Economic Research - Federal Reserve Bank of St. Louis

The Economic Impact of COVID-19 around the World

This article provides an account of the worldwide economic impact of the COVID-19 shock. In 2020, it severely impacted output growth and employment, particularly in middle-income countries. Governments responded primarily by increasing expenditure, supported by an expansion of the supply of money and debt. These policies did not put upward pressure on prices until 2021. International trade was severely disrupted across all regions in 2020 but subsequently recovered. For 2021, we find that the adverse effects of the COVID-19 shock on output and prices were significant and persistent, especially in emerging and developing countries.

Fernando Martin is an assistant vice president and economist, Juan M. Sánchez is a vice president and economist, and Olivia Wilkinson is a senior research associate at the Federal Reserve Bank of St. Louis.

INTRODUCTION

For over two years, the world has been battling the health and economic consequences of the COVID-19 pandemic. As of the writing of this article, deaths attributed to COVID-19 have surpassed six-and-a-half million people.  Global economic growth was severely impacted: World output by the end of 2021 was more than 4 percentage points below its pre-pandemic trend.  International trade was also significantly disrupted at the onset of the pandemic. The pandemic also prompted a strong policy response, resulting in a rise of government deficits and debt as well as widespread increases in the money supply. Finally, after an initial decline, prices have soared, resulting in elevated inflation rates.

This article provides an account of the worldwide economic impact of the COVID-19 shock. This shock was not felt simultaneously around the world, and mitigation policies, both health related and economic, varied substantially across countries. Yet there are some significant similarities in outcomes, especially when considering the pandemic period as a whole. Our analysis focuses on the shock's effects on specific groups of countries, related by their level of development and geographical location.

We find that the COVID-19 shock severely impacted output growth and employment in 2020, particularly in middle-income countries. The government response, mainly consisting of increased expenditure, implied a rise in debt levels. Advanced countries, having easier access to credit markets, experienced the highest increase in indebtedness. All regions also relied on monetary policy to support the fiscal expansion, and hence the money supply increased everywhere. The specific circumstances surrounding the shock implied that the expansionary fiscal and monetary policies did not put upward pressure on prices until 2021. International trade was severely disrupted across all regions in 2020 but subsequently recovered. When extending the analysis to 2021, we find that the adverse effects of the shock on output and prices have been significant and persistent, especially in emerging and developing countries.

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Economic Impact of Coronavirus

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COVID-19’s Economic Impact around the World

Key takeaways.

  • Although the COVID-19 pandemic affected all parts of the world in 2020, low-, middle- and high-income nations were hit in different ways.
  • In low-income countries, average excess mortality reached 34%, followed by 14% in middle-income countries and 10% in high-income ones.
  • However, middle-income nations experienced the largest hit to their gross domestic product (GDP) growth, followed by high-income nations.

COVID mask with flat map of the world on it.

Since the COVID-19 pandemic began in March 2020, the world economy has been affected in many ways. Poorer countries have suffered the most, but, despite their greater resources, wealthier countries have faced their own challenges. This article looks at the impact of COVID-19 in different areas of the world.

First, I put 171 nations into three groups according to per capita income: low, middle and high income. Second, I examined health statistics to show how hard-hit by the virus these nations were. Then, by comparing economic forecasts the International Monetary Fund (IMF) made in October 2019 (pre-pandemic) for 2020 with their actual values, I obtained estimates for the pandemic’s impact on growth and key economic policy variables.

Low- and high-income groups each compose 25% of the world’s countries, and the middle-income group makes up 50%. Average income per capita in 2019 was more than five times larger in the middle-income group than in the low-income group. In the high-income countries, it was almost 20 times larger.

Health Outcomes and Policies

The first table shows that COVID-19 had a significant impact on all three groups. Average excess mortality, which indicates how much larger the number of deaths was relative to previous years, was more than 34% in low-income countries, almost 14% in middle-income countries and about 10% in high-income countries. And even though poorer countries were more affected by deaths, their COVID-19 testing was much more limited given their smaller resources.

Since the beginning of the pandemic, high-income countries did more than one test per person, while low-income countries did only one test per 27 people (or 0.037 per person). Given the significant differences in testing, it is not surprising that reported cases were much higher in wealthier countries. Finally, note that there were significant differences in the progress of vaccination. As of June 2021, nearly 20% of the population in the wealthiest countries was fully vaccinated compared to about 2% in the poorest countries.

Impact on GDP Growth

COVID-19-related lockdowns were very common during 2020-21, directly impacting economic activity. The figure below shows the impact on GDP. To isolate the impact of COVID-19 from previous trends, I plotted the difference between the actual GDP growth in 2020 and the IMF forecast made in October 2019.

The immediate consequence of closing many sectors of the economy was a significant decline in GDP growth, which was as large as 8.7 percentage points for the median middle-income countries. Wealthier countries suffered a bit less, with a median of 6.4 percentage points, mainly because they began to recover before the end of 2020. The impact of COVID-19 was smaller in poorer countries because many did not have the resources to implement strict lockdowns. However, even in this group of countries, median GDP growth was 5.2 percentage points lower than expected.

Impact of COVID-19 on GDP Growth around the World

SOURCES: IMF World Economic Outlook Reports (April 2021 and October 2019), Penn World Table (version 10.0) and author’s calculations.

NOTE: The COVID-19 impact is the difference between the actual gross domestic product growth rate in 2020 and the IMF forecast for it made in October 2019.

Economic Policies

Differences in GDP performance are not only related to lockdowns but also to economic policy responses. The second table contains information about six policy variables.

In particular, the first three rows present the fiscal response to the pandemic computed as the difference between the actual value in 2020 and the IMF forecast made before the pandemic in October 2019 relative to GDP. Revenue relative to GDP declined slightly in all regions, but mostly in middle-income countries, reaching more than 1 percentage point of GDP.

Expenditures relative to GDP, however, increased in middle- and high-income countries while remaining stable in low-income countries. These expenditures increased by nearly 7 percentage points of GDP in high-income countries. The more significant fiscal deficit relative to GDP implied a larger increase in net government borrowing, which reached 7 percentage points of GDP in the median high-income countries.

Finally, COVID-19 also had a clear impact on the evolution of monetary aggregates such as cash and deposits. In the table, to isolate the impact of COVID-19 from previous trends, I present the growth rate of M1 and M2 M1 generally includes physical currency, demand deposits, traveler’s checks and other checkable deposits. M2 generally includes M1 plus savings deposits, money market securities, mutual funds and other time deposits. Note that the above definitions can differ slightly by country. net of the yearly growth rates of these variables between 2017 and 2019. The pandemic implied an increase in the growth rate of monetary aggregates across countries in all income groups, but more significantly in wealthier countries.

For instance, the growth rate in M1 was over 10 percentage points larger than in the previous two years in the median high-income countries. Without a change in money demand, such an acceleration in the quantity of money would have implied increasing inflation.

However, the last row of the table shows that inflation remained stable in 2020. In fact, for middle- and high-income countries, inflation in 2020 was lower than the IMF forecast made in October 2019.

Conclusions

COVID-19 impacted health outcomes in all regions of the world. Wealthier countries responded with more testing and quicker vaccination rates. Comparing actual outcomes with pre-pandemic forecasts, I found a significant impact of the pandemic on GDP growth, which is more prominent in middle-income countries.

I conjecture that the impact on GDP growth was less significant in the poorest countries because of less restrictive lockdowns and in the wealthiest countries because of more aggressive economic policies.

  • M1 generally includes physical currency, demand deposits, traveler’s checks and other checkable deposits. M2 generally includes M1 plus savings deposits, money market securities, mutual funds and other time deposits. Note that the above definitions can differ slightly by country.

Juan Sanchez

Juan M. Sánchez is an economist and senior economic policy advisor at the Federal Reserve Bank of St. Louis. He has conducted research on several topics in macroeconomics involving financial decisions by firms, households and countries. He has been at the St. Louis Fed since 2010. View more about the author and his research.

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The Regional Economist offers insights on regional, national and international issues. Views expressed are not necessarily those of the St. Louis Fed or Federal Reserve System.

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The Global Economic Impacts of Covid-19

Photo: PHILIP FONG/AFP via Getty Images

Photo: PHILIP FONG/AFP via Getty Images

Critical Questions by Stephanie Segal and Dylan Gerstel

Published March 10, 2020

Confirmed cases of the novel coronavirus (Covid-19), which first appeared in China at the end of last year, now exceed 115,000 as of March 10 and are likely to climb significantly higher. While over two-thirds of the total confirmed cases are in mainland China, the vast majority of new cases reported since February 25 have occurred outside the country. What was initially seen as a largely China-centric shock is now understood to be a global crisis. The virus’s spread has regrettably borne out analysts’ downside scenarios, with investors digesting the implications of disrupted supply chains, official containment measures, and spillovers from the real economy to financial markets. A decision by two of the world’s largest energy producers to maintain current levels of production, despite falling energy prices, has further unnerved investors while questions about governments’ abilities to mount an effective and coordinated response linger. The increased uncertainty has led to financial market volatility last seen during the global financial crisis.

Q1: What will be the impact of Covid-19 on the economy?

A1: The extent of the damage will depend on how quickly the virus is contained, the steps authorities take to contain it, and how much economic support governments are willing to deploy during the epidemic’s immediate impact and aftermath.

Early indications of Covid-19’s impact on the Chinese economy are worse than initially forecast. Surveys of China’s manufacturing and services sector plunged to record lows in February, automobile sales sank a record 80 percent , and China’s exports fell 17.2 percent in January and February. The official data confirmed a widespread slowdown in economic activity foreshadowed in low pollution levels and depressed shipping traffic , among other informal barometers. Analysts have sharply revised down estimates of Chinese growth, with many now predicting a drop in first quarter GDP, the first contraction since China began reporting quarterly data in 1992. As Covid-19 spreads, China’s economic recovery will be challenged as demand from other countries drops as they cope with the virus.

Although the outbreak appears to have slowed in China, Covid-19 and its impacts have gone global. Infections are mounting in Europe, South Korea, Iran, the United States, and elsewhere, with authorities implementing increasingly restrictive measures to contain the virus. Europe and Japan are likely already in recession territory given their weak fourth quarter performance and high reliance on trade. While the United States entered the crisis with a tailwind , some analysts are forecasting a contraction in U.S. GDP in the second quarter. Estimates of the global impact vary: early last week, the Organisation for Economic Co-operation and Development (OECD) predicted that Covid-19 will lower global GDP growth by one-half a percentage point for 2020 (from 2.9 to 2.4 percent); Bloomberg Economics warns that full-year GDP growth could fall to zero in a worst-case pandemic scenario.

Q2: What sectors and economies are most vulnerable?

A2: The Covid-19 outbreak has generated both demand and supply shocks reverberating across the global economy. Among major economies outside of China, the OECD forecasts the largest downward growth revisions in countries deeply interconnected to China, especially South Korea, Australia, and Japan. Major European economies will experience dislocations as the virus spreads and countries adopt restrictive responses that curb manufacturing activity at regional hubs, including in Northern Italy. As a result of depressed activity, the United Nations projects that foreign direct investment flows could fall between 5 and 15 percent to their lowest levels since the 2008-2009 global financial crisis.

At the sectoral level, tourism and travel-related industries will be among the hardest hit as authorities encourage “social distancing” and consumers stay indoors. The International Air Transport Association warns that Covid-19 could cost global air carriers between $63 billion and $113 billion in revenue in 2020, and the international film market could lose over $5 billion in lower box office sales. Similarly, shares of major hotel companies have plummeted in the last few weeks, and entertainment giants like Disney expect a significant blow to revenues. Restaurants, sporting events , and other services will also face significant disruption. Industries less reliant on high social interaction, such as agriculture, will be comparatively less vulnerable but will still face challenges as demand wavers.

Q3: What’s the relationship between the economy and the energy sector?

A3: Economic slowdowns generally lead to lower energy demand, and the fallout from Covid-19 has proved no different . Often, producers respond to demand slumps by cutting supply to buoy prices. Last week, members of the Organization of the Petroleum Exporting Countries (OPEC) and a few other major oil producers met to discuss an additional cut of 1.5 million barrels per day through the end of June in response to the outbreak. When the agreement collapsed, Saudi Arabia cut prices and lifted output , ostensibly to harm Russia for refusing to agree to production cuts . Following the Saudi decision, Brent Crude fell more than 20 percent , the sharpest one-day drop since 1991, with analysts predicting further declines ahead. The damage from the Saudi-Russian price war sends an unsettling signal to markets hungry for a coordinated policy response to the epidemic, especially considering Saudi Arabia’s current role as G20 president.

In response to the price shock, large oil producers, including U.S. firms, could pare back investment and production, with heavily indebted firms in particular at risk of layoffs, consolidations, and even bankruptcy . Investors are well aware that energy companies account for more than 11 percent of the U.S. high yield (below investment grade) market, with rollovers nearly impossible under current market conditions. In theory, lower oil prices should help oil-importing countries, but depressed activity due to Covid-19 could limit that benefit. In addition, the boom in domestic U.S. energy production in recent years means the United States is exposed to price declines in a way not seen in previous economic downturns.

Q4: How does the economic slowdown impact financial markets?

A4: Fears of a broader outbreak and its economic impact spread to financial markets last month, and most international indices are nearing bear market territory (declining at least 20 percent from the 52-week high) as investors process the lower corporate earnings that will result from the virus. The S&P 500 fell 7 percent to open the March 9 session, triggering a “ circuit breaker ” that briefly suspended trading for the first time since 1997. Overall, the index is down about 17 percent from its record high on February 19. Amid the equity rout, investors have fled to safe haven assets such as U.S. Treasury bonds, leading to record low yields . Low yields translate into low borrowing costs for the U.S. government, but low interest rates may not benefit private companies or individuals (or even all sovereigns) who may find financial markets too risk adverse to extend credit in light of such uncertainty. The longer the virus spreads, the more economic and company performance will be impacted, raising concerns about debt sustainability, especially for highly indebted countries and companies, absent official support.

Q5: How have governments responded to cushion the economic fallout from the epidemic?

A5: Thus far, national governments have announced largely uncoordinated, country-specific responses to the virus. In China, the epicenter of the outbreak, officials announced billions in special-purpose loans to companies facing liquidity constraints as well as financial support to specific sectors such as aviation. In the United States, the Federal Reserve cut the policy rate in an emergency action on March 3, and on March 9, in coordination with other U.S. bank regulators, it encouraged financial institutions to “meet the financial needs of customers and members affected by the coronavirus,” a move aimed at supporting financial conditions to prevent the growth shock from turning into a broader financial crisis. On March 9, the Federal Reserve Bank of New York also announced expanded overnight repurchase operations by $50 billion to avoid a deeper credit crunch.

The European Central Bank and Bank of England are expected to take action when their monetary policy committees meet later this month. On the fiscal front, President Trump previewed his administration’s plans to seek a payroll tax cut and assistance for impacted hourly workers and industries. Countries announcing fiscal measures just this month include Japan ($9.6 billion, or 0.19 percent of GDP), South Korea ($9.2 billion, 0.56 percent of GDP), and Italy ($4.1 billion, 0.20 percent of GDP). The adequacy of such spending will depend on the virus’s path as well as the effectiveness of other measures to contain negative spillovers from the growth shock.

In terms of coordinated action, on March 6, the G20 finance ministers and central bank governors pledged to take “appropriate” fiscal and monetary measures but made no specific commitments. On a March 3 phone call , G7 finance ministers reaffirmed their “commitment to use all policy tools” but did not outline specific steps. For their part, the International Monetary Fund and World Bank last week announced the availability of $50 billion and $12 billion in financing, respectively, to support low income and emerging market economies’ responses to the virus.

Scientists do not yet have a clear understanding of the virus’s behavior, transmission rate, and the full extent of contagion; uncertainty will be part of the backdrop for the foreseeable future. Coherent, coordinated, and credible policy responses provide the best chance at limiting the economic fallout from what is already and sadly a human tragedy.

Stephanie Segal is a senior fellow with the Simon Chair in Political Economy at the Center for Strategic and International Studies in Washington, D.C. Dylan Gerstel is a research assistant with the CSIS Simon Chair in Political Economy.

Critical Questions is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

Stephanie Segal

Stephanie Segal

Dylan Gerstel

Dylan Gerstel

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The Global Economy: on Track for Strong but Uneven Growth as COVID-19 Still Weighs

Global Economic Prospects - June 2021

A year and a half since the onset of the COVID-19 pandemic, the global economy is poised to stage its most robust post-recession recovery in 80 years in 2021. But the rebound is expected to be uneven across countries, as major economies look set to register strong growth even as many developing economies lag.

Global growth is expected to accelerate to 5.6% this year, largely on the strength in major economies such as the United States and China. And while growth for almost every region of the world has been revised upward for 2021, many continue to grapple with COVID-19 and what is likely to be its long shadow. Despite this year’s pickup, the level of global GDP in 2021 is expected to be 3.2% below pre-pandemic projections, and per capita GDP among many emerging market and developing economies is anticipated to remain below pre-COVID-19 peaks for an extended period. As the pandemic continues to flare, it will shape the path of global economic activity.

The United States and China are each expected to contribute about one quarter of global growth in 2021. The U.S. economy has been bolstered by massive fiscal support, vaccination is expected to become widespread by mid-2021, and growth is expected to reach 6.8% this year, the fastest pace since 1984. China’s economy – which did not contract last year – is expected to grow a solid 8.5% and moderate as the country’s focus shifts to reducing financial stability risks.

Lasting Legacies

Growth among emerging market and developing economies is expected to accelerate to 6% this year, helped by increased external demand and higher commodity prices. However, the recovery of many countries is constrained by resurgences of COVID-19, uneven vaccination, and a partial withdrawal of government economic support measures. Excluding China, growth is anticipated to unfold at a more modest 4.4% pace. In the longer term, the outlook for emerging market and developing economies will likely be dampened by the lasting legacies of the pandemic – erosion of skills from lost work and schooling; a sharp drop in investment; higher debt burdens; and greater financial vulnerabilities. Growth among this group of economies is forecast to moderate to 4.7% in 2022 as governments gradually withdraw policy support.

Among low-income economies, where vaccination has lagged, growth has been revised lower to 2.9%. Setting aside the contraction last year, this would be the slowest pace of expansion in two decades. The group’s output level in 2022 is projected to be 4.9% lower than pre-pandemic projections. Fragile and conflict-affected low-income economies have been the hardest hit by the pandemic, and per capita income gains have been set back by at least a decade.  

Regionally, the recovery is expected to be strongest in East Asia and the Pacific, largely due to the strength of China’s recovery. In South Asia, recovery has been hampered by serious renewed outbreaks of the virus in India and Nepal. The Middle East and North Africa and Latin America and the Caribbean are expected to post growth too shallow to offset the contraction of 2020. Sub-Saharan Africa’s recovery, while helped by spillovers from the global recovery, is expected to remain fragile given the slow pace of vaccination and delays to major investments in infrastructure and the extractives sector.  

Uncertain Outlook

The June forecast assumes that advanced economies will achieve widespread vaccination of their populations and effectively contain the pandemic by the end of the year. Major emerging market and developing economies are anticipated to substantially reduce new cases. However, the outlook is subject to considerable uncertainty. A more persistent pandemic, a wave of corporate bankruptcies, financial stress, or even social unrest could derail the recovery. At the same time, more rapid success in stamping out COVID-19 and greater spillovers from advanced economy growth could generate more vigorous global growth.

Even so, the pandemic is expected to have caused serious setbacks to development gains. Although per capita income growth is projected to be 4.9% among emerging market and developing economies this year, it is forecast to be essentially flat in low-income countries. Per capita income lost in 2020 will not be fully recouped by 2022 in about two-thirds of emerging market and developing economies, including three-quarters of fragile and conflict-affected low-income countries. By the end of this year, about 100 million people are expected to have fallen back into extreme poverty. These adverse impacts have been felt hardest by the most vulnerable groups – women, children, and unskilled and informal workers.

Global inflation, which has increased along with the economic recovery, is anticipated to continue to rise over the rest of the year; however, it is expected to remain within the target range for most countries. In those emerging market and developing economies in which inflation rises above target, this trend may not warrant a monetary policy response provided it is temporary and inflation expectations remain well-anchored.

Climbing Food Costs

Rising food prices and accelerating aggregate inflation may compound rising food insecurity in low-income countries. Policymakers should ensure that rising inflation rates do not lead to a de-anchoring of inflation expectations and resist using subsidies or price controls to reduce the burden of rising food prices, as these risk adding to high debt and creating further upward pressure on global agricultural prices.

A recovery in global trade after the recession last year offers an opportunity for emerging market and developing economies to bolster economic growth. Trade costs are on average one-half higher among emerging market and developing economies than advanced economies and lowering them could boost trade and stimulate investment and growth.

With relief from the pandemic tantalizingly close in many places but far from reach in others, policy actions will be critical. Securing equitable vaccine distribution will be essential to ending the pandemic. Far-reaching debt relief will be important to many low-income countries. Policymakers will need to nurture the economic recovery with fiscal and monetary measures while keeping a close eye on safeguarding financial stability. Policies should take the long view, reinvigorating human capital, expanding access to digital connectivity, and investing in green infrastructure to bolster growth along a green, resilient, and inclusive path.  

It will take global coordination to end the pandemic through widespread vaccination and careful macroeconomic stewardship to avoid crises until we get there.  

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This is what the economic fallout from coronavirus could look like

Traders work on the floor of the New York Stock Exchange (NYSE) as the building prepares to close indefinitely due to the coronavirus disease (COVID-19) outbreak in New York, U.S., March 20, 2020.  REUTERS/Lucas Jackson - RC2XNF90CN9H

Markets are down 35%, credit markets have seized up, and credit spreads have spiked to 2008 levels. Image:  REUTERS/Lucas Jackson

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Stay up to date:.

  • Macroeconomic and financial outcomes of the coronavirus have materialized in just three weeks, in comparison to the three years this took for the 2008 financial crisis.
  • Markets are down 35%, credit markets have seized up, and credit spreads have spiked to 2008 levels.

The shock to the global economy from COVID-19 has been both faster and more severe than the 2008 global financial crisis (GFC) and even the Great Depression. In those two previous episodes, stock markets collapsed by 50% or more, credit markets froze up, massive bankruptcies followed, unemployment rates soared above 10%, and GDP contracted at an annualized rate of 10% or more. But all of this took around three years to play out. In the current crisis, similarly dire macroeconomic and financial outcomes have materialized in three weeks.

Earlier this month, it took just 15 days for the US stock market to plummet into bear territory (a 20% decline from its peak) – the fastest such decline ever. Now, markets are down 35% , credit markets have seized up, and credit spreads (like those for junk bonds) have spiked to 2008 levels. Even mainstream financial firms such as Goldman Sachs, JP Morgan and Morgan Stanley expect US GDP to fall by an annualized rate of 6% in the first quarter, and by 24% to 30% in the second. US Treasury Secretary Steve Mnuchin has warned that the unemployment rate could skyrocket to above 20% (twice the peak level during the GFC).

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This is how much the coronavirus will cost the world's economy, according to the un , how could coronavirus impact italy's economy , coronavirus: us unemployment rate could hit 30%.

In other words, every component of aggregate demand – consumption, capital spending, exports – is in unprecedented free fall. While most self-serving commentators have been anticipating a V-shaped downturn – with output falling sharply for one quarter and then rapidly recovering the next – it should now be clear that the COVID-19 crisis is something else entirely. The contraction that is now underway looks to be neither V- nor U- nor L-shaped (a sharp downturn followed by stagnation). Rather, it looks like an I: a vertical line representing financial markets and the real economy plummeting.

Coronavirus Covid-19 virus infection China Hubei Wuhan contagion spread economics dow jones S&P 500 stock market crash 1929 depression great recession

Not even during the Great Depression and World War II did the bulk of economic activity literally shut down, as it has in China, the United States, and Europe today. The best -case scenario would be a downturn that is more severe than the GFC (in terms of reduced cumulative global output) but shorter-lived, allowing for a return to positive growth by the fourth quarter of this year. In that case, markets would start to recover when the light at the end of the tunnel appears.

But the best-case scenario assumes several conditions. First, the US, Europe, and other heavily affected economies would need to roll out widespread COVID-19 testing, tracing, and treatment measures, enforced quarantines, and a full-scale lockdown of the type that China has implemented. And, because it could take 18 months for a vaccine to be developed and produced at scale, antivirals and other therapeutics will need to be deployed on a massive scale.

Second, monetary policymakers – who have already done in less than a month what took them three years to do after the GFC – must continue to throw the kitchen sink of unconventional measures at the crisis. That means zero or negative interest rates; enhanced forward guidance; quantitative easing; and credit easing (the purchase of private assets) to backstop banks, non-banks, money market funds, and even large corporations (commercial paper and corporate bond facilities). The US Federal Reserve has expanded its cross-border swap lines to address the massive dollar liquidity shortage in global markets, but we now need more facilities to encourage banks to lend to illiquid but still-solvent small and medium-size enterprises.

Third, governments need to deploy massive fiscal stimulus, including through “helicopter drops” of direct cash disbursements to households. Given the size of the economic shock, fiscal deficits in advanced economies will need to increase from 2-3% of GDP to around 10% or more. Only central governments have balance sheets large and strong enough to prevent the private sector’s collapse.

But these deficit-financed interventions must be fully monetized. If they are financed through standard government debt, interest rates would rise sharply, and the recovery would be smothered in its cradle. Given the circumstances, interventions long proposed by leftists of the Modern Monetary Theory school, including helicopter drops, have become mainstream.

Unfortunately for the best-case scenario, the public-health response in advanced economies has fallen far short of what is needed to contain the pandemic, and the fiscal-policy package currently being debated is neither large nor rapid enough to create the conditions for a timely recovery. As such, the risk of a new Great Depression, worse than the original – a Greater Depression – is rising by the day.

Unless the pandemic is stopped, economies and markets around the world will continue their free fall. But even if the pandemic is more or less contained, overall growth still might not return by the end of 2020. After all, by then, another virus season is very likely to start with new mutations; therapeutic interventions that many are counting on may turn out to be less effective than hoped. So, economies will contract again and markets will crash again.

Moreover, the fiscal response could hit a wall if the monetization of massive deficits starts to produce high inflation, especially if a series of virus-related negative supply shocks reduces potential growth. And many countries simply cannot undertake such borrowing in their own currency. Who will bail out governments, corporations, banks, and households in emerging markets?

In any case, even if the pandemic and the economic fallout were brought under control, the global economy could still be subject to a number of “ white swan ” tail risks. With the US presidential election approaching, the COVID-19 crisis will give way to renewed conflicts between the West and at least four revisionist powers: China, Russia, Iran, and North Korea, all of which are already using asymmetric cyberwarfare to undermine the US from within. The inevitable cyber attacks on the US election process may lead to a contested final result, with charges of “rigging” and the possibility of outright violence and civil disorder.

Similarly, as I have argued previously, markets are vastly underestimating the risk of a war between the US and Iran this year; the deterioration of Sino-American relations is accelerating as each side blames the other for the scale of the COVID-19 pandemic. The current crisis is likely to accelerate the ongoing balkanization and unraveling of the global economy in the months and years ahead.

This trifecta of risks – uncontained pandemics, insufficient economic-policy arsenals, and geopolitical white swans – will be enough to tip the global economy into persistent depression and a runaway financial-market meltdown. After the 2008 crash, a forceful (though delayed) response pulled the global economy back from the abyss. We may not be so lucky this time.

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Affiliations.

  • 1 Universal Scientific Education and Research Network (USERN), Tehran, Iran.
  • 2 Fondazione Bruno Kessler, Povo, Italy.
  • 3 Universal Scientific Education and Research Network (USERN), Povo, Italy.
  • 4 University of Miami, Coral Gables, FL, USA.
  • 5 Universal Scientific Education and Research Network (USERN), Miami, FL, USA.
  • 6 Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy.
  • 7 Universal Scientific Education and Research Network (USERN), Turin, Italy.
  • 8 University of Waterloo, Waterloo, Canada.
  • 9 Universal Scientific Education and Research Network (USERN), Waterloo, Canada.
  • 10 Queen Mary, University of London, London, UK.
  • 11 University of Pavia, Pavia, Italy.
  • 12 Universal Scientific Education and Research Network (USERN), Pavia, Italy.
  • 13 Michigan State University, East Lansing, MI, USA.
  • 14 Universal Scientific Education and Research Network (USERN), East Lansing, MI, USA.
  • 15 Universal Scientific Education and Research Network (USERN), Tehran, Iran. [email protected].
  • 16 Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. [email protected].
  • PMID: 33973214
  • DOI: 10.1007/978-3-030-63761-3_46

Pandemics are enormous threats to the world that impact all aspects of our lives, especially the global economy. The COVID-19 pandemic has emerged since December 2019 and has affected the global economy in many ways. As the world becomes more interconnected, the economic impacts of the pandemic become more serious. In addition to increased health expenditures and reduced labor force, the pandemic has hit the supply and demand chain massively and caused trouble for manufacturers who have to fire some of their employees or delay their economic activities to prevent more loss. With the closure of manufacturers and companies and reduced travel rates, usage of oil after the beginning of the pandemic has decreased significantly that was unprecedented in the last 30 years. The mining industry is a critical sector in several developing countries, and the COVID-19 pandemic has hit this industry too. Also, world stock markets declined as investors started to become concerned about the economic impacts of the COVID-19 pandemic. The tourism industry and airlines have also experienced an enormous loss too. The GDP has reduced, and this pandemic will cost the world more than 2 trillion at the end of 2020.

Keywords: COVID-19; Economic impacts; Global economy; Market; Oil; Pandemic.

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The global education crisis – even more severe than previously estimated

Ellinore ahlgren, joão pedro azevedo, jessica bergmann, matt brossard, gwang- chol chang, borhene chakroun, marie-helene cloutier, suguru mizunoya, nicolas reuge, halsey rogers.

School girl watching online education classes and doing school homework. COVID-19 pandemic forces children online learning. Photo credit: Shutterstock

In our recent   The State of the Global Education Crisis: A Path to Recovery report (produced jointly by UNESCO, UNICEF, and the World Bank), we sounded the alarm: this generation of students now risks losing $17 trillion in lifetime earnings in present value, or about 14 percent of today’s global GDP, because of COVID-19-related school closures and economic shocks. This new projection far exceeds the $10 trillion estimate released in 2020 and reveals that the impact of the pandemic is more severe than previously thought . 

The pandemic and school closures not only jeopardized children’s health and safety with domestic violence and child labor increasing, but also impacted student learning substantially. The report indicates that in low- and middle-income countries, the share of children living in  Learning Poverty  – already above 50 percent before the pandemic – could reach 70 percent largely as a result of the long school closures and the relative ineffectiveness of remote learning.

Unless action is taken, learning losses may continue to accumulate once children are back in school, endangering future learning.

Figure 1. Countries must accelerate learning recovery

Severe learning losses and worsening inequalities in education

Results from global simulations of the effect of school closures on learning are now being corroborated by country estimates of actual learning losses. Evidence from Brazil , rural Pakistan , rural India , South Africa , and Mexico , among others, shows substantial losses in math and reading. In some low- and middle-income countries, on average, learning losses are roughly proportional to the length of the closures—meaning that each month of school closures led to a full month of learning losses (Figure 1, selected LMICs and HICs presents an average effect of 100% and 43%, respectively), despite the best efforts of decision makers, educators, and families to maintain continuity of learning.

However, the extent of learning loss varies substantially across countries and within countries by subject, students’ socioeconomic status, gender, and age or grade level (Figure 1 illustrates this point, note the large standard deviation, a measure which shows data are spread out far from the mean). For example, results from two states in Mexico show significant learning losses in reading and in math for students aged 10-15. The estimated learning losses were greater in math than reading, and they disproportionately affected younger learners, students from low-income backgrounds, and girls.

Figure 2. The average learning loss standardized by the length of the school closure was close to 100% in Low- and Middle-Income countries, and 43% in High-Income countries, with a standard deviation of 74% and 30%, respectively.

While most countries have yet to measure learning losses, data from several countries, combined with more extensive evidence on unequal access to remote learning and at-home support, shows the crisis has exacerbated inequalities in education globally.

  • Children from low-income households, children with disabilities, and girls were less likely to access remote learning due to limited availability of electricity, connectivity, devices, accessible technologies as well as discrimination and social and gender norms.
  • Younger students had less access to age-appropriate remote learning and were more affected by learning loss than older students. Pre-school-age children, who are at a pivotal stage for learning and development, faced a double disadvantage as they were often left out of remote learning and school reopening plans.
  • Learning losses were greater for students of lower socioeconomic status in various countries, including Ghana , Mexico , and Pakistan .
  • While the gendered impact of school closures on learning is still emerging, initial evidence points to larger learning losses among girls, including in South Africa and Mexico .

As a result, these children risk missing out on much of the boost that schools and learning can provide to their well-being and life chances. The learning recovery response must therefore target support to those that need it most, to prevent growing inequalities in education.

Beyond learning, growing evidence shows the negative effects school closures have had on students’ mental health and well-being, health and nutrition, and protection, reinforcing the vital role schools play in providing comprehensive support and services to students.

Critical and Urgent Need to Focus on Learning Recovery

How should decision makers and the international community respond to the growing global education crisis?

Reopening schools and keeping them open must be the top priority, globally. While nearly every country in the world offered remote learning opportunities for students, the quality and reach of such initiatives varied, and in most cases, they offered a poor substitute for in-person instruction. Stemming and reversing learning losses, especially for the most vulnerable students, requires in-person schooling. Decision makers need to reassure parents and caregivers that with adequate safety measures, such as social distancing, masking, and improved ventilation, global evidence shows that children can resume in-person schooling safely.

But just reopening schools with a business-as-usual approach won’t reverse learning losses. Countries need to create Learning Recovery Programs . Three lines of action will be crucial:

  • Consolidating the curriculum – to help teachers prioritize essential material that students have missed while out of school, even if the content is usually covered in earlier grades, to ensure the curriculum is aligned to students’ learning levels. As an example, Tanzania consolidated its curriculum for grade 1 and 2 in 2015, reducing the number of subjects taught and increasing time on ensuring the acquisition of foundational numeracy and literacy.
  • Extending instructional time – by extending the school day, modifying the academic calendar to make the school year longer, or by offering summer school for all students or those in need. In Mexico , the Ministry of Public Education announced planned extensions to the academic calendar to help recovery. In Madagascar , the government scaled up an existing two-month summer “catch-up” program for students who reintegrate into school after having left the system.
  • Improving the efficiency of learning – by supporting teachers to apply structured pedagogy and targeted instruction. A structured pedagogy intervention in Kenya using teachers guides with lesson plans has proven to be highly effective. Targeted instruction, or aligning instruction to students’ learning level, has been successfully implemented at scale in Cote D’Ivoire .

Finally, the report emphasizes the need for adequate funding. As of June 2021, the education and training sector had been allocated less than 3 percent of global stimulus packages. Much more funding will be needed for immediate learning recovery if countries are to avert the long-term damage to productivity and inclusion that they now face.

Learning Recovery as a Springboard to an Accelerated Learning Trajectory

Accelerating learning recovery has benefits that go well beyond short-term gains:  it can give children the necessary foundations for a lifetime of learning, and it can help countries increase the efficiency, equity, and resilience of schooling. This can be achieved if countries build on investments made and lessons learned during the crisis—most notably, with a focus on six areas:

  • Assessing student learning so instruction can be targeted to students’ learning levels and specific needs.
  • Investing in digital learning opportunities for all students, ensuring that technology is fit for purpose and focused on enhancing human interactions.
  • Reinforcing support that leverages the role of parents, families, and communities in children’s learning.
  • Ensuring that teachers are supported and have access to practical, high-quality professional development opportunities, teaching guides and learning materials. 
  • Increasing the share of education in the national budget allocation of stimulus packages and tying it to investments mentioned above that can accelerate learning.
  • Investing in evidence building - in particular, implementation research, to understand what works and how to scale what works to the system level.

It is time to shift from crisis response to learning recovery. We must make sure that investments and actions for learning recovery lay the foundations for more efficient, equitable, and resilient education systems—systems that truly deliver learning and well-being for all children and youth. Only then can we ensure learning continuity in the face of future disruption.

The report was produced as part of the  Mission: Recovering Education 2021 , through which the  World Bank ,  UNESCO , and  UNICEF  are focused on three priorities: bringing all children back to schools, recovering learning losses, and preparing and supporting teachers.

Ellinore Ahlgren

Education Consultant

João Pedro Azevedo

Lead Economist

Jessica Bergmann

Education Researcher – UNICEF Office of Research-Innocenti

Matt Brossard

Chief, Education – UNICEF Office of Research-Innocenti

Gwang-Chol Chang

Chief of Education Policy Section, Division of Policies and Lifelong Learning Systems, UNESCO Education Sector

Borhene Chakroun

Director, Division for Policies and Lifelong Learning Systems, UNESCO Education Sector

Marie-Helene Cloutier

Senior Economist

Suguru Mizunoya

Senior Advisor, Statistics and Monitoring (Education) – UNICEF New York HQ

Nicolas Reuge

Senior Adviser Education, UNICEF Headquarters

Halsey Rogers's picture

Lead Economist, Education Global Practice

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The global impact of the coronavirus pandemic

John hiscott.

a Pasteur Laboratory, Istituto Pasteur Italia - Fondazione Cenci Bolognetti, Rome, 00161 Italy

Magdalini Alexandridi

Michela muscolini, evelyne tassone, enrico palermo, maria soultsioti.

b Molecular Virology Laboratory, Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands

Alessandra Zevini

The coronavirus pandemic has engulfed the nations of the world for the first five months of 2020 and altered the pace, fabric and nature of our lives. In this overview accompanying the Special Issue of Cytokine & Growth Factor Reviews , we examine some of the many social and scientific issues impacted by SARS-CoV2 – personal lives, economy, scientific communication, the environment. International members of Istituto Pasteur in Rome and INITIATE, the Marie Curie Training Network reflect on the lasting global impact of the coronavirus pandemic.

1. Introduction

The World Health Organization (WHO) officially declared the SARS-CoV-2 outbreak a Public Health Emergency of International Concern on January 30, 2020 and a global pandemic on March 11, 2020. Countries were urged by WHO to adopt strict social distancing and quarantine measures to avoid virus spread and to protect public health [ 1 ]. Despite fragmented international efforts to contain the spread, SARS-CoV2 has spread to 213 countries, resulting in more than 5 million cases and deaths approaching 400,000 since its formal identification in Wuhan China in December 2019. This issue of Cytokine & Growth Factor Reviews is devoted to reviews from around the globe, describing the rapidly accumulating knowledge about the virus, the immunopathogenic consequences of severe disease, the consequences of the cytokine storm and potential therapeutic interventions that could improve morbidity and mortality until a vaccine can be developed and made available. Below, members of Istituto Pasteur in Rome and the Marie Curie ITN INITIATE ( https://initiate-itn.eu ) reflect on the lasting global impact of the coronavirus pandemic.

2. Warning signs

“ Pestilence is in fact very common, but we find it hard to believe in a pestilence when it descends upon us. There have been as many plagues as wars in history; yet always plagues and wars take people equally by surprise .”

- Albert Camus, The Plague

‘How quickly it hit us’ – this is one of the most common sentiments about the Covid-19 pandemic. We were all caught off guard in one way or another; in an instant, an obscure outbreak of pneumonia in an exotic foreign locale - in the next, a viral outbreak jumping from China to the heart of Italy, then to all of Europe, on to America - finally a plague that stopped the world. As the pandemic hit all countries of the globe, it became indisputably clear that everyone was connected - united against a viral scourge [ 2 ].

Despite the shock, there were plenty of warning signs. Since the beginning of the 21st century, recurring outbreaks and epidemics presaged what was coming - there was the first SARS outbreak in 2003, H1N1 influenza pandemic in 2009, MERS coronavirus in 2011, Ebola in 2014−16; mosquito-borne Zika in 2016. A collage of news magazines ( Fig. 1 ) screamed out warnings of an impending pandemic but the clichéd phrase ‘it’s not a matter of if, but when’ continued to be ignored. Even the messages from political leaders (Presidents Barak Obama and George W. Bush) and scientific leaders (NIAID Director Anthony Fauci) went unheard. Below are links to their statements from 2005 to 2017.

Fig. 1

Magazine covers from recent years announcing the arrival of new virus outbreaks around the globe.

https://edition.cnn.com/videos/politics/2020/04/10/barack-obama-2014-pandemic-comments-sot-ctn-vpx.cnn

https://abcnews.go.com/Politics/george-bush-2005-wait-pandemic-late-prepare/story?id=69979013

https://www.sciencealert.com/niaid-director-warned-us-government-of-a-surprise-outbreak-in-2017

International cooperation and a unified strategy of pandemic preparedness were not a priority. In the end, there was no united response - a global leadership void painfully revealed at a moment when it was most needed. What resulted was an international cacophony of last moment efforts, strategies and opinions to suppress the viral pandemic - after it was already upon the world.

3. Global scientific response

“ I have no idea what's awaiting me, or what will happen when this all ends. For the moment I know this: there are sick people and they need curing .”

In order to tackle the Covid-19 crisis, an unparalleled international scientific response has been launched with the goal to understand viral genetics, immunopathogenesis, and therapeutic strategies. Public and private funders across the globe have launched an unprecedented number of initiatives to support multidisciplinary projects addressing the detection, treatment and prevention of SARS-CoV2 infections. Most of the calls encourage collaboration between international scientists, industry, healthcare community, and government policy makers, to facilitate a well-integrated COVID-19 response. The dramatic effects of COVID-19 outbreak taught us that similar pandemics cannot be managed solely at the national level. For this reason, alliances, consortia and networks have emerged on every continent, to connect experts in different research areas of fundamental science, clinical trials, social and behavioural sciences, engineering, and bioinformatics [ 3 ].

In the same context, it has been remarkable how research groups and companies from all over the world have been “repurposing” equipment, facilities and product lines in a joint effort for a rapid response against the ongoing pandemic. Companies that were once producing perfume switched gears to production of much-needed hand sanitizers and disinfectants; industrial companies switched to making face masks which were in short supply in many countries, and automotive companies started production of medical devices, such as ventilators. Scientists in non-virology research fields, who were required to halt their research indefinitely due to the lockdowns, turned their laboratories into diagnostic testing facilities for SARS-CoV-2 and organized into volunteer groups to help researchers on the front lines with their skills and expertise [ [4] , [5] , [6] , [7] ].

This pandemic has also brought to light the importance of open science, data-sharing and new means of communication among members of the scientific community [ [7] , [8] , [9] , [10] ]. Numerous data sets are available publicly, alongside literature reviews and preprint articles in bioarxiv and medarxiv portals. This openness has resulted in a massive amount of information spreading swiftly, which is an important driving force moving COVID-19 research forward in a short time. Of course, such openness comes with a cost: the surge of preprints available in bioarxiv and medarxiv has made it harder to keep up with the screening process of articles to be published in the preprint repositories. More than ever before, information needs to be scrutinized before going public to avoid the danger of inaccuracies, misinformation or even conspiracy theories. Such a situation is unprecedented, as no other pandemic in human history has been tackled in this way. Many scientists all over the world welcome this new form of communication and data-sharing and believe that eventually there will be a balance between good-quality information spreading quicker versus perfect-quality information that is unavailable until much later [ 8 ].

The EU joined forces to coordinate a common response against the coronavirus pandemic. On 30th January 2020, when the pandemic was not declared yet, European Commission mobilized a budget of €10 million for research, that was subsequently increased to €47.5 million [ 11 ]; later on, the Innovative Medicines Initiative (IMI), a partnership between the European Commission and the pharmaceutical industry, invested a total of 90 € million for research proposals to combat the COVID-19 emergency [ 12 ]. During the Coronavirus Global Response pledging event organized by the EU together with WHO (May 4th), €7.4 billion was raised from donors worldwide, to be used “for developing, producing and deploying a vaccine for all”, the European Commission President von der Leyen said [ 13 ]. In the UK, Government invested £20 million to fund new studies against coronavirus, including studies to sequence the different virus isolates as a tool to understand virus behaviour, mutation frequency, virus spread and emergence of new strains [ 14 , 15 ].

Part of these funds will be also used to allow the rapid, large scale production of a vaccine. With more than 100 research laboratories conducting vaccine development research, and with eight vaccine candidates already moving to clinal trials, the race to develop an effective prophylactic vaccine is on [ 16 , 22 ]. Since the biotech firm Moderna announced plans to launch vaccine trials in humans, the US government has invested $483 million to scale up that company’s vaccine production [ 17 ]. Meanwhile, the National Institutes of Health (NIH), together with other government organizations and biotech companies, set up a partnership to coordinate efforts against the COVID-19 pandemic, giving priority to the development of an efficient vaccine and therapeutic drugs [ 18 ]. Days ago, Moderna announced the results of a small eight-person phase I trial of their spike mRNA vaccine candidate, and the preliminary results indicate that all subjects developed antibodies, even at the lowest dose of inoculum [ 19 ], encouraging the company to proceed with a phase II clinical trial that will involve 600 participants. However, scientists are cautious over the successes of such vaccine candidates since the levels of the immune response needed to grant protection against SARS-CoV-2 are not yet well understood [ 8 ].

European biotech companies are also working to develop a potential COVID-19 vaccine. In Germany, BioNTech has designed four vaccine candidates that deliver mRNA encoding four different viral antigens [ 20 ]; ReiThera in Rome, Leukocare in Munich, and Univercells in Brussels have announced the creation of a European consortium that will start the clinical trials of a COVID-19 vaccine. The two pharma giants Sanofi and GSK have recently started a collaboration finalized to the development of an adjuvanted COVID-19 vaccine [ 21 22 ]

To contribute to the pandemic effort, the COVID-19 High Performance Computing (HPC) Consortium demonstrates cooperation amongst global high tech giants Google, Microsoft, Amazon, and IBM; the HPC Consortium offers services, resources and expertise to support molecular modelling projects as the simulation of SARS-CoV2 entering in a host cell, the high throughput screening of drug candidates, and the evaluation of patients’ genomic features with prognostic values [ 23 ].

4. Lockdown & social distance

“The public lacked, in short, standards of comparison. It was only as time passed and the steady rise in the death-rate could not be ignored that public opinion became alive to the truth.”

A. Europe. As the pandemic spread throughout the world, countries took drastic measures to protect their citizens. These measures focused on achieving a fragile balance between limiting virus spread from person to person and maintaining economic activity. It was an impossible balance, although the timing of the implementation of these measures proved to be crucial, both for public health and SARS-CoV2 spread, as well as the economic impact on each country. Early lockdown and strict enforcement were the most effective strategies available to limit virus spread [ 24 , 25 ]. In an accompanying article in this issue, Olagnier & Mogensen describe the implementation of lockdown procedures in Denmark, a country with a remarkably rapid and effective response. The trilogy - social distance, personal hygiene, protective mask – became the mantra throughout Europe and the world.

Follow the spread of Covid-19 in a worldwide cases timeline ( Fig. 2 ): ( https://www.worldometer.info/coronavirus/worldwide-graphs ).

Fig. 2

Global distribution of the Covid-19 cases.

Working in close cooperation with the WHO and EU Member States, the European Union took clear, strict measures, based on the best available scientific expertise. Some member countries faced a significantly limited availability of personal protective equipment (PPE) and the public health systems came close to collapse from the ever-increasing number of severe cases requiring emergency intensive care and ventilation [ 26 ]. In some cases, medical equipment destined for other countries was confiscated [ 27 ]. On the 20th of March, the EU announced a funding scheme of 1,3 billion euro for bulk purchase of PPE [ 28 ]; unfortunately, the UK missed the opportunity to join that funding scheme [ 29 ].

In Europe, health systems adapted to the crisis by mobilizing staff, increasing pharmaceutical spending on vaccine development, and optimizing space with the aim to increase the number and availability of intensive care beds capacity. The European average is currently 11.5 critical care beds per 100.000 capita of population [ 30 ]; in addition to the shortage of ICU beds and ventilators, the lack of health workers to staff the new units became critical. Countries such as France used army forces and camps to transport patients and optimize care bed capacity [ 31 ]. Germany, with the highest proportion of ICU beds per capita of population and one of the best European health systems, campaigned to obtain the medical help of foreign doctors who were living in Germany but did not yet have a license to practice medicine [ 32 ]. In Italy, the Netherlands, France and the UK, retired doctors, nurses and medical students were recruited to help [ 33 ].

Rather than impose a lockdown of its population, the UK initially followed a mitigation strategy to build population immunity but abandoned this plan after realizing it would result in ‘hundreds of thousands of deaths,’ as noted in a report from the Imperial College's COVID-19 response team [ 34 ]. The subsequent illness of the Prime Minister and his transfer to intensive care further contributed to the realization that strict lockdown measures were necessary. Despite ongoing restrictions in the UK, the number of cases continues to rise, the death rate is the highest in Europe and the curve of infections has yet to plateau – a reflection of the lag time before the start of the lockdown.

The Johns Hopkins University (JHU) Coronavirus Resource Center ( http//:coronavirus.jhu.edu ) provides an important live global update of the spread of SARS-CoV2 that includes world map, US map and critical trends. As of 20th May 2020, the total reported cases in Europe were 1,909,592, and the total deaths are 167,538. The UK currently has the highest number of cases & deaths (250,138 & 35,169), followed by Italy (226, 699 & 32,169), Spain (232,037 & 27,778) and France (180,933 & 25,025).

Sweden similarly followed a plan of ‘voluntary’ social distancing, with the country remaining open. With a population of 10 million, the country remains amongst the top 25 in the world in terms of total number of cases, even though testing is reserved only for those with severe symptoms. These measures have not proved to be effective, and altogether the country has registered 5–10 times more deaths than neighboring Scandinavian countries. The above examples again demonstrate that fast response and strict lockdown saved lives.

JHU lists Sweden with 30,799 cases and 3743 deaths, compared to Denmark (11,315 & 551), Finland (6399 & 301) and Norway (8267 & 233).

Moreover, results from a recent antibody testing study across Spain showed that only 5% of the total number of participants tested positive for exposure to the virus and developed some level of immunity [ 35 , 36 ]. A modelling study, based on data obtained from French hospitals, has shown that by the 11th of May only 4.4 % of the French population had developed potential immunity against SARS-CoV-2 [ 37 ] Such numbers, even if remotely accurate, make it clear that letting the infection run its natural course will not result in protection levels high enough to satisfy the criteria of herd-immunity. On the other hand, if such data are interpreted as a low percentage of the population exposed to SARS-CoV-2 in two of the most affected countries in Europe, this showcases a massive positive impact of lockdown measures in containing the spread of the virus.

Lockdowns were not the only measures taken to protect public health. Asian countries which had experience with other viral outbreaks rapidly implemented strict movement restrictions and suspended all unnecessary activities, but in parallel ramped up testing for virus, as well as tracking and isolating cases and contacts [ 38 ]. At the same time, China in response to the surge of cases, built new, specially equipped hospitals to increase the number of intensive care beds, while in Korea, hotels were repurposed as care units exclusively for patients suffering from Covid-19. These countries were also the first to ban flights to and from other countries; borders were closed and open only for cargo trade [ 39 , 40 ].

JHU: Many months after the start of the outbreak in China the number of confirmed cases is more than 84,063 and the deaths are 4638; the case fatality ratio is close to 5,5%. As stated on numerous occasions, it is not clear how accurate the Chinese numbers are. Remarkably, in South Korea, the number of cases is 11,110, with only 263 deaths, numbers that reflect the positive impact of in depth efforts in testing, contact tracing and social distancing.

In the pandemic emergency, the lack of PPE and supplies like disinfectants created fear among frontline medics and staff. To draw attention to this aspect, German medical practitioners posed naked on a Twitter page; this protest was inspired by the French doctor Alain Colombié, who affirmed that doctors were being asked “to go to the front without weapons and no defences.” [ 41 ]. For the same reason protest marches involving doctors, nurses and paramedics took place in many countries - in Pakistan, they evolved into violent clashes between police and doctors, in Italy, silent flash-mobs protested the government response [ 42 , 43 ]

“Many continued hoping that the epidemic would soon die out and they and their families be spared. Thus, they felt under no obligation to make any change in their habits, as yet. Plague was an unwelcome visitant, bound to take its leave one day as unexpectedly as it had come.”

B. America. The first case of Covid-19 was confirmed in America on January 21 st and a few days later the White House Coronavirus Task Force was established. But with government inaction about the pandemic, weeks were lost when the government could have prepared its own response, informed the public and identified necessary medical supplies. New York City, with its dense population and hundreds of flights a day from Europe, became the epicenter of the pandemic in America. The first New York case was recognized on March 1, 2020, although reports now indicate that by March 1, there may have been as many as 10,000 cases in the state, imported from Italy and elsewhere. Mixed messages from city and state officials, essentially claiming ‘go on with your lives’ at the beginning of March further confused the response. Additional delays in announcing a lockdown and containment practices (the New York Pause was issued March 22) guaranteed the firm establishment of the virus in the city and state. New York Governor Andrew Cuomo became a daily fixture on the news, providing daily updates on the number of cases, the search for proper medical equipment and the courageous efforts of medical front line personnel. However, with more than 15,000 deaths in New York City, the critical need to recognize and respond swiftly to the virus was once again sadly reinforced by the staggering numbers. In contrast, California reacted more swiftly to the emergence of SARS-CoV2, and issued a ‘stay-at-home’ order on March 19, an important decision when hours and days mattered.

JHU: As of May 21st, New York state listed 354,370 cases with 28,636 deaths, while California registered 85,997 cases and 3497 deaths. For comparison the number of cases/deaths in New York City are 194,550 and 15,789, while in San Francisco, there are 2179 cases and 36 deaths.

By the end of March, all 50 states of the USA reported cases of Covid-19. A few weeks after the first Covid-19 case, the hospitals began reporting supply shortages - both for testing and personal protective equipment, a severe safety issue for frontline medical staff that was never addressed nationally. Rather, it was left to state governors to grapple with the purchase supplies on the international market [ 44 ]. In mid-March the army started constructing new hospital facilities [ 45 ]. As in Europe, large-scale gatherings were prohibited, schools and other educational institutions were closed, businesses shuttered and restrictions on movement were imposed.

JHU: As of 20 May 2020, the total reported cases in USA is 1,528,661, the number of deaths is more than 91,938.

5. Impact on economy

“The truth is that everyone is bored and devotes himself to cultivating habits. Our citizens work hard, but solely with the object of getting rich. Their chief interest is commerce, and their chief aim in life is, as they call it, 'doing business.'”

A. Europe. The eurozone was experiencing poor economic growth even before the shock of the pandemic, with an expansion of just 0.1% for the last three months of 2019. The economic productivity of the 19 countries of the Eurozone decreased by 3.8 % for the first three months of 2020, in the shadow of the spread of coronavirus throughout Europe. Analysts now say it is certain that the entire eurozone will experience the largest recession since its creation in the late 1990s. Germany, France and Italy, the three largest economies in the monetary union, have all entered into economic recession, with Eurostat recording an even bigger drop in gross national product (GDP) compared to what markets expected. Although countries have published data only for the first quarter of 2020, analysts predict an even greater recession for the second and third quarters of the year [ [46] , [47] , [48] ].

Of the individual Eurozone countries that published relevant data, France reported that after a recession of 0.1 % for the last quarter of 2019, its economy shrank by 5.8 % for the first 3 months of 2020, the largest recession since the country began recording data in the late 1940s. Italy has also experienced recession for the first half of the year, with the economy shrinking to 4.7 % after falling 0.3 % at the end of 2019. The effects of coronavirus pandemic on an already weak economy were enough to squash it. Spain, one of the countries hit hardest by the pandemic, reported a 5.2 % drop in the first quarter the year, while GDP in Belgium and Austria fell 3.9 % and 2.5 % respectively [ 46 , 47 ].

Germany’s economy shrank by 2.2 % in the first quarter of 2020, as the coronavirus pandemic pushed the eurozone's strongest economy into recession; the seasonally adjusted number of unemployed in Germany jumped by 373,000–2.64 million in April. The jobless rate climbed to 5.8 % from a low of 5% the previous month. The government also increased the number of ‘underemployed’ workers to 10.1 million during April; these part-time employment measures helped to maintain the overall employment figures in Germany [ 49 ].

According to Reuters, experts from the World Bank, the World Resources Institute (WRI) and other organizations warn that the coronavirus pandemic will leave behind about 100 million 'new poor’ living in cities around the world due to job losses and income [ 50 , 51 ]. In this scenario, another sad truth must be faced: coronavirus pandemic is widening the gap dividing rich and poor. As for any epidemic, poverty and inequality can exacerbate rates of transmission and mortality. The main factors that sentence poor people to illness are the lack of access to health care, plus poor and crowded living conditions. In the context of the current pandemic, a key mitigating factor in infection risk is the possibility of working remotely, but this is a luxury that a large segment of the workforce doesn’t have. For people who work outside home, the choice is between lose job, lose salary - or keep going out to work amid the pandemic. And because their financial position is more precarious, the only option is to continue to work, travelling in most cases by public transportation, despite the risk of infection for themselves and their families. A primary consequence of this phenomenon is the racial disproportion in sickness and death percentages in the US: African Americans are contracting SARS-CoV2 and dying for it at significantly higher rates compared to white Americans, and this has nothing to do with a biological or genetic predisposition toward coronavirus infection, but is more likely due to a "social predisposition” [ 52 ].

In the European Union, it was decided to provide financial assistance of 5% of its GDP to its member states [ 53 , [ 54 ]. The worst affected countries can use the funds to alleviate the financial burden of the immediate response measures, including assistance to the population, medical assistance and equipment, support to vulnerable groups, and measures to contain the spread of the disease, strengthen preparedness and communication. Among the various fiscal measures adopted to contain the economic fallout, several governments have decided to defer certain payments, including taxes, loans or utility bills, to improve the liquidity positions of individuals and companies facing difficulties. But, in many cases, those measures are not sufficient.

In Italy, the EU country worst affected by coronavirus, economy has been damaged in such a severe manner that people in some regions are running short of food and money. Many of these “new poor” have turned to charities for help, and several cases of looting at supermarkets have been reported. This critical situation encouraged Italians to give a new twist to an old custom known as “suspended coffee”. In this centuries-old Neapolitan tradition, bar customers pay in advance a coffee for someone who can't afford it. The same concept is being applied to “suspended grocery shopping”: customers buy food with a long shelf-life for the needy - such as pasta and canned goods. "Those who can, put something in, those who can't, help yourself": this is the slogan written on solidarity baskets that appeared in supermarkets, local grocery shops and even on the streets throughout Italy [ 55 ]. Beyond these acts of charity, an important help will come from the government, which has designated €400 m for food vouchers to those who can no longer afford groceries [ 56 ].

“He knew quite well that it was plague and, needless to say, he also knew that, were this to be officially admitted, the authorities would be compelled to take very drastic steps. This was, of course, the explanation of his colleagues' reluctance to face the facts.”

B. America. The country with the greatest wealth and medical minds in the world failed to heed warnings from China and then Italy; refused to acknowledge the ‘emergency of international concern’ from the World Health Organization on January 31, 2020; and lacked a pandemic preparedness plan that would have mobilized the American health system to respond to the coming viral pandemic as early as February. A failure of national leadership, compounded by the political divisions, and a fragmented state by state response guaranteed the numbers - more than 1.5 million cases and counting, deaths approaching 100,000. It is impossible to imagine that the United States will emerge from this pandemic with the same perspective on its historic economic inequality.

The coronavirus pandemic has already triggered the sharpest recession in the United States since the Great Depression. For the first 2 1/2 months of 2020, the economy continued to grow at a steady pace, but suddenly halted in mid-March - when businesses, travel industries, restaurants and retail shops were abruptly closed, and tens of millions of Americans were ordered to stay home in an effort to slow the spread of SAR-CoV2.More than 35 million people were suddenly out of work and have filed unemployment claims in recent weeks. The spread of the coronavirus has threatened the social and economic fabric of American communities and revealed in a striking way the inequities of the American system – a single event threw more that 35,000,000 people into joblessness and a step closer to poverty. Expanded unemployment benefits and a one-time stimulus package were forthcoming from the US House and Senate, but these are temporary solutions to a much larger structural inequality that the pandemic has exposed. The Covid-19 pandemic highlighted the flaws in the system and revealed two economic conditions that have been left unchecked: poverty and economic insecurity. An inclusive social safety net that includes a basic income and health coverage may be the only solution to ensure that its citizens have a strong foundation for preparedness for the next pandemic.

6. Psychological impact

“Thus, each of us had to be content to live only for the day, alone under the vast indifference of the sky.”

The measures taken to avoid the spread of the new coronavirus have left their mark on the psyche of citizens around the world. At its peak, an estimated 2.6 billion people – or a third of the world’s population – was living under some kind of lockdown or quarantine, arguably the largest psychological experiment ever conducted [ 57 ]. Adapting to new, unprecedented conditions brought a change in our daily routine and our habits, and imposed adverse effects on citizens at multiple levels. Fear of death and the end of humanity, loneliness and isolation at home, sadness and anxiety for the next day and the future of our loved ones are the grounds for psychological disorders. Increases in firearm and alcohol sales have been registered in the US over the last two months, clear signs of the stress and anxiety generated by coronavirus pandemic among people [ 58 , 59 ]. Since the onset of social distancing, calls to domestic abuse helplines or suicide hotlines have intensified all over the world [ 60 , 61 ]. France offered free accommodation to victims of violence in the home and encouraged people to ask for help in pharmacies [ 62 ]. Australia announced a special phone line named “coronavirus wellbeing support line.” [ 63 ]

In late February 2020, before European countries mandated various forms of lockdown, The Lancet published a review documenting the psychological impact of quarantine (the “restriction of movement of people who have potentially been exposed to a contagious disease”). In short, and perhaps unsurprisingly, people who are quarantined are likely to develop a wide range of symptoms of psychological stress and disorder, including low mood, insomnia, stress, anxiety, anger, irritability, emotional exhaustion, depression and post-traumatic stress symptoms [ 64 ]. In China, these expected mental health effects are already being reported in the first research papers about the lockdown [ 65 ]. A study reporting on the long-term effects of SARS quarantine among healthcare workers found a long-term risk for alcohol abuse, self-medication and long-lasting “avoidance” behavior - where some hospital workers avoid being in close contact with patients by simply not showing up for work. Scientists predict that, if the pandemic continues, psychological and social effects of Covid-19 will worsen and create the “perfect storm” of conditions for suicide, especially in the most vulnerable categories, like the elderly, poor and people suffering from previous mental problems [ 66 ].

“Well, personally, I've seen enough of people who die for an idea. I don't believe in heroism; I know it's easy and I've learned that it can be murderous. What interests me is living and dying for what one loves.”

Widespread measures adopted by governments facing the pandemic crisis were social distancing, country-wide lockdown, and restriction of traffic. Numerous constitutionalists have argued that such measures violate human rights, as freedom of movement is a fundamental right directly linked to human nature. However, international human rights law does recognize that during serious public health threats and public emergencies that threaten the life of a nation, restrictions on some rights can be justified.

Various measures have been taken by the majority of the countries to protect human rights in these difficult times. Countries like Ireland, Austria and Argentina have banned the evictions and have announced measures to protect housing, recognizing its role in the crisis response. Portugal announced that people with pending residency and asylum applications will be treated as permanent residents, giving them equal access to free health care [ 67 ]. Initially several incidents of racism and xenophobia were reported towards people of Chinese and Asian descent all over the world [ 68 ]. Some politicians started to use the term “Chinese Virus” to describe the SARS-Cov-2 pandemic and received criticism for their statements. As the virus spread into European countries and Italy became an epicenter, Italians were also subjected to racism. Unfortunately, such incidents are neither extraordinary nor isolated. Socioeconomic and anthropological/archaeological studies have shown that past pandemics, like the 1918 Spanish Flu and the Black Death in the 14th century, affected societies disproportionally [ 69 ]. People at the lower end of the socioeconomic spectrum were more likely to die from infectious diseases due to different treatment practices (or lack thereof) based on their societal status. African Americans, Latinos and indigenous populations have also faced health care inequalities and discriminations during the course of past pandemics. Since the current pandemic does not yet belong to the past, it is a pivotal moment in history to prevent such discriminations and racial inequalities from leaving their social stigma in the years to come.

7. Misinformation

“There comes a time in history when the man who dares to say that two and two do make four is punished with death.”

WHO has repeatedly stated the urgency of adhering to the measures and positions of the scientific community – social distance, personal hygiene and the use of protective masks. But such invasive measures also opened the floodgates of misinformation, with social and mass media spreading a range of questionable information; conspiracy theories, misinformation or non-scientific views regarding the virus, its origin and spread that endanger public health have acquired a criminal character in several countries.

One of the most difficult issues concerned reports that U.S. officials were investigating the possibility that the coronavirus was secretly ‘manufactured’ and/or ‘escaped’ from a Chinese lab in Wuhan, specifically the Wuhan Institute of Virology. There is no scientific evidence to support these theories. The sequencing and analysis of coronavirus genomes have already dispelled these rumors and instead demonstrate that bats are the likeliest source, suggesting that COVID-19 was created by nature, not humans. At its molecular level, the viral genome most closely resembles an isolate that already exists in horseshoe bats in Hunan province. Supported by several studies, bats have an unusually high capacity to harbor viruses and have been linked to past outbreaks, including SARS, MERS and Ebola. The virus may have spread from bats to an intermediary animal before infecting humans; this remains unclear. The fact that the earliest cases of COVID-19 were linked to a live animal market in Wuhan that sold exotic species only bolsters these observations.

In a recent study from Nature Medicine, researchers concluded "Our analyses clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus” [ 70 ]. It is well known that the Wuhan Institute of Virology and other Institutes have been studying coronaviruses and bats ever since the SARS outbreak of the early 2000s, but there is no evidence that this research was malicious, rather it was a response to the need to understand the pathogenesis and epidemiology of SARS. High containment research was essential, given earlier outbreaks, as well as warnings from former Presidents and scientific leaders (see above).

In 2003 the Chinese government was legitimately criticized for their attempted cover-up of the original SARS outbreak, leading to skepticism amongst its critics about the openness of its response to the SARS-CoV2 outbreak of 2019. Calls from over 100 nations for an investigation into the origins of SARS-CoV2 and the pandemic have been recognized by Premier Xi of China, with his qualification that the review take place ‘after the virus is under control’. There remains much to learn from the early days of the pandemic and the Chinese response, as well as the pandemic response of other countries. From an epidemiologic perspective, these were critical days; understanding the nature and necessity of the immediate response will only prepare the global community for the next outbreak.

8. An environmental surprise

“What’s true of all the evils in the world is true of plague as well. It helps men to rise above themselves.”

The massive shutdown of industry, business, global travel, farming and personal movement produced an unanticipated beneficial effect on the environment. All over the world, the levels of air pollution dropped [ 71 ]; in China, a 25 % reduction in carbon emissions has been reported [ 72 ], while in New York, air pollution dropped by 50 %. In northern Italy and central Europe, nitrogen dioxide (NO2) emissions decrease by 5o% ( Fig. 3 ) [ 73 , 74 ].

Fig. 3

Reduction of NO2 emissions over Northern Italy – January (left) & March (right). https://www.esa.int/ESA_Multimedia/Videos/2020/03/Coronavirus_nitrogen_dioxide_emissions_drop_over_Italy .

To observe statistics and videos of the impact of the coronavirus lockdown on environmental emissions, please visit: https://www.visualcapitalist.com/coronavirus-lockdowns-emissions/

And, in perhaps the most symbolic evidence of the impact of the global pause on the environment, the canals of Venice have cleared; in this video [ 75 ] a jelly fish swims in the canal, while Venetian buildings are reflected in the clear water.

https://www.youtube.com/watch?v=5zDqYvjld18

9. Conclusion

We have reached May 2020 and the lockdown efforts in most countries are winding down. At the time of writing, the population in Italy has moved forward with re-opening the economy; restaurants, stores and businesses are active once again, although the tourists have yet to return. Germany, Spain and France are moving forward with the re-opening their countries after reducing the number of cases and deaths through strict lockdown enforcement. The United States pushes ahead with re-opening business, travel, beaches and bars, despite the continued rise in cases and deaths. And new regions of concern are emerging; Brazil and Russia report massive daily increases in the number of cases and are now becoming the new epicenters, with the second and third highest rates of infection in the world. Singapore and China are carefully evaluating spikes in new cases - using testing, contact tracing and isolation to prevent a ‘second wave’ of coronavirus cases. Research and vaccine development are moving at ‘warp speed’ in the hopes of finding a treatment that will restore us to a new normal. In the first four months of 2020, Covid-19 has engulfed the world; it remains to be seen if global efforts during the next four months will unwrap our planet ( Fig. 4 ).

Fig. 4

Wrapped in Corona. A schematic view of the world as SARS-CoV-2 engulfs the planet.

The pandemic continues. Although it is not clear whether the virus will continue to smolder and ignite in different global regions during the summer, or perhaps retreat, only to return to new peaks in the fall and winter, most experts agree that Covid-19 is not going away anytime soon, and will probably be with us for the next two years [ 76 ]. On May 21st, the WHO reported 106,000 new cases of Covid-19 globally, the highest one day total since the pandemic began. As new knowledge about the virus accumulates, new complications of the disease arise, including the recent recognition of a serious Kawasaki-like disorder in children, termed multi-system inflammatory syndrome (MIS). And new modelling research states that had the lockdown of America been imposed two weeks earlier - March 9 vs March 23 - over 80 % of the cases and deaths could have been prevented. This sobering estimate brings us to another unsettling fact; throughout this crisis, efforts have been made to mute and even ridicule the response of scientific leadership to the pandemic. If Covid-19 ushers in a ‘new normal’ for citizens around the world, we hope that new reality will include the recognition that the voice of science, reason and experience must be heard.

Acknowledgements

The authors wish to thank Michaela Muscolini, Evelyne Tassone and Enrico Palermo for critical reading and comments. The authors also thank the students of INITIATE, the Marie Curie International Training Network for their scientific perspectives and writings during this pandemic period. Quotations in italics from Albert Camus, The Plague. This project was supported by funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 813343 for the Marie Curie ITN INITIATE program.

IMAGES

  1. Five charts that show the global economic impact of COVID-19

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