crucial to understand people’s risk perception and identify their trusted sources of information to effectively communicate and frame key messages in response to the emerging disease [ 4 ].

Since it is the novel coronavirus, its epidemiological features are not well known and new studies and publications will take anywhere from a month to a year making it important to know and understand the level of knowledge and preparedness of the healthcare personnel in terms of the managing the virus affected patients. Today healthcare professionals managing COVID-19 across the world are in an unprecedented situation, having to make tough decisions and working under extreme pressures. Decisions include equitable distribution of scant resources among the needy patients, balancing their own physical and mental healthcare needs along with those of the patients, aligning their desire and duty to patients with those to family and friends, and providing care for all unwell patients with constrained or inadequate resources. This may cause some to experience moral distress or mental health problems [ 5 ].

Effective communication is a priority in WHO’s COVID-19 roadmap; accurate and salient messages will enhance trust and enable the public to make informed choices based on recommendations [ 6 ].

As the outbreak intensified, social media has taken on new and increased importance with the large-scale implementation of social distancing, quarantine measures, and lockdown of complete cities. Social media platforms have become a way to enable homebound people to survive isolation and seek help, co-ordinate donations, entertain, and socialize with each other.

Social media platforms arguably support the conditions necessary for attitude change by exposing individuals to correct, accurate, health-promoting messages from healthcare professionals

In order to investigate community responses to SARS-CoV-2, we conducted this online survey among the general public and healthcare professionals to identify awareness of SARS-CoV-2 (perceived burden and risk), trusted sources of information, awareness of preventative measures and support for governmental policies and trust in authority to handle SARS-CoV-2 outbreak and put forward policy recommendations in case of similar future conditions.

We performed a cross-sectional survey of a convenient sample of respondents. The ethical approval for the study was taken from the Institutional Ethics Committee - 2, HM Patel Centre for Medical Care and Education, Karamsad via letter IEC/ HMPCMCE/ 2019 / Ex. 07/ dated March 23, 2020. All participants were above 18 years of age conveniently selected from the public at large by reaching out to the general public and healthcare professionals by the authors. The participants were largely from India. The consent of the participants was taken at the beginning of the survey. Two different self-administered questionnaires were used. The one for non-medical personnel (general public) is shown in Table ​ Table1, 1 , while the one for medical and paramedical personnel is shown in Table ​ Table2 2 .

COVID-19 (for non-medical personnel) question list
4Are you aware of COVID-19 or coronavirus?
5Are you worried that you can get infected?
6If no, why?
7Where do you get the information regarding coronavirus or COVID-19 from?
8Do you go to any specific websites?
9If yes, name of the website
10What are the symptoms of the disease that you know?
11How does the disease spread?
12How can you prevent the spread and protect yourself?
13Who should wear a mask?
14Do you wash your hands more frequently now?
15Are you aware of the technique of handwashing and use of sanitizer?
16How many times do you wash your hands?
17Do you avoid social gatherings or events?
18Have you cancelled a personal trip?
19If you are suffering from any of the symptoms but not having difficulty in breathing what will you do?
20If you have fever, cough and shortness of breath what should you do?
21Do you think the government of India is taking proper steps to control the spread of the disease?
22Do you believe that there is a treatment for the disease?
23Do you believe that there is a vaccine for the disease?
24Do you take the influenza vaccine every year?
25Do you have old people at home who take the influenza vaccine?
26If someone gets infected, for how long can he infect others?
27If you are exposed to an infected person, how long will it take to show symptoms of the disease?
28Would you be willing to self-isolate and work from home for 7 to 14 days if needed?
29Is your organization giving you the provision of working from home?
30What steps do you take to protect yourself?

WHO, World Health Organization

COVID-19 (for medical and paramedical personnel) question list
3If other, specify
6Are you worried that you can be infected with coronavirus?
7If no, why?
8Where do you get the information regarding coronavirus or COVID-19 from?
9Do you go to any specific websites?
10If yes, name of the website
11Have you read articles published in scientific journals with respect to COVID-19?
12Have you attended online or in-person any lectures organized by college, IMA or other professional organization?
13Have you listened to talks on YouTube by WHO or other experts?
14What source of information do you trust?
15If website, specify the website
16If any other source, specify
17What are the symptoms of the disease that you know?
18How does the disease spread?
19How can you prevent the spread and protect yourself?
20Are you avoiding social/public gathering?
21If yes, since when?
22Who should wear a mask?
23Should you wash your hands before wearing and after removing a mask?
24Do you wash your hands more frequently now and are you aware of WHO guidelines for handwashing?
25How many times do you wash your hands?
26How many steps are there for hand washing as recommended in WHO guidelines for hand hygiene?
27When should you wash your hands?
28If you are suffering from any of the symptoms but not having difficulty in breathing what will you do?
29If you have fever, cough and shortness of breath what should you do?
30Do you think the government is taking proper steps to control the spread of the disease?
31Do you believe that there is a treatment for the disease?
32Do you believe that there is a vaccine for the disease?
33Do you take influenza vaccine every year?
34Do you have old people at home who take influenza vaccine?
35If someone gets infected, for how long can he infect others?
36If you are exposed to an infected person, how long will it take to show symptoms of the disease?
37Is COVID-19 same as SARS (severe acute respiratory syndrome)?
38Have you previously managed SARS (severe acute respiratory syndrome) or other epidemics that cause respiratory issues?
39For how long the virus will survive on
40Can you get the infection from your pet (cats and dogs)?
41Have you cancelled a personal trip?
42Would you be willing to self-isolate and work from home for 7 to 14 days if needed?
43Is your organization giving you the provision of working from home?
44Are you taking hydroxychloroquine?
45Do you trust the task force of the ICMR on COVID-19?
46Which stage of the pandemic is India in?
47What steps do you take to protect yourself?

The questions were framed using information from the WHO, UpToDate, Indian Council of Medical Research (ICMR), Center for Disease Control (CDC), National Institute of Health (NIH), and New England Journal of Medicine (NEJM) website resources as updated till March 19, 2020. They were validated consensually by experts from the Department of Pediatrics, Pulmonary Medicine, Public Health, and General Internal Medicine. The COVID-19 questions for healthcare professionals, i.e., medical and paramedical personnel were applicable to consultants, residents, interns, medical students, physiotherapists, physiotherapy students, nurses, nursing students, dentists, etc. The questionnaire was administered in English with the help of Google forms, which is a cloud-based data management tool used for designing and developing web-based questionnaires and available free. A link to the online surveys was sent out to them via e-mails and different social media platforms, namely WhatsApp, Facebook, LinkedIn, and Instagram messages, hence without any geographical barrier. The data collection was started on the March 23, 2020 and was continued up till March 27, 2020 midnight. The dates are important as on 22 March there was a self-imposed Janata Curfew in response to Prime Minister of India’s call while from the midnight of March 24, 2020, there was a nationwide lockdown across India. The data was automatically collected in the form of a google sheet and the collected data was being exported automatically to google sheets (similar to Microsoft Excel).

Descriptive statistics [mean (SD), frequency (%)] were used to portray the characteristics of the participants as well as their awareness, sources of information, attitudes, and practices related to SARS-CoV-2. Due to large sample sizes in the healthcare professional group as well as the general public group, exploratory visual comparisons were presented without typical statistical tests of significance.

A total of 744 health and allied professionals and 502 persons from people at large consented and completed the survey. A majority (94.3%) of the participants were Indian residents with insignificant responses from outside India. It is presumed that the majority of the respondents are of Indian residents but the possibility of a handful of them being non-Indians cannot be ruled out because we did not collect demographic data. A comparison of awareness about SARS-CoV-2 between the general public and healthcare professionals is shown in Table ​ Table3 3 .

Awareness about SARS-CoV-2
 Healthcare professionals%General public at large%
Respondents744 502 
Country of residence (India)72597.4%45089.6%
Gender (female)37450.3%21943.6%
Age (year) - mean29.55 32.16 
Age (year) - SD12.53 13.32 
Worried about getting infected59480%41082%
Major sources of information
Healthcare professional48364.9%20140%
Scientific journals30440.9%NA 
Social networks51%39378.3%
Identified “difficulty in breathing” as main symptom72798%48697%
Precautionary measures
Hand washing73298.4%49799%
Wearing mask61182.1%34468.5%
Using sanitizer70494.6%47494.4%
Avoid public gatherings72196.9%49598.6%
Maintaining 1-meter distance69793.7%47895.2%
Avoid touching nose, eyes, mouth68592.1%46793%
Covering mouth while coughing and sneezing72196.9%48296%
Self-quarantine when needed 67590.7%47193.8%
Avoid public transport71496% 48095.6%
Knew there is no curative treatment21528.9%13326.5%
Knew there is no vaccine43858.9%29959.6%
Infected person can spread it up to 14 days53471.8%31562.7%
One can be asymptomatic up to 15 days after infection70294.3%45691%
Who should wear medical mask?    
Healthcare workers71996.6%47193.8%
Persons with respiratory symptoms71195.6%45690.8%
Healthy people to protect themselves30340.7%25350.4%
Person who is coughing/sneezing65287.6%44288%
Will ask for COVID-19 test for symptoms without difficulty in breathing306 41%24649%

The gender distribution was equal in the healthcare professionals group, whereas it was more male-dominated in the general public group (49.7% vs 56.4% males). The respondents were younger in the healthcare professionals group as compared to the general public group [mean (SD) age: 29.55 (12.53) vs 32.16 (13.32) years].

The majority of the participants from the healthcare professionals group [594 (80%)] and the general public group [410 (82%)] were worried about getting SARS-CoV-2 infection. Those who were not worried expressed justified reasons (mainly precautions) for their attitude. Online resources, television, peer group discussions, and scientific literature constituted the main sources of information in the healthcare professionals group, whereas television, social networking sites, and newspapers/magazines constituted the main sources of information in the general population group. Participants in both groups reported WHO and official Indian Government websites (ICMR, Ministry of Health and Family Welfare (MOHFW)) as the most trusted online resources.

Most of the healthcare professionals reported that they had accessed videos by WHO/other sources [514 (69%)], read scientific articles [407 (54.7%)], and attended online lectures [242 (32.5%)] related to SARS-CoV-2.

Most healthcare professionals [727(98%)] as well as the general public [486(97%)] identified “difficulty in breathing” as the main symptom of SARS-CoV-2 infection along with cough and fever. Respondents from both the groups were aware of precautionary measures such as hand washing/sanitizer, wearing masks, social distancing, covering mouth while sneezing, and self-quarantine. Majority of the participants (62.7% in the general public and 71.8% in healthcare professionals) were aware of the infection period and the asymptomatic period (91% in the general public and 94.3% in healthcare professionals), but there appeared to be some confusion regarding curative treatment and vaccine availability in both the groups. Most participants rightly endorsed medical masks for healthcare workers, symptomatic patients, and persons who are coughing/sneezing. However, an appreciable proportion of healthcare professionals [303(40.7%)], as well as respondents from the general public [253(50.4%)], wrongly endorsed medical masks for healthy persons to protect themselves. 

Most healthcare professionals [648(87.1%)] expressed their trust in the ICMR task force on SARS-CoV-2. Similar feelings were echoed by the general public [426(85%)] in trusting the current government. 

Half of the general public respondents showed eagerness for the SARS-CoV-2 test without difficulty in breathing. A similar trend was observed among health professionals. Almost all respondents from the general public (98%) and the healthcare professionals (100%) endorsed seeking medical help if the breathing difficulty was involved.

Slightly more healthcare professionals reported regular influenza vaccination as compared to the general public [175(23.5%) vs 76(15.1%)]. Almost all the respondents agreed for self-isolation if needed. The majority of the respondents reported that they were washing the hands more frequently and knew the correct way of handwashing.

We present here a study of the awareness of SARS-CoV-2 among healthcare professionals and the general public with a comparison of many features among them. It is heartening to note that the knowledge with respect to SARS-CoV-2 is relatively high among the respondents.

There are, however, various limitations of the study and these are inherent due to the circumstances in which this survey was done. The study was begun on March 23, 2020, one day after Janata Curfew in India as requested by the Prime Minister and one day before the lockdown on March 24, 2020 [ 7 ]. The survey was filled during the days of the lockdown when the respondents had a lot of time on their hands and were probably active on social media as well as watching the television news. Hence, it is quite relevant that many individuals have their information from these two sources, making it important to ensure that accurate information through verified channels and healthcare professionals are presented and broadcasted to the people. This also points towards the importance of the right people being active on social media so that they can communicate the scientifically validated information to the masses.

The curfew and the lockdown ensured that the seriousness of the disease was impressed upon by the highest offices in the country, which is reflected in people taking good precautionary measures to protect themselves from the disease as well as break the chain of transmission. The cases in India have hence not risen to a very high number as rapidly as expected/projected, which also probably indicates that the message was well conveyed and well perceived. As this is a survey that was filled remotely, we need to be cautious in drawing strong conclusions.

Another limitation of the study is that the questionnaire was in the form of google forms and the language of conduct was English. This implies that the people who did not have access to the internet and were not literate were unable to be a part of this survey. But as the source of information for all the general public remains similar (television is ubiquitous in India), we can infer that they would have a similar response. We base this inference as the main sources of information of the public at large were newspapers, television, and WhatsApp despite having access to websites and other online sources. In villages, often the literate readout regional newspapers and news received on mobiles to the rest of the family/friends to ensure dissemination of information.

It is now known that the basic reproductive number (R0) of coronavirus is more in healthcare professionals as compared to the lay public and hence the relative indifference or "no worries" approach of healthcare professionals towards getting infected by SARS-CoV-2 is a concern. In the scenario where adequate personal protective equipment (PPE) may not be available to the healthcare facilities in India due to increased global demand, it is important that healthcare workers know their risk for being infected. In a recent study in Mumbai, 79% of the healthcare professionals were aware of the various PPE required with only 54.5% of them being aware of isolation procedures needed for SARS-CoV-2 infected patients [ 8 ]. The numbers for paramedical staff were also lower. India imports raw materials for PPE production from China and South Korea. Due to the shortage of materials and low rate of supply, the availability has taken a massive hit resulting in an acute shortage in the market. It is highly likely that many healthcare professionals will not use appropriate PPE, will get infected, and further spread infections to patients [ 9 - 11 ]. The Bhilwara cohort in Rajasthan is an example of how a healthcare professional needs to protect against infection since he/she is likely to transmit it to others [ 12 ]. Another example in Mumbai is Saifee hospital, which was shut down due to an infected healthcare professional who continued to work and passed on the infection to many during the asymptomatic phase. The SARS-CoV-2 disease presents a unique organism that can be spread for at least five days before developing symptoms and up to 37 days after presentation [ 13 , 14 ]. Given its high infectivity, it is a recipe for disaster if healthcare personnel gets it. We have not collected demographic information from the participants and hence it is possible that many of them work in situations where they may not anticipate getting infected. The previous few months have shown how surgeons, orthopedicians, dentists, etc., who typically do not deal with infectious diseases are getting infected by coronavirus [ 15 , 16 ]. In this scenario, it is worrying that only 80% of healthcare professionals were worried while the public was slightly more worried (82%).

The difference in the source of information for healthcare professionals and the general public is stark when we compare information garnered through social media. Social media at 78.3% is the second-highest source for the general public, while the healthcare professionals give it a measly 1%. Since social media is prone to fake news, it is heartening that healthcare professionals are not learning from it. However, the reliance of the general public on social media indicates that healthcare professionals, professional organizations, and government officers need to invest a significant proportion of their time and resources to be active on social media to disseminate correct news. The shots heard round the world rapid-response network is an example that needs to be followed [ 17 ]. In another example, we have Dr. Roberto Burioni who has successfully given accurate data on social media. If more healthcare professionals were to enrich social media, it would be a useful platform for the public [ 18 , 19 ]. While many government officials are active on Twitter in India, the platform that is commonly used in India is WhatsApp, Telegram, Instagram, and TikTok and these are dynamic and keep changing. WhatsApp in the middle of this pandemic reduced the forwarding to just one person for a message that had been forwarded five times from the previous number of forwarding to five people (which was unlimited initially) [ 20 ]. It indicates the importance of this platform across the world for the spreading of messages. The healthcare professionals rated scientific journals at just about 40.9%. It may be due to the low availability of high-quality evidence or poor access that many healthcare professionals in India have to scientific journals, which are mostly published out of developed countries [ 21 ]. In a pandemic situation, this disparity in access can be catastrophic and hence most journals have provided open access to all coronavirus-related publications. Healthcare professionals accessed websites such as WHO, Medscape, MOHFW, CDC, Worldometers, covid19.com , ICMR, UpToDate, and PubMed, for reliable information, which is an indicator of their faith in health organizations across the world. Interestingly though at a low 29.3%, much of the general public accessed similar websites such as WHO, MOHFW, CDC, and ICMR. At the time that the survey was administered, online webinars via zoom or other applications were just beginning in India to educate clinicians searching for answers. This is not reflected in our current study due to many of the responses being filled before the same or the respondents not being part of these audiences. The study authors have attended many of these meetings conducted by the Indian Academy of Pediatrics, etc., and this information is made available via email or WhatsApp messages. In a changing world, both healthcare professionals and the general public need to have reliable and accurate sources of information.

The severity of illness was well identified by all who were surveyed as being difficulty in breathing. Another heartening aspect was that precautionary measures were well known to both the groups of participants with appropriate hand washing techniques, avoidance of public gatherings, and covering of the mouth while coughing and sneezing as the top three precautionary measures. During the first week of March in India, all the telephone and cellular caller tunes were changed to advisories of how to prevent coronavirus disease and when to seek medical help, which included the above messages apart from appeals on television, etc [ 22 ].

There was less knowledge related to treatment and vaccine among both healthcare professionals and the general public, which was a disappointing finding for healthcare professionals as they were expected to be aware of this. The same could be said of the knowledge of the infectivity period and duration of being asymptomatic after infection. There was a good knowledge of the usage of masks among the general public and healthcare professionals except for the usage of medical masks for healthy people to protect themselves. The ICMR and other bodies have issued guidelines on the usage of masks and this seems to have been disseminated widely [ 23 ]. There was also a low insistence on the need for testing those without respiratory difficulty. In a scenario where testing resources are limited, this is an appropriate response but since it is possible to have the infection without respiratory difficulty, especially early on, this disinterest in getting tested, especially in healthcare personnel is worrisome when there is enough evidence of spread from asymptomatic and mildly symptomatic persons. It is also likely that this response may be due to the fact during the time that this questionnaire was administered, the total cases rose from 400+ to about 800+ and the testing strategy of ICMR was limited to those with contact or travel to SARS-CoV-2-affected areas [ 24 ].

Since writing this manuscript, except for a single source event of a religious gathering in Delhi, which caused the doubling of cases to increase from about seven days to 4.1 days, it is reasonable to conclude that adequate knowledge exists among the general public. We can only hope that this would be enough to ensure that lockdown to reduce transmission and flatten the curve will be successful [ 25 - 28 ].


The COVID-19 pandemic has affected the world in various ways. The deficiency of information, the need for accurate information, and the rapidity of its dissemination are important, as this pandemic requires the cooperation of entire populations. The rapid survey that we conducted had a good response and we show that healthcare professionals and the general public were quite well informed about the coronavirus. They are aware of the measures needed to be taken to reduce the spread of the disease. The knowledge present allows the authors to speculate that the lockdown in India would be effective. The public receives a large amount of information from social media such as WhatsApp and the medical fraternity and government need to develop strategies to ensure that accurate information needs to spread in these fora. The public awareness is quite high and it is important that the knowledge of communication channels be known and be kept at the topmost priority throughout the pandemic.


We are thankful to Dr. Mili Shah for language check of our manuscript.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

Human Ethics

Consent was obtained by all participants in this study. INSTITUTIONAL ETHICS COMMITTEE ‐ 2 H M PATEL CENTRE FOR MEDICAL CARE AND EDUCATION, KARAMSAD [ECR/1123/Inst/GJ/2018] issued approval IEC/ HMPCMCE/ 2019 / Ex. 07/. The following is part of the text of the approval letter indicating approval for the study. "Your research proposal ‘Response of the public and health care providers to a pandemic of a new virus’ was submitted for review and approval by committee members under Exempt Review. As it involves collection of data using anonymous online questionnaire with maintenance of privacy and confidentiality, it qualified for an Exempt from Full Committee Review. The matter was reviewed by Committee Members and decided to review it under ‘Exempt from full committee’ review. After review and subsequent clarification by you, the project is approved by IEC in its present form. As the online form has information and consent section, which needs to be read and accepted by the respondents before answering the study questions, committee waivers the need for any other consent for data collection."

Animal Ethics

Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue.

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The impact of COVID-19 on speech-language and hearing professions in low- and middle-income countries: Challenges and opportunities explored


  • 1 Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg. [email protected].
  • PMID: 36226974
  • PMCID: PMC9557934
  • DOI: 10.4102/sajcd.v69i2.937

Background: Since the advent of the coronavirus disease 2019 (COVID-19), the speech-language and hearing (SLH) professions globally have been confronted with novel and unexpected challenges.

Objective: The aim of this article was to explore the impact of COVID-19 on SLH professions in low- and middle-income countries (LMICs) as presented in the Special Issue of the South African Journal of Communication Disorders in the year 2022.

Method: Divergent from the standard editorial writing style, this editorial adopted a research approach where a qualitative, descriptive scoping review design was conducted to meet the objectives of the study. Three specific objectives were targeted: (1) exploring the challenges to SLH research, teaching and practice; (2) establishing evidence-based solutions available for these challenges that can be used to improve the professions' response in the post-pandemic era; and (3) determining the areas that require further investigation, alternative solutions and innovation for improved readiness for future pandemics. A total of 21 manuscripts were reviewed that covered three predetermined themes - research, teaching and practice - that were constructed through a deductive approach as part of the call for papers for the special issue. These manuscripts were from academics, researchers and clinicians from various institutions in LMICs. The review is presented using thematic analysis.

Results: The review raised important challenges, presented under various subthemes, to the three key themes. These challenges reflect on the impact of COVID-19 on the SLH professions in terms of research, teaching, service provision and ethical challenges, as well as its impact on speech language, hearing, swallowing and balance functions. The review also advanced solutions and future directions during and beyond COVID-19.

Conclusion: These findings raise global implications for research, teaching and practice that are not only relevant to the SLH professions.

Keywords: COVID-19; audiology; clinical research; hearing professions; practice; speech–language pathology; teaching and learning.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

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Opinion Zeynep Tufekci

An Object Lesson From Covid on How to Destroy Public Trust

Credit... Nicole Natri

Supported by

Zeynep Tufekci

By Zeynep Tufekci

Opinion Columnist

  • June 8, 2024

Big chunks of the history of the Covid pandemic were rewritten over the last month or so in a way that will have terrible consequences for many years to come.

Under questioning by a congressional subcommittee, top officials from the National Institutes of Health, along with Dr. Anthony Fauci, acknowledged that some key parts of the public health guidance their agencies promoted during the first year of the Covid-19 pandemic were not backed up by solid science. What’s more, inconvenient information was kept from the public — suppressed, denied or disparaged as crackpot nonsense.

Remember the rule that we should all stay at least six feet apart? “It sort of just appeared,” Fauci said during a preliminary interview for the subcommittee hearing, adding that he “was not aware of any studies” that supported it. Remember the insistence that the virus was primarily spread by droplets that quickly fell to the floor? During his recent public hearing, he acknowledged that to the contrary, the virus is airborne.

As for the repeated assertion that Covid originated in a “wet market” in Wuhan, China, not in an infectious diseases laboratory there, N.I.H. officials were privately expressing alarm over that lab’s lax biosafety practices and risky research. In his public testimony, Fauci conceded that even now there “has not been definitive proof one way or the other” of Covid-19’s origins.

Officials didn’t just spread these dubious ideas, they also demeaned anyone who dared to question them . “ Dr. Fauci Throws Cold Water on Conspiracy Theory That Coronavirus Was Created in a Chinese Lab ” was one typical headline. At the hearings, it emerged that Dr. David Morens, a senior N.I.H. figure, was deleting emails that discussed pandemic origins and using his personal account so as to avoid public oversight . “We’re all smart enough to know to never have smoking guns, and if we did we wouldn’t put them in emails and if we found them we’d delete them,” he wrote to the head of a nonprofit involved in research at the Wuhan lab.

I wish I could say these were all just examples of the science evolving in real time, but they actually demonstrate obstinacy, arrogance and cowardice. Instead of circling the wagons, these officials should have been responsibly and transparently informing the public to the best of their knowledge and abilities.

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Readers respond to essays on long Covid, hypochondria, and more

Patrick Skerrett

By Patrick Skerrett June 22, 2024

Illustration of a large open envelope with many symbols of healthcare and science pouring out, on a purple background

F irst Opinion is STAT’s platform for interesting, illuminating, and maybe even provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others.

To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT publishes selected Letters to the Editor received in response to them. You can submit a Letter to the Editor here , or find the submission form at the end of any First Opinion essay.


“Long Covid feels like a gun to my head,” by Rachel Hall-Clifford

Thank you for this. I’m a 65-year-old woman who’s Covid cautious and wears a mask in public places (yes, in 2024). I’ve never had Covid as far as I know, and I try to keep up with the research. I feel like everybody would be more cautious if they read this article on long Covid, because it helps to really understand the horrible ways that a mild case of Covid can affect your life in ways that are unimaginable.

— Hildy Hogate

“I’m a hypochondriac. Here’s how the health care system needs to deal with people like me,” by Hal Rosenbluth

Health anxiety is the less biased term, rather than hypochondria with all its comic baggage.

Though the writer likes full body scans for himself and they suit his particular fears, many, many people with health anxiety, including me, wouldn’t get within 10 feet of a full body scan. It would be the opposite of reassuring.

Even if it did reassure for the moment, anyone with health anxiety knows reassurance is short-lived. A scan done in, say, January, might reassure a non-anxious person for the next six months. But it would be the rare person with health anxiety who would feel reassured for more than a couple of weeks.

And why on earth would you want to create a separate billing code for this, which would, without question, be used to pick out, stigmatize, and limit access to medical care? That doesn’t help patients, it soothes and enriches insurers, who would undoubtedly limit access to care based on a scan. How long would it take before you called to make an appointment with your doctor and were told sorry, your insurance won’t cover an office visit — your scan said you have no problems?

The writer’s personal experience, psychology, and taste for scans are just that, personal. They don’t generalize to most, or even many, of those who suffer from health anxiety.

— Maria Perry

“NIH needs reform and restructuring, key Republicans committee chairs say,” by Cathy McMorris Rodgers and Robert B. Aderholt

I agree with the authors that NIH needs reform. I was an athletic, otherwise healthy person who was struck down and disabled by long Covid in January 2022. For over two years, I’ve watched life pass me by as NIH has fumbled the $1.15 billion allocated to it by Congress to study and treat long Covid. This initiative, known as RECOVER, has failed to publish any research that furthers our understanding of the underlying cause of long Covid and the vast majority of clinical trials they’ve launched are for drugs that people have already tried and found unhelpful.

Perhaps NIH would not have bungled the long Covid funding had it not completely ignored other post viral diseases, namely myalgic encephalomyelitis (ME) for the past 40 years. ME receives only $15 million a year — the most underfunded disease per patient burden at the NIH.

NIH should reevaluate how it allocates funding to diseases and base allocations on objective patient burdens. HIV, a disease with treatments that allow people with it to live mostly normal lives, receives $3.3 billion annually through NIH. Meanwhile, ME patients are disabled, have no approved treatments, and suffer a higher patient burden. Covid long haulers are suffering the same fate, many struck down as first wavers in March of 2020 are still disabled and sick as ever over four years later. Despite this, there is still no yearly allocation for long Covid in NIH’s baseline budget, as funding has only ever come from one time appropriations. NIH should right-size funding for ME and long Covid and start taking these diseases seriously.

— John Bolecek, long Covid patient

“Addressing health care workers’ trauma can help fight burnout,” by Sadie Elisseou

Thank you for writing this essay on the trauma and burnout that are all too common among today’s health care workforce. I applaud you for underscoring the importance of trauma-informed organizations and the critical value of workplaces that are safe, supportive, and flexible.

As a nurse educator and researcher, I have come to understand the important role of resilience in the work that nurses do. Considering two-thirds of nurses (65%) experience burnout, resilience-building skills are critical to mitigating nurse exhaustion and preserving our nation’s nursing pipeline. If actions are not taken to better protect the physical and mental health of our healthcare workforce, patient care will suffer. Lawmakers must take notice.

Some efforts in Congress have been successful. Congress has introduced legislation to reauthorize the Dr. Lorna Breen Provider Protection Act , bipartisan legislation that recognizes the need for mental health resources and support programs for healthcare professionals. Since its original enactment, this act has been instrumental in funding grant programs for mental health training, education, peer support, and crisis intervention services.

The reauthorization of this measure would expand grants to more than 200,000 other types of health care settings as well as renew the focus on reducing administrative burden for health care workers. While this bill is not a perfect solution, it does provide needed to support for a workforce that is understaffed, overworked, and in need to relief.

I urge Congress to finish the job and fully reauthorize the Dr. Lorna Breen Provider Protection Act this year.

— Stephanie Turner, R.N., Ed.D., M.S.N., ATI Nursing Education

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Patrick skerrett.

Acting First Opinion Editor

Patrick Skerrett is filling in as editor of First Opinion , STAT's platform for perspective and opinion on the life sciences writ large, and host of the First Opinion Podcast .

STAT encourages you to share your voice. We welcome your commentary, criticism, and expertise on our subscriber-only platform, STAT+ Connect

To submit a correction request, please visit our Contact Us page .

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Long-Term Health Effects of COVID-19: Disability and Function Following SARS-CoV-2 Infection (2024)

Chapter: 6 overall conclusions.

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6 Overall Conclusions This chapter presents nine conclusions derived by the committee from evidence presented throughout the report. This chapter does not include ref- erences. Citations to support the text and conclusions herein are provided in previous chapters of the report. DIAGNOSIS OF LONG COVID Long COVID is associated with a wide range of new or worsening health conditions and encompasses more than 200 symptoms involving nearly every organ system. There currently are no consensus-based diagnos- tic criteria for the condition; criteria for diagnosis are evolving as experi- ence and research findings develop. Diagnosis of Long COVID is generally based on a known or presumed history of acute SARS-CoV-2 infection (as indicated by a positive viral test or patient self-report; as of this writing, no diagnostic test for Long COVID is available), the presence of Long COVID health effects and symptoms, and consideration of other conditions and etiologies that could be causing the symptoms. Testing to diagnose acute SARS-CoV-2 infection, as well as testing capacity and behaviors, has changed dramatically over the course of the COVD-19 pandemic. Testing was constrained during the early phase of the pandemic, although it subsequently became increasingly available, and the introduction of at-home testing meant that many people may not have reported their positive results to health care systems. As a result of these two drivers, many individuals infected with SARS-CoV-2 never received formal 215 PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 215 5/21/24 11:25 AM

216 LONG-TERM HEALTH EFFECTS OF COVID-19 documentation of their diagnosis. Sole reliance on a documented history of SARS-CoV-2 infection when diagnosing Long COVID will miss these indi- viduals. Therefore, the presence of signs and symptoms and self-reported prior infection are generally considered sufficient to establish a diagnosis of SARS-CoV-2 infection. Continued research on and discussion of Long COVID will help inform a case definition and standardized diagnosis. Based on its review of the literature, the committee reached the follow- ing conclusion: 1. Long COVID is a complex chronic condition caused by SARS-CoV-2 infection that affects multiple body systems. Because of wide variability in testing practices over the course of the pandemic, many people expe- riencing Long COVID have not received a formal diagnosis of prior SARS-CoV-2 infection. A positive test for SARS-CoV-2 is not necessary to consider a diagnosis of Long COVID. EPIDEMIOLOGY Long COVID can impact people across the lifespan, from children to older adults, as well as across sex, gender, racial, ethnic, and other demo- graphic groups. Women are twice as likely as men to experience Long COVID. Population surveys suggest that, as noted above, in 2022, the over- all prevalence of Long COVID was around 3.4 percent in U.S. adults and 0.5 percent in children. Estimates of the prevalence of specific long-term health effects of SARS-CoV-2 vary in the literature. This variation reflects the dynamic nature of the pandemic itself, as the virus has evolved and spawned many variants and subvariants (likely with different propensities to cause Long COVID), as well as the introduction of vaccines and treatments for acute infection (e.g., antivirals, steroids), both of which have been shown to reduce the risk of long-term health effects. Variation in incidence and preva- lence estimates also stem from the heterogeneity of study designs, including choice of control groups, methods used to account for the effect of baseline health, specification of outcomes, and other methodological differences. In addition, the broad multisystem nature of Long COVID and the fact that the associated health effects are expressed differently by age group and sex and by baseline health compound the challenge of identifying and quan- tifying affected populations. Symptoms of SARS-CoV-2 infection range in severity from mild to severe, and the literature suggests that the severity of acute SARS-CoV-2 infection is a risk factor for Long COVID. For example, a large Scottish population-based study found that 5 percent of those with mild infection had not recovered at least 6 months following infection, compared with 16 percent of those who required hospitalization—a ratio of approximately 1:3. PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 216 5/21/24 11:25 AM

OVERALL CONCLUSIONS 217 Based on its review of the literature, the committee reached the follow- ing conclusion: 2. The risk of Long COVID increases with the severity of acute infec- tion. By the committee’s best estimate, people whose infection was suf- ficiently severe to necessitate hospitalization are 2–3 times more likely to experience Long COVID than are those who were not hospitalized, and among those who were hospitalized, individuals requiring life support in the intensive care unit may be twice as likely to experience Long COVID. However, people with mild disease can also develop Long COVID, and given the much higher number of people with mild versus severe disease, they make up the great majority of people with Long COVID. HEALTH EFFECTS Long COVID is associated with hundreds of symptoms and new or worsening health effects that manifest in many different body systems. In keeping with the three domains of functioning in the International Clas- sification of Functioning, Disability and Health model of disability, health effects experienced in Long COVID may manifest as impairments in body structures and physical and psychological functions, with resulting activity limitations and restrictions on participation. Evidence on clustering of the post-acute and long-term health effects of SARS-CoV-2 infection remains inconsistent across studies. Consensus is needed on terms, definitions, and methodological approaches for generating better-quality and more consis- tent evidence. Based on its review of the literature, the committee reached the follow- ing conclusion: 3. Long COVID is associated with a wide range of new or worsening health conditions impacting multiple organ systems. Long COVID can cause more than 200 symptoms and affects each person differently. Attempts to cluster symptoms have yielded heterogeneous results. FUNCTIONAL IMPACT AND RISK FACTORS Some of the symptoms and health effects associated with Long COVID can be severe enough to interfere with an individual’s day-to-day functioning, including participation in work and school activities. Functional disability associated with Long COVID has been characterized as the inability to return to work, poor quality of life, diminished ability to perform activities of daily living, decreased physical and cognitive function, and overall disability. PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 217 5/21/24 11:25 AM

218 LONG-TERM HEALTH EFFECTS OF COVID-19 The severity of acute COVID-19 is a major risk factor for poor functional outcomes, but even people with mild initial illness can experience long-term functional impairments. Increased number and severity of long-term symp- toms correlate with decreased quality of life, physical functioning, and ability to work or perform in school. Other risk factors for poor functional out- comes include female sex, lack of vaccination against SARS-CoV-2, baseline disability or comorbidities, and smoking. There is some overlap between SSA’s current Listing of Impairments (Listings) and health effects associated with Long COVID, such as impaired lung and heart function. However, it is likely that most individuals with Long COVID applying for Social Security disability benefits will do so based on health effects not covered in the Listings. Three frequently reported health effects that can significantly interfere with the ability to perform work or school activities and may not be captured in the SSA Listings are chronic fatigue and post-exertional malaise, post-COVID-19 cognitive impairment, and autonomic dysfunction, all of which can be difficult to assess clinically in terms of their severity and effects on a person’s functioning. Based on its review of the literature, the committee reached the follow- ing conclusion: 4. Long COVID can result in the inability to return to work (or school for children and adolescents), poor quality of life, diminished ability to perform activities of daily living, and decreased physical and cognitive function for 6 months to 2 years or longer after the resolution of acute infection with SARS-CoV-2. Increased number and severity of long- term health effects correlates with decreased quality of life, physical and mental functioning, and ability to participate in work and school. Health effects that may not be captured in SSA’s Listing of Impairments yet may significantly affect an individual’s ability to participate in work or school include, but are not limited to, post-exertional malaise and chronic fatigue, post-COVID-19 cognitive impairment, and autonomic dysfunction. LONG COVID IN CHILDREN AND ADOLESCENTS While there are various definitions of children, adolescents, and young people, for the purposes of this report, “children” or “pediatrics” refers to the entire pediatric age range and “adolescents” to children at the older end of the spectrum (i.e., ages ~11 to 18 years). Even though most children experience mild acute COVID-19 illness, they can experience Long COVID regardless of the severity of their acute infection. As with adults, they may experience health effects across many body systems. Commonly reported symptoms include fatigue, weakness, headache, sleep disturbance, muscle PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 218 5/21/24 11:25 AM

OVERALL CONCLUSIONS 219 and joint pain, respiratory problems, palpitations, altered sense of smell or taste, dizziness, and dysautonomia. Although pediatric presentations and intervention options may overlap with those in adults—particularly among adolescents, who may be more likely than children to mimic the adult presentation and trajectory—pediatric management of Long COVID entails specific considerations related to developmental age and/or dis- abilities and history gathering. In general, children have fewer preexisting chronic health conditions compared with adults; thus, long COVID may represent a substantial change from their baseline, particularly for those that were previously healthy. Limited data are available on long-term outcomes in children. Some youth with persistent symptoms experience difficulties that affect their quality of life and result in increased school absences, as well as decreased participation and performance in school, sports, and other activities. Risk factors for the development of Long COVID include acute-phase hospi- talization, preexisting comorbidity, and infection with pre-Omicron vari- ants. Most children with Long COVID recover slowly over time, but not all. In one prospective cohort study of 1,243 children (ages 4-10) with Long COVID, for example, 48 percent remained symptomatic at 6 months, 13 percent at 12 months, and 5 percent at 18 months after infection. Impor- tantly, severity of symptoms and functional impairment from Long COVID symptoms were not correlated with traditional clinical testing (e.g., lung ultrasound, standard systolic and diastolic function on echocardiogram). It is important to note that in pediatrics, because of typical develop- ment, the baseline for performance of skills is constantly changing, espe- cially among young children. This can make deviations in their performance during Long COVID challenging to assess, and there may be a delay in recognition of any deviations (e.g., lack of developing a skill at the appro- priate age). Additionally, the duration of symptoms (e.g., 1 or 3 months) can feel very different to and have a greater impact on children compared with adults. Currently, there is a dearth of prospective and cross-sectional studies on the prevalence, risk factors, and time course and pattern of Long COVID in children. More research is needed to identify the long-term functional implications of Long COVID in children, because information from adult studies may not be directly applicable to the pediatric population. Based on its review of the literature, the committee reached the follow- ing conclusion: 5. Although the large majority of children recover fully from SARS-CoV-2 infection, some develop Long COVID and experience persistent or intermittent symptoms that can reduce their quality of life and result in increased school absences as well as decreased participation and per- formance in school, sports, and other activities. Overall, the trajectory PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 219 5/21/24 11:25 AM

220 LONG-TERM HEALTH EFFECTS OF COVID-19 for recovery is better among children compared with adults. More research is needed to understand the long-term functional implications of Long COVID in children, as information from adult studies may not be directly applicable. DISEASE MANAGEMENT Currently there are no Food and Drug Administration (FDA)–approved drugs or disease-modifying treatments for Long COVID. As with other complex multisystem conditions, management of Long COVID relies on techniques for controlling symptoms and improving functional ability, such as pacing (i.e., balancing periods of activity and rest in daily life), mobility support, social support, diet modulation, pharmacological treatment of secondary health effects, cognitive-behavioral therapy, and rehabilitation. Management often requires a multidisciplinary team. Because of the mul- tisystem nature of the condition, different approaches may be needed to address the variety of clinical presentations and environmental factors (e.g., living situation, work requirements, family support) among individuals. Numerous randomized controlled trials are currently being undertaken to determine the efficacy of a number of identified pharmacological agents; however, limited data have been published, and trials are yet to be finalized. Based on its review of the literature, the committee reached the follow- ing conclusion: 6. There currently is no curative treatment for Long COVID itself. Man- agement of the condition is based on current knowledge about treating the associated health effects and other sequelae. As with other complex multisystem chronic conditions, treatment focuses on symptom man- agement and optimization of function and quality of life. DISEASE COURSE AND PROGNOSIS Recovery from Long COVID varies among individuals, and data on recovery trajectories are rapidly evolving. Initial data suggest that peo- ple with persistent Long COVID symptoms generally improve over time, although preliminary studies suggest that recovery can plateau 6–12 months after acute infection. Studies have shown that only 18–22 percent of those who have persistent symptoms at 5–6 months following infection have fully recovered by 1 year. Among those who do not improve, most remain stable, but some worsen. More information on recovery trajectories at 1 year or longer may become available in the next few years. Rehabilitation and symptom management, including pacing, may improve function in some people with Long COVID, regardless of the severity of disease or duration PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 220 5/21/24 11:25 AM

OVERALL CONCLUSIONS 221 of symptoms, although the benefits are greater for those who are younger and who have had Long COVID for a shorter period of time. Based on its review of the literature, the committee reached the follow- ing conclusion: 7. Recovery from Long COVID varies among individuals, and data on recovery trajectories are rapidly evolving. There is some evidence that many people with persistent Long COVID symptoms at 3 months following acute infection, including children and adolescents, have improved by 12 months. Data for durations longer than 12 months are limited, but preliminary data suggest that recovery may plateau or progress at a slower rate after 12 months. HEALTH EQUITY The burden of seeking care and finding adequate services for Long COVID is challenging and can impact the potential for recovery. Patients with Long COVID may encounter skepticism about their symptoms when they present in medical settings, which discourages care seeking. This is particularly true for individuals disadvantaged by their social or economic status, geographic location, or environment, and can result in preventable disparities in the burden of disease and opportunities to achieve optimal health. Disadvantaged groups include members of some racial and ethnic minorities, people with disabilities, women, LGBTQI1 (lesbian, gay, bisex- ual, transgender, queer, intersex, or other) individuals, people with limited English proficiency, and others. Individuals with Long COVID have increased health care utilization and financial burden, which may be exacerbated if they are unable to work to gain income and or receive health insurance coverage. Members of dis- advantaged groups, especially early in the pandemic, were more likely to contract SARS-CoV-2, more likely to be hospitalized with acute COVID-19, more likely to have adverse clinical outcomes, and less likely to be vac- cinated, potentially increasing their risk of developing Long COVID. In addition, these groups are more likely to be uninsured or underinsured. Even for those with insurance coverage, some of the services that have been shown to improve function may not be covered by their benefits. Moreover, the availability of specialized Long COVID services is limited, and capacity does not match the demand for rehabilitation specialists. Limited transpor- tation, distance from clinics, and the inability to take time away from work or school are known barriers to care. The availability issue is particularly problematic for individuals living in medically underserved areas. Information about COVID is rapidly evolving, and this dynamic nature of the science may contribute to some patient hesitancy regarding PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 221 5/21/24 11:25 AM

222 LONG-TERM HEALTH EFFECTS OF COVID-19 prophylactic and therapeutic management for acute infection or Long COVID. Low levels of health literacy may also place some individuals at increased risk for misinformation, which may prevent them from fully tak- ing advantage of health care resources to protect and improve their health. Low health literacy may also impact individual self-management of the symptoms and conditions associated with Long COVID. Based on its review of the literature, the committee reached the follow- ing conclusion: 8. Social determinants of health, such as socioeconomic status, geographic location, health literacy, and race and ethnicity, affect access to health care. With respect to acute SARS-CoV-2 infection and Long COVID, adverse social determinants of health have contributed to disparities in access to SARS-CoV-2 testing; vaccination; and therapeutics, includ- ing treatments for acute infection and specialized rehabilitation clinics for Long COVID. In addition, the demand for specialty care exceeds capacity, resulting in waitlists for the receipt of services. SIMILAR CHRONIC CONDITIONS Long COVID shares many features with other complex multisystem conditions, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia, and postural orthostatic tachycardia syndrome (POTS). The mechanism of action for infection-associated chronic illnesses remains unclear, and further investigation is needed. Current theories regarding potential mechanisms of action include viral persistence, immune dysregulation (including cytokine dysregulation or mast cell activation), neurological disturbances (e.g., neuroinflammation), cardiovascular damage (e.g., endothelial dysfunction, coagulation issues, orthostatic intolerance), gastrointestinal dysfunction (e.g., secondary to gut microbiome dysbiosis), metabolic issues (energy insufficiency, reactive oxygen species production, mitochrondrial dysfunction), and genetic variations. Currently, there are no specific laboratory-based diagnostic tests for Long COVID or ME/CFS, and diagnosis involves consideration of other potential causes of the symptoms. In general, Long COVID (especially that which does not meet criteria for ME/CFS) has a better prognosis than ME/ CFS. Some manifestations of Long COVID are similar to those of ME/CFS, and like ME/CFS, Long COVID appears to be a chronic illness, with few patients achieving full remission. Studies comparing Long COVID and ME/ CFS have several limitations, however. Because Long COVID is a new dis- ease, study participants are usually newly diagnosed, while ME/CFS study participants often have had the condition for longer and so are less likely to improve. Moreover, the definition of ME/CFS requires that symptoms PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 222 5/21/24 11:25 AM

OVERALL CONCLUSIONS 223 be ongoing for 6 months or more, whereas the duration criteria for Long COVID vary in the literature from 2 to 6 months, making the two condi- tions difficult to compare. Based on its review of the literature, the committee reached the follow- ing conclusion: 9. Complex, infection-associated chronic conditions affecting multiple body systems are not new, and Long COVID shares many features with such conditions as myalgic encephalomyelitis/chronic fatigue syn- drome, fibromyalgia, and postural orthostatic tachycardia syndrome. Current theories about the pathophysiology of these conditions include immune dysregulation, neurological disturbances, cardiovascular dam- age, gastrointestinal dysfunction, metabolic issues, and mitochondrial dysfunction. More research is needed to understand the natural history and management of complex multisystem chronic conditions, including Long COVID. PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 223 5/21/24 11:25 AM

PREPUBLICATION COPY—Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 224 5/21/24 11:25 AM

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, many individuals infected with the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have continued to experience lingering symptoms for months or even years following infection. Some symptoms can affect a person's ability to work or attend school for an extended period of time. Consequently, in 2022, the Social Security Administration requested that the National Academies convene a committee of relevant experts to investigate and provide an overview of the current status of diagnosis, treatment, and prognosis of long-term health effects related to Long COVID. This report presents the committee conclusions.


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Director-General's opening remarks at the media briefing on COVID-19 – 10 May 2021

  • Globally, we are now seeing a plateauing in the number of COVID-19 cases and deaths, with declines in most regions including the Americas and Europe, the two worst-affected regions. But it’s an unacceptably high plateau, with more than 5.4 million reported cases and almost 90 thousand deaths last week. 
  • Any decline is welcome, but we have been here before. And cases and deaths are still increasing rapidly in WHO’s South-East Asia region, and there are countries in every region with increasing trends.  
  • Today, the WHO Foundation is launching the “Together for India” appeal to raise funds to support WHO’s work in India, including the purchase of oxygen, personal protective equipment and medicines. 
  • High- and upper-middle income countries represent 53% of the world’s population, but have received 83% of the world’s vaccines. By contrast, low- and lower-middle income countries account for 47% of the world’s population, but have received just 17% of the world’s vaccines.  


Good morning, good afternoon and good evening.

Globally, we are now seeing a plateauing in the number of COVID-19 cases and deaths, with declines in most regions including the Americas and Europe, the two worst-affected regions.

But it’s an unacceptably high plateau, with more than 5.4 million reported cases and almost 90 thousand deaths last week.

Any decline is welcome, but we have been here before. Over the past year, many countries have experienced a declining trend in cases and deaths, have relaxed public health and social measures too quickly, and individuals have let down their guard, only for those hard-won gains to be lost.

And cases and deaths are still increasing rapidly in WHO’s South-East Asia region, and there are countries in every region with increasing trends.

Today, the WHO Foundation is launching the “Together for India” appeal to raise funds to support WHO’s work in India, including for the purchase of oxygen, personal protective equipment and medicines.

To donate, go to who.foundation, look for the black “Donate” button and select the “Together for India” appeal.

Globally, we are still in a perilous situation. The spread of variants, increased social mixing, the relaxation of public health and social measures and inequitable vaccination are all driving transmission.

Yes, vaccines are reducing severe disease and death in countries that are fortunate enough to have them in sufficient quantities, and early results suggest that vaccines might also drive down transmission.

But the shocking global disparity in access to vaccines remains one of the biggest risks to ending the pandemic.

High- and upper-middle income countries represent 53% of the world’s population, but have received 83% of the world’s vaccines.

By contrast, low- and lower-middle income countries account for 47% of the world’s population, but have received just 17% of the world’s vaccines.

Redressing this global imbalance is an essential part of the solution, but not the only part, and not an immediate solution. We cannot put all our eggs in one basket.

We have many vaccines for many diseases, but for each of them we still need a combination of vaccines and public health measures. The same is true with COVID-19.

Vaccines prevent disease. But we can also prevent infection with public health tools that have been so effective in so many places.

My message to leaders is, use every tool at your disposal to drive transmission down, right now. Even if your country has a downward trend, now is the time to surge your capacities.

Even in countries with the highest vaccination rates, public health capacities must be strengthened to prepare for the possibility of vaccine-evading variants, and for future emergencies.

My message to individuals is, every contact you have with someone outside your household is a risk – the level of risk varies according to the type of contact, the duration of contact and the level of transmission where you live.

Each contact might carry a small risk on its own, but the more contacts, the higher the risk.

In many northern hemisphere countries where the weather is warmer, people are getting together for social gatherings.

In the southern hemisphere, colder temperatures are driving people inside.

Both situations carry different types of risk. But when you know your risk, you can lower your risk.

There will come a time when we can all take off our masks, when we no longer have to keep our distance from each other, when we can once again go safely to concerts, sporting events, rallies and restaurants – as people in some countries are able to do now because they have no transmission.

But for most of the world’s population who are not yet vaccinated, we’re not there yet.

To get there, we continue to urge all countries to develop and implement comprehensive and cohesive national plans, based on the 10 pillars of WHO’s Strategic Preparedness and Response Plan.

How quickly we end the pandemic, and how many sisters and brothers we lose along the way, depends on how quickly and how fairly we vaccinate a significant proportion of the global population, and how consistently we all follow proven public health measures.

Christian, back to you.

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Clinical trial article, efficacy and safety of ultra-short wave diathermy on covid-19 pneumonia: a pioneering study.

conclusion for covid 19 speech

  • 1 Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 2 WHO Collaborating Center for Training and Research in Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 3 Paraplegic Center, Hayatabad, Peshawar, Pakistan
  • 4 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Background: The ultra-short wave diathermy (USWD) is widely used to ameliorate inflammation of bacterial pneumonia, however, for COVID-19 pneumonia, USWD still needs to be verified. This study aimed to investigate the efficacy and safety of USWD in COVID-19 pneumonia patients.

Methods: This was a single-center, evaluator-blinded, randomized controlled trial. Moderate and severe COVID-19 patients were recruited between 18 February and 20 April 2020. Participants were randomly allocated to receive USWD + standard medical treatment (USWD group) or standard medical treatment alone (control group). The negative conversion rate of SARS-CoV-2 and Systemic Inflammatory Response Scale (SIRS) on days 7, 14, 21, and 28 were assessed as primary outcomes. Secondary outcomes included time to clinical recovery, the 7-point ordinal scale, and adverse events.

Results: Fifty patients were randomized (USWD, 25; control, 25), which included 22 males (44.0%) and 28 females (56.0%) with a mean (SD) age of 53 ± 10.69. The rates of SARS-CoV-2 negative conversion on day 7 ( p  = 0.066), day 14 ( p  = 0.239), day 21 ( p  = 0.269), and day 28 ( p  = 0.490) were insignificant. However, systemic inflammation by SIRS was ameliorated with significance on day 7 ( p  = 0.030), day 14 ( p  = 0.002), day 21 ( p  = 0.003), and day 28 ( p  = 0.011). Time to clinical recovery (USWD 36.84 ± 9.93 vs. control 43.56 ± 12.15, p  = 0.037) was significantly shortened with a between-group difference of 6.72 ± 3.14 days. 7-point ordinal scale on days 21 and 28 showed significance ( p  = 0.002, 0.003), whereas the difference on days 7 and 14 was insignificant ( p  = 0.524, 0.108). In addition, artificial intelligence-assisted CT analysis showed a greater decrease in the infection volume in the USWD group, without significant between-group differences. No treatment-associated adverse events or worsening of pulmonary fibrosis were observed in either group.

Conclusion: Among patients with moderate and severe COVID-19 pneumonia, USWD added to standard medical treatment could ameliorate systemic inflammation and shorten the duration of hospitalization without causing any adverse effects.

Clinical Trial Registration : chictr.org.cn , identifier ChiCTR2000029972.


The outbreak of the coronavirus disease 2019 (COVID-19) pandemic has prompted efforts to manage the threat to the well-being of populations worldwide ( 1 – 4 ). The new variants of SARS-CoV2 have emerged and have spread widely worldwide ( 5 , 6 ). In response to the critical demand for high-quality clinical guidance at the peak of the outbreak in China, guidelines were published to clarify that physical therapy could play an important role in managing COVID-19 ( 7 – 10 ).

Ultra–short wave diathermy (USWD) and short-wave diathermy (SWD) are both forms of radiofrequency radiation energy with high-frequency electrotherapy (27.12or 40.68 MHz) as the commonly used tools of physical therapy and rehabilitation ( 11 ). The USWD and SWD have been used for decades in the field of rehabilitation for managing a variety of conditions: such as spontaneous pneumothorax ( 12 , 13 ), knee osteoarthritis ( 14 , 15 ), pelvic inflammation ( 16 ), peptic ulcer ( 17 ), peripheral myelinopathies ( 18 ), lung injury ( 19 ), and respiratory infectious diseases, etc. ( 20 – 22 ). USWD has similar therapeutic properties to SWD but the former got deeper penetration, less heat production, and is considered more suitable for the acute phase ( 23 ). The therapeutic effects of USWD and SWD on the body parts include producing deep heat (about 5 cm under the skin), inducing vasodilation, enhancing cellular activity, attenuating inflammation, and reducing pain ( 18 , 24 – 29 ). It has previously been proven that raising the temperature decreases the activity and viability of the viruses ( 30 ). Thus, based on earlier studies, the utilization of short-wave diathermy could aid in such infectious conditions. During the outbreak of severe acute respiratory syndrome (SARS) in 2003, USWD was widely used by rehabilitation professionals in China to reduce pulmonary inflammation, and Zhang et al. ( 31 ) evaluated the efficacy of USWD and conventional therapy, finding that USWD could accelerate recovery and reduce the length of hospital stay in 38 patients with SARS. USWD has also been proven helpful for acute lung injury in rats by attenuating inflammation through the modulation of macrophage polarization ( 18 ). However, its application for COVID-19 pneumonia still needs to be validated.

In order to find robust evidence for the efficacy and safety of USWD in COVID-19 patients, we designed a randomized controlled trial to investigate the application of USWD in managing COVID-19 pneumonia.

Methods and materials

Trial design and ethical considerations.

This single-center, evaluator-blinded, two-arm (1:1 ratio) parallel design, superiority randomized controlled trial was approved by the ethics committee of the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (certificate of approval number: TJ-C20200127), and prospectively registered on 17 February 2020, with the Chinese Clinical Trials Registry (Identifier: ChiCTR2000029972). The study was conducted in accordance with the relevant regulations and guidelines of good clinical practice and the Declaration of Helsinki. Patient recruitment, randomization, and study events are visually described in the CONSORT flow diagram ( Figure 1 ). Participants were recruited between 18 February 2020 and 20 April 2020. Before randomization, written and verbal informed consent was obtained, and informative essays that clearly showed the risks and the supposed benefits accompanying the participation were provided to each patient.


Figure 1 . Flow chat of participant screening and randomization. a Amang 15 exculded, 5 tested negatives for SARS-CoV-2, 3 were positive for other pathogens, 7 needed ICU care. b Three patients declined to participate during precliminary screening because of personal reasons.


Patients of all genders admitted at the Tongji Hospital of Huazhong University of Science and Technology (Wuhan, China), and qualifying the following criteria and were recruited in this study as follows: (1) aged 18 to 65 years, (2) positive SARS-CoV-2 nucleic acid test by nasopharyngeal swabs, and (3) multiple patchy ground-glass shadows or other typical manifestations in both lungs diagnosed in lung computed tomography (CT). The exclusion criteria were: (1) positive tests for other pathogens, such as influenza, tuberculosis, mycoplasma, etc., (2) patients with metal implants or pacemakers, (3) requiring mechanical ventilation, (4) multiple organ failure requiring intensive care unit (ICU) monitoring and treatment, (5) bleeding tendency or active bleeding in the lungs, (6) shock, (7) cancer and severe underlying diseases, (8) severe cognitive impairment, (9) pregnancy or lactation, (10) those without informed consent, and (11) those with other contraindications to ultra–short wave diathermy. Subjects who met any of the exclusion criteria were not enrolled in this study.

All participants were classified as moderate or severe COVID-19 according to the severity of the disease (Classification according to the sixth edition of COVID-19 Diagnosis Guidelines released by China’s National Health Commission). The detailed classification criteria of moderate and severe cases were as, moderate: COVID-19 patients with fever and respiratory symptoms (such as cough, dyspnea, etc.) with CT findings of pneumonia, severe: COVID-19 patients meeting any of the following three signs, (1) respiratory rate (RR) ≥ 30 times/min, (2) oxygen saturation (SpO 2 ) ≤93% at rest, (3) Arterial oxygen tension/fractional inspired oxygen ratio (PaO 2 /FiO 2 ) ≤ 300 mmHg (1 mmHg = 0.133 kPa).

Randomization, allocation, and blinding

A statistician, who was not a part of the study, created an online randomization plan on www.randomization.com using the permuted blocks method with small blocks of various sizes. A total of 50 patients were randomized to either an experimental USWD group (n = 25) or a control group ( n  = 25). This was an assessor-blinded, controlled study, and because of the nature of the interventions, it could not be a therapist-or patient-blinded study; however, a well-trained healthcare team comprising two evaluators, two statisticians, and two data collectors were blinded to the groups/treatment allocation. The outcomes were independently documented based on a mutual consensus between the data collectors ( Figure 1 ).

Sample size

A priori sample size calculation was performed using GPower software version 3.1 (Düsseldorf, Nordrhein-Westfalen, Germany) based on the mean values of the length of clinical recovery from a previous SARS study ( 31 ), we estimated that with 80% power, 5% two-sided type I error rate, and an effect size of 0.72, enrolment of 62 participants should be sufficient to detect a statistically significant between-group difference of 6.6 days in the length of recovery from symptoms. However, four more participants were included in the total sample size to manage the expected 5% dropouts, making the total sample size 66 (33 participants in each group). We could not find a study with a similar intervention, reporting the primary variables as our study to calculate the required sample size more accurately.


The control group received the standard medical treatment as recommended by the sixth edition of the Chinese COVID-19 Diagnosis Guidelines, which included medical care, oxygen therapy, fluid suppletion, nonsteroidal anti-inflammatory drugs (NSAIDs) with analgesic, anti-inflammatory, and antipyretic properties, antiviral drugs, and sufficient antibiotics when combined with bacterial infection. The experimental group (USWD) received the nationally recommended standard medical treatment in addition to the USWD. The USWD was performed through the application of ultra-short wave therapy electrodes on the anterior and posterior parts of the trunk for 10 min, twice daily for 12 consecutive days. The ultra-short wave therapy machine specifications and details are as follows: ultra-short wave electricizer (Dajia DL-C-C, factory no: BE1003094, A.C. power 220 V, 50 Hz, 700VA, Shantou Medical Equipment Factory Co., Ltd., China, Guangdong). We applied USWD in continuous mode with a frequency of 27.12 MHz and a power of 200 W. With these parameters, the patient would feel mild or no heat. In contrast, the control group received only the nationally recommended standard treatment. Moreover, the testing of USWD machine output, disinfection of the machine and electrodes, wearing masks, and protective suits, and testing of the patient’s skin sensation before the intervention were performed to ensure treatment safety.

Data collection tools

The data collection forms developed for this trial consisted of medical history forms to obtain relevant medical history, case report form (CRF) to collect treatment-related data, and adverse events form to collect data on the occurrence of any adverse event during the trial.

Clinical observation

The clinical assessment was performed at five-time points: at baseline, and on days 7, 14, 21, and 28 of treatment. The evaluation details are as follows:

Before treatment: (I) Evaluation and recording of demographic data, vital signs (pulse, respiration, blood pressure, body temperature), blood oxygen saturation, and vital capacity, (II) Medical history: including current medical history, past medical history, and drug-allergy history, (III) Laboratory tests: SARS-CoV-2 nucleic acid test by pharyngeal swabs RT-PCR, Complete blood count (CBC), Lactate dehydrogenase (LDH), (IV) Radiological examination: Chest CT, (V) Other tests: ECG, (VI) Combined medications, and (VII) Symptoms evaluation: Completing the 7-category ordinal scale and SIRS scores.

Treatment and follow-up period (days 7, 14, 21, and 28): (I) Evaluation and recording of vital signs (pulse, respiration, blood pressure, body temperature), blood oxygen saturation, and vital capacity, (II) Laboratory blood tests: SARS-CoV-2 nucleic acid test by pharyngeal swabs RT-PCR, Complete blood count (CBC), Lactate dehydrogenase (LDH), serum enzyme levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and international normalized ratio (INR), (III) Radiological examination, in some patients chest CT scans were not performed frequently due to radiation hazards, but only underwent CT scans after treatment, mainly on day 14, (IV) Other tests and assessments. ECG, and (V) Symptoms evaluation, completion of SIRS scores (including heart and respiratory rate, mean arterial pressure, SpO 2 , body temperature, white blood cells, and level of consciousness), and the 7-category ordinal scale.

Outcome measurements

Primary outcomes.

The primary outcomes were the negative conversion rate of SARS-CoV-2 nucleic acid test by reverse transcription PCR (RT-PCR) and Systemic Inflammatory Response Scale (SIRS) (Supplementary Appendix 1) in the USWD group on days 7, 14, 21, and 28 of treatment, compared with those in the control group (standard medical treatment alone).

Secondary outcomes

The secondary outcomes included the clinical outcomes (the time to clinical recovery, 7-point ordinal scale), lung CT images, combined medications, and laboratory blood tests in the USWD group at days 7, 14, 21, and 28 after treatment, compared with those in the control group. An artificial intelligence (AI)-aided CT image analysis tool was applied for the quantitative analysis of the infected lung area proportion and volume. The quantification of lung pneumonia in COVID-19 patients was measured from chest CT by using an available deep learning approach described detailedly before ( 32 ). Quantitative analysis of lung opacification was performed using a commercial deep learning software in InferScholarTM Center (InfervisionTM, Beijing, China).

The definitions of clinical recovery were as follows: (1) temperature returned to normal for more than 3 days; (2) significant improvement in respiratory symptoms (such as cough and breathing difficulty); (3) significant decrease in acute exudative lesions on lung CT imaging; and (4) two consecutive negative nucleic acid test results with nasopharyngeal swabs (the sampling interval was at least 24 h).

Adverse events, assessment of vital signs, abnormal serum laboratory tests and clinical complications during the intervention were collected in both groups.

Statistical analysis

We planned to enroll 66 participants according to our protocol; however, due to the subsequent unavailability of COVID-19 patients at our hospital, we had to restrict the study to 50 patients. All statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 25.0 and GraphPad Prism 8. An intention-to-treat analysis was used. Data normality was assessed with the Kolmogorov–Smirnov, and Shapiro–Wilk tests. Continuous variables are presented as mean (standard deviation, SD) in case of normal distribution of data or median (inter-quartile range, IQR) in case of non-normal distribution, while categorical variables are presented as count (%). Descriptive statistics (mean, frequencies, and percentages) were calculated for demographic variables and primary and secondary variables in the study. Baseline and post-intervention comparisons between the USWD and control groups were performed using an independent samples t -test and Mann–Whitney statistics based on the normality results of the data. The proportions of categorical variables were compared using Fisher’s exact test/chi-square test. The Chi-square test was used for the evaluation of the 7-point ordinal scale, and the Mann–Whitney test was used for the SIRS scale (treated as ordinal scales). A difference-in-difference (D-in-D) analysis was used to analyze the AI-assisted CT scan data. Patients who failed to reach the negative conversion of SARS-CoV-2 by the cut-off date of the analysis were considered as right-censored at the last visit date. All patients were treated after the completion of follow-up (28 days).

Patient demographics and clinical characteristics

A total of 70 patients were screened in this study, 20 were excluded for reasons and finally, 50 subjects were eligible to be enrolled, and randomized for this study. The CONSORT flow diagram is shown in Figure 1 . Of the 50 enrolled participants, 22 (44.0%) were men and 28 (56.0%) were women, with a mean age (SD) of 53 ± 10.69 years. With 30 (60%) moderate and 20 (40%) severe cases, the USWD group contained more patients with severe conditions (52%) than the control group (28%), The median duration between onset and admission were 21 (13–27.0) days. The majority of the participants were non-smokers (86.0%), and 34.0% had co-morbid conditions ( Table 1 ), such as diabetes (22%), hypertension (20%), and cardiovascular diseases (8%). Fever (90%), breathing difficulty (56%), dry cough (50%), diarrhea (34%), and fatigue (24%) were the top five most common symptoms reported on presentation ( Table 2 ). Moreover, most of the patients had a dry cough (50%), while very few had a productive cough (14%). The baseline clinical characteristics of all participants are shown in Tables 1 , 2 , and Supplementary Table S1 . Both groups were balanced at baseline with insignificant differences in demographic data, clinical features, disease severity, and laboratory tests.


Table 1 . The demographics, severity, and baseline characteristics.


Table 2 . The comorbidities and symptoms at baseline.

The negative conversion rate of SARS-CoV-2 nucleic acid

In this study, we continuously conducted nucleic acid tests at least once weekly. The SARS-CoV-2 nucleic acid test negative conversion rate showed no significant difference between the USWD and control groups at days 7 ( p = 0.066), 14 ( p = 0.239), 21 ( p = 0.269), and 28 ( p = 0.490) ( Table 3 ; Figure 2A ).


Table 3 . Primary and secondary clinical outcomes.


Figure 2 . Primary and secondary outcomes at baseline, on days 7, 14, 21 and 28 by treatment group. (A) The SARS-CoV-2 nucleic acid negative conversion rate showed no significant difference between the USWD and control group at day 7 ( p  = 0.239), day 14 ( p  = 0.269), and day 28 ( p =  0.490). (B) The clinical condition on SIRS score showed statistically significant difference on day 7 ( p = 0.030), day 14 ( p  = 0.002), day 21 ( p = 0.003) and day 28 ( p  = 0.011). (C) Time to clinical recovery in the USWD group was significantly shortened comparing with the control group ( p  = 0.037). (D) Clinical status on 7-point ordinal scale on study days 21 and 28 showed significance ( p  = 0.002, 0.003), whereas the difference at day 7 and 14 was insignificant ( p  = 0.524, 0.108).

Clinical status of patients

Antiviral treatments were widely used in our study, there were 22 (88%) in the control group and 23 (92%) in the USWD group receiving different types of antiviral drugs, mainly oseltamivir, and abidol. The SIRS scores, which reflect patients’ present clinical condition, were statistically significantly different between the two groups at days 7 ( p = 0.030), 14 ( p = 0.002), 21 ( p = 0.003), and 28 ( p = 0.011) ( Table 3 ; Figure 2B ). The time to clinical recovery (days) in the USWD group was (6.72 ± 3.14) days shorter than that in the control group (36.84 ± 9.93 vs. 43.56 ± 12.15, p  = 0.037). Moreover, the 7-point ordinal scale after intervention on days 21, and 28 also showed significant differences between the two groups ( p  = 0.002, and p  = 0.003, respectively). However, the difference on days 7 and 14 was not statistically significant ( p  = 0.524, p  = 0.108) ( Table 3 ; Figures 2C , D ). These findings suggest the therapeutic efficacy of implementing USWD in patients with COVID-19 pneumonia.

CT scans and quantitative analysis

In Figure 3 , the CT images depicted the recovery progress in moderate and severe cases in both groups. Obvious multiple ground-glass opacities (GGOs) were observed, especially in the bilateral lower lung, with local thickening and adhesion of bilateral pleura. Pulmonary fibrosis, d stripe shadows, and consolidations could be seen in severe COVID-19 cases. Most of all, the worsening of pulmonary fibrosis was not observed in any group. The pulmonary fibrosis found before treatment was recovered in most of the patients (recovery: USWD = 14/15 and control = 16/18, p  = 1.000).


Figure 3 . Chest CT images of moderate and severe cases in control and USWD group. (A–D) the CT scan of moderate cases in the control group show. (E–H) the CT scan of moderate cases in the USWD group. (I–L) : the CT scan of severe cases in the control group (M–P) the CT scan of severe cases in the USWD group.

The further artificial intelligence (AI)-aided quantitative analysis of CT images found that the mean volume of infected lung could reach 337.81 cm 3 before treatment, while the lower lung had the worst infection areas and proportion (221.56 cm 3 , 65.6%) ( Supplementary Table S2 ). Both groups showed improvements in the AI-aided CT imaging analysis. Following comparisons of quantitative values demonstrated USWD group got more decreased whole lung infection volume (69.7 cm 3 vs. 46.2 cm 3 ) and proportion (3.8% vs. 1.4%) than the control group without between-group significant differences ( Table 4 ).


Table 4 . Comparison of mean AI-assisted CT quantitative analysis of CT images between USWD and control group.

Adverse events (AEs), and complications

No serious AEs, deaths, permanent disability, neoplasia, or empyrosis cases were registered during the trial. Routine serum laboratory tests showed that all parameters were in almost equal and normal ranges in both groups. However, the WBC counts were significantly lower in the USWD group than in the control group (5.51 ± 1.38 vs. 6.56 ± 1.97). In contrast, the median (IQR) monocyte count was significantly higher in USWD than in the control group (8.92 [2.20] vs. 7.10 [1.15]), but the difference was of uncertain clinical importance ( Table 5 ). Out of 50 patients, 22 each in the USWD and control groups had complications, 16 (64%) and 15 (60%) patients in the control and USWD group, respectively, had complications of bacterial pneumonia infections in the course and were treated with antibiotic drugs. Other complications included abnormal liver function test (LFT; 52% vs. 48%, p  = 0.777), electrolyte imbalance (32% vs. 44%, p  = 0.382), hyperfibrinogenaemia (44% vs. 48%, p  = 0.777), and mild anemia (32% vs. 52%, p  = 0.152) ( Table 5 ). All complications were unrelated to USWD treatment and were not statistically different between the two groups.


Table 5 . The laboratory values and complications in USWD and control groups.

USWD could induce vasodilation, increase blood flow, reduce inflammation, and decrease pain in a continuous mode ( 15 , 18 ), suggesting that USWD might be beneficial for COVID-19 pneumonia. However, high-quality evidence to recommend the application of USWD in improving COVID-19 pneumonia is still lacking. To the best of our knowledge, this is the first randomized clinical trial investigating the efficacy of USWD treatment in COVID-19.

In this randomized clinical trial, we systematically investigated the therapeutic efficacy and safety of USWD in patients with moderate or severe COVID-19 pneumonia. The administration of USWD improved the clinical condition of patients with COVID-19 pneumonia who were hospitalized and required supplemental oxygen therapy. However, the SARS-CoV-2 negative conversion rate was not significantly increased by USWD, suggesting that USWD exerts therapeutic function independent of the direct antiviral effect. Surprisingly, after a 12-day course of USWD administered twice daily, there was a significant improvement in the mean scores of SIRS, an indicator of clinical condition. At the same time, USWD could shorten the course of COVID-19 pneumonia by (6.72 ± 3.14) days. These findings of this study are consistent with previous studies in 2003 during the SARS. Zhang LF ( 31 ) used USWD in 38 SARS pneumonia patients, and found that the administration of USWD accelerated pneumonia recovery and shortened the length of hospital stay. Some other studies with bacterial pneumonia patients treated with USWD showed similar results in clinical recovery as the findings in our study. He YG ( 33 ) found USWD could reduce inflammation, and promote lung tissue repair in children with bronchopneumonia. Du QP ( 34 ) applied USWD therapy in infants with pneumonia and reported that additional USWD reduced the duration period of symptoms, shortened the treatment course, and reduced the use of antibiotics. Moreover, Zhu Q ( 35 ) reported that USWD combined with standard medications could impart better properties to pulmonary function and clinical recovery. Our study provided further evidence of the effectiveness of USWD in the role of inflammation control, which suggests that USWD might be a potential therapeutic means for COVID-19 pneumonia.

Treatment with USWD, however, increased the number of monocytes in our study, which are an important component of the body’s immune system, although within normal range, and reduced the number of WBCs, which is a biological marker of inflammation. These findings are consistent with those of previous studies of the physiological effects of short-wave therapy ( 24 ), supporting the immune response to accelerate recovery. Thus, the administration of USWD at an early stage in pneumonia may stimulate and boost the body’s natural defenses against microorganisms ( 36 ).

Lung CT images could provide supportive assistance in the early diagnosis and monitoring of lung lesions in patients with COVID-19 pneumonia. Previously, there were concerns like USWD induces fibroblastic activity, and that the enriched oxygen environment could hypothetically increase the risk of pulmonary complications, such as pulmonary fibrosis. There was a theoretical hypothesis that the synergistic activity of USWD and high oxygen environment in COVID-19 pneumonia patients could cause or aggravate pulmonary fibrosis ( 26 , 37 , 38 ). In fact, some pre-clinical studies found that USWD could increase the extensibility of collagenous tissue ( 15 ), protect damaged lung tissue, and reduce pulmonary interstitial fibrosis ( 39 , 40 ). Previous clinical studies have shown that USWD as adjuvant therapy in children and adults with pneumonia was effective and did not aggravate pulmonary fibrosis ( 41 – 43 ). In our study, the pulmonary fibrosis observed in CT before treatment was recovered in most of the patients, and worsening of pulmonary fibrosis was not observed in any patient. Overall, the finding of pulmonary fibrosis recovery could completely overcome the safety concerns of fibrosis in USWD.

Additionally, Lung opacification percentages and volume of the whole lung and five lobes were automatically quantified by using a deep learning algorithm ( 32 ). Traditional visual evaluation of CT scans is subjective, and its validity mainly depends on the radiologist’ experience. Quantitative analysis of the CT imaging using the artificial intelligence tool, such as deep learning, could provide an automatic and objective estimation to identify the severity, monitor disease progression and help understand the course of COVID-19 pneumonia ( 44 , 45 ). We applied AI-aided CT assessment tools to compare the therapeutic effect on lung opacification between the two groups in this study, which made our research more rigorous.

Strengths and limitations

The strength of our study is the rigorous design of our randomized controlled trial. As the cases in our study were from the early period of the pandemic outbreak when the virus was extremely virulent and there was no vaccine available, which was conducive to fully demonstrating the effect of USWD. Finally, USWD therapy was easy to apply and had few contraindications, it could economize the medical costs and may help to reduce the consumption of antibiotics or antivirals once widely applied in the future.

The major limitation of the present study was the relatively small sample size, and the follow-up period of only 28 days, which maybe not be long enough for severe COVID-19 patients. Moreover, many novel SARS-CoV-2 variants like delta and omicron had emerged, and the effectiveness of USWD for the new variants was uncertain. Given that the function of USWD was dependent on non-specific anti-inflammatory properties, USWD might conceivably be effective for different SARS-CoV-2 variants.

USWD could not accelerate the SARS-CoV-2 nucleic acid negative conversion rate. However, the administration of USWD could significantly improve the clinical status and effectively shorten the length of hospitalization in patients with moderate and severe COVID-19 pneumonia, without aggravating pulmonary fibrosis. Further studies are necessary to understand the definite curative effects of USWD in COVID-19 pneumonia and other different pathogens.

Data availability statement

The original contributions presented in the study are included in the article/ Supplementary material , further inquiries can be directed to the corresponding author.

Ethics statement

The studies involving human participants were reviewed and approved by The ethics committee of the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (certificate of approval number: TJ-C20200127). The patients/participants provided their written informed consent to participate in this study.

Author contributions

HC contributed to the supervision, drafting, and finalizing of the study. LH, QL, and SS equally contributed to compiling and describing the results. Moreover, authors LH and QL contributed to designing the CRF, medical history forms development, data collection, and interpretation. SS and MN contributed to writing and formatting the manuscript. LX designed the USWD treatment protocol, while BC did the CT scan analysis. IA contributed to data analysis. All authors contributed to the article and approved the submitted version.

The study was funded by the Key Research and Development program of Hubei province (No. 2022BCA028) and the Health Commission of Hubei Province (No. WJ2023M003).


The authors are grateful for the support in the statistical analysis provided by Professor Xiaobin Yin from the School of Public Health, Tongji Medical College, Huazhong University of Science and Technology. The authors thank doctor Chunchu Deng for english language assistance in the final manuscript.

Conflict of interest

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

Publisher’s note

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

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fmed.2023.1149250/full#supplementary-material

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33. He, YG, Ruan, Q, Chang, XM, and Zhu, Y. Changes of serum cytokines in children with bronchopneumonia treated with ultrashort wave diathermy. J Appl Clin Pediatr . (2006) 21:323–4. doi: 10.3760/cma.j.issn.0254-1424.2003.06.005

34. Du, QP, Nan, JG, Lv, Q, Ye, MQ, Lv, CJ, and Luo, D. Benefits of adjuvant therapy with transcutaneous ion introduction of traditional Chinese medicine by using microcomputer control intermediate frequency stimulator and ultrashort wave therapy on 112 cases of infantile pneumonia. Chin J Gen Pract . (2012) 10:1232–322. doi: 10.16766/j.cnki.issn.1674-4152.2012.08.063

35. Zhu, Q, Sun, YG, Zhao, AP, and Li, Z. Effect of ultrashort wave and medications on pulmonary function of pneumonia patients. Chin J Phys Ther . (1999) 22:75–7. doi: 10.1016/B978-008043005-8/50012-3

36. Martin, GM, and Erickson, DJ. Medical diathermy. J Am Med Assoc . (1950) 142:27–32. doi: 10.1001/jama.1950.72910190003007

37. Hill, J, Lewis, M, Mills, P, and Kielty, C. Pulsed short-wave diathermy effects on human fibroblast proliferation. Arch Phys Med Rehabil . (2002) 83:832–6. doi: 10.1053/apmr.2002.32823

38. Hu, Y, Fu, J, and Xue, X. Association of the proliferation of lung fibroblasts with the ERK1/2 signaling pathway in neonatal rats with hyperoxia-induced lung fibrosis. Exp Ther Med . (2019) 17:701–8. doi: 10.3892/etm.2018.6999

39. Zhou, SH, Jiang, XY, and Yang, ZH. Effect of Ultrashortwave diathermy on experimental pulmonary interstitial fibrosis. Chin J Phys Med Rehabil. (2002) 24:533–5. doi: 10.3760/cma.j.issn.0254-1424.2002.09.007

40. Huang, PP, Zhang, QB, Zhou, Y, Liu, AY, Wang, F, Xu, QY, et al. Effect of radial extracorporeal shock wave combined with ultrashort wave diathermy on fibrosis and contracture of muscle. Am J Phys Med Rehabil . (2021) 100:643–50. doi: 10.1097/PHM.0000000000001599

41. Luo, Q, Yuan, ZJ, Wu, YC, and Tan, HQ. Effect of ultrashort wave in the treatment of children with Mycoplasma pneumonia and serum inflammatory factors. Chin J Phys Med Rehabil. (2020) 42:559–61. doi: 10.3760/cma.j.issn.0254-1424.2020.06.019

42. Ma, T, and Shang, R. Effect of ultrashort wave and magnetic therapy on serum inflammatory factors in children with bronchial pneumonia. Chin J Phys Med Rehabil . (2018) 40:519–20. doi: 10.3760/cma.j.issn.0254-1424.2018.07.010

43. Hu, JC, Luo, L, Yang, ZJ, and Xiang, JW. The effect of ultrashort wave adjuvant therapy on adult mycoplasma pneumoniae pneumonia and serum cytokines. Chin J Phys Med Rehabil. (2012) 34:61–3. doi: 10.3760/cma.j.issn.0254-1424.2012.01.020

44. Vardhanabhuti, V. CT scan AI-aided triage for patients with COVID-19 in China. Lancet Digit Health . (2020) 2:e494–5. doi: 10.1016/S2589-7500(20)30222-3

45. Wang, M, Xia, C, Huang, L, Xu, S, Qin, C, Liu, J, et al. Deep learning-based triage and analysis of lesion burden for COVID-19: a retrospective study with external validation. Lancet Digit Health . (2020) 2:e506–15. doi: 10.1016/S2589-7500(20)30199-0

Keywords: coronavirus disease 2019, ultra-short wave diathermy, rehabilitation, systemic inflammatory response scale, time to clinical recovery, pneumonia, pulmonary fibrosis

Citation: Huang L, Li Q, Shah SZA, Nasb M, Ali I, Chen B, Xie L and Chen H (2023) Efficacy and safety of ultra-short wave diathermy on COVID-19 pneumonia: a pioneering study. Front. Med . 10:1149250. doi: 10.3389/fmed.2023.1149250

Received: 21 January 2023; Accepted: 18 May 2023; Published: 05 June 2023.

Reviewed by:

Copyright © 2023 Huang, Li, Shah, Nasb, Ali, Chen, Xie and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Hong Chen, [email protected] ; [email protected]

† These authors have contributed equally to this work and share first authorship

This article is part of the Research Topic

COVID-19: Integrating Artificial Intelligence, Data Science, Mathematics, Medicine and Public Health, Epidemiology, Neuroscience, Neurorobotics, and Biomedical Science in Pandemic Management, volume II

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conclusion for covid 19 speech

  • > Being Human during COVID-19
  • > Conclusion

conclusion for covid 19 speech

Book contents

  • Frontmatter
  • List of Figures and Table
  • Notes on Contributors
  • Introduction
  • Part I Knowing Humans
  • Part II Marginalized Humans
  • Part III Biosocial Humans
  • Part IV Human Futures
  • Conclusion: Thinking about ‘the Human’ during COVID-19 Times Conclusion

Conclusion: Thinking about ‘the Human’ during COVID-19 Times - Conclusion

Published online by Cambridge University Press:  13 October 2022

In this final chapter we draw together some of the main themes emerging from the various chapters and reflect on what this tells us about being human in COVID-19 times. As outlined in the introduction, these essays have focused on three key issues during the pandemic that are fundamentally concerned with the experience, meaning and understanding of being human. Firstly, the marginalization of many groups of people and how they are de/valued in the response to the virus. Secondly, the role of new scientific knowledge and other forms of expertise in these processes of inclusion and exclusion. Thirdly, the remaking and reordering of society as a result of the pandemic and the opening up of new futures for work, the environment, culture and daily life. These themes were considered in the four sections of the collection, and the main points from each are summarized here, before a final consideration is offered on what this tells us about being human during and after the pandemic.

Knowing humans

This collection of essays starts by exploring how COVID-19 has been known and represented in different metaphors, models, representations, and media, as the pandemic has unfolded. In analysing these processes, new insights are provided about how we understand the human. While the virus was the same molecular structure the world over (at least before the onset of variants), this section shows the myriad of different methods and resources by which the resulting disease and its impacts became known to policymakers, professionals and publics, and how these differed across the world. Three key features of this emerge. Firstly, whether through science, metaphor or imagery, the ways in which COVID-19 became known could both exacerbate existing inequalities or provide the means to counter them (Nerlich; Ballo and Pearce; Rosvik et al). In this sense, they form the ground for contestation over the meaning of COVID-19. Secondly, citizens found themselves dislocated from established sources of knowledge about the virus, which they felt to be either incomplete or inadequate (Garcia; Vicari and Yang; Rostvik et al). These uncertainties about what risks they faced, how to respond, and their responsibilities to self and others, fed into high levels of distrust and confusion.

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  • By Paul Martin , Stevienna de Saille , Kirsty Liddiard , Warren Pearce
  • Edited by Paul Martin , University of Sheffield , Stevienna de Saille , University of Sheffield , Kirsty Liddiard , University of Sheffield , Warren Pearce , University of Sheffield
  • Book: Being Human during COVID-19
  • Online publication: 13 October 2022
  • Chapter DOI: https://doi.org/10.46692/9781529223149.023

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Surviving Medical School During a Pandemic: Experiences of New York Medical Students During the Height of SARS-CoV-2

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Background: The COVID-19 pandemic dramatically altered the landscape of medical education. While patients overwhelmed hospital systems, lockdowns and social distancing recommendations took priority, and medical education was pushed online. Early in 2020, New York State (NYS) was hit especially hard by COVID-19. Objective: This study sought to understand the effect of the COVID-19 pandemic on medical students well-being and education. Methods: NYS medical students responded to a six-question survey during April and May 2020. Questions assessed self-reported changes in stress levels, academic performance, and board preparation efforts. Open-ended data was analyzed using a modified grounded theory approach. Results: 488 responses across 11 medical schools were included (response rate of 5.8%). Major themes included: standardized test-related stressors (23%), study-related changes (19%), education and training concerns (17%), financial stressors (12%), and additional family obligations (12%). Second year students reported more stress/anxiety than students in other years (95.9%, p-value< 0.00001). Reported stress/anxiety, effects on exam preparation, and anticipated academic effect varied by geographics. Conclusions: While all NYS medical students reported being greatly affected, those closest to the NY City pandemic epi-center and closest to taking the Step 1 exam were the most distressed. Lack of flexibility of the medical education system during this public health emergency contributed to worsened student well-being. It is time to make plans for supporting the long-term mental health needs of these physicians-in-training and to examine ways the academic medical community can better adapt to the needs of students affected by a large public health emergency in the future.

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The NFL responds after a player urges female college graduates to become homemakers

Rachel Treisman

conclusion for covid 19 speech

Kansas City Chiefs player Harrison Butker, pictured at a press conference in February, is in hot water for his recent commencement speech at Benedictine College in Kansas. Chris Unger/Getty Images hide caption

Kansas City Chiefs player Harrison Butker, pictured at a press conference in February, is in hot water for his recent commencement speech at Benedictine College in Kansas.

Kansas City Chiefs kicker Harrison Butker stirred controversy off the field this weekend when he told a college graduating class that one of the "most important titles" a woman can hold is "homemaker."

Butker denounced abortion rights, Pride Month, COVID-19 lockdowns and "the tyranny of diversity, equity and inclusion" in his commencement address at Benedictine College, a Catholic liberal arts school in Atchison, Kan.

The 28-year-old, a devout Catholic and father of two, also railed against "dangerous gender ideologies" and urged men to "fight against the cultural emasculation of men." At one point, he addressed women specifically.

Why the NFL (Still) Has a Diversity Problem

Black Stories. Black Truths.

Why the nfl (still) has a diversity problem.

"I want to speak directly to you briefly because I think it is you, the women, who have had the most diabolical lies told to you, how many of you are sitting here now about to cross the stage, and are thinking about all the promotions and titles you're going to get in your career," he said. "Some of you may go on to lead successful careers in the world. But I would venture to guess that the majority of you are most excited about your marriage and the children you will bring into this world."

Harrison Butker chokes up while discussing his wife, encouraging Benedictine College female grads to embrace motherhood. pic.twitter.com/qm73MBl0Hl — The College Fix (@CollegeFix) May 13, 2024

"I can tell you that my beautiful wife Isabelle would be the first to say that her life truly started when she began living her vocation as a wife and as a mother," Butker said.

The 20-minute speech has been viewed more than 455,000 times on YouTube since Saturday and generated considerable backlash — and memes — on social media, especially from people critical of his views on women. Many pointed out that Butker's own mom is a clinical medical physicist.

Butker also drew ire from fans of Taylor Swift, who is dating fellow Chiefs player Travis Kelce, a relationship that has famously helped bring many new female fans to the NFL. Later in the speech, he quoted Swift — though not by name — while talking about what he sees as the problem of priests becoming "overly familiar" with their parishioners.

The Swift-Kelce romance sounds like a movie. But the NFL swears it wasn't scripted

Super Bowl 2024

The swift-kelce romance sounds like a movie. but the nfl swears it wasn't scripted.

"This undue familiarity will prove to be problematic every time, because as my teammate's girlfriend says, 'Familiarity breeds contempt,' " he said, quoting a lyric from her song Bejeweled.

One Swift fan account joked about petitioning for the pop star to replace Butker as the Chiefs' kicker. A real online petition , calling for the Chiefs to dismiss Butker for his "sexist, homophobic, anti-trans, anti-abortion and racist remarks," has gained 95,000 signatures and counting since Monday.

Butker and the team have not commented publicly on his speech and the backlash to it, though late Wednesday the NFL issued a statement distancing itself from it.

"Harrison Butker gave a speech in his personal capacity," Jonathan Beane, the NFL's senior VP and chief diversity and inclusion officer told NPR on Thursday. "His views are not those of the NFL as an organization."

What else did Butker say?

Butker has been vocal about his faith, telling the Eternal Word Television Network in 2019 that he grew up Catholic but practiced less in high school and college before rediscovering his belief later in life.

Last year, Butker appeared in an ad for the nonprofit Catholic Vote urging Kansans to support a referendum that would limit abortion rights in the state (it was ultimately unsuccessful ). He's also one of several athletes who has partnered with a Catholic prayer app . And days after the Chiefs won this year's Super Bowl, Butker spent a week "in reflection" at a monastery in California.

He also gave the commencement address at his alma mater Georgia Tech last year, in which he urged students to "get married and start a family."

Women are earning more money. But they're still picking up a heavier load at home

Women are earning more money. But they're still picking up a heavier load at home

This time around, Butker started his speech by suggesting he had been reluctant to give it: He said he originally turned down the president's invitation because he felt that one commencement speech was enough, "especially for someone who isn't a professional speaker."

He was persuaded, he said, in part by leadership's argument about how many milestones graduating seniors had missed because of the COVID-19 pandemic.

"As a group, you witnessed firsthand how bad leaders who don't stay in their lane can have a negative impact on society," he said in his opening remarks. "It is through this lens that I want to take stock of how we got to where we are and where we want to go as citizens, and yes, as Catholics."

He criticized President Biden for his handling of the pandemic and his stance on abortion, which he said falsely suggests people can simultaneously be "both Catholic and pro-choice."

Butker blamed "the pervasiveness of disorder" for the availability of procedures like abortion, IVF, surrogacy and euthanasia, as well as "a growing support for degenerate cultural values and media."

6 in 10 U.S. Catholics are in favor of abortion rights, Pew Research report finds

6 in 10 U.S. Catholics are in favor of abortion rights, Pew Research report finds

At one point, he referenced an Associated Press article from earlier this month about the revival of conservative Catholicism that prominently featured Benedictine College as an example.

The school of roughly 2,000 gets top ratings from the Cardinal Newman Society , a nonprofit that promotes Catholic education in the U.S., for policies including offering daily mass and prohibiting campus speakers who "publicly oppose Catholic moral teaching."

"I am certain the reporters at the AP could not have imagined that their attempt to rebuke and embarrass places and people like those here at Benedictine wouldn't be met with anger, but instead with excitement and pride," Butker said, before making an apparent reference to LGBTQ Pride Month in June.

"Not the deadly sin sort of pride that has an entire month dedicated to it," he said, as laughter could be heard from the crowd.

How are people responding?

The official YouTube video of Butker's speech shows the crowd standing and applauding at the end, though the AP reports that reactions among graduates were mixed. Several told the outlet they were surprised by his comments about women, priests and LGTBQ people.

Kassidy Neuner told the AP that the speech felt "degrading," suggesting that only women can be homemakers.

"To point this out specifically that that's what we're looking forward to in life seems like our four years of hard work wasn't really important," said Neuner, who is planning on attending law school.

The Vatican says surrogacy and gender theory are 'grave threats' to human dignity

The Vatican says surrogacy and gender theory are 'grave threats' to human dignity

Butker's comments have gotten some support, including on social media from football fan accounts and Christian and conservative media personalities .

"Christian men should be preaching this regularly," tweeted former NFL player T.J. Moe. "Instead, it's so taboo that when someone tells the obvious truth that anyone who holds a biblical worldview believes, it's national news."

Still, other public figures — including musicians Maren Morris and Flava Flav — were quick to disagree.

Even the official Kansas City account weighed in, tweeting on Wednesday that Butker resides not there but in a neighboring suburb, Lee's Summit. The tweet has since been deleted and the account apologized for the tweet .

Kansas City Mayor Quinton Lucas tweeted that he believed Butker holds a "minority viewpoint" in the state but defended his right to express it.

Graduates chant in support of Palestinians during the University of Michigan's commencement ceremony at Michigan Stadium in Ann Arbor on Saturday.

Campus protests over the Gaza war

How student protests are changing college graduations.

"Grown folks have opinions, even if they play sports," he wrote . "I disagree with many, but I recognize our right to different views."

Justice Horn, the former chair of Kansas City's LGBTQ Commission, was more critical, writing on X (formerly Twitter) that "Harrison Butker doesn't represent Kansas City nor has he ever." He called the city one that "welcomes, affirms and embraces our LGBTQ+ community members."

The Los Angeles Chargers also trolled Butker in its Sims-style schedule release video on Wednesday, which ends with a shot of his animated, number 7 jersey-wearing character cooking and arranging flowers in a kitchen.

  • Kansas City Chiefs
  • commencement addresses
  • working women
  • Taylor Swift


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    Butker denounced abortion rights, Pride Month, COVID-19 lockdowns and "the tyranny of diversity, equity and inclusion" in his commencement address at Benedictine College, a Catholic liberal arts ...

  30. Leading scientist joins calls for Covid convictions amnesty

    A leading scientist has backed calls for a Covid fines "amnesty" as he warned that criminalising the public must be avoided in future pandemics.. Karl Friston, a neurology professor at UCL and ...