essay on advantages and disadvantages of covid 19

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Pros and Cons of Covid-19: A Tale of Two Sides

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The positive effects of COVID-19 and the social determinants of health: all in it together?

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The positive effects of covid-19

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We welcome Bryn Nelson’s analysis of the potentially positive effects of public and policy responses to COVID-19, particularly in providing an opportunity to reassess priorities. Nelson highlights the unanticipated benefits of recent behaviour changes – but we suggest the real revolution is a re-discovery of the health potential of state intervention. Governments worldwide have taken unprecedented steps to suppress viral spread, strengthen health systems, and prioritise public health concerns over individual and market freedoms, , with reductions in air pollution, road traffic accidents and sexually transmitted infections a direct (if temporary) result of the embrace of collective over individual liberty. Aside from an outbreak of alt-right protests, the usual accusations of ‘nanny state’ interference have been replaced by calls for centralised governance, funding and control on a scale unseen in peacetime.

While applauding this paradigm shift, it’s important to acknowledge both its partial nature and its extremely uneven impacts – positive or otherwise. As Nelson notes, negative impacts of the current pandemic (such as unemployment and hunger) are ‘unquestionably troubling’, and while governments proclaim that “we’re all in this together” it’s already clear the virus disproportionately affects the poor, ethnic minorities and other socially disadvantaged groups. , Even more troublingly, the very measures intended to suppress viral spread are themselves exacerbating underlying social inequities. , While a drop in traffic is very welcome, the edict to ‘work from home’ is disastrous for casually-employed service or retail workers; and while social distancing may have reduced viral transmission in some groups, its benefits are less evident for those who are homeless, in overcrowded housing or refugee camps. In maximising the potential for COVID-19 to have positive effects, we must understand and address why its negative effects are so starkly mediated by class, ethnicity and (dis)ability.

Back in 2008, the WHO Commission on the Social Determinants of Health highlighted that population health and its social distribution are driven by the conditions in which people are born, grow, live, work and age, and that social injustice is the biggest killer of all. This insight provokes serious questions about the unequal effects of this pandemic and its associated policy responses, both positive and negative. Like Nelson, we hope the currently crisis will produce valuable lessons – most especially in understanding the need for collective action to create a healthier and more equal society.

There are three critical issues here. First, if governments are serious about “preventing every avoidable death”, COVID response strategies need to take account of their unequal impacts. While many states have acted swiftly to support businesses and wage-earners,4 these interventions are largely blind to class, gender and race. Unemployment and food insecurity have already increased with disproportionate effects on women and low-income workers,13 and growing income inequalities are predicted. Charities report dramatic increases in domestic violence with an estimated doubling in domestic abuse killings since the start of the lockdown. While COVID-19 is already more fatal in Black and minority ethnic groups, we have yet to see the extent to which the response will exacerbate existing racial inequities in employment, income and housing. Governments must recognise – and ameliorate – inequalities in the negative effects of COVID-19.

Second, when developing strategies for transitioning out of lockdown, governments need to take account of the unequal impacts of any changes. The Scottish Government has signalled its intention to ease restrictions in ways that “promote solidarity… promote equality... [and] align with our legal duties to protect human rights”.23 Other governments should also consider how plans for lifting the lockdown can be tailored to minimize harm to already disadvantaged groups, and to ensure equal enjoyment of the associated benefits.

Finally, COVID-19 will produce a truly positive effect if the scale of the mobilisation to counter the pandemic can be matched by a sustained commitment to reducing social, economic and environmental inequalities in the longer term. Without such a commitment, we are perpetuating a situation in which many people live in a state of chronic vulnerability. This is bad for society, not only because it undermines social cohesion and trust, but because it places us all at increased risk. COVID-19 unmasks the illusion that health risk can be localised to the level of the individual, community, or even nation state.

If we’re serious about using this crisis to reassess our priorities, , we need to recognise the urgent need for change beyond individual ‘risky behaviour’. To paraphrase Rudolf Virchow, the promotion of health is a social science, and large-scale benefits come from political – not individual – change. The genuinely positive effects of COVID-19 will come when we acknowledge the centrality of wealth redistribution, public provision and social protection to a resilient, healthy and fair society.12, Only then can governments begin to claim that we’re “all in it together”.

References 1. Nelson B. The positive effects of covid-19. BMJ 2020;369;m1785 doi: 10.1136/bmj.m1785 2. Oxford COVID-19 Government Response Tracker. Oxford: Oxford University, Blavatnik School of Government. https://www.bsg.ox.ac.uk/research/research-projects/oxford-covid-19-gove... (accessed 25 March 2020) 3. Kickbush I, Leung GM, Bhutta ZA et al. Covid-19: how a virus is turning the world upside down [editorial]. BMJ 2020; 369:m1336 doi:10.1136/bmj.m1336 4. Gostin LO, Gostin KG. A broader liberty: JS Mill, paternalism, and the public’s health. Public Health 2009; 123(3): 214-221 5. BBC News. Coronavirus lockdown protests: What’s behind the US demonstrations? BBC [online], 21 April 2020. URL https://www.bbc.co.uk/news/world-us-canada-52359100 6. Calman K. Beyond the ‘nanny state’: Stewardship and public health. Public Health 2009; 123(S): e6-10 7. Economist. Building up the pillars of state [briefing]. The Economist, March 28th 2020. 8. Bell T. Sunak’s plan is economically and morally the right thing to do [opinion]. Financial Times, March 21 2020. URL https://www.ft.com/content/70d45e68-6ab6-11ea-a6ac-9122541af204 9. Office of National Statistics. Deaths involving COVID-19 by local area and socioeconomic deprivation: deaths occurring between 1 March and 17 April 2020. Statistical bulletin. London: Office of National Statistics. 10. Van Dorn A, Cooney RE, Sabin ML. COVID-19 exacerbating inequalities in the US. Lancet 2020 395(10232): 1243-4 11. Friel S, Demio S. COVID-19: can we stop it being this generation’s Great Depression? 14 April 2020. Insightplus, Medical Journal of Australia. URL https://insightplus.mja.com.au/2020/14/covid-19-can-we-stop-it-being-thi... 12. Banks J, Karjalainen H, Propper C, Stoye G, Zaranko B (2020). Recessions and health: The long-term health consequences of responses to coronavirus. IFS Briefing Note BN281. London: Institute for Fiscal Studies. https://www.ifs.org.uk/publications/14799 13. Sainato M. Lack of paid leave will leave millions of US workers vulnerable to coronavirus. Guardian [online], 9 March 2020. URL https://www.theguardian.com/world/2020/mar/09/lack-paid-sick-leave-will-... 14. Eley A. Coronavirus: The rough sleepers who can’t self-isolate. BBC [online], 22 March 2020. London: British Broadcasting Corporation. URL https://www.bbc.co.uk/news/uk-51950920 15. Lancet. Redefining vulnerability in the era of COVID-19. Lancet 2020 395(10230): 1089. https://doi.org/10.1016/S0140-6736 (20)30757-1 16. Hargreaves S, Kumar BN, McKee M, Jones L, Veizis A. Europe’s migrant containment policies threaten the response to covid-19 [editorial]. BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1213 17. WHO Commission on the Social Determinants of Health. Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva: World Health Organization. 18. Joyce R, Xu X (2020). Sector shutdowns during the coronavirus crisis: which workers are most exposed? IFS Briefing Note BN278. London: Institute for Fiscal Studies. https://www.ifs.org.uk/publications/14791 19. Scottish Government. COVID-19 – A Framework for Decision Making. April 2020 Edinburgh: Scottish Government, 2020. URL https://www.gov.scot/publications/coronavirus-covid-19-framework-decisio... 20. The Poverty Alliance. National organisations & the impact of Covid-19: Poverty Alliance briefing, 22nd April 2020. Edinburgh: The Poverty Alliance. URL https://www.povertyalliance.org/wp-content/uploads/2020/04/Covid-19-and-... 21. Crawford R, Davenport A, Joyce R, Levell P (2020). Household spending and coronavirus. IFS Briefing Note BN279. London: Institute for Fiscal Studies. https://www.ifs.org.uk/publications/14795 22. Townsend M. Revealed: surge in domestic violence during Covid-19 crisis. The Guardian [online], 12 April 2020. URL https://www.theguardian.com/society/2020/apr/12/domestic-violence-surges... 23. Grierson J. Domestic abuse killings ‘more than double’ amid Covid-19 lockdown. Guardian [online], 15 April 2020. URL https://www.theguardian.com/society/2020/apr/15/domestic-abuse-killings-... 24. Barr C, Kommenda N, McIntyre N, Voce Antonio. Ethnic minorities dying of Covid-19 at higher rate, analysis shows. Guardian [online], 22 April 2020. URL https://www.theguardian.com/world/2020/apr/22/racial-inequality-in-brita... 25. Haque Z. Coronavirus will increase race inequalities [blog]. 26 March 2020. London: Runnymede Trust. URL https://www.runnymedetrust.org/blog/coronavirus-will-increase-race-inequ... 26. Wilkinson R, Pickett K. The Spirit Level. Why Equality is Better for Everyone. London: Penguin Books, 2010 27. Woodward A, Kawachi I. Why reduce health inequalities? Journal of Epidemiology & Community Health. 2000; 54(12):923-929. 28. Collin J, Lee K (2003). Globalisation and transborder health risk in the UK. London: The Nuffield Trust. https://www.nuffieldtrust.org.uk/research/globalisation-and-transborder-... 29. Mackenbach J. Politics is nothing but medicine at a larger scale: reflections on public health’s biggest idea. J Epidemiol Community Health 2009; 63(3): 181-4 doi: 10.1136/jech.2008.077032 30. Graham H. Unequal Lives. Health and Socioeconomic Inequalities. Maidenhead: Open University Press/McGraw Hill, 2007.

Competing interests: No competing interests

Seven positive outcomes of COVID-19

COVID-19 has had undeniable and horrific consequences on people’s lives and the economy. With sickness, death and unemployment rates soaring almost everywhere on our planet, it is easy to despair.

Notwithstanding the gruesomeness of this situation, there are some outcomes that could have a long-term positive impact on the planet and humanity.

1. The Environment

The first positive aspect of COVID-19 is the effect on the environment .  Carbon emissions are down globally and with manufacturing and air travel grinding to a halt, the planet has had a chance to rejuvenate.

China recorded an 85 per cent increase in days with good air quality in 337 cities between January and March. With tourists gone from Italy, the long-polluted canals of Venice now appear clear as fish and other wildlife start returning. Elsewhere, wildlife is also reappearing in other major cities and the biodiversity is slowly starting to return in various parts of the world.

The coronavirus is also raising hopes of fewer battles and less conflict, resulting in increased levels of peace. The United Nations called to end all wars in the face of COVID-19 as the world confronts a common enemy: “It’s time to put armed conflict on lockdown,” stated Secretary-General António Guterres.

So many businesses have had to reinvent themselves with a new 'business as unusual' philosophy.

And according to the ABC, a ceasefire was declared by the Saudis fighting Houthi rebels in Yemen. Although there are many places in the Middle East where war persists, a stronger lockdown could lead to less violence in these countries too.

3. Connectedness

A third positive outcome is a rejuvenated sense of community and social cohesion. Self-isolation challenges us as social animals who desire relationships, contact and interaction with other humans.

However, people all around the world are finding new ways to address the need for interconnectedness.  In Italy, one of the worst-hit countries, people are joining their instruments and voices to create music from their balconies . People are leading street dance parties while maintaining social distancing.

People are using social media platforms to connect, such as the Facebook group The Kindness Pandemic , with hundreds of daily posts. There is a huge wave of formal and informal volunteering where people use their skills and abilities to help.

4. Innovation

COVID-19 is a major market disruptor that has led to unprecedent levels of innovation. Due to the lockdown, so many businesses have had to reinvent themselves with a new 'business as unusual' philosophy.

This includes cafes turning into takeaway venues (some of which also now sell milk or face masks) and gin distilleries now making hand sanitisers .

Many businesses have had to undergo rapid digitalisation and offer their services online. Some could use this wave of innovation to reimagine their business model and change or grow their market.

5. Corporate Responsibility

Coronavirus is driving a new wave of corporate social responsibility (CSR). The global pandemic has become a litmus test for how seriously companies are taking their CSR and their work with key stakeholders: the community, employees, consumers and the environment.

Home-schooling is becoming the new way of learning, exposing many parents to what their children know and do.

Companies are donating money, food and medical equipment to support people affected by the coronavirus. Others are giving to healthcare workers, including  free coffee at McDonald’s Australia and millions of masks from  Johnson & Johnson .

Many are supporting their customers, from Woolworths introducing an exclusive shopping hour for seniors and people with disabilities to Optus giving free mobile data so its subscribers can continue to connect.

6. Reimagined Education

The sixth positive outcome is massive transformation in education. True, most of it was not by choice. With schools closing down all around the world, many teachers are digitalising the classroom , offering online education, educational games and tasks and self-led learning.

Silver linings amid the suffering: Professor Debbie Haski-Leventhal believes a new found sense of gratitude for freedoms we take for granted and a global trend in thanking health workers who are at the frontline are among the positives to come out of the crisis.

We are globally involved in one of the largest-scale experiments in changing education at all levels. Home-schooling is becoming the new way of learning, exposing many parents to what their children know and do.

Similarly, universities are leading remote learning and use state-of-the-art solutions to keep students engaged. Some universities are using augmented and virtual reality to provide near real-life experiences for galvanising students’ curiosity, engagement and commitment and for preparing students for the workplace.

7. Gratitude

Finally, the seventh gift that COVID-19 is giving us is a new sense of appreciation and gratefulness . It has offered us a new perspective on everything we have taken for granted for so long – our freedoms, leisure, connections, work, family and friends. We have never questioned how life as we know it could be suddenly taken away from us.

Hopefully, when this crisis is over, we will exhibit new levels of gratitude . We have also learned to value and thank health workers who are at the frontline of this crisis, risking their lives everyday by just showing up to their vital work. This sense of gratefulness can also help us develop our resilience and overcome the crisis in the long-term.

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All of these positive aspects come at a great price of death, sickness and a depressed global economy. As heartbreaking and frightening as this crisis is, its positive outcomes can be gifts we should not overlook. If we ignore them, all of this becomes meaningless.

It will be up to us to change ourselves and our system to continue with the positive environmental impact, peace, connectedness, innovation, corporate responsibility, reimagined education and gratitude. This crisis will end. We will meet again. We can do so as better human beings.

Debbie Haski-Leventhal is a Professor of Management at the Macquarie Business School. She is a TED speaker and the author of Strategic Corporate Social Responsibility: Tools and Theories for Responsible Management and The Purpose-Driven University .

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Weighing the benefits and costs of COVID-19 restrictions

July 20, 2021 – Over the course of the COVID-19 pandemic, policymakers and the public have often vehemently disagreed about the pros and cons of restrictions such as lockdowns. Proponents of restrictions argue that they save lives; opponents say they destroy livelihoods. Amid these often nasty debates, researchers have been churning out benefit-cost analyses that aim to shed light on which restrictions are “worth it” and which aren’t.

“There are now a huge number of these analyses,” said Lisa Robinson , senior research scientist and deputy director of the Center for Health Decision Science at Harvard T.H. Chan School of Public Health. “It’s become an enormous undertaking.” For her part, Robinson has been exploring the complexities involved in valuing deaths averted by COVID-19 policies , using a well-established but widely-misunderstood metric called the “value per statistical life,” or VSL.

In the big picture, analyses of COVID-19 policies need to take into account how many lives they could potentially save, of course. But they also need to consider the potential downsides. For instance, how many people could lose their jobs if a state puts a lockdown into effect? What educational losses will occur among kids who miss months of in-person school? If restrictions on restaurants are lifted, how do we weigh the economic benefits against the potential increase in COVID-19 cases—and the deaths that might result?

“What benefit-cost analysis does is require people to carefully and rigorously explore the impacts of a policy,” Robinson said. “Something may sound like a great idea on the surface, but digging more deeply into its real-world effects often unearths unexpected consequences. These analyses also highlight the trade-offs implicit whenever we make a decision about how to allocate resources.”

Assigning a money value to life

Robinson has been exploring how best to estimate the VSL—a metric commonly used to evaluate lifesaving interventions—in analyzing the relative costs and benefits of COVID-19 policies. She tackled the issue in a study she co-authored last year, which a recent article in The Economist characterized as “the best attempt at weighing up these competing valuations.”

Although the phrase “value per statistical life” suggests that the government, or someone else, is somehow placing a value on someone’s life, Robinson emphasizes that this is not the case. Rather, economists start by investigating how much of their own income individuals are willing to exchange to reduce their own chance of dying by a small amount—such as by paying extra to buy a safer car or choosing a less risky job for lower pay. These estimates are then converted into estimates of value of reducing expected deaths—that is to say, into the VSL.

Policymakers often use VSL, for example, when determining what safety requirements to impose on automobiles or how low to set standards for pollution emissions. In looking at the population as a whole, U.S. regulatory agencies making benefit-cost calculations currently estimate the VSL as roughly $10 or $11 million. A $10 million VSL means that a typical individual is willing to pay $1,000 to reduce his or her chance of dying within a given year by 1 in 10,000, Robinson explained in a 2020 blog post that looked at COVID-19 benefit-cost analysis and the VSL.

She noted, however, that the $10 million or $11 million figure is for the average member of the population—for someone middle-aged. An individual’s willingness to pay to reduce mortality risk may not stay the same across their life course. For example, older people have fewer expected years of life remaining than the average member of the population, and less opportunity for future earnings, which could change the VSL calculation and therefore make a difference when COVID-19 policies are assessed.

Yet another consideration to take into account is the value people may place on avoiding the substantial pain and suffering caused by COVID-19—including struggling to breathe, or being put on a ventilator—which could increase the VSL. In an October 2020 paper , Robinson’s colleague and frequent co-author James Hammitt , professor of economics and decision sciences, also noted that people may be more likely to place a higher value on avoiding risks they view as “dreaded, uncertain, catastrophic, and ambiguous”—like COVID-19.

The overall point, according to Robinson, is that analysts and policymakers comparing the benefits and costs of particular COVID-19 policies should take care to examine uncertainty in the VSL estimates. VSL is likely to vary depending on who is affected by the policy and by how they view the risks that they experience.

She acknowledges the difficulty involved in deciding on COVID-19 restrictions. But she is also gratified to see that people are using benefit-cost analysis to carefully explore the implications of those tough decisions.

“When COVID hit, benefit-cost analysis really got a lot of attention in the mass media,” she said. “I was so excited that this field that I’ve been involved in for so long is now the subject of stories in major news outlets like the New York Times and the Wall Street Journal. People are really paying attention to its usefulness in policymaking.”

– Karen Feldscher

photo: Anthony Quintano/Wikimedia Commons

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What are the benefits and risks of vaccines for preventing COVID-19?

Key messages

– Most vaccines reduce, or probably reduce, the number of people who get COVID-19 disease and severe COVID-19 disease.

– Many vaccines likely increase number of people experiencing events such as fever or headache compared to placebo (sham vaccine that contains no medicine but looks identical to the vaccine being tested). This is expected because these events are mainly due to the body's response to the vaccine; they are usually mild and short-term.

– Many vaccines have little or no difference in the incidence of serious adverse events compared to placebo. 

– There is insufficient evidence to determine whether there was a difference between the vaccine and placebo in terms of death because the numbers of deaths were low in the trials.

– Most trials assessed vaccine efficacy over a short time, and did not evaluate efficacy to the COVID variants of concern. 

What is SARS-CoV-2 and COVID-19?

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is the virus that causes COVID-19 disease. Not everyone infected with SARS-CoV-2 will develop symptoms of COVID-19. Symptoms can be mild (e.g. fever and headaches) to life-threatening (e.g. difficulty breathing), or death.

How do vaccines prevent COVID-19?

While vaccines work slightly differently, they all prepare the body's immune system to prevent people from getting infected with SARS-CoV-2 or, if they do get infected, to prevent severe disease.

What did we want to find out?

We wanted to find out how well each vaccine works in reducing SARS-CoV-2 infection, COVID-19 disease with symptoms, severe COVID-19 disease, and total number of deaths (including any death, not only those related to COVID-19).

We wanted to find out about serious adverse events that might require hospitalization, be life-threatening, or both; systemic reactogenicity events (immediate short-term reactions to vaccines mainly due to immunological responses; e.g. fever, headache, body aches, fatigue); and any adverse events (which include non-serious adverse events).

What did we do? 

We searched for studies that examined any COVID-19 vaccine compared to placebo, no vaccine, or another COVID-19 vaccine.

We selected only randomized trials (a study design that provides the most robust evidence because they evaluate interventions under ideal conditions among participants assigned by chance to one of two or more groups). We compared and summarized the results of the studies, and rated our confidence in the evidence based on factors such as how the study was conducted.

What did we find? 

We found 41 worldwide studies involving 433,838 people assessing 12 different vaccines. Thirty-five studies included only healthy people who had never had COVID-19. Thirty-six studies included only adults, two only adolescents, two children and adolescents, and one included adolescents and adults. Three studied people with weakened immune systems, and none studied pregnant women.

Most cases assessed results less than six months after the primary vaccination. Most received co-funding from academic institutions and pharmaceutical companies. Most studies compared a COVID-19 vaccine with placebo. Five evaluated the addition of a 'mix and match' booster dose.

Main results 

We report below results for three main outcomes and for 10 World Health Organization (WHO)-approved vaccines (for the remaining outcomes and vaccines, see main text). There is insufficient evidence regarding deaths between vaccines and placebo (mainly because the number of deaths was low), except for the Janssen vaccine, which probably reduces the risk of all-cause deaths. 

People with symptoms

The Pfizer, Moderna, AstraZeneca, Sinopharm-Beijing, and Bharat vaccines produce a large reduction in the number of people with symptomatic COVID-19.

The Janssen vaccine reduces the number of people with symptomatic COVID-19.

The Novavax vaccine probably has a large reduction in the number of people with symptomatic COVID-19.

There is insufficient evidence to determine whether CoronaVac vaccine affects the number of people with symptomatic COVID-19 because results differed between the two studies (one involved only healthcare workers with a higher risk of exposure).

Severe disease

The Pfizer, Moderna, Janssen, and Bharat vaccines produce a large reduction in the number of people with severe disease.

There is insufficient evidence about CoronaVac vaccine on severe disease because results differed between the two studies (one involved only healthcare workers with a higher risk of exposure).

Serious adverse events

For the Pfizer, CoronaVac, Sinopharm-Beijing, and Novavax vaccines, there is insufficient evidence to determine whether there was a difference between the vaccine and placebo mainly because the number of serious adverse events was low.

Moderna, AstraZeneca, Janssen, and Bharat vaccines probably result in no or little difference in the number of serious adverse events. 

What are the limitations of the evidence?

Most studies assessed the vaccine for a short time after injection, and it is unclear if and how vaccine protection wanes over time. Due to the exclusion criteria of COVID-19 vaccine trials, results cannot be generalized to pregnant women, people with a history of SARS-CoV-2 infection, or people with weakened immune systems. More research is needed comparing vaccines and vaccine schedules, and effectiveness and safety in specific populations and outcomes (e.g. preventing long COVID-19). Further, most studies were conducted before the emergence of variants of concerns.

How up to date is this evidence?

The evidence is up to date to November 2021. This is a living systematic review. Our results are available and updated bi-weekly on the COVID-NMA platform at covid-nma.com.

Compared to placebo, most vaccines reduce, or likely reduce, the proportion of participants with confirmed symptomatic COVID-19, and for some, there is high-certainty evidence that they reduce severe or critical disease. There is probably little or no difference between most vaccines and placebo for serious adverse events. Over 300 registered RCTs are evaluating the efficacy of COVID-19 vaccines, and this review is updated regularly on the COVID-NMA platform ( covid-nma.com ).

Implications for practice

Due to the trial exclusions, these results cannot be generalized to pregnant women, individuals with a history of SARS-CoV-2 infection, or immunocompromized people. Most trials had a short follow-up and were conducted before the emergence of variants of concern.

Implications for research

Future research should evaluate the long-term effect of vaccines, compare different vaccines and vaccine schedules, assess vaccine efficacy and safety in specific populations, and include outcomes such as preventing long COVID-19. Ongoing evaluation of vaccine efficacy and effectiveness against emerging variants of concern is also vital. 

Different forms of vaccines have been developed to prevent the SARS-CoV-2 virus and subsequent COVID-19 disease. Several are in widespread use globally. 

To assess the efficacy and safety of COVID-19 vaccines (as a full primary vaccination series or a booster dose) against SARS-CoV-2.

We searched the Cochrane COVID-19 Study Register and the COVID-19 L·OVE platform (last search date 5 November 2021). We also searched the WHO International Clinical Trials Registry Platform, regulatory agency websites, and Retraction Watch.

We included randomized controlled trials (RCTs) comparing COVID-19 vaccines to placebo, no vaccine, other active vaccines, or other vaccine schedules.

We used standard Cochrane methods. We used GRADE to assess the certainty of evidence for all except immunogenicity outcomes. 

We synthesized data for each vaccine separately and presented summary effect estimates with 95% confidence intervals (CIs). 

We included and analyzed 41 RCTs assessing 12 different vaccines, including homologous and heterologous vaccine schedules and the effect of booster doses. Thirty-two RCTs were multicentre and five were multinational. The sample sizes of RCTs were 60 to 44,325 participants. Participants were aged: 18 years or older in 36 RCTs; 12 years or older in one RCT; 12 to 17 years in two RCTs; and three to 17 years in two RCTs. Twenty-nine RCTs provided results for individuals aged over 60 years, and three RCTs included immunocompromized patients. No trials included pregnant women. Sixteen RCTs had two-month follow-up or less, 20 RCTs had two to six months, and five RCTs had greater than six to 12 months or less. Eighteen reports were based on preplanned interim analyses.

Overall risk of bias was low for all outcomes in eight RCTs, while 33 had concerns for at least one outcome.

We identified 343 registered RCTs with results not yet available. 

This abstract reports results for the critical outcomes of confirmed symptomatic COVID-19, severe and critical COVID-19, and serious adverse events only for the 10 WHO-approved vaccines. For remaining outcomes and vaccines, see main text. The evidence for mortality was generally sparse and of low or very low certainty for all WHO-approved vaccines, except AD26.COV2.S (Janssen), which probably reduces the risk of all-cause mortality (risk ratio (RR) 0.25, 95% CI 0.09 to 0.67; 1 RCT, 43,783 participants; high-certainty evidence).

Confirmed symptomatic COVID-19

High-certainty evidence found that BNT162b2 (BioNtech/Fosun Pharma/Pfizer), mRNA-1273 (ModernaTx), ChAdOx1 (Oxford/AstraZeneca), Ad26.COV2.S, BBIBP-CorV (Sinopharm-Beijing), and BBV152 (Bharat Biotect) reduce the incidence of symptomatic COVID-19 compared to placebo (vaccine efficacy (VE): BNT162b2: 97.84%, 95% CI 44.25% to 99.92%; 2 RCTs, 44,077 participants; mRNA-1273: 93.20%, 95% CI 91.06% to 94.83%; 2 RCTs, 31,632 participants; ChAdOx1: 70.23%, 95% CI 62.10% to 76.62%; 2 RCTs, 43,390 participants; Ad26.COV2.S: 66.90%, 95% CI 59.10% to 73.40%; 1 RCT, 39,058 participants; BBIBP-CorV: 78.10%, 95% CI 64.80% to 86.30%; 1 RCT, 25,463 participants; BBV152: 77.80%, 95% CI 65.20% to 86.40%; 1 RCT, 16,973 participants).

Moderate-certainty evidence found that NVX-CoV2373 (Novavax) probably reduces the incidence of symptomatic COVID-19 compared to placebo (VE 82.91%, 95% CI 50.49% to 94.10%; 3 RCTs, 42,175 participants).

There is low-certainty evidence for CoronaVac (Sinovac) for this outcome (VE 69.81%, 95% CI 12.27% to 89.61%; 2 RCTs, 19,852 participants).

Severe or critical COVID-19

High-certainty evidence found that BNT162b2, mRNA-1273, Ad26.COV2.S, and BBV152 result in a large reduction in incidence of severe or critical disease due to COVID-19 compared to placebo (VE: BNT162b2: 95.70%, 95% CI 73.90% to 99.90%; 1 RCT, 46,077 participants; mRNA-1273: 98.20%, 95% CI 92.80% to 99.60%; 1 RCT, 28,451 participants; AD26.COV2.S: 76.30%, 95% CI 57.90% to 87.50%; 1 RCT, 39,058 participants; BBV152: 93.40%, 95% CI 57.10% to 99.80%; 1 RCT, 16,976 participants).

Moderate-certainty evidence found that NVX-CoV2373 probably reduces the incidence of severe or critical COVID-19 (VE 100.00%, 95% CI 86.99% to 100.00%; 1 RCT, 25,452 participants).

Two trials reported high efficacy of CoronaVac for severe or critical disease with wide CIs, but these results could not be pooled.

Serious adverse events (SAEs)

mRNA-1273, ChAdOx1 (Oxford-AstraZeneca)/SII-ChAdOx1 (Serum Institute of India), Ad26.COV2.S, and BBV152 probably result in little or no difference in SAEs compared to placebo (RR: mRNA-1273: 0.92, 95% CI 0.78 to 1.08; 2 RCTs, 34,072 participants; ChAdOx1/SII-ChAdOx1: 0.88, 95% CI 0.72 to 1.07; 7 RCTs, 58,182 participants; Ad26.COV2.S: 0.92, 95% CI 0.69 to 1.22; 1 RCT, 43,783 participants); BBV152: 0.65, 95% CI 0.43 to 0.97; 1 RCT, 25,928 participants). In each of these, the likely absolute difference in effects was fewer than 5/1000 participants.

Evidence for SAEs is uncertain for BNT162b2, CoronaVac, BBIBP-CorV, and NVX-CoV2373 compared to placebo (RR: BNT162b2: 1.30, 95% CI 0.55 to 3.07; 2 RCTs, 46,107 participants; CoronaVac: 0.97, 95% CI 0.62 to 1.51; 4 RCTs, 23,139 participants; BBIBP-CorV: 0.76, 95% CI 0.54 to 1.06; 1 RCT, 26,924 participants; NVX-CoV2373: 0.92, 95% CI 0.74 to 1.14; 4 RCTs, 38,802 participants).

For the evaluation of heterologous schedules, booster doses, and efficacy against variants of concern, see main text of review.

• Open access
• Published: 02 January 2024

Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data

• Stephanie A Ponce 1 ,
• Alexis Green 1 ,
• Paula D. Strassle 2   na1 &
• Anna María Nápoles 1   na1  

BMC Public Health volume  24 , Article number:  22 ( 2024 ) Cite this article

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The COVID-19 pandemic had a profound social and economic impact across the United States due to the lockdowns and consequent changes to everyday activities in social spaces.

The COVID-19’s Unequal Racial Burden (CURB) survey was a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults living in the U.S. For this analysis, we used data from the 1,931 participants who responded to the 6-month follow-up survey conducted between 8/16/2021-9/9/2021. As part of the follow-up survey, participants were asked “What was the worst thing about the pandemic that you experienced?” and “Was there anything positive in your life that resulted from the pandemic?” Verbatim responses were coded independently by two coders using open and axial coding techniques to identify salient themes, definitions of themes, and illustrative quotes, with reconciliation across coders. Chi-square tests were used to estimate the association between sociodemographics and salient themes.

Commonly reported negative themes among participants reflected disrupted lifestyle/routine (27.4%), not seeing family and friends (9.8%), and negative economic impacts (10.0%). Positive themes included improved relationships (16.9%), improved financial situation (10.1%), and positive employment changes (9.8%). Differences in themes were seen across race-ethnicity, gender, and age; for example, adults ≥ 65 years old, compared to adults 18–64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p  < 0.001) as a negative aspect of the pandemic, and Spanish-speaking Latino adults were much more likely to report improved relationships compared to other racial-ethnic groups (31.1% vs. 14.8–18.6%, p  = 0.03).

Positive and negative experiences during the COVID-19 pandemic varied widely and differed across race-ethnicity, gender, and age. Future public health interventions should work to mitigate negative social and economic impacts and facilitate posttraumatic growth associated with pandemics.

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Introduction

The impact of the COVID-19 pandemic on morbidity and mortality, as well as the social, behavioral, and economic impacts have been well-documented. As of May 23, 2023, the CDC estimates that the COVID-19 pandemic has caused 6,152,982 hospitalizations and 1,128,903 deaths in the United States (U.S) [ 1 ]. In addition to the pandemic itself, mitigation measures adopted during the pandemic to reduce transmission across the U.S. also had major social and economic impacts [ 2 ]. Efforts to mitigate the spread of COVID-19 infection, including social distancing, lockdowns, and transitions to remote work, became a source of life disruptions and emotional distress [ 3 , 4 ]. Racial-ethnic disparities in the burden of COVID-19 morbidity and mortality, as well as negative social and economic consequences have been reported.

However, mitigation efforts and COVID-related policies also may have had positive impacts. Traumatic events, life crises, and illnesses, although challenging to move through, have often resulted in positive psychological change as people seek new ways of making meaning from these experiences. These positive psychological changes that result from traumatic events have been referred to as posttraumatic growth and defined as “positive psychological changes experienced as a result of the struggle with trauma or highly challenging situations.” [ 5 ] Previous research has indicated that women experience higher levels of posttraumatic growth, compared to men, and that increasing age moderates posttraumatic growth among women [ 6 ]. During the COVID-19 pandemic, women have been found to report higher posttraumatic growth during quarantine [ 7 ] and COVID-19 related hospitalization [ 8 ]; however, these studies were not based in the United States.

Additionally, in response to the COVID-19 pandemic, many companies adapted by creating new telework and flexible work schedule policies during lockdowns, [ 9 , 10 ] which have been associated with improved work-life balance and family relationships [ 11 , 12 ]. Initial reports during the pandemic indicate that the lockdown period also served as a time to find oneself [ 13 ], pursue new passions and hobbies [ 13 ], and save money [ 14 ] due to the lack of regular social outings and a decrease in transportation related expenses such as gas. COVID-19 associated posttraumatic positive growth experiences have not been well-researched, especially across diverse racial-ethnic groups.

Given the extensive social, behavioral, and economic changes and mitigation measures resulting from the COVID-19 pandemic, it is important to understand the positive and negative perceived consequences of these events among U.S. adults, and any differences across race-ethnicity, gender, and age. Thus, the purpose of this mixed-methods study was to capture the voices of a diverse, national sample of American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino (English- and Spanish-speaking), White, and multiracial adults (≥ 18 years old) living in the U.S and perceived major positive and negative impacts of the pandemic.

Study population and survey development

For this study we used data from the COVID-19’s Unequal Racial Burden (CURB) online survey, which was administered by YouGov, a nonpartisan consumer research firm based in Palo Alto, CA, which uses a proprietary, opt-in survey panel comprised of over 1.8 million US residents to conduct nationally representative surveys. Panel members are recruited through a variety of methods to ensure diversity, and then were matched to a theoretical target sample. For this study, the target sample was drawn from the 2018 American Community Survey 1-year sample data, and included 1,000 Asian, 1,000 Black/African American, 1,000 Latino (including 500 Spanish-speaking), 1,000 White, 500 American Indian/Alaska Native, 500 Native Hawaiian/Pacific Islander, and 500 multiracial adults aged ≥ 18 years (n = 5,500 total). The survey was conducted in both English and Spanish (Latino participants only). The baseline CURB survey was first created in English, translated into Spanish by an American Translators Association certified translator, and then finalized by four bilingual/bicultural researchers via reconciliation and decentering methods. Questions added or modified in the follow-up survey were translated into Spanish by our bilingual/bicultural researchers.

The baseline survey was completed between December 8, 2020, and February 17, 2021, and the 6-month follow-up survey between August 16, 2021, and September 9, 2021 (35.1% response rate), Supplemental Table 1 . For this analysis, we included all participants who responded to both the baseline and 6-month follow-up survey (n = 1,931). The CURB survey development and sampling design details have been previously described [ 15 ].

The National Institutes of Health Office of Institutional Review Board Operations determined that this study does not qualify as human subjects research because data were de-identified (IRB# 000166).

Identifying negative and positive aspects of the COVID-19 pandemic

As part of the 6-month follow-up survey, all participants were asked two open-ended questions: (1) What was the worst thing about the pandemic that you experienced? and (2) Was there anything positive in your life that resulted from the pandemic? Verbatim responses were coded independently using open and axial coding methods in two steps by two coders (SAP, AG) [ 16 ]. Responses from Spanish-speaking Latino participants were translated into English, reviewed, and reconciled by two bilingual-bicultural research team members (SAP, AMN) prior to coding. In the first step, coders categorized responses to both questions using open coding methods (breaking the data into discrete parts and creating codes to label them). Then, applying axial coding methods (i.e., codes were organized into categories/themes), the responses for each question were coded for salient themes, definitions of themes, and illustrative quotes. Consensus was reached through iterative meetings between the coders and the rest of the study team.

Participant sociodemographics

Race-ethnicity was captured by asking respondents “Which one of the following would you say best describes your race/ethnicity?” with response options of Latino/a/x or Hispanic, American Indian or Alaska Native, Asian, Black or African American, Pacific Islander, White, and multiracial. Latino participants were further stratified into English- and Spanish-speaking, depending on their survey language preference; 68.9% of Spanish-speaking Latino participants also self-reported limited English proficiency, compared to only 5.4% of English-speaking Latino participants. Gender was categorized as male, female, and transgender or nonbinary. Age was captured as a continuous variable and categorized as 18–34, 35–49, 50–64, and ≥ 65 years old.

Statistical analysis

Descriptive statistics and Chi-square tests were used to compare the prevalence of salient themes for the two open-ended questions across self-reported race-ethnicity, gender, and age. Due to the small number of participants that identified as transgender or non-binary (n = 26), comparisons across gender were restricted to comparing male and female participants only. All analyses were conducted using SAS version 9.4 (SAS Inc., Cary, NC). Due to the relatively low response rate of the follow-up survey, results were not weighted to generate nationally representative estimates.

Worst aspects of the COVID-19 pandemic

Overall, 1,511 of 1,931 participants (78.2%) responded to “What was the worst thing about the pandemic that you experienced?” Respondent characteristics can be found in Supplemental Table 2 .

Salient themes, definitions, and illustrative quotes for the worst aspects of the COVID-19 pandemic are reported in Table  1 . Overall, the most commonly reported negative aspect was disrupted lifestyle/routine (27.4%), Fig.  1 A. Responses included disrupted lifestyle/routine due to reduced services and restrictions in places like school, healthcare settings, restaurants, places of worship, and other places of recreation or routine outings. Missed important life events such as graduations, weddings, and internship opportunities were also noted. Adults ≥ 65 years-old, compared to adults 18–64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p  < 0.001) as a negative impact of the pandemic, Supplemental Fig.  1 A. No significant racial-ethnic or gender differences in the prevalence of disrupted lifestyle/routine were observed.

Overall prevalence of reported (A) negative and (B) positive impacts of the COVID-19 pandemic among a diverse sample of adults living in the US, COVID-19’s Unequal Racial Burden (CURB) survey, 8/16/2021-9/9/2021

“My senior year of college was ruined by the pandemic. I missed my senior cross-country season and the chance to go to nationals in indoor track.” (Female, 18–34 years old, White).

The next most commonly reported worst aspect was negative economic impacts (10.0%), Fig.  1 A. Respondents reported negative changes in employment/unemployment, decreased financial security, decreased job security, increased cost of products/living, and increased shortages. Younger adults (< 65 years old) were more likely to report negative economic impacts compared to adults ≥ 65 years old (11.0% vs 2.3%, p  = 0.001), Supplemental Fig.  1 B.

“Not being able to purchase certain food items, toilet paper, paper towels, masks, disinfectant spray. The prices of items increasing.” (Female, 18–34 years old, multiracial).

“Recently having to live off one income plus whatever unemployment pays. My bank account has been negative, often because of bills being pulled and not having the funds.” (Female, 35–49 years old, English-speaking Latino).

Overall, not seeing family/loved ones (9.9%) and (9.0%) isolation were reported as negative aspects by roughly 1 in 10 respondents, respectively, Fig.  1 A. Reasons included concerns of transmission and decreased quality of social interactions due to masking and social distancing. Women, compared to men, were more likely to report not seeing family/loved ones as the worst aspect of the pandemic (12.5% vs. 6.6%, p  < 0.001). Increasing age was associated with being more likely to report not seeing family/loved ones (18–34 years old, 6.8%; 35–49 years old, 8.5%; 50–64 years old, 11.0%;and ≥ 65 years old, 13.1%; p  = 0.034). Racial-ethnic differences were also observed ( p  = 0.004), with Native Hawaiian/Pacific Islander (15.3%), White (12.2%), Asian (10.7%), and English-speaking Latino (10.2%) adults reporting higher prevalence of not seeing family/loved ones compared to, Fig.  2 . No significant differences in the reporting of isolation were seen across race-ethnicity, gender, or age.

Prevalence of reporting not seeing family/loved ones during the COVID-19 pandemic, stratified by race-ethnicity, among a diverse sample of adults living in the US, COVID-19’s Unequal Racial Burden (CURB) survey, 8/16/2021-9/9/2021

" Me senti alejado del mundo y necesitaba contacto con otras personas pero creo que la pandemia todavia no ha pasado” (“I felt cut off from the world and needed contact with other people but I believe that the pandemic has not yet passed”) (Female, 50–64 years old, Spanish-speaking Latino).

“Being separated from my kids and grandchildren who live in another state 2500 miles from my home. During the pandemic we planned and canceled three trips to see them. Finally made the trip after 18 months without in person contact.” (Male, ≥ 65 years old, White).

Other negative aspects reported were fear (8.9%), death/loss of a loved one (6.7%), negative perceptions of others (6.4%), having to mask (5.3%), misinformation (4.9%), travel restrictions (4.5%), others ignoring mandates (4.1%), getting or having a loved one get COVID-19 (3.7%), psychological distress (3.4%), political polarization (2.5%), government control/loss of autonomy (2.4%), and worse health/health behaviors (1.7%), Fig.  1 A.

Positive aspects of the COVID-19 pandemic

Overall, 1,033 participants responded to “ Was there anything positive in your life that resulted from the pandemic? ” (53.5%). Respondent characteristics are reported in Supplemental Table 2 .

Salient themes, definitions, and illustrative quotes for the positive impacts of the COVID-19 pandemic are reported in Table  2 . The most commonly reported positive impact of the COVID-19 pandemic was improved relationships (16.9%), Fig.  1 B. Reasons for improved relationships included spending more time at home and more quality time with loved ones. Women (18.8% vs. 15.0% p  = 0.03) and adults 18–49 years old (20.1% vs. 14.2%, p  = 0.004) were more likely to report improved relationships, compared to men and older age groups, Supplemental Fig.  2 A. Spanish-speaking Latino adults were also much more likely to report improved relationships compared to other racial-ethnic groups, (31.1% vs. 14.8–18.6%, p  = 0.03), Fig.  3 A.

Prevalence of reporting (A) improved relationships , (B) improved financial situations , and (C) positive employment changes , stratified by race-ethnicity, among a diverse sample of adults living in the US, COVID-19’s Unequal Racial Burden (CURB) survey, 8/16/2021-9/9/2021

“Got to spend more time with family. Reconnected with friends I had lost touch with.” (Male, 35–49 years old, Asian).

Improved financial situation (10.1%) and positive employment changes (9.8%) were also reported as positive results of the pandemic. Reasons included increased savings, increased work flexibility, increased income, and reduced commutes. Improved financial situation was more commonly reported by men compared to women (12.3% vs. 8.2%, p  = 0.003), Supplemental Fig.  2 B. Positive employment changes were more often reported by younger adults (18–49 years old) compared to older age groups (13.5% vs. 6.8%, p  < 0.001), Supplemental Fig.  2 C. American Indian/Alaska Native and Spanish-speaking Latino adults were less likely to report improved financial situation and positive employment changes as positive aspects of the pandemic, compared to other racial-ethnic groups (11.2% v. 6.4%, p  = 0.001), Fig.  3 B,C.

“I received unemployment and extra federal UI benefits so was able to save and payoff my auto loan early.” (Female, 50–64 years old, Black/African American).

“I got paid more money from my current employer.” (Male, 18–34 years old, multiracial).

Participants also reported improved health habits (6.3%), increased time for leisure activities (6.1%), personal growth (5.3%), pace of life slowing down (5.0%), ability to work from home (4.9%), saving money (4.5%), feelings of gratitude (3.6%), increased government assistance (2.6%), appreciation for mitigation measures (2.1%), increased use of technology for communication (2.0), and strengthened/newfound spirituality (1.8%), Fig.  1 B.

This mixed-methods study investigated perceived negative and positive experiences associated with the COVID-19 pandemic in from the perspectives of racially-ethnically diverse U.S. adults. Overall, negative aspects of the pandemic were reported more frequently than positive ones. Salient perceptions of the worst aspects of the pandemic included disrupted lifestyle/routine, negative economic impacts, not seeing family/loved ones, and isolation. Disrupted lifestyles and routines and not seeing family and loved ones were more frequently reported by older adults compared to younger age groups, while younger adults were more likely to report negative economic impacts. Not seeing family and loved ones was more frequently reported also by Native Hawaiian/Pacific Islander, White, Asian, and English-speaking Latino adults than other racial-ethnic groups. The most common positive aspects of the pandemic reported included improved relationships, improved financial situation, and positive employment changes. Women, adults aged 18–49 years, and Spanish-speaking Latino adults were more likely than men, older age groups, and other racial-ethnic groups to report improved relationships with family and friends as positive aspects. American Indian/Alaska Native adults and Spanish-speaking Latino adults, were less likely to report positive economic impacts, compared to other racial-ethnic groups. These findings highlight the importance of qualitative research in capturing life experiences during the COVID-19 pandemic.

The high prevalence of disrupted lifestyles can be attributed to restrictions on public spaces, the transition to online spaces, and changes in available services during the peak of the pandemic in the U.S. are expected. New York, for example, closed all nonessential businesses and restricted out-of-home activities for residents beginning in March 22, 2020 [ 17 ]. However, in the United States these policies were implemented on a state-by-state (and sometimes city-by-city) basis, leading to differences across the country [ 18 ]. Many of these closures/restrictions led to students and employees transitioning their classroom and office spaces to home settings, significantly changing their household dynamic. Learning and work environments were dependent on the spaces available, which in some cases were crowded, loud, and suboptimal, especially for those in a household with more than one person distance learning or working from home [ 19 ]. Routine outings for groceries and necessities also became high-risk and, in some cases, contactless, further reducing opportunities for movement and social interaction [ 20 ]. Reduced opportunities for social interaction and movement during the pandemic have been reflected in reported decreases in steps and increases in screentime [ 21 ].

Disruptions in daily activities, business closures, and restricted out-of-home activities also appeared to have severe negative consequences on individual and household finances. Individuals reported increased financial insecurity, loss of job or job security, and an overall negative change in their financial situation because of the pandemic. Both our study and others have found that younger adults disproportionately experienced financial strain because of the pandemic [ 22 , 23 ]. Other studies have also reported that financial hardship during the COVID-19 pandemic was more substantial among racial-ethnic minorities and low-income adults [ 24 , 25 ].

Interestingly, we also found that two of the most common positive aspects of the COVID-19 pandemic were improvements in financial situations and employment situations. The COVID-19 pandemic resulted in large increases in the proportion of the workforce teleworking and most likely led to improved work life balance due to fewer commute hours. Over half of individuals able to work from home have reported that working from home has made it easier to balance work with their personal life [ 26 ]. Beyond work from home flexibility, opportunities for hazard pay, government pandemic assistance, and reduced spending were associated with the pandemic allowing for some households and individuals to strengthen or gain financial security. However, increased financial stability has been primarily reported by upper-income and middle-income households, retired adults, and among adults with a bachelor’s degree or higher [ 25 , 27 ].

Improvements in relationships with family, loved ones, and neighbors were also reported, most likely due to increased use of immediate social networks to satisfy social interaction needs and reduce isolation, when broader engagement was limited due to enforced restrictions on public spaces and travel. Lockdowns across the country led to spending more time at home with family and loved ones [ 28 ]. Conversely, studies have also found an increase in reported loneliness and isolation as a result of the COVID-19 pandemic and lockdown, [ 29 , 30 , 31 ] prompting the U.S. Surgeon General to release a 2023 report on the “loneliness and isolation” epidemic in the U.S., exacerbated by the pandemic [ 32 ]. Quarantining during prior outbreaks has been associated with poor mental health, and increased feelings of isolation, anger, confusion, and frustration [ 33 , 34 ]. Additional research on the impact of social networks and household structures on feelings of isolation and loneliness during lockdowns and quarantines are needed to better understand how to prevent poor mental health during future outbreaks.

Social distancing also encouraged increased use of texting, video calling, and social media as means of communication [ 35 ]. It could be that increased use of these alternatives to in-person contact led to more frequent and/or improved quality of social interactions and relationships for some individuals. For example, in a study among Italian adults, voice and video calls, online gaming platforms, social media, and watching movies in party mode were associated with reduced feelings of loneliness, anger, and boredom due to perceived social support from these interactions [ 36 , 37 ]. A study among Australian adults found that communicative smartphone use during the pandemic was found to increase friendship satisfaction over time [ 38 ]. Further research in the potential of technology to reduce isolation and improve social connections is warranted. However, cultural values influence interpersonal interaction styles and preferences and need to be considered. For example, the high proportion of Spanish-speaking Latino adults reporting improved relationships may be tied to familism (i.e., the cultural emphasis on one’s family as a main source of emotional and instrumental social support when needed, including elements of loyalty, reciprocity, and solidarity within one’s family) [ 39 ]. At least one other study has also found that Latino adults reported positive changes in their relationships during the pandemic [ 40 ].

Similar to findings from the SARS epidemic in 2002–2004, [ 41 ] our participants also reported positive experiences of personal growth, living life at a slower pace, more time for leisure activities, and increased feelings of gratitude due to the pandemic. The additional time to pause and reflect, paired with the hardships of the pandemic, led many to adopt new perspectives characterized by greater appreciation of the people in their lives and for life in general [ 42 ]. Our study results support the important role of gratitude and its potential for bolstering resilience during times of tragedy and uncertainty [ 43 ]. In total, these experiences can be framed as posttraumatic growth resulting from the challenges of the pandemic. Such personal growth may serve a protective role in buffering the negative effects of fear associated with pandemics, and enhance satisfaction with life [ 44 ] and psychological wellbeing especially among older adults [ 45 , 46 ]. Public health efforts to support such growth during widespread pandemics could focus on evidence-based methods for generating posttraumatic growth and emotional resiliency, such as education to enhance emotional regulation, disclosure, meaning finding in trauma, and service to others [ 5 ].

This study adds to the sparse literature characterizing social patterning of positive and negative changes during the COVID-19 pandemic, including the potentially contradictory effects of the pandemic on individuals. Our study’s use of qualitative methods has allowed us to capture the nuances of respondents’ lived experiences within the context of the COVID-19 pandemic. Differences across age, gender, and race-ethnicity captured in this study point to a diversity of experiences and the need for recovery strategies tailored to community needs. The nationally representative sample employed in our study also facilitated our capturing a broad range of experiences across racial/ethnic minority, language, age, and gender groups.

Study limitations include our low response rate to the follow-up survey, which may have inhibited our ability to detect statistically significant differences in responses to the two open-ended questions. Response rates also differed across participant race-ethnicity and not all participants responded to the open-ended questions, which may have impacted findings. Additionally, our 6-month follow-up survey was conducted in August-September 2021, and respondents’ experiences may have changed over time as the pandemic continued to evolve. The surveys were also administered online, and individuals with limited internet access or familiarity with technology and limited literacy may have been less likely to participate. For example, we did not find racial-ethnic differences in reports of negative economic experiences, possibly due to the online nature of our survey, which may have biased our sample toward those with greater economic resiliency. However, the potential of online surveys to conduct qualitative research has been previously noted [ 47 ]. Furthermore, the CURB survey was only administered in English and Spanish (for Latino participants), which means adults who prefer other languages were likely to be excluded. This may have especially impacted our Asian adult cohort, as 31.9% of Asian adults nationally are estimated to have limited English proficiency (compared to 12.3% in our survey). Finally, our survey was not designed to capture an equal number of individuals living in each state or city, and the effects of the heterogeneous COVID-19 responses across the country may not have been captured fully.

In this study, we used a mixed-methods approach to capture the perceived negative and positive impacts of the COVID-19 pandemic on people’s lives among a diverse group of adults. Responses varied by race-ethnicity, gender, and age, indicating that the lived experiences of diverse groups differed, most likely due to variation in access to economic and social resources for managing COVID-related disruptions and hardships. A more nuanced understanding of such variation in the perceived positive and negative effects of pandemics can inform tailored public health efforts to mitigate potentially harmful factors and support posttraumatic growth and emotional resiliency during health crises.

Data availability

Data is available upon reasonable request. Contact Dr. Paula Strassle ([email protected]) for access.

Abbreviations

COVID-19’s Unequal Racial Burden

United States

Centers of Disease Control and Prevention

Stephanie A. Ponce

Alexis Green

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This research was supported by the Division of Intramural Research of the National Institute on Minority Health and Health Disparities. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Institutes of Health or the U.S. Government.

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SAP and AG conceived the study, made substantial contributions to the analysis, interpretation of data, drafting and revision of work. AMN made substantial contributions to the conception of the study and substantial revision of the work. PDS conceived the study, made substantial contributions to the analysis, interpretation of data and drafting and revision of the work. All authors have read and approved the manuscript.

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Ponce, S.A., Green, A., Strassle, P.D. et al. Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data. BMC Public Health 24 , 22 (2024). https://doi.org/10.1186/s12889-023-17491-w

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

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

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

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

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Research Article

The good, the bad and the ugly of lockdowns during Covid-19

Contributed equally to this work with: Talita Greyling, Stephanie Rossouw, Tamanna Adhikari

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing

Affiliation School of Economics, University of Johannesburg, Johannesburg, South Africa

Roles Conceptualization, Data curation, Investigation, Methodology, Project administration, Software, Supervision, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation School of Economics, Auckland University of Technology, Auckland, New Zealand

Roles Data curation, Formal analysis, Investigation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing

• Talita Greyling, 
• Stephanie Rossouw, 
• Tamanna Adhikari

• Published: January 22, 2021
• https://doi.org/10.1371/journal.pone.0245546
• Peer Review
• Reader Comments

Amidst the rapid global spread of Covid-19, many governments enforced country-wide lockdowns, with likely severe well-being consequences. In this regard, South Africa is an extreme case suffering from low levels of well-being, but at the same time enforcing very strict lockdown regulations. In this study, we analyse the causal effect of a lockdown and consequently, the determinants of happiness during the aforementioned. A difference-in-difference approach is used to make causal inferences on the lockdown effect on happiness, and an OLS estimation investigates the determinants of happiness after lockdown. The results show that the lockdown had a significant and negative impact on happiness. In analysing the determinants of happiness after lockdown, we found that stay-at-home orders have positively impacted happiness during this period. On the other hand, other lockdown regulations such as a ban on alcohol sales, a fear of becoming unemployed and a greater reliance on social media have negative effects, culminating in a net loss in happiness. Interestingly, Covid-19, proxied by new deaths per day, had an inverted U-shape relationship with happiness. Seemingly people were, at the onset of Covid-19 positive and optimistic about the low fatality rates and the high recovery rates. However, as the pandemic progressed, they became more concerned, and this relationship changed and became negative, with peoples' happiness decreasing as the number of new deaths increased.

Citation: Greyling T, Rossouw S, Adhikari T (2021) The good, the bad and the ugly of lockdowns during Covid-19. PLoS ONE 16(1): e0245546. https://doi.org/10.1371/journal.pone.0245546

Editor: Francesco Di Gennaro, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, ITALY

Received: July 29, 2020; Accepted: December 30, 2020; Published: January 22, 2021

Copyright: © 2021 Greyling et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: The following authors received salaries from their institutions, whom were also the funders of the research. 1. Prof T Greyling: University of Johannesburg via the University Research Fund. 2. Dr Stephanie Rossouw: Auckland University of Technology via the Faculty of Business, Economics and Law. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

1. Introduction

In an attempt to curb the spread of Covid-19 and minimise the loss of life, governments around the world have imposed their version of mandatory self-isolation through implementing lockdown regulations. Unfortunately, restricting people's mobility and depriving them of what matters most might intensify the negative effect on happiness levels.

In an extreme country case, this might be amplified. In this study, we treat an extreme country as a country with very strict lockdown regulations, with likely high infection rates, amidst low levels of well-being. We define well-being as those aspects of life that society collectively agrees are important for a person's quality of life, happiness and welfare. One of the dimensions of well-being, material (income) hinges on a bleak economic outlook.

To this end, our primary aim in this study is to use the Gross National Happiness Index (GNH), a real-time measure of well-being, derived from Big Data, to investigate if lockdown regulations in itself caused a decrease in happiness. Secondly, we determine which factors matter most (factors significantly influencing happiness) to happiness under these changed circumstances. We accomplish these aims by using two econometric techniques: difference-in-difference (DiD) and ordinary least squares (OLS).

Against this backdrop, the current study makes several contributions to the literature:

• Determining whether lockdown regulations cause a decline in happiness –in an extreme country case scenario.
• Investigating specifically the determinants of happiness during a lockdown, whereas other studies have focused on mental well-being and related matters (see section 2).
• Being one of the few studies (see also Rossouw, Greyling and Adhikari; Greyling, Rossouw and Adhikari [ 1 , 2 ]) that investigates the effect of lockdown on happiness making use of real-time Big Data . Other studies such as Hamermesh [ 3 ] and Brodeur et al. [ 4 ] also use Big Data, though limited to Google Trends (see section 2).

These results give policymakers the necessary information to take action in increasing the happiness of the nation and set the scene for increased economic, social and political well-being. It also allows them to reflect on happiness outcomes due to their policy actions. An additional benefit of the current study is that policymakers do not need to wait for extended periods to see the consequences of their policies, as we are making use of real-time data, with immediate information. Usually, policymakers can only evaluate their own decision making, with significant time-lags, prolonging the implementation of corrective actions.

Our results indicate lockdown itself causes a decrease in happiness. Furthermore, in an extreme country case (a country under stringent lockdown regulations coupled with low levels of well-being) what matters most to happiness under lockdown is the factors directly linked to the regulations that were implemented. These factors can be classified as (i) social capital issues; lack of access to alcohol (and tobacco), increased social media usage, and more time to spend at home, of which all are negatively related to happiness except the stay-at-home factor, and (ii) economic issues; concerns over jobs and the threat of retrenchments, which are negatively related to happiness. The finding on the stay-at-home order is interesting as even though lockdown itself caused a decline in happiness, it seems that people adjust and over time begin to appreciate the benefits of staying at home.

Noteworthy is that Covid-19, proxied by new deaths per day, had an inverted U-shape relationship to happiness. Seemingly people were, at the onset of Covid-19, positive and optimistic as the fatality rate was relatively low and recovery rates high. However, as the pandemic progressed, they became more concerned, and this relationship changed and became negative, with peoples' happiness decreasing as the number of new Covid-19 deaths increased.

The rest of the paper is structured as follows. The next section contains a brief background on South Africa and briefly discusses literature about happiness and studies conducted on the impacts of pandemics and consequently lockdown regulations. Section 3 describes the data, the selected variables and outlines the methodology used. The results follow in section 4, while the paper concludes in section 5.

2. Background and literature review

2.1 south africa.

In this study, we focus on South Africa because it presents us with a unique case to investigate the effect of a lockdown on happiness when levels of well-being are already low. Health and income, two dimensions of well-being, was significantly affected, although in opposite directions. Health was positively affected by the lockdown since it limited the spread of Covid-19. At the stage of writing the paper (3 June 2020), the number of new Covid-19 cases were nearly 120,000 (John Hopkins University [ 5 ]). On the other hand, the economic outlook of the country, and therefore peoples' incomes, was negatively affected. This opposite effect has led to significant debates on the value of the implementation of the lockdown.

Furthermore, South Africa implemented one of the most stringent lockdown regulations (comparable to the Philippines and Jordan), which exacerbated the costs to well-being and the economy while already experiencing a severe economic downturn. Therefore, South Africa is an example of an extreme country case which unfortunately amplifies the effects of the difficult choices made by policymakers. Therefore, we take advantage of this unique country case and determine how stringent lockdown regulations impact happiness during a one in 100-year event.

In South Africa, there are five levels of differing lockdown regulations, with alert level 5 being the most stringent and alert level 1 the most relaxed. The idea behind these levels is to curb the spread of Covid-19 and give time to South Africa's health system to prepare itself. Additionally, as they move down in levels, South Africans receive increasingly more of their previous liberties back. During level 5, which was announced 23 March 2020 and implemented on 27 March 2020, South Africans were only allowed to leave their homes to purchase or produce essential goods. All South Africans were instructed to work from home, there was no travel allowed, the sale of alcohol and tobacco were banned, people were not allowed to exercise outside their homes, and the police and defence force ensured compliance to the restrictions. South Africa moved to level 4 lockdown on 01 May 2020. With this move, they received back the ability to exercise outside from 6 am—9 am, purchase more than just essential goods, including food deliveries as long as it was within curfew.

Interestingly, the sale of alcohol and tobacco was still banned. On 01 June they moved to level 3, allowing restricted sales of alcohol (Mondays to Thursdays) and the re-opening of certain businesses. However, the services industry, especially beauty and tourism, remained closed. At the time of writing this paper, South Africa was still under level 3 lockdown.

Whereas everybody understands that the Covid-19 infections curve needs to be flattened, there are grave concerns that these stringent lockdown regulations will also flatline South Africa's well-being and economy. Before the Covid-19 lockdown, South Africa's average happiness levels were 6.32 compared to an average of 7.23 and 7.16 in Australia and New Zealand, respectively (Greyling et al. [ 2 ]). Furthermore, South Africa had a 29 per cent unemployment rate, and the gross domestic product (GDP) has been estimated to shrink by 7 per cent in 2020 (Bureau of Economic Analysis [ 6 ]). According to the South African Reserve Bank [ 7 ], an additional 3 to 7 million people can potentially become unemployed as a direct consequence of the pandemic, thereby increasing unemployment rates to approximately 50 per cent. The country's sovereign credit rating was downgraded to junk status in March 2020, which impacted on political stability, the level of the national debt and debt interest payments. Add to this already grim situation, the fact that consumption of South Africans has been declining in 2020, with a significant decrease seen after lockdown, then one can very easily see how the well-being and happiness levels in South Africa can plummet.

2.2 Happiness

Why should we care whether people's happiness is adversely impacted by not only a global pandemic but also by the response from the government? The studies of Helliwell, Layard, Stiglitz et al., Veenhoven, Diener and Seligman and others [ 8 – 12 ], have shown beyond a shadow of a doubt that if policymakers want to maximise the quality of life of their citizens, they need to consider subjective measures of well-being. Piekalkiewicz [ 13 ] states that happiness may act as a determinant of economic outcomes: it increases productivity, predicts one's future income and affects labour market performance. By measuring happiness, individuals themselves reveal their preference and assigned priority to various domains, which cannot be identified by a measure such as GDP. As was pointed out by Layard [ 9 ], while economists use exactly the right framework for thinking about public policy, the accounts we use of what makes people happy are wrong. In layman's terms, we say that utility increases with the opportunities for voluntary exchange. However, Layard [ 14 ] argues that this overlooks the significance of involuntary interactions between people. Policymakers should formulate policy to maximise happiness or well-being, as is the main aim of many constitutions. This can be achieved by directing economic, social, political and environmental policy to maximise well-being while acknowledging that people's norms, aspirations, feelings and emotions are important. Thereby underscoring that understanding and measuring happiness should be an integral part of the efforts to maximise the quality of life.

On the other hand, if people's happiness is negatively affected, such as it was in the wake of the Covid-19 pandemic and the implementation of lockdown regulations, there are far-reaching consequences.

These consequences are as follows:

• Social capital: unhappier people display less altruistic behaviour in the long run (Dunn et al. [ 15 ]). They are also less active, less creative, poor problem solvers, less social, and display more anti-social behaviour (Lyubomirsky et al. [ 16 ]). If unhappier people display more anti-social behaviour, South Africa could see an increase in behaviour such as unrests, violent strikes and perhaps higher crime rates.
• Health care: unhappier people are less physically healthy and die sooner (Lyubomirsky et al. [ 16 ]). Additionally, unhappy people engage in riskier behaviour such as smoking and drinking, thereby placing unnecessary pressure on national health systems.
• Economic: unhappy workers are typically less productive, in particular in jobs that require sociability and problem solving (Bryson et al. [ 17 ]). If an economy can raise the rate of growth of productivity, by ensuring their workers are happier, then the trend growth of national output can pick up.

2.3 Literature on the determinants of happiness during a lockdown

Having established that policymakers should strive to maximise the happiness of their people, it is necessary to know what determines happiness. Previous studies have investigated, at a macro-level, what influences happiness and found that economic growth, unemployment and inflation play a significant role (Stevenson and Wolfers, Perović, Sacks et al. [ 18 – 20 ]). However, these studies were conducted during 'normal' periods and not under such conditions that are currently plaguing the world. The current study will have the opportunity to investigate this exact question, namely what determines happiness during a lockdown driven by a global health pandemic.

Naturally, the number of studies being conducted to examine the effect of Covid-19 is growing exponentially. This increasing interest in the effect of a global pandemic as well as the policies implemented by governments on peoples' well-being, come on the back of relatively few studies conducted during prior pandemics such as SARS and the H1N1. When SARS hit in 2002 and then again when H1N1 hit in 2009, scholars were only truly starting to understand that for governments to formulate policies to increase well-being, you needed to measure well-being. Of the current studies being conducted on the effect of Covid-19 or lockdown regulations on all affected domains, not many studies are in a position to use real-time Big Data, such as we do.

In layman's terms, Big Data is a phrase used to describe a massive volume of both structured (for example stock information) and unstructured data (for example tweets) generated through information and communication technologies such as the Internet (Rossouw and Greyling [ 1 ]). At the time of writing this paper, the following studies were closest aligned with our study and focused on:

• nationwide lockdown on institutional trust, attitudes to government, health and well-being, using survey data collected at two points in time (December 2019 and April 2020) (1003 respondents) (Sibley et al. [ 21 ]). Their preliminary results showed a small increase in people's sense of community and trust. However, they also found an increase in anxiety/depression post-lockdown and hinted at longer-term challenges to mental health.
• the happiness of married and single people while in government-imposed lockdown by running simulations to formulate predictions, using Google Trends data (Hamermesh [ 3 ]). Not surprisingly, married people were more satisfied with life than single people.
• the timing of decision-making by politicians to release lockdown based on a comparison of economic benefits with the social and psychological benefits versus the cost, increase in deaths if policymakers released lockdown too early (Layard et al. [ 22 ])
• the stages of GNH using a Markov switching model in New Zealand (Rossouw et al. [ 23 ]). They found that happiness was at a lower level and the unhappy state lasted longer than was expected. Furthermore, they found that the factors important for New Zealand's happiness post-Covid-19 were related to international travel, employment and mobility.
• exploring Covid-19 related determinants of life dissatisfaction and feelings of anxiety in a cross-country study using survey data collected between 23 March and 30 April (de Pedraza et al. [ 24 ]). They found that persons with poorer general health, without employment, living without a partner, not exercising daily and those actively seeking out loneliness report higher dissatisfaction and higher anxiety. Additionally, they found that the effect of Covid-19 on dissatisfaction and anxiety levels off with a higher number of cases.

2.4 Literature on the causal effect of a lockdown

To the knowledge of the authors, there are only two papers that investigated the causal effect between lockdowns and population well-being. Brodeur et al. [ 4 ] investigated the changes in well-being (and mental health) in the United States and Europe after a lockdown was implemented, using Google Trends data. They found an increase in searches for loneliness, worry and sadness, which indicated a negative effect on mental health. Greyling et al. [ 2 ] conducted a cross-country study investigating the effect of lockdown on happiness. They found that lockdown caused a negative effect on happiness, notwithstanding the different characteristics of the countries (South Africa, New Zealand and Australia), the duration and the type of lockdown regulations. When they compared the effect size of the lockdown regulations, they found that South Africa, with the most stringent lockdown regulations incurred the greatest happiness costs.

Brodeur et al. [ 4 ] study analysed data from one Big Data source, Google Trends and collected data for a short period between only 01 January 2019 and 10 April 2020 in countries that had introduced a full lockdown by the end of this period. Greyling et al. [ 2 ] study used both Google Trends and the GNH index but did not investigate the determinants of happiness after lockdown for an extreme country case.

In summary, taking all of the above into consideration, there is not one study which determines causality between lockdown and happiness and analyses the determinants of happiness in an extreme country case using real-time , Big Data . Therefore, our study is the first of its kind.

3. Data and methodology

To estimate the causal effects of a lockdown on happiness, we use a Difference-in-Difference (DiD) approach (see section 3.3.1). The technique compares happiness (dependent variable), before and after the treatment (the lockdown) to a counterfactual time period in the year before. For the control period, we select the same time period, with the same number of days in 2019, corresponding to the number of days in 2020, thus 152 days in each year (01 January 2020 to 03 June 2020, excluding 29 February 2020). Our results should thus be interpreted as the average impact of the lockdown on happiness, comparing pre and post-lockdown in 2020 to the same time period in 2019, which we assume had normal levels of Gross National Happiness (see a discussion on the GNH in section 3.2.1). In this manner, we also account for seasonal trends in happiness.

In the analyses, we make use of daily data for South Africa. As high-frequency data available at almost real-time, is scarce, we make use of novel Big Data methodologies to harvest data. Additionally, we use the Oxford Stringency dataset that was released in May 2020, which includes data related to lockdown regulations, such as time-series data on the stay-at-home index, Covid-19 cases and Covid-19 deaths (Hale et al., Roser et al. [ 25 , 26 ]).

3.2 Selection of variables

The selection of the variables included in our estimations is based on the reviewed literature, the contents of tweets related to the lockdown and data availability.

3.2.1 Gross National Happiness Index–the dependent variable.

To measure happiness (the dependent variable), we make use of the Gross National Happiness Index (GNH), which was launched in April 2019 (Greyling, Rossouw and Afstereo [ 27 ]). This project measures the happiness (mood) of a country's citizens during different economic, social and political events.

Since February 2020, the researchers extended the project that initially analysed the sentiment of tweets, to incorporate the analysis of the emotions underpinning tweets. The team did this to determine which emotions are most prominent on specific days or events.

To construct the GNH index, the researchers use Big Data methods and extract tweets from the voluntary information-sharing social media platform Twitter. Big Data, such as Twitter, provides real-time information for policymakers to assist them when facing short-term deadlines with imperfect information. Big Data also allows governments to 'listen' and capture those variables which their citizens deem to be important for their well-being, rather than relying on pre-defined economic utility theories. Big Data offers governments the opportunity to observe people's behaviour and not just their opinions. This approach of revealed preferences unveils a reflexive picture of society because it allows the main concerns of citizens (and the priority ranking of those concerns) to emerge spontaneously, and it complements as such the information captured by gross domestic product. Lastly, Big Data does not suffer from non-response bias (Callegaro and Yang [ 28 ]).

Greyling, Rossouw and Afstereo [ 27 ] apply sentiment analysis to a live Twitter-feed and label every tweet as having either a positive, neutral or negative sentiment. This sentiment classification is then applied to a sentiment-balance algorithm to derive a happiness score. The happiness scores range between 0 and 10, with five being neutral, thus neither happy nor unhappy.

All tweets per day are extracted, and a happiness score per hour is calculated. The index is available live on the GNH website (Greyling, Rossouw and Afstereo [ 27 ]). In South Africa, the average number of tweets extracted for 2020 is 68,524 per day. South Africa has approximately 11 million Twitter users, representing almost 18 per cent of the population (Omnicore [ 29 ]). Although the number of tweets is extensive and represents significant proportions of the populations of the countries, it is not representative. However, Twitter accommodates individuals, groups of individuals, organisations and media outlets, representing a kind of disaggregated sample, thus giving access to the moods of a vast blend of Twitter users, not found in survey data.

Furthermore, purely based on the vast numbers of the tweets, it seems that the GNH index gives a remarkably robust reflection of the evaluative mood of a nation. Also, we correlate the GNH index with 'depression' and 'anxiety', derived from the 'Global behaviors and perceptions at the onset of the Covid-19 Pandemic data ' survey, for the period from 01 March 2020 (OFS [ 30 ]). We find it negative and statistically significant related, therefore, it seems that the GNH index derived from Big Data gives similar trends to survey data. (We would have appreciated the opportunity to correlate the GNH to a happiness measure–but a happiness measure, as such, was not included in the survey).

Considering the GNH index over time, we found that the index accurately reflects a nation's emotions, for example, when South Africa won the Rugby World Cup on 02 November 2019, the happiness index accurately depicted the joy experienced by South Africans ( Fig 1 ). The hourly happiness score was 7.9 at 13:00, the highest score ever measured, at the exact time that the final whistle was blown to announce the victory of the Springboks over England.

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Source: Authors' calculations using GNH dataset (Greyling et al. [ 27 ]).

https://doi.org/10.1371/journal.pone.0245546.g001

Also, when the famous American basketball player, Kobe Bryant and his daughter Gigi, tragically passed away on 27 January 2020, the happiness index once again captured the negative mood of the nation, and the happiness score decreased to 5.8, significantly below the mean (see Fig 2 ). The result of the GNH mirrors the one determined by the Hedonometer, which recorded an average happiness score of 5.89 on the day of Bryant's death. The top three words that made this day sadder than the previous seven were 'crash', 'died' and 'rip'.

https://doi.org/10.1371/journal.pone.0245546.g002

3.2.2 The selection of covariates included in estimations.

We found ourselves in uncharted territory, as there are limited studies estimating happiness functions during a lockdown (see Brodeur et al., Greyling et al., Rossouw et al. [ 2 , 4 , 23 ]). As a result, we considered these studies and the tweets to determine the factors to consider, which might influence happiness during a lockdown , as well as the most tweeted subjects. It was evident from the tweets that the main topics of discussion related to economic concerns, the prohibition of the sale of alcohol and tobacco, the stay-at-home orders and the Covid-19 pandemic itself.

To estimate our difference-in-difference model, we restricted our covariates to the lockdown variable, a year effect, the difference-in-difference estimator and controlled for new Covid-19 deaths, job searches and searches for alcohol. We were restricted in the number of covariates due to the limited observations and potentially encountering the issue of over-identification of the models. Therefore, we selected those variables which were available for both 2019 and 2020, and which were also trending subjects during the lockdown period. We were not able to add a stay-at-home variable which captures the lack of mobility, as the counterfactual time period is then not comparable to 2020.

Lockdown, our treatment variable, divides the sample into two distinct time periods: before the announcement of the lockdown, 23 March 2020 and thereafter. We make use of the date of the announcement of the lockdown rather than the date of the implementation, as this showed the severest effect on happiness (see Brodeur et al. [ 4 ]).

The Covid-19 pandemic and consequent spread of the virus is the reason for the lockdown. As such, we include the number of new daily Covid-19 deaths as well as its square. This will allow us to control for the likelihood of a U-shaped relationship between the number of Covid-19 deaths and happiness. Furthermore, there is likely a lagged effect on happiness due to Covid-19 deaths being reported in the media only the following day. Therefore, we lag these variables by one day. We derive the data from the Oxford Stringency data set (Hale et al. and Roser et al. [ 25 , 26 ]).

To measure jobs (a proxy for future job uncertainty) and the sale of alcohol and tobacco, we use the methodology as set out by Nuti et al. and Brodeur et al. [ 4 , 31 ] and use daily searches on Google Trends (see also Simionescu and Zimmermann [ 7 ]). We considered searches for both the alcohol and tobacco topic; however, the variables follow the same trends during the lockdown period and are highly correlated (r = 0.83). We are, furthermore, restricted in the number of covariates to include in the model and decided to include only 'alcohol' in the estimations. We justify this decision since the ban of alcohol affects a larger proportion of the population. It is estimated that 41 per cent of males and 17.1 per cent of females consume on average 9.3 litres of alcohol per capita annually whereas only 17.6 per cent smoke (Peltzer et al. and Reddy et al. [ 32 , 33 ]). However, as a robustness check, we also run all estimations using the searches for tobacco.

It should be noted that when we use Google Trends data, it is expressed as an index between 0 and 100 with 0 being the "least" interest and 100 being the "most" interest shown in the topic for the year. However, the series are not comparable across years as the underlying data is sourced from different search requests for each of the two years. To address this, we use a scaling procedure outlined in Brodeur et al. [ 4 ]. First, we generate "weekly" interest weights for each day by expressing the average weekly score that a particular daily score fell on, as a proportion of the average yearly score. Then, we multiply the daily scores with these weights to obtain weighted search trends. Finally, we normalise these weighted search trends to render us a score between 0 and 100, which is comparable across years.

Other topics that are trending are related to the 'stay-at-home' orders. The Oxford Stringency dataset includes a time series variable on the stay-at-home orders. It differs on a day to day basis according to its stringency. It is an ordinal variable plus binary of geographic scope. It takes the value 0 if there are no stay-at-home orders and 1 if the government recommends not leaving your house. Value 2 represents people not leaving their homes with the exceptions of daily exercise, grocery shopping, and 'essential' trips. Not leaving your home with minimal exceptions (e.g. allowed to leave only once a week, or only one person can leave at a time, etc.) takes the value 3 (Hale et al. [ 25 ]).

Furthermore, we include the number of tweets per day, as it forms part of the Twitter data extracted daily for South Africa (Greyling et al. [ 27 ]), which is a proxy for connectivity. It also gauges the opportunity cost of not being able to have face to face interactions, which seems to be negatively related to happiness (Chae and Wilson et al. [ 34 , 35 ]). Interestingly the number of tweets increased markedly during the lockdown period, from an average of 60,708 to 80,000 tweets per day. Table 1 provides descriptive statistics for the variables included in the estimations.

https://doi.org/10.1371/journal.pone.0245546.t001

3.3 Methodology

3.3.1 difference-in-difference..

Where GNH it is the daily happiness for South Africa at time t . The treatment variable lockdown takes the value of 0 pre-announcement day (23 March) and one post-announcement of lockdown in both the year of the actual lockdown (2020) as well as the year before the lockdown (2019). Year is a dummy variable where 1 is the year 2020. We control for new deaths per million with a one-day lag as well as the quadratic effect of new deaths per million on GNH. Additionally, we control for the effect of job and alcohol searches. As a robustness test, we use the number of new Covid-19 cases instead of new Covid-19 deaths (see Table 4 in S1 Appendix ).

Our main coefficient of interest is the interaction between the lockdown and the year variable. If it is found to be significant, it provides evidence of a causal effect of the lockdown on the dependent variable, in the current year, notwithstanding the trend in 2019.

3.3.2 OLS regression.

Here, y t refers to the Gross National Happiness Index (GNH) for each day and X t is a vector of several relevant covariates to account for the changes in the happiness levels during the lockdown period. μ t is the error term.

Due to the various factors that affect happiness, some of our independent variables may be correlated with the error term, leading to endogeneity concerns. Depending on the direction of the correlation between the error term and the X-variable, the coefficient could be biased upwards or downwards. For instance, the coefficient on the indicator for jobs is likely biased upwards as it, in all likelihood, shows the effect of concerns about jobs as well as some other negative economic shock on happiness. In the absence of panel data or an appropriate instrument, it is difficult to ascertain causality to Eq ( 2 ). However, simply correlating the covariates and the error term we find all levels of correlation to be less than 0.3, although a very basic test, this still indicates that the likelihood that endogeneity might bias estimations is relatively small. A natural extension of the work, as better data becomes available with time, would be to address these concerns.

We cannot rule out the probability of autocorrelation and heterogeneity in our data, especially due to its time-series nature. We use robust standard errors to account for this. The choice of our controls, however, comes with a caveat. Seeing as we only have 81 daily observations using a larger battery of covariates would lead to problems arising due to overfitting of the model. This issue is considered in Green [ 36 ], who suggests a minimum of 50 observations for any regressions as well as an additional eight observations per additional term. As a robustness test, we included tobacco rather than alcohol products (see Table 5 in S1 Appendix ).

4. Results and analysis

4.1 difference-in-difference estimation.

Fig 3 tracks the dependent variable (GNH) over the time period before and after the date of the lockdown (23 March) in the year of the lockdown (2020) and the year preceding it. On the day of the announcement of the lockdown and for a few successive days, we see a sharp downwards departure from the 2019 trend, assumed to be normal.

https://doi.org/10.1371/journal.pone.0245546.g003

Table 2 provides the results for the difference-in-difference specification, which helps us to make causal inferences on the effect of the lockdown on the GNH. At the outset, we notice a negative and significant effect of the 'year' variable (p<0.001), showing that on average the GNH was lower in 2020 than in 2019.

https://doi.org/10.1371/journal.pone.0245546.t002

We control for trends in job searches (a proxy for job uncertainty) and alcohol searches (a proxy for increased interest in alcohol-related topics in the specification). Both variables show a negative association with GNH, implying if there are more searches for jobs or alcohol, reflecting a scarcity in these items, GNH decreases. The negative effect of alcohol is statistically significant at the 1% level (p<0.001). We also control for lagged new Covid-19 related deaths and lagged new Covid-19 related deaths squared, both are significant (p<0.001). Interesting is the finding of the significant inverted U-shaped relationship between new Covid-19 deaths and happiness ( Fig 4 ). In the earlier stages of the pandemic, with very few new Covid-19 deaths, it appears that people were positive and optimistic as the fatality rates were very low and the recovery rates very high. However, as time progressed, the higher fatality rates turned the relationship around so that the number of new Covid-19 cases were negatively related to happiness.

https://doi.org/10.1371/journal.pone.0245546.g004

To determine if the decrease in GNH was due to the lockdown (the treatment) specifically and not just due to the year trend, we must consider the estimated coefficient of the interaction variable 'lockdown and year'. We report a negative and statistically significant coefficient (p-value 0.064) on the interaction variable, indicating that 'lockdown' caused, on average a decrease in GNH of 0.101 points when compared to its mean values for average 2019 values, controlling for the general trend in the two years. Thus, we can conclude that the lockdown caused a decline in GNH in 2020 compared to 2019. The decline of 0.101 may seem small at first but given the low general levels of happiness in South Africa compared to other countries (Greyling et al. [ 27 ]) the reduction is substantial.

4.2 Regression analysis

To address the second research question, namely, to determine the factors that are related to happiness after the lockdown was implemented, we consider the results of Table 3 .

https://doi.org/10.1371/journal.pone.0245546.t003

Table 3 shows that job searches (p-value 0.09), searches for alcohol (p-value<0.001) and the number of tweets is negatively related to happiness. In contrast, the stay-at-home index is positively related to happiness (p-value<0.001). The squared relationship between new Covid-19 deaths and happiness is negative and statistically significant (p-value<0.001), indicating that this relationship changed over time as was highlighted in section 4.1. Suppose we consider the relatively low mortality rate (0.02 per cent of confirmed cases in the early stages) compared to countries such as the USA (3.9 per cent), the U.K. (15.4 per cent) and Spain (9.4 per cent). In that case, it could explain the initial positive relationship between the number of new Covid-19 deaths and happiness. Although as time passed and the death rate increased (currently, the mortality rate is at 1.5 per cent of confirmed cases), this relationship became negative. As a robustness test, we used the number of new Covid-19 cases and its square instead of the new Covid-19 deaths and found similar results (see Table 4 in S1 Appendix ).

As expected, job searches, a proxy for uncertainty about the future job market is negatively related to happiness (p-value<0.001). Analysing the tweets, we realised that this is a major concern, which is closely related to economic concerns. The economic performance of South Africa in the last year has been weak with high levels of unemployment (increase to 50 per cent), low growth rates (GDP is expected to contract with 7 per cent in 2020) and high debt to income ratios (government debt as a percentage of GDP– 80 per cent). In a recent survey conducted by Statistics South Africa on behavioural and health impacts of the Covid-19 pandemic (Statistics South Africa [ 37 ]), it was found that 95 per cent of the respondents were very concerned about the economy. In contrast, only 60 per cent was concerned about the Covid-19 pandemic itself. This supports our current findings in that economic factors matter more to South Africans happiness levels than Covid-19 itself.

Alcohol-related searches are also found to be negatively related to happiness (p-value<0.001). Considering the close correlation between alcohol and tobacco products, we can assume that what holds for alcohol products, also holds for tobacco products. As a robustness test, we excluded the alcohol variable and included searches for tobacco variable and found very similar results (see Table 5 in S1 Appendix ). South Africa is one of the very few countries globally that have banned alcohol and tobacco sales during the Covid-19 pandemic. It is argued that these products contribute to the negative effects of the virus. The banning of these products had severe implications on different levels of society. Individuals see this as a major infringement of their human rights, negatively affecting their happiness. Furthermore, research done by Sommer et al. [ 38 ] proved that because of the presence of hordenine in beer, it significantly contributes to mood-elevation. In South Africa, which is well-known for its high per capita beer and alcohol consumption (Statistics South Africa [ 39 ]), also related to 'socialising', the ban on these products had a severe negative effect on happiness. Even in level 3, when the ban on alcohol sales was lifted, but still restricted, we found this negative relationship.

The restricted sale of alcohol and tobacco has indirect consequences for South Africans happiness via the economic impact since these industries are two of the largest industries in South Africa. They employ people across the whole supply chain from production to retail. Due to the ban on these industries, people can potentially lose their jobs. Lastly, the government sector forgoes all taxes on these products. This is against the backdrop of the recent downgrade of South Africa's debt rating to junk status in an already very uncertain fiscal environment. If all of these factors are aggregated, we can understand that the cumulative effect of the banning and restriction of sales of these products severely decreases the happiness levels. In Table 5 in S1 Appendix , we use tobacco searches instead of alcohol to estimate the determinants of happiness, which gives us results that are qualitatively similar to Table 3 .

The number of tweets is negatively related to happiness (p-value<0.001). Previous research has shown that increases in the use of social media are negatively related to happiness (Rolland et al., Chae and Wilson et al. [ 34 , 40 , 41 ]). Noteworthy is that the number of tweets during the lockdown period increased significantly from an average of 60,708 per day before the lockdown to 80,000 per day after the lockdown indicating that more people used social media during the lockdown period.

Interesting is the result of the stay-at-home orders being positively related to happiness (p-value<0.001). On analysing the contents of the tweets, we find the following. South Africans are wary of contracting Covid-19, and therefore, they abide by the stay-at-home orders and social distancing regulations to minimise the risk. That means that the stay-at-home orders in itself increase happiness; it is only once the other lockdown regulations are added that a total decrease in happiness levels are experienced.

Additional benefits revealed from analysing the tweets show that being at home provides a more peaceful and calmer environment compared to the rushed experience outside their homes. Also, people in the suburbs seem to be more convivial, with strangers greeting one another as people went for short walks around their neighbourhoods. In general, people have more time to spend with their loved ones. People earning salaries incur major savings, as there is less opportunity to spend money. People also save on commuting to and from workplaces and other destinations. One of the unexpected benefits of the stay-at-home orders is the much lower crime rates experienced in the country. Homes are constantly occupied, limiting the risk of residential robberies (-3.8 per cent). Other types of crimes such as murder (-72 per cent), rape (-87.2 per cent) and carjacking (-80.9 per cent) are much lower as well (Adapted from the speech of Police Minister Cele 2020 [ 42 ]).

In summary, what changed when the lockdown regulations to curb the spread of Covid-19 were implemented? It caused a significant decrease in happiness, and factors related to the lockdown regulations became relevant determinants of happiness.

5. Conclusions

In this paper, we used the Gross National Happiness Index (GNH), a real-time measure of well-being, derived from Big Data, to investigate whether lockdown regulations caused a decrease in happiness. Additionally, we determined which factors matter to happiness under these changed circumstances. We accomplished these aims by using two models: difference-in-difference and ordinary least squares.

We added to the current literature by determining causality between lockdown and happiness and analysing the determinants of happiness after a lockdown in an extreme country case using real-time , Big Data . Subsequently, this was the first study of its kind.

To determine if the decrease in GNH was due to the lockdown, specifically, we considered the estimated coefficient of the interaction variable 'lockdown and year'. We found a negative and statistically significant coefficient on the interaction variable, indicating that the lockdown caused a decline in GNH in 2020 compared to 2019.

As regards to the factors that are related to happiness after the lockdown was implemented, we found searches for alcohol (tobacco), the number of tweets and uncertainty about the future job market to be negatively related to happiness. In contrast, stay-at-home orders are positively related to happiness. Interesting is the negative and statistically significant squared relationship between new Covid-19 deaths and happiness, indicating that this relationship initially was positive but became negative over time.

Considering the results mentioned above, it ultimately means that if policymakers want to increase happiness levels and increase the probability to achieve the happiness levels of 2019, they must consider those factors that matter most to peoples' happiness. These factors include allowing creatures of habits some of their lost comforts by reinstating the sale of alcohol and tobacco. In saying that, we do advocate for responsible alcohol use by all South Africans and note that the significant effect of the ban on the sale of alcohol could be confounded by the restriction on social gatherings as well.

These results are important for countries in similar well-being situations, thus low levels of happiness, a diverse state of the economy and an increasing number of Covid-19 cases to evaluate what the effect of a strict lockdown is.

Additionally, policymakers should assure citizens that there is a credible plan to get the economy, which is currently in dire straits, back on track. Such an economic plan should stimulate growth, create job opportunities and increase employment rates, supply the necessary infrastructure and deal with curbing vast budget deficits and debt burdens. Hopefully, such policies will fuel the dying embers of a dying economy and increase well-being levels.

Lastly, it would be remiss of us not to note the limitations of the study. First, we were restricted in the number of covariates we could add to our difference-in-difference model due to the limited observations and therefore potentially overidentifying the models. Second, regarding the inverted U-shaped relationship between new Covid-19 deaths and happiness, we acknowledge that there might be confounding factors at play, initially seen as ‘positives' of the lockdown, but later turned into negatives. However, using alternative sets of covariates in the regression analyses, the inverted U-shape between new Covid-19 deaths and happiness remained. Therefore we trust that the revealed relationship is robust.

Supporting information

S1 appendix. robustness checks..

https://doi.org/10.1371/journal.pone.0245546.s001

https://doi.org/10.1371/journal.pone.0245546.s002

Acknowledgments

We would like to thank our colleagues Professor Emeritus John Knight from Oxford University and Dr Kelsey O'Connor from STATEC Luxembourg, for their generosity in providing feedback on the study.

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• Open access
• Published: 12 May 2020

Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality

• Jörg M. Fegert 1 ,
• Benedetto Vitiello 2 ,
• Paul L. Plener 1 , 3 &
• Vera Clemens 1  

Child and Adolescent Psychiatry and Mental Health volume  14 , Article number:  20 ( 2020 ) Cite this article

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The coronavirus disease 2019 (COVID-19) is profoundly affecting life around the globe. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment in affected countries. These measures have the potential to threaten the mental health of children and adolescents significantly. Even though the current crisis can bring with it opportunities for personal growth and family cohesion, disadvantages may outweigh these benefits. Anxiety, lack of peer contact and reduced opportunities for stress regulation are main concerns. Another main threat is an increased risk for parental mental illness, domestic violence and child maltreatment. Especially for children and adolescents with special needs or disadvantages, such as disabilities, trauma experiences, already existing mental health problems, migrant background and low socioeconomic status, this may be a particularly challenging time. To maintain regular and emergency child and adolescent psychiatric treatment during the pandemic is a major challenge but is necessary for limiting long-term consequences for the mental health of children and adolescents. Urgent research questions comprise understanding the mental health effects of social distancing and economic pressure, identifying risk and resilience factors, and preventing long-term consequences, including—but not restricted to—child maltreatment. The efficacy of telepsychiatry is another highly relevant issue is to evaluate the efficacy of telehealth and perfect its applications to child and adolescent psychiatry.

There are numerous mental health threats associated with the current pandemic and subsequent restrictions. Child and adolescent psychiatrists must ensure continuity of care during all phases of the pandemic. COVID-19-associated mental health risks will disproportionately hit children and adolescents who are already disadvantaged and marginalized. Research is needed to assess the implications of policies enacted to contain the pandemic on mental health of children and adolescents, and to estimate the risk/benefit ratio of measures such as home schooling, in order to be better prepared for future developments.

Coronavirus disease 2019 (COVID-19) is profoundly affecting lives around the globe. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment of affected countries. The current situation affects children, adolescents and their families in an exceptional way. Kindergartens and schools have been closed, social contacts strongly limited and out-of-home leisure time activities canceled. Parents are asked to support their children with home schooling, while at the same time working from home. External support by other family members and social support systems have fallen away. Beside worries and anxieties related to COVID-19, the economic situation has worsened with high and rising levels of unemployment in all affected countries. This has put a lot of pressure on children, adolescents and their families which could result in distress, mental health problems and violence.

As the pandemic is evolving through phases, this paper evaluates the impact these phases might have on mental health of children and adolescents and the provision of psychiatric services. This paper highlights some key challenges and concerns for treatment and research on child and adolescent psychiatry (CAP) across Europe during the different pandemic phases and offers some recommendations that can be adopted immediately.

Due to the complexity of the issues and research questions and the aim to provide timely support for CAP professional, as method, a narrative review was chosen. A selective scientific literature review was conducted based on knowledge about the course of epidemics, current experiences in CAP treatment and personal communication with CAP professionals all over Europe [ 1 ].

Epidemiological phases of pandemic

Knowledge of epidemic infections allows us to divide the pandemic into three phases, and to identify, within each phase, different psychological reactions (see Fig.  1 ).

Three phases of the pandemic. Pandemic infections can be divided into three phases: preparation phase, punctum maximum phase and return to normality phase. Within each phase, different psychological reactions exist: Epidemiological measures lead to a flattening and prolongation of the curve

Phase one or the preparation phase: Governments enforce social distancing, shutdown and general measures of hygiene in order to contain and mitigate the spreading of the infection and latten the curve of new cases over time.

Phase two or the punctum maximum phase: The curve reaches the highest incidence of new cases, and mortality rate peaks, including a plateau phase. In the current pandemic, a predictions of when this occurs have been made, and some countries seem to have passed this point while many others have not yet reach it.

Phase three or the return to normality phase: recovering from the pandemic, which requires re-organizing and re-establishing services and practices.

Measures of containment and mitigation, such as social distancing and hygiene, can succeed in flattening the curve and in this way reducing the height of the punctum maximum (number of infected subjects), but with a more prolonged time course for returning to normality.

Pandemic-related mental health risks of children and adolescents

During the pandemic (phase one and two).

During the recent Coronavirus disease 2019 (COVID-19) outbreak in China, 54% of the participants of a large online study rated the impact of the outbreak on their mental health as moderate to severe, with depressive symptoms and anxiety being the conditions most often stated [ 2 ]. The current crises imposes multifaceted burdens on children. They include the socio-ecological impact of the pandemic, which is understood to be enormous. The environment of children is affected at different levels– including community and family - as well as the individual child itself [ 3 ].

Community-related risks for mental health

Since the pandemic was announced, at the community level, there has been disruption of, or more limited access to basic services, such as kindergarten, schools, and routine medical care [ 4 ]. Several countries have seen a re-organization of hospital services, with provisional care (including re-assigning doctors and nurses not usually involved in critical care). There have been closures, partial closures or reduced services of inpatient and day-care facilities, with outpatient contacts reduced in some places to emergency cases only. Some hospitals have been unable to accept new inpatients due to the risk of infection [ 1 ]. Questions have arisen on how to deal with the risk of infected patients in closed units infecting staff and other patients. There have been concerns for the possible future lack of adequate resources for mental health services as most resources are directed towards ICU and somatic care [ 1 ]. Importantly, even the activity of child protection services and currently existing programs of support or supervision by youth welfare agencies have been disrupted or interrupted [ 5 ]. The lack of access to these basic services can be particularly harmful for vulnerable children and/or families.

Moreover, leisure time activities have been limited. In most countries, children have not been allowed to use regular playgrounds, social group activities are prohibited and sports clubs are closed [ 4 ]. Social relations have been strongly limited to closest family members. In several countries, contact to peers has been prohibited or severely limited [ 6 ]. This can have a negative impact on children and adolescents given the importance of peer contact for well-being [ 7 , 8 ]. Many countries have experienced a lock-down of schools [ 9 ]. As pointed out by a recent review, school closures may not have a major impact on reducing infections and preventing deaths [ 10 ]. Hence, possible negative consequences such as loss of education time, restricted access to peers and loss of daily structure need to be taken into account when estimating the advantages and disadvantages of this particular measure. Moreover, in some communities, stigmatization of infected children and families may occur.

Challenges within the families

At the family level, the pandemic has led to a re-organization of everyday life. All family members have to cope with the stress of quarantine and social distancing. School shutdowns have led to home-schooling and potential postponement of exams. Parents have experienced increased pressure to work from home, to keep jobs and businesses running as well as to take care of schooling children at home at the same time, while caregiver resources including grandparents and the wider family have been restricted. Family connections and support may be disrupted. Fear of losing family members who belong to a risk group can increase. In case of death, the pandemic disrupts the normal bereavement processes of families. Grief and mourning of lost family members, especially in cases where contact with the infected member is restricted or refused, could lead to adjustment problems, post-traumatic stress disorder, depression and even suicide of both, adults and young people [ 11 ].

It also has fallen on the parents’ shoulders to inform and explain to children about the COVID-19 pandemic, and to handle fear and anxiety accompanying these uncertain times. All family members may have own fears related to COVID-19. Taken together, this can result in enormous stress and psychological distress for all family members.

The pandemic has major economic implications and puts financial pressure on many families. It has been shown in previous economic recessions that economic pressure, even if not accompanied by social distancing, can pose a severe threat to mental health. Firstly, economic recessions and connected factors such as unemployment, income decline, and unmanageable debts are significantly associated with a decrease of mental well-being, increased rates of several mental disorders, substance-related disorders, and suicidal behaviors [ 12 , 13 ]—risks that of course also concern parents [ 14 ]. The recent recession therefore has added to the fact that low socioeconomic status is a well-known risk factor for poor mental health in children [ 15 ]. Mental illness and substance abuse of parents significantly influence parent–child relations [ 16 , 17 , 18 ] and increase the risk for mental health problems in children [ 19 ].

Domestic violence and child maltreatment

Additionally, in economic recessions a significant increase in domestic violence can be seen [ 20 ]. Income loss and economic hardship can lead to feelings of economic stress and consequent marital conflict [ 21 , 22 ]. Quarantine can lead to decreased freedom and privacy, and consequently higher stress. It may also increase existing controlling behaviors by perpetrators as they struggle to regain a sense of control. Exposure to perpetrators is increased, and the possibilities of victims to temporarily escape abusive partners are reduced [ 23 ]. In the current COVID-19 crisis, there have been reports from all over the world about a significant increase in domestic violence [ 24 ]. UN secretary general António Guterres pointed out a “horrifying global surge in domestic violence” [ 25 ]. Exposure to domestic violence again significantly affects mental health of children [ 26 , 27 ] and has the potential to create long-term consequences [ 28 ].

Moreover, a notable increase in physical, emotional and sexualized violence against children during recession has been reported. For example, Huang and colleagues were able to prove a doubling of the incidence of abusive head trauma, a particularly severe form of child abuse associated with a high mortality rate, during the “Great Recession” 2007–2010 [ 29 ]. In the literature, an increase of all forms of child maltreatment has been proven during a recession in a wide variety of cultures [ 30 ]. Based on these data, for the COVID-19 pandemic, a worldwide increase in the risks for children and adolescents is a plausible assumption. The current reduced societal supervision and lack of access to child protection services is an additional burden.

Taken together, despite a lack of literature specifically addressing the impact of recession on children, existing data point towards threats to mental health of children and adolescents. This is confirmed by one study that directly assessed adolescent mental health during the financial crisis in Greece. The researchers found an increase in mental health problems during the recession [ 31 ]. Notably, this study also demonstrates that mental health was impaired disproportionately in the most vulnerable socio-economic groups—adolescents whose families faced more severe economic pressure.

Quarantine-associated risks

Besides economic pressure, COVID-19 pandemic-related quarantine in several countries could significantly affect mental health. In a recent review on the psychological impact of quarantine, Samantha Brooks and colleagues pointed out that post-traumatic stress symptoms (PTSS) occur in 28 to 34% and fear in 20% of subjects in quarantine [ 32 ]. Additional quarantine-related mental health problems include depression, low mood, irritability, insomnia, anger and emotional exhaustion [ 32 ]. Horesh et al. argue that the COVID-19 crisis involves numerous characteristics seen in mass traumatic events so an increase in PTSS during and after the pandemic can be expected [ 33 ].

The scarcely available data point towards a detrimental effect of disease-containment measures such as quarantine and isolation on the mental health of children. In a study conducted after the H1N1 and SARS epidemics in Central and North America, criteria for PTSD based on parental reporting were met by 30% of the children who had been isolated or quarantined [ 34 ].

Another quarantine-associated threat is an increased risk of online sexual exploitation. Since the beginning of the pandemic, children and adolescents have spent more time online, which may increase the risk of contact with online predators. Due to limited social encounter, children’s outreach to new contacts and groups online has increased. As more adults have been isolated at home, there may also be an extended demand for pornography [ 35 ]. Europol has already reported an increase in child pornography since the beginning of the pandemic [ 36 ].

The question remains, whether infection with COVID-19 can directly lead to onset or aggravation of mental disorders. Seropositivity to influenza A, B and Coronaviruses has been associated with a history of mood disorders [ 37 ]. In addition, onset of psychotic disorders has been reported to be associated with different Coronavirus strains [ 38 ].

In summary, phases one and two of the current COVID-19 pandemic represent a dangerous accumulation of risk factors for mental health problems in children and adolescents of enormous proportions: re-organization of family life, massive stress, fear of death of relatives, especially with relation to grandparents and great-grandparents, economic crisis with simultaneous loss of almost all support systems and opportunities for evasion in everyday life, limited access to health services as well as a lack of social stabilization and control from peer groups, teachers at school, and sport activities.

Can there be beneficial consequences for mental health from the current crisis?

Together with multiple threats to mental health, the current pandemic could also provide opportunities. When families successfully complete the initial transition phase, the absence of private and business appointments, guests and business trips can bring rest and relaxation into family life. Several external stressors disappear. Mastering the challenges of the COVID-19 crisis together may strengthen the sense of community and cohesion among family members. More time with caregivers can go along with increased social support, which strengthens resilience [ 39 ]. In addition, children troubled by school due to bullying or other stressors, can experience the situation of home-schooling as relieving, as a main stressor in their everyday life ceases to exist.

Moreover, mastering current challenges could contribute to personal growth and development. Personal growth is an experience of psychological development as compared with a previous level of functioning or previous attitudes towards life. Thus, successful management of stress and trauma can lead to personal growth, which in turn reinforces the sense of competence and becomes a protective factor for coping with future stressors [ 40 ].

However, environmental factors such as socio-demographics, individual social networks and social support affect the outcome of a crisis [ 41 , 42 ]. Therefore, the opportunity for personal growth may be unequal (see also “Focus on high risk children”). Nevertheless, personal characteristics determine stress-related growth as well. These factors include intrinsic religiousness and positive affectivity. Intrinsic religiousness is suggested to help to find meaning in crisis, the relevance of positive affectivity shows the importance of positive mood and attitude for stress-related growth [ 42 ].

The long way back to normality after the pandemic (phase three)

One major challenge after the pandemic will be to deal with its sequelae. One main consequence will be the economic recession and its implications for mental health of children and their families, as discussed above. During the acute phase of the pandemic, stressors such as social distancing, re-organization of family life, school and businesses, fear of COVID-19 infections, and possibly loss of family members/friends are initially in the forefront. Economic problems may be recognized mainly after the acute phase of the pandemic, although their starting point was in an earlier phase. Some parents might have lost their jobs or businesses, while others might have to deal with an accumulated workload or face major re-organization at work. For children and adolescents, the pressure from school to catch-up for time lost during the acute phase of the pandemic may increase. However, there is evidence that rate and direction of change in macroeconomic conditions rather than actual conditions affect harsh parenting [ 43 ]. This suggests that the expectation of a negative economic development is a stronger determinant of negative parental behavior than actual recession, which could point towards the conclusion that harsh parenting and violence will have its climax during the acute phase of the pandemic.

Due to interruption of regular medical services, resources in the health care system may not be enough to overcome previous lack of treatment and supervision. Moreover, not only the accumulation of inadequately treated cases, but furthermore the enhanced need for mental health services might be a problem. The increase of mental health problems in children and their families due to recession and quarantine is discussed above and can be expected to further increase in phase three due to emerging recession. Literature suggests that mental health symptoms will outlast the acute phase of the pandemic. In health-care workers, the risk for alcohol abuse or dependency symptoms was still increased 3 years after quarantine [ 44 ]. A quarter of quarantined subjects avoided crowded enclosed places and one-fifth avoided public spaces [ 45 ].

Additionally, the increased risk of child maltreatment and household dysfunction may not diminish immediately after the pandemic as several triggers such as economic pressure and mental health problems of parents will last for some time. Moreover, sequelae of pandemic-associated increase of maltreatment of children and adolescents may last for a lifetime. Adverse childhood experiences are known to affect the life of survivors across their life span. Long-term effects include increased risk for numerous mental and physical disorders [ 46 ], reduced life quality [ 47 ], developmental and cognitive impairments [ 48 , 49 ], social problems [ 50 ] and a reduction of up to 20 years in life expectancy [ 51 ].

Focus on high risk children

The consequences of the pandemic can hit every child. However, there are several indicators that children who are already disadvantaged are at highest risk. First, financial losses will cause increased economic pressure to low-income families due to lack of savings. Second, there may be increased disparities between families with high and low socio-economic status, for example due to differences in parental support for home schooling and leisure activities during the pandemic. Specific modalities such as telemedicine and telepsychiatry may be less accessible for children of low-income families who may not have the resources to use telepsychiatry or to use it in a safe and confidential environment.

Another highly vulnerable group is that of children and adolescents with chronic disorders, for whom important support and therapies may have been reduced or cancelled. For children with intellectual disability, it can be hard to understand the situation and the necessity for the restrictions, with consequent increase in anxiety and agitation. Besides, children with disabilities are at higher risk for child maltreatment [ 52 ]. During the pandemic, due to lack of social control and impaired ability to communicate, this risk can increase.

Children and adolescents having experienced adverse events before the pandemic occurred are especially vulnerable for consequences of the COVID-19 crisis. The experience of adverse childhood experiences (ACEs) is associated with higher risk for mental health problems. Maltreatment has been found to be associated with consequent heightened neural response to signals of threat [ 53 ]. Moreover, while emotional reactivity is increased, emotion regulation is decreased [ 54 ]. This suggests that children and adolescents who have experienced adversity before the pandemic are at higher risk to develop anxiety and adopt dysfunctional strategies to manage the COVID-19-associated challenges.

Another important high-risk group is that of children and adolescents with already existing mental health problems. Most mental disorders require regular psychotherapy and psychiatric treatment. Therefore, lack of access to health services can be particularly detrimental. Severity and outcome of mental disorders could worsen because of delay in prompt diagnosis and treatment. This would be especially problematic for conditions such as early onset schizophrenia, in which early treatment is an important prognostic factor. However, there are more pandemic-associated risks for this group. Taking care of children with mental health problems, in particular externalizing disorders, can be challenging [ 55 ]—thus adding to the already increased distress of parents during the pandemic.

With increasing levels of psychopathology, capacity for emotion regulation and adaptive coping is reduced, while maladaptive coping increases [ 56 ], a pattern also observed in children and adolescents with a history of child maltreatment [ 57 ]. Likewise, children with previously existing psychopathology are at greater risk to show severe worry about political news [ 58 ]. Together, this suggests that current COVID-19 crisis-associated stress is particularly harmful for children and adolescents with mental disorders or a history of child maltreatment. On the other hand, stress exposure can enhance already existing psychopathology [ 59 ], which can lead to more severe courses of mental disorders—meeting reduced treatment resources. An impact of recession on self-harm has been shown in different studies, especially after the world economic crisis 2008 [ 60 ]. As self-harm is predominantly found among adolescents [ 61 ], an upsurge of self-injurious and suicidal behavior in youth can be hypothesized as a consequence of the COVID-19 pandemic. This issue should receive urgent attention. Thus, it is likely that the COVID-19 pandemic will lead to an exacerbation of existing mental health disorders as well as contribute to the onset of new stress-related disorders in many, especially children and adolescents with pre-existing vulnerabilities—aggravating pre-existing disadvantages.

Unaccompanied and accompanied refugee minors are a high-risk group for all the aforementioned vulnerabilities—low socioeconomic status, experience of ACEs and mental health problems [ 62 ]. Additionally, as some early cases of COVID-19 have been reported in refugee institutions, shelters and camps, the consequent panic and fear of infection can increase the risk of stigmatization of refugees. As many countries are hosting a large number of refugees, and there is a lack of medical and psychiatric specialist care for them, COVID-19-associated mental health risk may disproportionately hit these children and adolescents already disadvantaged and marginalized [ 63 , 64 ].

Practical challenges and research questions in Child and Adolescent Psychiatry of associated with the COVID-19 pandemic

Preparation phase (phase one).

During preparation phase, it is necessary to provide clear and correct information to parents and patients. A good understanding of COVID-19 is important to prevent panic and help comply with the measures for containment and mitigation mandated by the government. Information can include tips for parents on how to talk to children and adolescents about COVID-19, the associated risks and the changes in daily life. Moreover, information on how to manage daily life at home during quarantine and social distancing as well as home schooling can be helpful. Support regarding how to address anxiety and stress in children is important (For information on these issues (see e.g. recommendations of ESCAP [ 65 ] and AACAP [ 66 ]). Information should be made available to parents regarding how to ensure regular psychotherapeutic and psychiatric treatment and crisis intervention during social distancing and other restrictions of phase one and two.

Parents and patients in need of ongoing medication should be advised by their doctor to stock a certain amount in case of a rupture in stock. This is not regarded as hoarding but taking adequate measures to treat chronically ill patients. Furthermore, doctors could issue extra prescriptions in order to ensure that patients have sufficient medication during phase two of the pandemic.

A good option to maintain treatment during the pandemic is telepsychiatry. During the preparation phase, technical prerequisites should be met and already existing tools can be adapted. Concerns about data protection and high technical protection standards should be addressed and user-friendly systems that can be used by all age groups regardless of abilities shall be established. It has been shown in several studies, reviews and meta-analyses, that online-delivered psychotherapeutic care for children and adolescents is feasible and effective [ 67 , 68 , 69 , 70 ], so that it can be understood as primary source of standard care in times of restricted physical contact. However, not all children and adolescents may have the technical equipment for telepsychiatry. More importantly, not all may have the opportunity for a safe, confidential space at home.

In most countries, national societies of CAP have taken an active role to face the pandemic. They have been putting forward initiatives to support the continuity of care, to guide parents, teachers, children and health professionals on how to handle the mental issues and to advocate national authorities on the bio-psycho-social impact of the crisis on the life of children and adolescents.

Punctum maximum phase (phase two)

First, CAP needs to provide services for children and adolescents with mental health disorders. A proportion of children with acute and life-threatening psychiatric disorders require CAP inpatient treatments throughout all phases of the pandemic. Children with pre-existing mental needs, e.g. severe forms of autism, have been deprived of professional support systems meaning families and parents have been left to cope on their own. Due to closure of specialized and complex educational settings for children with developmental problems and multiple handicaps in many countries, problems will exacerbate. CAP institutions should keep contact with patients of special need by using online interventions or phone contact, to avoid disrupting current treatment programs and offer support to caregivers.

Severity and outcome of mental disorders could worsen because of delay in prompt diagnosis and treatment. This would be especially problematic for conditions such as early onset schizophrenia, for which the duration of untreated psychosis has been linked with future level of functioning.

Crisis interventions must be accessible all the time. This support will not only be needed by patients with existing mental health disorders, but also those developing anxiety, depression or adjustment problems and post-traumatic stress disorder as a consequence of losing near relatives during the pandemic. Moreover, there are several additional pandemic-related risks for traumatization. As discussed earlier, domestic violence and child abuse might increase due to extended periods of isolation within an abusive or unsafe home, and less intense supervision from child protection services and lacking support from peers or schools. Although words like “anxiety,” “fear,” and “stress” are constantly mentioned in media, specific peri- and posttraumatic implications of this crisis are not acknowledged [ 33 ]. To offer specific help is a central task of CAP. Therefore, several appointments should be arranged for patients with new onset of child psychiatric disorders and adequate care provided. Since there is a shortage of CAP professionals throughout Europe, protection of this scare resource is crucial. Therefore, screening of patients via helplines could be useful as a triage measure to identify the most severe cases. Patients who need to be seen in person due to an acute and severe mental health problem should pass a COVID-19 screening before getting into contact with CAP professionals to assure appropriate safety measures including protective gear. The latter also needs to be existent in handling severely agitated or aggressive patients in emergency psychiatric care. As COVID-19 can spread via saliva, protective measures (in addition to masks, gloves and protective clothing) need to include face shields.

Another important issue regarding CAP treatment during the acute phase of the pandemic are restrictions on parental visits for inpatients and their increased isolation from families and social contacts that can lead to an increased risk of depression, anxiety and suicidal behavior. If inpatients have reduced access to family members due to hygiene restrictions, units should maintain contact with the patient’s family as much as possible in order to adhere to the UN Convention on the Rights of the Child. Moreover, digital communication with the patient’s family should be encouraged.

CAP is an understaffed medical discipline, with a shortage of specialists vis-à-vis mental health needs. Some young child psychiatry trainees have been re-assigned to assist in other medical departments for urgent care during the pandemic [ 1 ]. This could leave them at risk of delaying or disrupting their training and qualifications. Alternatively, innovative didactic modalities such as online training and supervision, video presentations, web-based programs and courses can provide trainees in child psychiatry with formative activities. Allowing time spent in providing critical care (if re-assigned) to count towards their overall clinical requirements would be an important step to ensure timely completion of training.

Long return to normality (phase three)

In the third phase of the pandemic (return to normality), it will be important to quickly re-organize and re-establish lost treatment with patients and develop strategies for CAP to deal with the burden and strain of new patients not seen and not referred during the pandemic. During the acute phase of the pandemic, in several countries only emergencies have been addressed. This has not only been restricted to regular mental health services but has also included child protection services and support for children and families. Offering adequate services to families for dealing with the aftermath of the pandemic is central for reducing long-term consequences for mental health.

The economic crisis brought by the pandemic could have long-term negative consequences leading to increased family conflict, abuse, suicidality and substance abuse. Access to mental health services is needed to cope with the increased demand in times of economic recession [ 13 ].

Reports are indicating a decline of people using medical services (e.g. emergency services, general practitioners, calls or demands for psychiatric assessment) for fear of being infected by COVID-19. Consequently, after the crisis there might be a sudden surge of activity to a magnitude possibly overwhelming the capacity of CAP services.

During the acute phase of the pandemic victims of domestic violence and child maltreatment may not be noticed due to lack of social control by peers and staff in school, sport clubs etc. and reduced accessibility of support services. In phase three, due to less parental control and more contact to others, some children and adolescents may confide incidents during the pandemic to others. CAP must be prepared to offer specific treatment for these children and adolescents. CAP professionals must be aware of this increased risk and consequently be sensitive for signs of maltreatment. In case of suspicion, specific anamnesis should be taken, and diagnostic clarification made.

Further research

The current COVID-19 crisis has imposed numerous restrictions on research. Laboratories have been closed, scientific staff has been working from home, recruitment in studies has been paused. However, this time has brought up numerous interesting research questions that should be addressed within the next months. One major question has been the effect of social distancing on children, adolescents and their families. As stated above, isolation and home schooling can affect mental health in multiple ways. However, this has been the first time in history these measures have been implemented widely and comprehensively. Prevalence of psychiatric disorders including anxiety disorders, depression, posttraumatic stress disorder, suicide attempts and NSSI in minors and parents should be monitored. In longitudinal studies, the effect of different political measures on mental health and well-being should be assessed. Risk and resilience factors for children, adolescents and families could be identified with mixed-method approaches. The role of previous traumatization and other environmental and individual factors on stress regulation and coping can give meaningful insights on stress resilience research. During the current pandemic, risk factors accumulate like under a burning glass. For example, disentangling the real-time impact of parental unemployment or family financial hardship and the effect of social distancing and isolation could give important information in order to estimate the costs of current measures. This would also provide information about the risk–benefit ratio of certain measures to inform decision-makers and better prepare for future scenarios. The effects of the current situation on adverse childhood experiences should be assessed. This includes both household dysfunctions such as mental health or substance abuse of parents, and domestic violence and child maltreatment.

Another issue to be addressed is the means in which children and adolescents to stay in touch with peers during the crisis. The last decade has been characterized by an increasing use of online services to get in touch with peers as well as mating. The pandemic may catalyze this transition for good or for bad. It might ease social encounters but might result in unrealistic high demands on partners, tension between the virtual and the real self and increased distance from “real” life. The current crisis has hit several young people at a pivotal moment of their social development. To assess the effect of this virtualization of social relations on further development of children and adolescents is of great interest.

Furthermore, gender issues and the role of fathers and mothers is an interesting subject. The current Corona crisis has shown that “essential employees” are mostly female [ 71 ].

With a lot of creativity and motivation to reorganize mental health care, the pandemic has seen a massive increase in the use of telepsychiatry. It is useful to analyze the interventions used during the pandemic such as telepsychiatry and to determine measures of quality control. Patients, CAP professionals and parents should be surveyed on their experiences of online therapy. Outcomes of telepsychiatry in a real-life clinical outpatient setting should be evaluated and compared to regular face-to-face therapy as current knowledge on the efficacy of online interventions is restricted to controlled intervention studies so far.

Conclusions

There are numerous pandemic-related mental health risks for children and adolescents. During the acute phase, the main burden has been associated with social distancing, increased pressure on families and reduced access to support services. After the pandemic, economic recession and consequences of anxiety, stress and violence exposure may be predominant issues to meet in CAP care.

Despite the difficult circumstances, CAP professionals shall maintain regular and emergency treatment as far as possible in order to reduce negative consequences for children and adolescents. Flexibility and creativity have been needed to ensure treatment during the different phases of the pandemic. All CAP professionals should be aware of the numerous mental health threats associated with the pandemic.

COVID-19-associated mental health risk has disproportionately hit disadvantaged and marginalized children and adolescents. A special focus should be set on these children in order to prevent aggravating pre-existing disadvantages.

The current pandemic accumulates several risk factors for mental health of children and adolescents. Longitudinal real-time studies can help to disentangle these factors and their relevance for stress-regulating coping processes and mental health. Finally, the current pandemic, stressful and disruptive as it is, could provide the opportunity to introduce innovative approaches to delivering mental health services through telepsychiatry thus possibly fostering a more efficient use of available resources. It will remain to be determined through appropriate research which modalities prove indeed effective and safe.

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

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Fegert, J.M., Vitiello, B., Plener, P.L. et al. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health 14 , 20 (2020). https://doi.org/10.1186/s13034-020-00329-3

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Top 10 risks and opportunities for education in the face of COVID-19

Subscribe to the center for universal education bulletin, rebecca winthrop rebecca winthrop director - center for universal education , senior fellow - global economy and development @rebeccawinthrop.

April 10, 2020

March 2020 will forever be known in the education community as the month when almost all the world’s schools shut their doors. On March 1, six governments instituted nationwide school closures due to the deadly coronavirus pandemic, and by the end of the month, 185 countries had closed, affecting 90 percent of the world’s students. The speed of these closures and the rapid move to distance learning has allowed little time for planning or reflection on both the potential risks to safeguard against and the potential opportunities to leverage.

With every crisis comes deep challenges and opportunities for transformation— past education crises have shown that it is possible to build back better. To help me reflect on what some of these challenges and opportunities may be, I recently spoke to Jim Knight , current member of the House of Lords, head of education for Tes Global, and former U.K. schools minister; and to Vicki Phillips , current chief of education at the National Geographic Society and a former U.S. superintendent of schools and state secretary of education. They provide perspectives from inside and outside of government in the U.K. and U.S., though their insights can likely help the many countries worldwide struggling to continue education during the pandemic.

Risks and challenges

#1: Distance learning will reinforce teaching and learning approaches that we know do not work well.

Jim: Many countries are shifting to distance learning approaches, whether through distributing physical packets of materials for students or through using technology to facilitate online learning. And there are real risks because many of these approaches can be very solitary and didactic when you’re just asking students to sit and quietly watch videos, read documents online, or click through presentations—that’s really dull. The worst form of learning is to sit passively and listen, and this may be the form that most students will receive during school closures. It serves no one well, especially those who are the furthest behind.

#2: Educators will be overwhelmed and unsupported to do their jobs well.

Vicki: Teachers had little or no notice about their schools closing and shifting to online learning—this can be challenging for anybody. They’ve shared that they are overwhelmed with all sorts of materials and products, and we are seeing educators begin to push back and request help filtering through all the resources to find those that are quality.

At the same time, teachers are just like the rest of us in that they are experiencing this strange new world as mothers, fathers, aunts, uncles, and grandparents. They are trying to deal with their individual lives and take care of their kids and find new ways to make sure that learning continues.

#3: The protection and safety of children will be harder to safeguard.

Jim: In the U.K., we have stringent processes around checking who has access to children during school, in after-school clubs and sports. Schools have safeguard measures in place to ensure that predators toward children, such as pedophiles, can’t access young people. Now, once you move to online learning in a home environment, you can’t safeguard against this. People have to be mindful about the design of online learning so that bad individuals don’t get to children outside of their home.

#4: School closures will widen the equity gaps.

Vicki: Over the last decade or so, progress has been made in the number of students who have access to devices and connectivity, making this move to online learning possible. At the same time, not every child has access to digital devices or internet connectivity at home, and we need to ensure those kids get access to learning resources as well. This means that learning resources need to be available on every kind of device and it means, for kids who don’t have access, we still need to find a way to reach them.

#5: Poor experiences with ed-tech during the pandemic will make it harder to get buy-in later for good use of ed-tech.

Jim: We know that some students who use ed-tech during the pandemic will have a poor experience because they’re not used to it. Some people will say, “During the virus we tried the ed-tech-enabled learning approaches, it was terrible, and look at my test scores.” Yes, this will happen. People’s test scores will be impacted. People will become unhappy because the mental health effects of being isolated will be profound. We must be prepared for that. Those poor experiences are really important to learn what does and doesn’t work.

Opportunities to Leverage

#1: Blended learning approaches will be tried, tested, and increasingly used.

Jim: We know that the more engaging learning styles are ones that are more interactive, and that face-to-face learning is better than 100 percent online learning. We also know blended learning can draw on the best of both worlds and create a better learning experience than one hundred percent face-to-face learning. If, after having done 100 percent online at the end of this, I think it’s quite possible that we can then think about rebalancing the mix between face-to-face and online. Teachers will have started to innovate and experiment with these online tools and may want to continue online pedagogies as a result of all this. That’s really exciting.

#2: Teachers and schools will receive more respect, appreciation, and support for their important role in society.

Vicki: I think it will be easier to understand that schools aren’t just buildings where students go to learn, and that teachers are irreplaceable. There’s something magic about that in-person connection, that bond between teachers and their students. Having that face-to-face connection with learners and being able to support them across their unique skills⁠—that’s very hard to replicate in a distance learning environment. Also, many students access critical resources at school, such as meals, clothing, and mental health support that may not be as widely available at home.

#3: Quality teaching and learning materials will be better curated and more widely used.

Vicki: Educators are looking to other educators as well as trusted sources to help curate high-quality online learning tools. At National Geographic, we’ve curated collections for K-12 learners in our resource library. We’ve created a new landing page that allows educators, parents, and caregivers to access our free materials quickly, and inspire young people. But it’s not just teachers struggling—it’s parents and other caregivers who are trying to bring learning to life. To that end, we’re livestreaming our Explorer Classroom model that connects young people with scientists, researchers, educators, and storytellers. During this transition, we want students and families to have access to that larger world, in addition to their own backyard.

#4: Teacher collaboration will grow and help improve learning.

Jim: As a profession, I hope we come out of this crisis stronger by collaborating and working together. I’m a firm believer in not asking heavily burdened teachers to reinvent the wheel. At my company Tes, we’ve got a big resource-sharing platform for teachers, including coronavirus-related resources. There are other platforms too, such as Teachers Pay Teachers and Khan Academy, where teachers can see what others have done. A teacher could say, “well, rather than record a video with the instructional element I need, I might be able to find someone who has done that really well already.” One of the most important things teachers can do now is draw on what others are doing: Form community online, share the burden, and make things a bit easier.

#5: This crisis will help us come together across boundaries.

Vicki: We would be remiss if we didn’t take away a greater sense of empathy for each other—the idea that we can work through anything together—from this crisis. I think it’s an opportunity for the education sector to unite, forge connections across countries and continents, and truly share what works in a global way. I don’t think, prior to this crisis, that we’ve been able to do this, and we will have missed a big opportunity if we don’t try to do that now.

Jim: We will get through this stronger. I live in a divided country, and from where I sit, it looks like the U.S. is a divided country too. When you go through a big national crisis like this, you come out stronger as a country because you’ve been fighting together, working together.

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• Review Article
• Published: 27 September 2021

Why lockdown and distance learning during the COVID-19 pandemic are likely to increase the social class achievement gap

• Sébastien Goudeau   ORCID: orcid.org/0000-0001-7293-0977 1 ,
• Camille Sanrey   ORCID: orcid.org/0000-0003-3158-1306 1 ,
• Arnaud Stanczak   ORCID: orcid.org/0000-0002-2596-1516 2 ,
• Antony Manstead   ORCID: orcid.org/0000-0001-7540-2096 3 &
• Céline Darnon   ORCID: orcid.org/0000-0003-2613-689X 2  

Nature Human Behaviour volume  5 ,  pages 1273–1281 ( 2021 ) Cite this article

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The COVID-19 pandemic has forced teachers and parents to quickly adapt to a new educational context: distance learning. Teachers developed online academic material while parents taught the exercises and lessons provided by teachers to their children at home. Considering that the use of digital tools in education has dramatically increased during this crisis, and it is set to continue, there is a pressing need to understand the impact of distance learning. Taking a multidisciplinary view, we argue that by making the learning process rely more than ever on families, rather than on teachers, and by getting students to work predominantly via digital resources, school closures exacerbate social class academic disparities. To address this burning issue, we propose an agenda for future research and outline recommendations to help parents, teachers and policymakers to limit the impact of the lockdown on social-class-based academic inequality.

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The widespread effects of the COVID-19 pandemic that emerged in 2019–2020 have drastically increased health, social and economic inequalities 1 , 2 . For more than 900 million learners around the world, the pandemic led to the closure of schools and universities 3 . This exceptional situation forced teachers, parents and students to quickly adapt to a new educational context: distance learning. Teachers had to develop online academic materials that could be used at home to ensure educational continuity while ensuring the necessary physical distancing. Primary and secondary school students suddenly had to work with various kinds of support, which were usually provided online by their teachers. For college students, lockdown often entailed returning to their hometowns while staying connected with their teachers and classmates via video conferences, email and other digital tools. Despite the best efforts of educational institutions, parents and teachers to keep all children and students engaged in learning activities, ensuring educational continuity during school closure—something that is difficult for everyone—may pose unique material and psychological challenges for working-class families and students.

Not only did the pandemic lead to the closure of schools in many countries, often for several weeks, it also accelerated the digitalization of education and amplified the role of parental involvement in supporting the schoolwork of their children. Thus, beyond the specific circumstances of the COVID-19 lockdown, we believe that studying the effects of the pandemic on academic inequalities provides a way to more broadly examine the consequences of school closure and related effects (for example, digitalization of education) on social class inequalities. Indeed, bearing in mind that (1) the risk of further pandemics is higher than ever (that is, we are in a ‘pandemic era’ 4 , 5 ) and (2) beyond pandemics, the use of digital tools in education (and therefore the influence of parental involvement) has dramatically increased during this crisis, and is set to continue, there is a pressing need for an integrative and comprehensive model that examines the consequences of distance learning. Here, we propose such an integrative model that helps us to understand the extent to which the school closures associated with the pandemic amplify economic, digital and cultural divides that in turn affect the psychological functioning of parents, students and teachers in a way that amplifies academic inequalities. Bringing together research in social sciences, ranging from economics and sociology to social, cultural, cognitive and educational psychology, we argue that by getting students to work predominantly via digital resources rather than direct interactions with their teachers, and by making the learning process rely more than ever on families rather than teachers, school closures exacerbate social class academic disparities.

First, we review research showing that social class is associated with unequal access to digital tools, unequal familiarity with digital skills and unequal uses of such tools for learning purposes 6 , 7 . We then review research documenting how unequal familiarity with school culture, knowledge and skills can also contribute to the accentuation of academic inequalities 8 , 9 . Next, we present the results of surveys conducted during the 2020 lockdown showing that the quality and quantity of pedagogical support received from schools varied according to the social class of families (for examples, see refs. 10 , 11 , 12 ). We then argue that these digital, cultural and structural divides represent barriers to the ability of parents to provide appropriate support for children during distance learning (Fig. 1 ). These divides also alter the levels of self-efficacy of parents and children, thereby affecting their engagement in learning activities 13 , 14 . In the final section, we review preliminary evidence for the hypothesis that distance learning widens the social class achievement gap and we propose an agenda for future research. In addition, we outline recommendations that should help parents, teachers and policymakers to use social science research to limit the impact of school closure and distance learning on the social class achievement gap.

Economic, structural, digital and cultural divides influence the psychological functioning of parents and students in a way that amplify inequalities.

The digital divide

Unequal access to digital resources.

Although the use of digital technologies is almost ubiquitous in developed nations, there is a digital divide such that some people are more likely than others to be numerically excluded 15 (Fig. 1 ). Social class is a strong predictor of digital disparities, including the quality of hardware, software and Internet access 16 , 17 , 18 . For example, in 2019, in France, around 1 in 5 working-class families did not have personal access to the Internet compared with less than 1 in 20 of the most privileged families 19 . Similarly, in 2020, in the United Kingdom, 20% of children who were eligible for free school meals did not have access to a computer at home compared with 7% of other children 20 . In 2021, in the United States, 41% of working-class families do not own a laptop or desktop computer and 43% do not have broadband compared with 8% and 7%, respectively, of upper/middle-class Americans 21 . A similar digital gap is also evident between lower-income and higher-income countries 22 .

Second, simply having access to a computer and an Internet connection does not ensure effective distance learning. For example, many of the educational resources sent by teachers need to be printed, thereby requiring access to printers. Moreover, distance learning is more difficult in households with only one shared computer compared with those where each family member has their own 23 . Furthermore, upper/middle-class families are more likely to be able to guarantee a suitable workspace for each child than their working-class counterparts 24 .

In the context of school closures, such disparities are likely to have important consequences for educational continuity. In line with this idea, a survey of approximately 4,000 parents in the United Kingdom confirmed that during lockdown, more than half of primary school children from the poorest families did not have access to their own study space and were less well equipped for distance learning than higher-income families 10 . Similarly, a survey of around 1,300 parents in the Netherlands found that during lockdown, children from working-class families had fewer computers at home and less room to study than upper/middle-class children 11 .

Data from non-Western countries highlight a more general digital divide, showing that developing countries have poorer access to digital equipment. For example, in India in 2018, only 10.7% of households possessed a digital device 25 , while in Pakistan in 2020, 31% of higher-education teachers did not have Internet access and 68.4% did not have a laptop 26 . In general, developing countries lack access to digital technologies 27 , 28 , and these difficulties of access are even greater in rural areas (for example, see ref. 29 ). Consequently, school closures have huge repercussions for the continuity of learning in these countries. For example, in India in 2018, only 11% of the rural and 40% of the urban population above 14 years old could use a computer and access the Internet 25 . Time spent on education during school closure decreased by 80% in Bangladesh 30 . A similar trend was observed in other countries 31 , with only 22% of children engaging in remote learning in Kenya 32 and 50% in Burkina Faso 33 . In Ghana, 26–32% of children spent no time at all on learning during the pandemic 34 . Beyond the overall digital divide, social class disparities are also evident in developing countries, with lower access to digital resources among households in which parental educational levels were low (versus households in which parental educational levels were high; for example, see ref. 35 for Nigeria and ref. 31 for Ecuador).

Unequal digital skills

In addition to unequal access to digital tools, there are also systematic variations in digital skills 36 , 37 (Fig. 1 ). Upper/middle-class families are more familiar with digital tools and resources and are therefore more likely to have the digital skills needed for distance learning 38 , 39 , 40 . These digital skills are particularly useful during school closures, both for students and for parents, for organizing, retrieving and correctly using the resources provided by the teachers (for example, sending or receiving documents by email, printing documents or using word processors).

Social class disparities in digital skills can be explained in part by the fact that children from upper/middle-class families have the opportunity to develop digital skills earlier than working-class families 41 . In member countries of the OECD (Organisation for Economic Co-operation and Development), only 23% of working-class children had started using a computer at the age of 6 years or earlier compared with 43% of upper/middle-class children 42 . Moreover, because working-class people tend to persist less than upper/middle-class people when confronted with digital difficulties 23 , the use of digital tools and resources for distance learning may interfere with the ability of parents to help children with their schoolwork.

Unequal use of digital tools

A third level of digital divide concerns variations in digital tool use 18 , 43 (Fig. 1 ). Upper/middle-class families are more likely to use digital resources for work and education 6 , 41 , 44 , whereas working-class families are more likely to use these resources for entertainment, such as electronic games or social media 6 , 45 . This divide is also observed among students, whereby working-class students tend to use digital technologies for leisure activities, whereas their upper/middle-class peers are more likely to use them for academic activities 46 and to consider that computers and the Internet provide an opportunity for education and training 23 . Furthermore, working-class families appear to regulate the digital practices of their children less 47 and are more likely to allow screens in the bedrooms of children and teenagers without setting limits on times or practices 48 .

In sum, inequalities in terms of digital resources, skills and use have strong implications for distance learning. This is because they make working-class students and parents particularly vulnerable when learning relies on extensive use of digital devices rather than on face-to-face interaction with teachers.

The cultural divide

Even if all three levels of digital divide were closed, upper/middle-class families would still be better prepared than working-class families to ensure educational continuity for their children. Upper/middle-class families are more familiar with the academic knowledge and skills that are expected and valued in educational settings, as well as with the independent, autonomous way of learning that is valued in the school culture and becomes even more important during school closure (Fig. 1 ).

Unequal familiarity with academic knowledge and skills

According to classical social reproduction theory 8 , 49 , school is not a neutral place in which all forms of language and knowledge are equally valued. Academic contexts expect and value culture-specific and taken-for-granted forms of knowledge, skills and ways of being, thinking and speaking that are more in tune with those developed through upper/middle-class socialization (that is, ‘cultural capital’ 8 , 50 , 51 , 52 , 53 ). For instance, academic contexts value interest in the arts, museums and literature 54 , 55 , a type of interest that is more likely to develop through socialization in upper/middle-class families than in working-class socialization 54 , 56 . Indeed, upper/middle-class parents are more likely than working-class parents to engage in activities that develop this cultural capital. For example, they possess more books and cultural objects at home, read more stories to their children and visit museums and libraries more often (for examples, see refs. 51 , 54 , 55 ). Upper/middle-class children are also more involved in extra-curricular activities (for example, playing a musical instrument) than working-class children 55 , 56 , 57 .

Beyond this implicit familiarization with the school curriculum, upper/middle-class parents more often organize educational activities that are explicitly designed to develop academic skills of their children 57 , 58 , 59 . For example, they are more likely to monitor and re-explain lessons or use games and textbooks to develop and reinforce academic skills (for example, labelling numbers, letters or colours 57 , 60 ). Upper/middle-class parents also provide higher levels of support and spend more time helping children with homework than working-class parents (for examples, see refs. 61 , 62 ). Thus, even if all parents are committed to the academic success of their children, working-class parents have fewer chances to provide the help that children need to complete homework 63 , and homework is more beneficial for children from upper-middle class families than for children from working-class families 64 , 65 .

School closures amplify the impact of cultural inequalities

The trends described above have been observed in ‘normal’ times when schools are open. School closures, by making learning rely more strongly on practices implemented at home (rather than at school), are likely to amplify the impact of these disparities. Consistent with this idea, research has shown that the social class achievement gap usually greatly widens during school breaks—a phenomenon described as ‘summer learning loss’ or ‘summer setback’ 66 , 67 , 68 . During holidays, the learning by children tends to decline, and this is particularly pronounced in children from working-class families. Consequently, the social class achievement gap grows more rapidly during the summer months than it does in the rest of the year. This phenomenon is partly explained by the fact that during the break from school, social class disparities in investment in activities that are beneficial for academic achievement (for example, reading, travelling to a foreign country or museum visits) are more pronounced.

Therefore, when they are out of school, children from upper/middle-class backgrounds may continue to develop academic skills unlike their working-class counterparts, who may stagnate or even regress. Research also indicates that learning loss during school breaks tends to be cumulative 66 . Thus, repeated episodes of school closure are likely to have profound consequences for the social class achievement gap. Consistent with the idea that school closures could lead to similar processes as those identified during summer breaks, a recent survey indicated that during the COVID-19 lockdown in the United Kingdom, children from upper/middle-class families spent more time on educational activities (5.8 h per day) than those from working-class families (4.5 h per day) 7 , 69 .

Unequal dispositions for autonomy and self-regulation

School closures have encouraged autonomous work among students. This ‘independent’ way of studying is compatible with the family socialization of upper/middle-class students, but does not match the interdependent norms more commonly associated with working-class contexts 9 . Upper/middle-class contexts tend to promote cultural norms of independence whereby individuals perceive themselves as autonomous actors, independent of other individuals and of the social context, able to pursue their own goals 70 . For example, upper/middle-class parents tend to invite children to express their interests, preferences and opinions during the various activities of everyday life 54 , 55 . Conversely, in working-class contexts characterized by low economic resources and where life is more uncertain, individuals tend to perceive themselves as interdependent, connected to others and members of social groups 53 , 70 , 71 . This interdependent self-construal fits less well with the independent culture of academic contexts. This cultural mismatch between interdependent self-construal common in working-class students and the independent norms of the educational institution has negative consequences for academic performance 9 .

Once again, the impact of these differences is likely to be amplified during school closures, when being able to work alone and autonomously is especially useful. The requirement to work alone is more likely to match the independent self-construal of upper/middle-class students than the interdependent self-construal of working-class students. In the case of working-class students, this mismatch is likely to increase their difficulties in working alone at home. Supporting our argument, recent research has shown that working-class students tend to underachieve in contexts where students work individually compared with contexts where students work with others 72 . Similarly, during school closures, high self-regulation skills (for example, setting goals, selecting appropriate learning strategies and maintaining motivation 73 ) are required to maintain study activities and are likely to be especially useful for using digital resources efficiently. Research has shown that students from working-class backgrounds typically develop their self-regulation skills to a lesser extent than those from upper/middle-class backgrounds 74 , 75 , 76 .

Interestingly, some authors have suggested that independent (versus interdependent) self-construal may also affect communication with teachers 77 . Indeed, in the context of distance learning, working-class families are less likely to respond to the communication of teachers because their ‘interdependent’ self leads them to respect hierarchies, and thus perceive teachers as an expert who ‘can be trusted to make the right decisions for learning’. Upper/middle class families, relying on ‘independent’ self-construal, are more inclined to seek individualized feedback, and therefore tend to participate to a greater extent in exchanges with teachers. Such cultural differences are important because they can also contribute to the difficulties encountered by working-class families.

The structural divide: unequal support from schools

The issues reviewed thus far all increase the vulnerability of children and students from underprivileged backgrounds when schools are closed. To offset these disadvantages, it might be expected that the school should increase its support by providing additional resources for working-class students. However, recent data suggest that differences in the material and human resources invested in providing educational support for children during periods of school closure were—paradoxically—in favour of upper/middle-class students (Fig. 1 ). In England, for example, upper/middle-class parents reported benefiting from online classes and video-conferencing with teachers more often than working-class parents 10 . Furthermore, active help from school (for example, online teaching, private tutoring or chats with teachers) occurred more frequently in the richest households (64% of the richest households declared having received help from school) than in the poorest households (47%). Another survey found that in the United Kingdom, upper/middle-class children were more likely to take online lessons every day (30%) than working-class students (16%) 12 . This substantial difference might be due, at least in part, to the fact that private schools are better equipped in terms of online platforms (60% of schools have at least one online platform) than state schools (37%, and 23% in the most deprived schools) and were more likely to organize daily online lessons. Similarly, in the United Kingdom, in schools with a high proportion of students eligible for free school meals, teachers were less inclined to broadcast an online lesson for their pupils 78 . Interestingly, 58% of teachers in the wealthiest areas reported having messaged their students or their students’ parents during lockdown compared with 47% in the most deprived schools. In addition, the probability of children receiving technical support from the school (for example, by providing pupils with laptops or other devices) is, surprisingly, higher in the most advantaged schools than in the most deprived 78 .

In addition to social class disparities, there has been less support from schools for African-American and Latinx students. During school closures in the United States, 40% of African-American students and 30% of Latinx students received no online teaching compared with 10% of white students 79 . Another source of inequality is that the probability of school closure was correlated with social class and race. In the United States, for example, school closures from September to December 2020 were more common in schools with a high proportion of racial/ethnic minority students, who experience homelessness and are eligible for free/discounted school meals 80 .

Similarly, access to educational resources and support was lower in poorer (compared with richer) countries 81 . In sub-Saharan Africa, during lockdown, 45% of children had no exposure at all to any type of remote learning. Of those who did, the medium was mostly radio, television or paper rather than digital. In African countries, at most 10% of children received some material through the Internet. In Latin America, 90% of children received some remote learning, but less than half of that was through the internet—the remainder being via radio and television 81 . In Ecuador, high-school students from the lowest wealth quartile had fewer remote-learning opportunities, such as Google class/Zoom, than students from the highest wealth quartile 31 .

Thus, the achievement gap and its accentuation during lockdown are due not only to the cultural and digital disadvantages of working-class families but also to unequal support from schools. This inequality in school support is not due to teachers being indifferent to or even supportive of social stratification. Rather, we believe that these effects are fundamentally structural. In many countries, schools located in upper/middle-class neighbourhoods have more money than those in the poorest neighbourhoods. Moreover, upper/middle-class parents invest more in the schools of their children than working-class parents (for example, see ref. 82 ), and schools have an interest in catering more for upper/middle-class families than for working-class families 83 . Additionally, the expectation of teachers may be lower for working-class children 84 . For example, they tend to estimate that working-class students invest less effort in learning than their upper/middle-class counterparts 85 . These differences in perception may have influenced the behaviour of teachers during school closure, such that teachers in privileged neighbourhoods provided more information to students because they expected more from them in term of effort and achievement. The fact that upper/middle-class parents are better able than working-class parents to comply with the expectations of teachers (for examples, see refs. 55 , 86 ) may have reinforced this phenomenon. These discrepancies echo data showing that working-class students tend to request less help in their schoolwork than upper/middle-class ones 87 , and they may even avoid asking for help because they believe that such requests could lead to reprimands 88 . During school closures, these students (and their families) may in consequence have been less likely to ask for help and resources. Jointly, these phenomena have resulted in upper/middle-class families receiving more support from schools during lockdown than their working-class counterparts.

Psychological effects of digital, cultural and structural divides

Despite being strongly influenced by social class, differences in academic achievement are often interpreted by parents, teachers and students as reflecting differences in ability 89 . As a result, upper/middle-class students are usually perceived—and perceive themselves—as smarter than working-class students, who are perceived—and perceive themselves—as less intelligent 90 , 91 , 92 or less able to succeed 93 . Working-class students also worry more about the fact that they might perform more poorly than upper/middle-class students 94 , 95 . These fears influence academic learning in important ways. In particular, they can consume cognitive resources when children and students work on academic tasks 96 , 97 . Self-efficacy also plays a key role in engaging in learning and perseverance in the face of difficulties 13 , 98 . In addition, working-class students are those for whom the fear of being outperformed by others is the most negatively related to academic performance 99 .

The fact that working-class children and students are less familiar with the tasks set by teachers, and less well equipped and supported, makes them more likely to experience feelings of incompetence (Fig. 1 ). Working-class parents are also more likely than their upper/middle-class counterparts to feel unable to help their children with schoolwork. Consistent with this, research has shown that both working-class students and parents have lower feelings of academic self-efficacy than their upper/middle-class counterparts 100 , 101 . These differences have been documented under ‘normal’ conditions but are likely to be exacerbated during distance learning. Recent surveys conducted during the school closures have confirmed that upper/middle-class families felt better able to support their children in distance learning than did working-class families 10 and that upper/middle-class parents helped their children more and felt more capable to do so 11 , 12 .

Pandemic disparity, future directions and recommendations

The research reviewed thus far suggests that children and their families are highly unequal with respect to digital access, skills and use. It also shows that upper/middle-class students are more likely to be supported in their homework (by their parents and teachers) than working-class students, and that upper/middle-class students and parents will probably feel better able than working-class ones to adapt to the context of distance learning. For all these reasons, we anticipate that as a result of school closures, the COVID-19 pandemic will substantially increase the social class achievement gap. Because school closures are a recent occurrence, it is too early to measure with precision their effects on the widening of the achievement gap. However, some recent data are consistent with this idea.

Evidence for a widening gap during the pandemic

Comparing academic achievement in 2020 with previous years provides an early indication of the effects of school closures during the pandemic. In France, for example, first and second graders take national evaluations at the beginning of the school year. Initial comparisons of the results for 2020 with those from previous years revealed that the gap between schools classified as ‘priority schools’ (those in low-income urban areas) and schools in higher-income neighbourhoods—a gap observed every year—was particularly pronounced in 2020 in both French and mathematics 102 .

Similarly, in the Netherlands, national assessments take place twice a year. In 2020, they took place both before and after school closures. A recent analysis compared progress during this period in 2020 in mathematics/arithmetic, spelling and reading comprehension for 7–11-year-old students within the same period in the three previous years 103 . Results indicated a general learning loss in 2020. More importantly, for the 8% of working-class children, the losses were 40% greater than they were for upper/middle-class children.

Similar results were observed in Belgium among students attending the final year of primary school. Compared with students from previous cohorts, students affected by school closures experienced a substantial decrease in their mathematics and language scores, with children from more disadvantaged backgrounds experiencing greater learning losses 104 . Likewise, oral reading assessments in more than 100 school districts in the United States showed that the development of this skill among children in second and third grade significantly slowed between Spring and Autumn 2020, but this slowdown was more pronounced in schools from lower-achieving districts 105 .

It is likely that school closures have also amplified racial disparities in learning and achievement. For example, in the United States, after the first lockdown, students of colour lost the equivalent of 3–5 months of learning, whereas white students were about 1–3 months behind. Moreover, in the Autumn, when some students started to return to classrooms, African-American and Latinx students were more likely to continue distance learning, despite being less likely to have access to the digital tools, Internet access and live contact with teachers 106 .

In some African countries (for example, Ethiopia, Kenya, Liberia, Tanzania and Uganda), the COVID-19 crisis has resulted in learning loss ranging from 6 months to more 1 year 107 , and this learning loss appears to be greater for working-class children (that is, those attending no-fee schools) than for upper/middle-class children 108 .

These findings show that school closures have exacerbated achievement gaps linked to social class and ethnicity. However, more research is needed to address the question of whether school closures differentially affect the learning of students from working- and upper/middle-class families.

Future directions

First, to assess the specific and unique impact of school closures on student learning, longitudinal research should compare student achievement at different times of the year, before, during and after school closures, as has been done to document the summer learning loss 66 , 109 . In the coming months, alternating periods of school closure and opening may occur, thereby presenting opportunities to do such research. This would also make it possible to examine whether the gap diminishes a few weeks after children return to in-school learning or whether, conversely, it increases with time because the foundations have not been sufficiently acquired to facilitate further learning 110 .

Second, the mechanisms underlying the increase in social class disparities during school closures should be examined. As discussed above, school closures result in situations for which students are unevenly prepared and supported. It would be appropriate to seek to quantify the contribution of each of the factors that might be responsible for accentuating the social class achievement gap. In particular, distinguishing between factors that are relatively ‘controllable’ (for example, resources made available to pupils) and those that are more difficult to control (for example, the self-efficacy of parents in supporting the schoolwork of their children) is essential to inform public policy and teaching practices.

Third, existing studies are based on general comparisons and very few provide insights into the actual practices that took place in families during school closure and how these practices affected the achievement gap. For example, research has documented that parents from working-class backgrounds are likely to find it more difficult to help their children to complete homework and to provide constructive feedback 63 , 111 , something that could in turn have a negative impact on the continuity of learning of their children. In addition, it seems reasonable to assume that during lockdown, parents from upper/middle-class backgrounds encouraged their children to engage in practices that, even if not explicitly requested by teachers, would be beneficial to learning (for example, creative activities or reading). Identifying the practices that best predict the maintenance or decline of educational achievement during school closures would help identify levers for intervention.

Finally, it would be interesting to investigate teaching practices during school closures. The lockdown in the spring of 2020 was sudden and unexpected. Within a few days, teachers had to find a way to compensate for the school closure, which led to highly variable practices. Some teachers posted schoolwork on platforms, others sent it by email, some set work on a weekly basis while others set it day by day. Some teachers also set up live sessions in large or small groups, providing remote meetings for questions and support. There have also been variations in the type of feedback given to students, notably through the monitoring and correcting of work. Future studies should examine in more detail what practices schools and teachers used to compensate for the school closures and their effects on widening, maintaining or even reducing the gap, as has been done for certain specific literacy programmes 112 as well as specific instruction topics (for example, ecology and evolution 113 ).

Practical recommendations

We are aware of the debate about whether social science research on COVID-19 is suitable for making policy decisions 114 , and we draw attention to the fact that some of our recommendations (Table 1 ) are based on evidence from experiments or interventions carried out pre-COVID while others are more speculative. In any case, we emphasize that these suggestions should be viewed with caution and be tested in future research. Some of our recommendations could be implemented in the event of new school closures, others only when schools re-open. We also acknowledge that while these recommendations are intended for parents and teachers, their implementation largely depends on the adoption of structural policies. Importantly, given all the issues discussed above, we emphasize the importance of prioritizing, wherever possible, in-person learning over remote learning 115 and where this is not possible, of implementing strong policies to support distance learning, especially for disadvantaged families.

Where face-to face teaching is not possible and teachers are responsible for implementing distance learning, it will be important to make them aware of the factors that can exacerbate inequalities during lockdown and to provide them with guidance about practices that would reduce these inequalities. Thus, there is an urgent need for interventions aimed at making teachers aware of the impact of the social class of children and families on the following factors: (1) access to, familiarity with and use of digital devices; (2) familiarity with academic knowledge and skills; and (3) preparedness to work autonomously. Increasing awareness of the material, cultural and psychological barriers that working-class children and families face during lockdown should increase the quality and quantity of the support provided by teachers and thereby positively affect the achievements of working-class students.

In addition to increasing the awareness of teachers of these barriers, teachers should be encouraged to adjust the way they communicate with working-class families due to differences in self-construal compared with upper/middle-class families 77 . For example, questions about family (rather than personal) well-being would be congruent with interdependent self-construals. This should contribute to better communication and help keep a better track of the progress of students during distance learning.

It is also necessary to help teachers to engage in practices that have a chance of reducing inequalities 53 , 116 . Particularly important is that teachers and schools ensure that homework can be done by all children, for example, by setting up organizations that would help children whose parents are not in a position to monitor or assist with the homework of their children. Options include homework help groups and tutoring by teachers after class. When schools are open, the growing tendency to set homework through digital media should be resisted as far as possible given the evidence we have reviewed above. Moreover, previous research has underscored the importance of homework feedback provided by teachers, which is positively related to the amount of homework completed and predictive of academic performance 117 . Where homework is web-based, it has also been shown that feedback on web-based homework enhances the learning of students 118 . It therefore seems reasonable to predict that the social class achievement gap will increase more slowly (or even remain constant or be reversed) in schools that establish individualized monitoring of students, by means of regular calls and feedback on homework, compared with schools where the support provided to pupils is more generic.

Given that learning during lockdown has increasingly taken place in family settings, we believe that interventions involving the family are also likely to be effective 119 , 120 , 121 . Simply providing families with suitable material equipment may be insufficient. Families should be given training in the efficient use of digital technology and pedagogical support. This would increase the self-efficacy of parents and students, with positive consequences for achievement. Ideally, such training would be delivered in person to avoid problems arising from the digital divide. Where this is not possible, individualized online tutoring should be provided. For example, studies conducted during the lockdown in Botswana and Italy have shown that individual online tutoring directly targeting either parents or students in middle school has a positive impact on the achievement of students, particularly for working-class students 122 , 123 .

Interventions targeting families should also address the psychological barriers faced by working-class families and children. Some interventions have already been designed and been shown to be effective in reducing the social class achievement gap, particularly in mathematics and language 124 , 125 , 126 . For example, research showed that an intervention designed to train low-income parents in how to support the mathematical development of their pre-kindergarten children (including classes and access to a library of kits to use at home) increased the quality of support provided by the parents, with a corresponding impact on the development of mathematical knowledge of their children. Such interventions should be particularly beneficial in the context of school closure.

Beyond its impact on academic performance and inequalities, the COVID-19 crisis has shaken the economies of countries around the world, casting millions of families around the world into poverty 127 , 128 , 129 . As noted earlier, there has been a marked increase in economic inequalities, bringing with it all the psychological and social problems that such inequalities create 130 , 131 , especially for people who live in scarcity 132 . The increase in educational inequalities is just one facet of the many difficulties that working-class families will encounter in the coming years, but it is one that could seriously limit the chances of their children escaping from poverty by reducing their opportunities for upward mobility. In this context, it should be a priority to concentrate resources on the most deprived students. A large proportion of the poorest households do not own a computer and do not have personal access to the Internet, which has important consequences for distance learning. During school closures, it is therefore imperative to provide such families with adequate equipment and Internet service, as was done in some countries in spring 2020. Even if the provision of such equipment is not in itself sufficient, it is a necessary condition for ensuring pedagogical continuity during lockdown.

Finally, after prolonged periods of school closure, many students may not have acquired the skills needed to pursue their education. A possible consequence would be an increase in the number of students for whom teachers recommend class repetitions. Class repetitions are contentious. On the one hand, class repetition more frequently affects working-class children and is not efficient in terms of learning improvement 133 . On the other hand, accepting lower standards of academic achievement or even suspending the practice of repeating a class could lead to pupils pursuing their education without mastering the key abilities needed at higher grades. This could create difficulties in subsequent years and, in this sense, be counterproductive. We therefore believe that the most appropriate way to limit the damage of the pandemic would be to help children catch up rather than allowing them to continue without mastering the necessary skills. As is being done in some countries, systematic remedial courses (for example, summer learning programmes) should be organized and financially supported following periods of school closure, with priority given to pupils from working-class families. Such interventions have genuine potential in that research has shown that participation in remedial summer programmes is effective in reducing learning loss during the summer break 134 , 135 , 136 . For example, in one study 137 , 438 students from high-poverty schools were offered a multiyear summer school programme that included various pedagogical and enrichment activities (for example, science investigation and music) and were compared with a ‘no-treatment’ control group. Students who participated in the summer programme progressed more than students in the control group. A meta-analysis 138 of 41 summer learning programmes (that is, classroom- and home-based summer interventions) involving children from kindergarten to grade 8 showed that these programmes had significantly larger benefits for children from working-class families. Although such measures are costly, the cost is small compared to the price of failing to fulfil the academic potential of many students simply because they were not born into upper/middle-class families.

The unprecedented nature of the current pandemic means that we lack strong data on what the school closure period is likely to produce in terms of learning deficits and the reproduction of social inequalities. However, the research discussed in this article suggests that there are good reasons to predict that this period of school closures will accelerate the reproduction of social inequalities in educational achievement.

By making school learning less dependent on teachers and more dependent on families and digital tools and resources, school closures are likely to greatly amplify social class inequalities. At a time when many countries are experiencing second, third or fourth waves of the pandemic, resulting in fresh periods of local or general lockdowns, systematic efforts to test these predictions are urgently needed along with steps to reduce the impact of school closures on the social class achievement gap.

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Acknowledgements

We thank G. Reis for editing the figure. The writing of this manuscript was supported by grant ANR-19-CE28-0007–PRESCHOOL from the French National Research Agency (S.G.).

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Goudeau, S., Sanrey, C., Stanczak, A. et al. Why lockdown and distance learning during the COVID-19 pandemic are likely to increase the social class achievement gap. Nat Hum Behav 5 , 1273–1281 (2021). https://doi.org/10.1038/s41562-021-01212-7

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COVID-19’s impact on remote work life: Top 5 advantages and disadvantages

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Coping with the new normal —of working from home, physically isolating from colleagues, and maneuvering the necessary technologies dictated by remote work—was not a choice, but a quickly situated necessity, as workers and office leaders struggled to adapt. The entertainment technology company FunCorp’s CIO Denis Litvinov took a deep dive into how the pandemic affected remote work. Many of those who were working from home (WFH), noted the report, were incredulous that the COVID-19 crisis and the resulting telecommuting was still a thing, seven months later.

SEE: Digital Transformation: A CXO’s guide (ZDNet/TechRepublic special feature) | Download the free PDF version (TechRepublic)

As the new normal enters its seventh month of social distancing and mask-wearing, it’s unlikely we’ll be returning to the way things were . Indeed, it is beginning to look like this lifestyle and way of working will be around for quite some time.

Litvinov’s report is a pull-no-punches look at the 10 most critical factors to the remote work forced on many employees in the industry, and breaks it down into the top five advantages and the top five disadvantages.

SEE: COVID-19 workplace policy (TechRepublic Premium)

FunCorp’s five positives of WFH

• Allows for an appropriate work/home balance. Most businesses are conducted in major metropolitan areas, and employees were previously saddled with commutes, exhausting traffic jams, or queues for public transport. WFH, and especially with entire families quarantining together, employees have the opportunity to spend more time with family and home life. Fun Corp’s surveys found employees are less stressed than before the pandemic. Unfortunately, world events have not and don’t contribute to less stress.
• Productivity and focus are on the uptick. Even though there are distractions in the home, the report found overall concentration at work has improved. With the reduction of external irritants, stress is reduced and assignments are completed more efficiently, quickly and with Reduced stress levels due to lack of external irritants allow tasks to be performed faster with fewer errors or inaccuracies.
• More top talent want to WFH. “You pull from a larger talent pool,” Litvinov’s report said. By expanding geo-targeted employment, which had been previously possible but not common, it’s now the norm and has drawn talent once uninterested in telecommuting to embracing it, and looking for positions that allowed for WFH and began completing applications for these open positions.
• Budget friendly with better cost management. Businesses can redistribute budgets and save on their operating costs. Expenses are now viewed in “a more reasonable and business-oriented way,” while still considering the global economic crisis. Office, equipment, and rental fees can now be translated into helping the current financial situation.
• Wider search range benefits diversity and inclusion. Companies can now recruit talent from cities or even countries they did not have previous access to, because the hires would be working in an office setting. The recruitment process has been opened up to more diversity and inclusion.

FunCorp’s top five drawbacks to WFH

Quarantining. Even though there are tech employees who describe themselves as introverts, it turns out, the report found, they’re not really so introverted. There’s been no greater light shone on this than during quarantine and isolation. Isolation has greatly affected employees’ and leaders’ moods, and water-cooler talk proved essential, even for those who are self-described or perceived as unsociable.

Not home-office compatible . Not everyone has a perfect space to work remotely , and it can be impossible to figure a way to have an effective and organized work area. They’re not able to set up an arrangement conducive to full concentration, which can directly affect employee efficiency.

No man is an island, at least when it comes to productivity . Autonomy doesn’t work for everyone, not everyone can efficiently self-organize work.

Productivity fails. WFH can present an average fall in performance. And it does not boil down to a single failure, but rather a set of reasons. Based on an individual’s personality and character they might not make WFH work for them. Notable, those who procrastinate and are easily distracted struggle with productivity.

Electronic communications can be easily misunderstood. In addition to missing in-person chats and meetings, both formal and informal, many surveyed worried about the necessary digital communication systems, such as email, chat, social media, and text, and the potential for miscommunication.

Litvinov concluded, “In general, we believe that technology companies can quickly move to distributed work without significant loss of quality.”

Despite the toll the coronavirus has had on the US economy, health and social devastation, Litvinov considers these many months of the new normal as “an unprecedented opportunity to run the world’s biggest-ever workplace experiment.” The majority of the global technology workforce, the FunCorp report noted, were unprepared for the February/March rapid switch to remote work settings.

New companies and startups had distributed teams, generally for cost optimization. However, mature businesses which had a pre-planned and well-structured production process often took a different route than their newer counterparts. A survey from Global Workplace Analytics found 56% of the US tech workforce, or 75 million employees, have a job description perfectly compatible with remote work (or nearly so).

The Bureau of Labor Statistics (BLS) defined a potential remote job as being work-from-home-compatible, as one that:

• Had an information component
• Included individual vs. group work
• Had clear parameters for evaluation
• Did not require personal contact with customers
• Did not require physical work that could only be done on-site

The survey included the following Bureau of Labor Statistics (BLS) categories as compatible:

• Professional specialty
• Technical support
• Administrative support
• Half of sales jobs (assuming that half were non-retail)

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Six Key Advantages and Disadvantages of Working from Home in Europe during COVID-19

Affiliations.

• 1 DTU Management Department, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
• 2 Department of Human Resource Studies, Tilburg University, 5037 AB Tilburg, The Netherlands.
• PMID: 33668505
• PMCID: PMC7917590
• DOI: 10.3390/ijerph18041826

The number of people working from home (WFH) increased radically during the coronavirus (COVID-19) pandemic. The purpose of this study was therefore to investigate people's experiences of WFH during the pandemic and to identify the main factors of advantages and disadvantages of WFH. Data from 29 European countries on the experiences of knowledge workers ( N = 5748) WFH during the early stages of lockdown (11 March to 8 May 2020) were collected. A factor analysis showed the overall distribution of people's experiences and how the advantages and disadvantages of WFH during the early weeks of the pandemic can be grouped into six key factors. The results indicated that most people had a more positive rather than negative experience of WFH during lockdown. Three factors represent the main advantages of WFH: (i) work-life balance, (ii) improved work efficiency and (iii) greater work control. The main disadvantages were (iv) home office constraints, (v) work uncertainties and (vi) inadequate tools. Comparing gender, number of children at home, age and managers versus employees in relation to these factors provided insights into the differential impact of WFH on people's lives. The factors help organisations understand where action is most needed to safeguard both performance and well-being. As the data were collected amidst the COVID-19 pandemic, we recommend further studies to validate the six factors and investigate their importance for well-being and performance in knowledge work.

Keywords: COVID-19; advantages; disadvantages; experiences; knowledge work; survey; working from home.

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Conflict of interest statement

The authors declare no conflict of interest.

Positive (advantages) versus negative (disadvantages)…

Positive (advantages) versus negative (disadvantages) working from home experience scores.

Visualising the differences in the…

Visualising the differences in the factors between the employees and managers (* p…

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The Impact of COVID-19 on E-learning: Advantages and Challenges

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• Batool M. Amarneh 22 ,
• Muhammad Turki Alshurideh   ORCID: orcid.org/0000-0002-7336-381X 22 , 23 ,
• Barween H. Al Kurdi   ORCID: orcid.org/0000-0002-0825-4617 24 &
• Zaid Obeidat   ORCID: orcid.org/0000-0003-3710-6901 23  

Part of the book series: Advances in Intelligent Systems and Computing ((AISC,volume 1377))

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• The International Conference on Artificial Intelligence and Computer Vision

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COVID-19 is the recent coronavirus illness in 2019, began in Wuhan city of China, and has spread quickly worldwide, making billions of individuals face the huge lockdown. The World Health Organization (WHO) proclaimed the COVID plague a pandemic. A considerable number of colleges and educational institutions over the world have either dropped all occasions or postponed those, including educational workshops, meetings, and different sports activities. Colleges and educational institutions take in-depth measures to shield all students and staff members from the exceptionally contagious illness. Due to this pandemic, the shifting to E-learning platforms became the safest option to continue the educational process. In this review, this paper introduces a summary of several prior pieces of research done about the merits and demerits of E-learning along with some global statistics and survey done by using Google forms on 82 university students (undergraduates and postgraduates) who study in UAE to determine if they oppose or support the reliance on E-learning.

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Amarneh, B.M., Alshurideh, M.T., Al Kurdi, B.H., Obeidat, Z. (2021). The Impact of COVID-19 on E-learning: Advantages and Challenges. In: Hassanien, A.E., et al. Proceedings of the International Conference on Artificial Intelligence and Computer Vision (AICV2021). AICV 2021. Advances in Intelligent Systems and Computing, vol 1377. Springer, Cham. https://doi.org/10.1007/978-3-030-76346-6_8

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Advantages and disadvantages of digital mental health initiatives in Nigeria - a qualitative interview study.

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Exploring barriers to mental health services utilization at kabutare district hospital of rwanda: perspectives from patients, social isolation, mental health, and use of digital interventions in youth during the covid-19 pandemic: a nationally representative survey, mental health service provision in low- and middle-income countries, are we there yet unbundling the potential adoption and integration of telemedicine to improve virtual healthcare services in african health systems, listening to mental health crisis needs at scale: using natural language processing to understand and evaluate a mental health crisis text messaging service, the ethical practice of psychotherapy: clearly within our reach., coronavirus disease 2019 (covid-19) and global mental health, the role of telehealth during covid-19 outbreak: a systematic review based on current evidence, rigour and qualitative research., “pandemic fear” and covid-19: mental health burden and strategies, related papers.

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Advantages and Disadvantages of E-Learning Innovations during COVID-19 Pandemic in Higher Education in Poland

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The paper presents the results of the research on the advantages and disadvantages of innovative e-learning during the COVID-19 pandemic in higher education. In the first stage, an internet questionnaire was used for the study. The research was carried out in Poland on a sample of 621 students. The results allowed the researchers to determine variables that are important for the proper implementation of innovative e-learning, and the emergent perspectives for this form of education after the end of the COVID-19 pandemic. Among the most significant disadvantages, there was a lack of direct contact with colleagues, difficulties with teaching practical subjects, lack of direct contact with the teacher, and too much time spent in front of a computer/telephone or other mobile device. The most important correlations included the following: students satisfied with e-learning assess the advantages highly and the disadvantages lower; all the advantages of innovative e-learning are positively correlated with the student’s assessment of the ease of acquiring content in e-learning, and negatively correlated with the student’s assessment of the ease of acquiring content in traditional education; the easier the student assimilates innovative e-learning content, the higher the student’s evaluation of the advantages of e-learning; students who perceive e-learning content as difficult to absorb have low motivation to learn remotely; the better the student knows information technology, the more highly the student evaluates the advantages of innovative e-learning; the better resources to participate in e-learning activities the student has, the higher the student’s evaluation of the advantages of e-learning; the more often innovative e-learning solutions are used in a given university, the better the student assesses the advantages of e-learning.

1. Introduction

During the COVID-19 pandemic, many universities around the world, including Polish ones, which previously used mainly traditional education [ 1 ], were forced to switch to e-learning. This new, innovative solution can be used in many universities to adjust the way of learning to the changing situation. The perception and evaluation of e-learning by students during the pandemic, and the identification of the advantages and disadvantages of this type of education, are interesting and worthy of investigation. It is also important to determine what variables may influence students’ perception of particular advantages and disadvantages of e-learning. This knowledge will allow researchers to determine variables that are important for the proper implementation of e-learning, and the understand the perspectives which are posed for this form of education after the end of the COVID-19 pandemic.

Based on the analysis of the literature on the advantages and disadvantages of e-learning [ 2 , 3 , 4 ], comparison of traditional and e-learning [ 5 , 6 , 7 , 8 ], practical e-learning [ 9 ], improving quality of teaching [ 10 , 11 ], e-learning innovative tools [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ] and services usage in e-learning [ 19 , 20 ], we have found the research gap in terms of advantages and disadvantages of innovative e-learning in higher education during the COVID-19 pandemic. It is worth noting that there has been no research about variables influencing the advantages and disadvantages of innovative e-learning. In the research, the following goals were set:

• • G1: To analyze the advantages and disadvantages of innovative e-learning that are the most important from the point of view of university students.
• • G2: To analyze the relation between the advantages and disadvantages of innovative e-learning at universities.
• • G3: To analyze the relation between the evaluation of advantages and disadvantages of innovative e-learning and the ease of acquiring content in traditional learning and e-learning by students.
• • G4: To analyze the relationship between the assessment of the advantages and disadvantages of innovative e-learning, and other investigated variables.

To realize the mentioned goals, the following scientific expectations were formulated:

• • E1: The most important advantages of innovative e-learning refer to the reduction in travel time and study expenses.
• • E2: Good contact with teachers and the teachers’ ability to communicate about the use of remote tools are important variables positively influencing e-learning.
• • E3: The easier the student assimilates e-learning content, the higher the student evaluates the advantages of e-learning.
• • E4: The better the student knows information technology, the higher the student evaluates the advantages of e-learning.
• • E5: The better resources to participate in e-learning activities the student has, the higher the student evaluates the advantages of e-learning.
• • E6: The more often innovative e-learning solutions are used in a given university, the better the student assesses the advantages of e-learning.

2. Literature Review

E-learning is a method that has been known and used for many years, long antedating the COVID-19 pandemic [ 21 , 22 , 23 , 24 ]. The term e-learning has emerged because of the integration of Information and Communication Technology (ICT) in education fields [ 22 ]. The development of computer technology has made remote tools and methods more and more popular—this is also the case in education. Despite the fact that educational institutions mostly use traditional methods to provide knowledge to students, it has been predicted that e-learning’s popularity will grow [ 25 ]. According to Global Market Insight [ 25 ], the COVID-19 pandemic has had a positive impact on e-learning industry revenue. Employee safety concerns have encouraged corporations to implement work-from-home practices. The telecommunications and broadband sector has increased accessibility to economical internet connectivity plans. Nearly 4.9 billion individuals use the internet globally, while in 2019 it was 4.1 billion. As the number of internet users increases, more and more people will be able to access e-learning platforms to take courses or complete degrees. In addition to education, the use of remote work methods [ 26 , 27 , 28 ] and tools [ 29 , 30 , 31 , 32 ] is also observed in different work areas. The COVID-19 pandemic had a strong impact on e-learning popularization and the change in the usage of innovative e-learning tools in university education [ 33 ]. According to research [ 33 ], the percentage of students familiar with the analyzed e-learning tools has increased significantly during the pandemic. There has been a visible rise, especially in the usage of the following tools: MS Teams, Zoom, and Google Classroom. Students have also used e-learning platforms. It is worth noting that e-learning tools were not used on a large scale before the pandemic [ 34 , 35 ].

On the other hand, the younger generation has been raised with the usage of mobile technology and the Internet. Children with smartphones follow YouTube channels, play games, and record and post videos—this is something common these days. Young people’s getting used to using mobile devices may make it difficult for them to focus on traditional lectures. Because of this, educators should also strive to use modern technologies and apply them to teaching purposes and involve students in lectures [ 36 , 37 ]. Mobile technologies enhance the e-learning opportunity [ 38 ]. Remote education meets the needs of young generations because, among other reasons, it is based on mobile technologies [ 39 ]. E-learning is a great opportunity to better adapt to the expectations of modern students [ 40 ]. Furthermore, social media can also be used for education [ 41 ]. However, it should be emphasized that e-learning should be accompanied by high standards of quality [ 42 ]. The usage of information technologies at universities is very attractive and fruitful; however, it does not always mean that the implementation of e-learning is easy and is done correctly [ 43 ]. Additionally, changes in learning can also lead to increased sustainability at universities [ 44 ].

The introduction of remote education is not sufficient if it is not followed by good quality content, teaching method, materials, ways of verifying knowledge and skills, and last but not least, competent academics [ 45 ]. Bylieva et al. [ 46 ] noticed that an important parameter that influences the behavior of students and their educational progress in general is precisely the focus on practice. In Assareh and Bidokht’s [ 47 ] research, four kinds of e-learning barriers were outlined. They include the following barriers:

• • Learners—who can have financial problems, motivation issues, problems with assessment of their progress, isolation from peers’ matters, inadequate skills and experience in distance learning, and problems with affection and the social domain;
• • Teachers—with barriers such as lack of adequate knowledge about the e-teaching environment, difficulty in the assessment of progress in the different domain;
• • Curriculum—ambiguity, quality, resources, teaching process, evaluation;
• • School—in this area, there are organizational and structural factors.

Overcoming the groups of barriers mentioned above requires more cooperation from such participants as curriculum developers, teachers, students’ parents, social authorities, technology specialists, and also the preparation of virtual and real interaction between students, teachers, and society [ 47 ]. According to Becker et al. [ 48 ] the critical issue in order to successfully implement e-learning is to ensure that users know about the nature of e-learning and to address concerns about its validity and usefulness. Providing opportunities to actively engage with the material, and potentially with other learners, is also very important. In many cases, it can only be accomplished by implementing a quality learning product that can then be experienced by individual learners. What is more, people responsible for e-learning adoption need to be aware of the fact that organizational issues such as support and time allocation should be part of any strategy to adopt e-learning. Knowing the barriers to the implementation of e-learning will help to successfully overcome them.

Some of the barriers are related to the disadvantages of e-learning. Hence, the identification of disadvantages, but also advantages [ 49 , 50 , 51 , 52 ], of e-learning is an important issue [ 53 , 54 , 55 ]. There is much research on the topic of advantages and disadvantages, to name a few (e.g., [ 2 , 3 , 4 , 5 , 6 ]). Some of the research [ 9 , 10 , 11 ] is focused on the challenges and advantages of e-learning. There is also more detailed research which discusses the positive sides of e-learning with the use of WhatsApp [ 12 , 13 , 14 ], YouTube [ 19 , 20 ], tablet PCs [ 17 , 18 ], and smartphones [ 15 , 16 ]. Some authors [ 7 , 8 ] compare e- and traditional education in terms of pros and cons. From the university’s point of view, e-learning leads to some organizational savings, better use of the infrastructure, and increased flexibility in time [ 56 ]. More significantly, this type of learning offers greater opportunities for post-graduate study, and better attendance at classes [ 57 ]. On the other hand, e-learning leads to limited interpersonal contacts and isolation from peers, which might have affected the mental well-being of students [ 58 ]. It is worth noting that the results of research conducted on smaller research samples differs from each other; namely some results show that e-learning does not necessary cause isolation [ 59 ], and some other research pays attention to isolation among teachers [ 60 ]. An important issue related to the quality of e-learning is verification of the results, and this topic is broadly described in the literature, including e-cheating and its prevention [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. It is worth emphasizing that both traditional [ 1 ] and e-learning [ 7 ] have many positive sides and it is difficult to clearly define which of them is unambiguously better.

The possibility exists of using innovative learning solutions based on the use of widespread e-learning in recent years, especially due to the COVID-19 pandemic [ 70 , 71 , 72 , 73 , 74 ]. Using e-learning, we could base our approach upon the traditional innovation approach or use open innovation [ 75 , 76 , 77 ]. We can describe open innovation as a combination of external and internal ideas and a path to develop something, especially using new technology [ 78 ]. In e-learning, the open innovation approach can base its approach upon mixing external solutions—computer programs, applications, and technical solutions—with the internal experiences from within the organization [ 79 , 80 , 81 , 82 ]. This approach can lead to an increase in the effectiveness of innovative solutions used in the university’s learning. It is especially important to look for experience and expertise outside of the organization, because in the open innovation approach, external experts can create a significant amount of added value. Many e-learning solutions have an open character because we can use them without paying for them if we do not need the full version of the application. Such is the case, for example, with the use of Zoom platform in e-learning [ 83 , 84 , 85 , 86 , 87 , 88 ].

Usually, when discussing advantages and disadvantages, the authors refer to the period before the pandemic; however, some research on e-learning during the COVID-19 pandemic has also been published lately. These works usually discuss the process of organization and the application of the e-learning method and tools in the education field [ 57 , 89 , 90 , 91 , 92 , 93 , 94 , 95 ]. Some authors [ 89 , 90 , 96 , 97 ] noticed that the implementation of remote learning in universities was a great challenge. Universities, even technological ones, did not expect a rapid need to switch to distance learning [ 98 ] from traditional learning [ 1 ]. Therefore, to continue courses during the so-called waves of the pandemic, education had to face the challenge of preparing and operating educational or videoconferencing platforms, acquiring e-learning skills and knowledge, and overcoming barriers, as well as resistance to the new. One important issue is also the motivation of students to learn online. Authors [ 99 , 100 ] conducted a study identifying factors influencing student motivation in remote learning during the pandemic.

Based on the analysis of research publications, it can be claimed that there is much research on the advantages and disadvantages of e-learning that was done before the pandemic. There is also some research on e-learning during the pandemic. However, there is a lack of papers that discuss and identify advantages and disadvantages of e-learning during the pandemic of COVID-19. We found only two papers that refer to the topic of pros and cons of e-learning during the pandemic. The first one [ 53 ], is focused only on advantages. The other one [ 101 ] discusses the challenges and opportunities, therefore it can be treated as discussing advantages. However, there are no satisfactory studies on identifying and evaluating advantages and disadvantages by students during the pandemic of COVID-19. Therefore, it was justified to conduct research on this topic.

3. Methodology

The paper presents the results of the research conducted in Poland in December 2021. The participants included a sample of 621 students from Polish universities. An internet—Google—questionnaire was used for the study. Google Forms offers survey administration, which means that in addition to the possibility of creating a form with questions, it allows researchers to automatically collect data and save them to an MS Excel file. We used in our research a non-random process approach to collect our data, but a convenient sample. It was not possible to use a random sample, because we did not have the list of all students. Questionnaires were sent to and posted on Facebook pages of Polish technical universities. In the research, a quantitative data collection method was used. The next stage included the statistical analysis of the collected data. In our data analysis we used the following quantitative technics: standard deviation analysis, histograms analysis, and Spearman’s rank correlation.

In the below text and tables, correlations statistically significant at the level of statistical significance α = 0.05 are shown in bold and green.

According to the calculator of the minimum research sample, for an unknown population size and the assumed statistical significance α = 0.05, the sample is 386 students [ 102 , 103 , 104 , 105 ]. The number of questionnaires obtained meets the condition of the minimum research sample. A five-point Likert scale was used for all questions in the survey.

The first part of the research referred to the advantages of using e-learning in higher education.

In this case, the following variables were used:

• • A1—Saving time;
• • A2—Lack of travel necessity;
• • A3—Possibility of learning from own home country/city;
• • A4—Lower costs;
• • A5—Individualization of the learning process;
• • A6—Easy access to materials;
• • A7—Good contact with the teacher;
• • A8—Higher availability of academic teachers;
• • A9—Ease of student progress tracking;
• • A10—Less mental and physical stress;
• • A11—Possibility of interaction (discussion on the forum, sending reactions);
• • A12—Convenience;
• • A13—Limiting the spread of the SARS-CoV-2 virus.

The second part of the questionnaire contained variables concerning the disadvantages occurring in the case of using e-learning in the university. The following disadvantages were taken into account in the research:

• • D1—Lack of direct contact with the teacher;
• • D2—Lack of direct contact with colleagues;
• • D3—Necessity to purchase e-learning equipment (computer/laptop/smartphone/headphones/microphone etc.);
• • D4—Low quality of e-learning materials;
• • D5—Difficulties with motivation to learn;
• • D6—Discomfort resulting from the use of information technology;
• • D7—Poor preparation of academic teachers for e-learning;
• • D8—Difficulties with teaching practical subjects;
• • D9—Difficulties in accessing traditional academic resources (e.g., libraries, reading rooms);
• • D10—Lack of possibility of using other academic activities (e.g., science clubs, sports sections);
• • D11—Difficulties with collaborating with colleagues;
• • D12—Cyber-threats;
• • D13—Risk of being recorded/photographed/“screenshot” etc.;
• • D14—Lack of possibility to verify student’s knowledge/skills reliably (e.g., due to the ease of cheating during tests via the Internet);
• • D15—Lack of/decreased privacy;
• • D16—Technical problems on the part of the lecturer;
• • D17—Technical problems on the part of the participants;
• • D18—Too much time spent in front of a computer/telephone or other mobile device
• • D19—Increase in electricity costs;
• • D20—Excessive use of own equipment;
• • D21—Difficult conditions to use e-learning in the place of residence.

During studying the variables influencing the advantages and disadvantages of e-learning at university, the following variables were taken into account in the survey:

• • Students’ evaluation of acquiring content in traditional education [ 1 ];
• • Students’ evaluation of acquiring content in e-learning;
• • The student’s familiarity with information technology;
• • Having the proper resources by students to participate in e-learning activities;
• • Innovative e-learning solutions used by the university.

The STATISCICA-13.3 software was used to analyze the collected data.

In the first stage of the research, the advantages of using innovative e-learning at universities were studied. Table 1 presents the results of the analysis for all variables. They included values of the averages, medians, and standard deviations.

The advantages of innovative e-learning in higher education.

Source: Authors.

As important advantages the students evaluated the following ones (rated over 4.0 out of 5.0, as already stated):

• • Lack of travel necessity—4.82;
• • Possibility of learning from own home country/city—4.62;
• • Saving time—4.54;
• • Lower costs—4.45;
• • Convenience—4.44;
• • Limiting the spread of the SARS-CoV-2 virus—4.37;
• • Easy access to materials—4.14.

For all the variables mentioned above, the median value was 5—which is the highest possible level.

It is worth noting that the highest-rated advantages are mostly those related to the convenience of studying and savings—time and money (related to travel to the university). In Poland generally, a substantial portion of the students come from outside of university cities [ 106 , 107 ]. Also, in recent years, we can observe an increasing number of students outside Poland studying in Polish universities [ 108 , 109 ]. This situation can have an impact on problems connected with costs of traveling to and from university and the cost of living in university cities. The use of innovative e-learning significantly reduces the cost of studying and facilitates studying for people from smaller towns, for whom, in the case of traditional education, the costs of travel and accommodation in a large city can be a great obstacle to studying. Ease of access to materials, despite the fact that it is also important, is a factor of less importance compared to the aspects related to saving time and money.

Another very important factor was limiting the spread of the SARS-CoV-2 virus. It is interesting that, although innovative e-learning was introduced in Polish universities due to the pandemic, limiting the spread of the virus was rated only in the sixth place among the examined advantages. It proves that even though the pandemic initiated the widespread use of e-learning at universities, its use made students pay attention to other advantages of this type of learning. The results may suggest that e-learning could also be used after the end of the pandemic. Perhaps it will not be the basic form of teaching for all students, but its advantages may make it an alternative to traditional classes in some fields of study. Some earlier studies after the time of the pandemic pointed out the advantages of e-learning over traditional learning from the point of view of learners’ satisfaction. For example R. Tawafak [ 110 ], Alghazo [ 111 ], Titthasiri [ 112 ] or Hurlbut [ 113 ] wrote about it.

The rest of the studied advantages were rated below 4.0. In particular, it is worth noting that the lowest-rated advantage was good contact with the teacher (3.06). This suggests that e-learning does not improve contact with teachers and, thus, traditional learning works better.

We have analyzed histograms for the two highest rated advantages, which are lack of travel necessity and the possibility of learning from own home country/city. They are characterized by asymmetry—skewed—towards upper values in the scale. Most of the surveyed students (556) considered the lack of necessary travel to be a very important advantage of e-learning. Among the respondents, only six people decided that this advantage was not significant (1 or 2 points on the five-point Likert scale). In the case of the possibility of learning from their own home country or city, 493 people assessed this issue as very important (5 points), while 22 people considered it as unimportant (1 or 2 points).

Table 2 presents the results of research on the studied disadvantages of using e-learning. The average, median, and standard deviation values are given for each disadvantage. The research shows that the students did not consider any of the studied disadvantages of e-learning to be very significant;the average never exceeded 4.0, and the median never reached a value of 5.0. It should be noted that significant disadvantages are those whose average value exceeds 3.0, and whose median is 4.0. In this category, there are the following disadvantages: lack of direct contact with colleagues (rate 3.71), difficulties with teaching practical subjects (3.60), lack of direct contact with the teacher (3.41); too much time spent in front of a computer/telephone or other mobile device (rating 3.31).

The disadvantages of innovative e-learning in higher education.

The data analysis shows that the most important drawbacks of e-learning are connected with the reduction of social contacts; first of all, it concerns contacts between students, but also contacts between the student and the lecturer. Human beings are naturally social beings, and the lack of interpersonal contacts or limiting them to the Internet is not a natural and healthy matter. Many studies have shown the problematic effects of e-learning on social contacts between students and students and teachers. For example, the problem was analyzed by H. Baber [ 114 ], Di Pietro at al. [ 115 ], and Al Rawashdeh et al. [ 116 ]. A long-term reduction of direct social contact is a very important barrier [ 117 , 118 ]. Overcoming this issue largely determines the effectiveness of using e-learning in teaching at the level of higher education.

It should also be noted that not all fields of study are suitable for e-learning in the same way. The respondents indicated that an especially significant problem is the difficulty in teaching practical subjects. While there are no major difficulties in teaching theoretical subjects with the use of e-learning, efficient remote education is hard to realize in the case of practical skills and subjects. Research results suggest that practical courses/subjects should be taught in a traditional way after the end of the COVID-19 pandemic, while e-learning can be used to teach theoretical subjects. This approach can permit universities and students to use the advantages of e-learning, i.e., reducing the costs and time of traveling, as well as offer the study of efficiently practical skills, while at the same time not exposing students to social isolation.

The obtained results support the E1 expectation, which was formulated as follows: the most important advantages of innovative e-learning refer to the reduction in travel time and study expenses.

Subsequently, the disadvantage of e-learning may also be the difficulties with motivation to learn (the average value of 3.04, and the median value of 3.0), and the presence of technical problems on the part of students (the average value 3.14, at the median value of 3.0).

Research has shown that students do not feel discomfort resulting from the use of new technologies (2.08). In addition, the surveyed students did not consider the threats related to cybersecurity (rating 3.25) and the decrease in the level of privacy (rating 2.14) to be significant.

Table 3 contains an analysis of the relationship between the advantages and disadvantages of e-learning perceived by the surveyed students. Spearman’s rank correlation coefficient was used to analyze the relationship between the variables. The respective values of the coefficients are presented in Table 3 .

Spearman’s rank correlation between variables concerning the advantages and disadvantages of e-learning in universities.

When analyzing Table 3 , negative correlation coefficients between assessments of advantages and disadvantages by the studied students are observed in most cases. Students who are not satisfied with e-learning evaluate the disadvantages higher and the advantages lower. It is worth noting that the average value of advantages is higher than the average value of disadvantages. It shows that the university students who participated in the survey believe that the advantages of e-learning outweigh its disadvantages.

The analysis of cases for which the correlations have the highest values leads to interesting conclusions—they are statistically significant and exceed 0.4. This kind of situation can be observed for the D5 variable—difficulties with motivation to learn. This variable is negatively correlated at the level below −0.4 with the following variables: A7 (good contact with the teacher), A8 (high availability of academic teachers), A10 (less mental and physical stress), and A11 (possibility of interaction). The conducted research shows that to avoid problems with motivation in e-learning, students should be provided with good-quality contacts with academic teachers, including easy access to them via electronic means and the possibility of interaction with both teachers, and other students. This reduces stress and motivation problems.

Variable D11—difficulties with collaborating with colleagues—is also negatively correlated at a level below −0.4 with several studied advantages. They include the following: A7 (good contact with the teacher), A8 (higher availability of academic teachers), A9 (ease of student progress tracking), A10 (less mental and physical stress), and A11 (possibility of interaction). In this case, a similar phenomenon as for the discussed variable D5 can be observed: good contacts and the possibility of interaction with the teacher and students “protect” against problems related to the difficulties of cooperation with colleagues from the group.

Similar results were obtained for the D1 variable—lack of direct contact with the teacher; D2—lack of direct contact with colleagues; D8—difficulties with teaching practical subjects; and D14—lack of possibility to verify student’s knowledge/skills reliably (e.g., due to the ease of cheating during tests via the Internet).

Based on the conducted research, it can be claimed that good contact with academic teachers has a significant impact on reducing the occurrence of e-learning disadvantages. The teachers must be properly prepared to give e-learning classes. In particular, such classes must be easily accessible and enable students to quickly and separately contact their teacher and classmates. Good contact with teachers, as well as their high communication skills with the use of remote tools, can significantly reduce the occurrence of many disadvantages of e-learning. The obtained results support the expectation E2, which was formulated as follows: good contact with teachers and their ability to communicate on the use of remote tools are important variables positively influencing e-learning.

In the next stage of the research, an analysis of the Spearman correlation between the advantages and disadvantages of e-learning and the assessment of the ease of acquiring content during traditional classes and e-learning classes by students were performed. Accordingly, Table 4 presents Sperman’s correlations between the advantages of using e-learning and the ease of acquiring content by students in traditional learning and e-learning, and Table 5 shows the results of correlations between the disadvantages of using e-learning and the ease of acquiring content by students in traditional learning and e-learning.

Sperman’s rank correlations between the advantages of using innovative e-learning and the ease of acquiring content by students in traditional learning and e-learning.

Sperman’s rank correlations between the disadvantages of using innovative e-learning and the ease of acquiring content by students in traditional learning and e-learning.

All calculated correlation coefficients are statistically significant at the level of statistical significance α = 0.05. Research shows that all the advantages of e-learning are positively correlated with the student’s assessment of the ease of acquiring content in e-learning by students, and negatively correlated with the student’s assessment of the ease of acquiring content in traditional education. The obtained research results support the expectation E3 formulated as follows: the easier the student assimilates e-learning content, the higher the student evaluates the advantages of e-learning.

The opposite situation occurs for the disadvantages of e-learning. They are positively correlated with the ease of acquiring the content in traditional learning, and negatively correlated with the ease of acquiring the content in e-learning. On the basis of the results, we can say that the worse the student assimilates e-learning content, the higher the student evaluates the disadvantages of e-learning.

When analyzing the data on the advantages of e-learning, it can be observed that the highest level of correlation (above 0.5) between the studied advantages and the student’s perception of the ease of acquiring e-learning content occurs for the following variables: good contact with the teacher (correlation coefficient at a level of 0.56); possibility of interaction (0.52); higher availability of academic teachers (0.52), and less mental and physical stress (0.51). Again, the importance of the preparation of academic teachers for interpersonal communication with the use of remote tools is observed. The results support the expectation E2—good contact with teachers and their ability to communicate on the use of remote tools are important variables positively influencing e-learning.

In the case of the relationship between the disadvantages of using e-learning in universities and the ease of acquiring traditional and e-content, it can be observed that the highest negative correlation coefficient (−0.64) occurs between the ease of acquiring e-learning content and difficulties in motivation to learn. There are many international research efforts about the advantages and disadvantages of using e-learning in high education. For example, the topic is described V. Arkorful and N. Abaidoo [ 2 ], M. Curelary et al. [ 119 ] and A. Alsoud and A. Harasis [ 120 ]. People who perceive e-learning content as difficult to absorb have low motivation to learn remotely. The problem of importance of motivation in effectiveness of e-learning was analyzed by N. Elayan [ 121 ], M. El-Seoud et al. [ 122 ] and M. Ja’ashan [ 123 ]. The perceived difficulties of the content discourage them from this type of learning and make them not motivated enough. The problems connected with the impact of difficulty of content on e-learning was also analyzed by G. Bora [ 124 ] and L. Li and H. Zhang [ 125 ]. A similar relationship occurs in the case of cooperation with colleagues within groups. The problems connected with the impact of e-learning on collaboration between students was analyzed by Hurajowa et al. [ 126 ].

The last stage of the research considers the relationship between the advantages and disadvantages of e-learning, and variables such as the student’s knowledge of information technology, the student’s possession of resources necessary for e-learning, and the level of innovation of e-learning solutions used by university at which the given student studies.

The Spearman’s rank correlation coefficient was used for the analysis. Table 6 shows the results for the advantages, and Table 7 the disadvantages.

Sperman’s rank correlations between the advantages of using e-learning and the student’s knowledge of information technology, the student’s possession of resources necessary for e-learning, and the innovation of e-learning solutions used by university at which the given student studies.

Sperman’s rank correlations between the disadvantages of using e-learning and student’s knowledge of information technology, student’s possession of resources necessary for e-learning, and innovation of e-learning solutions used by university in which the given student studies.

In the case of the advantages of e-learning, the following relationships were observed in the study:

• • All studied advantages are positively correlated with students’ knowledge of information technology;
• • All studied advantages are positively correlated with the student’s possession of resources necessary for e-learning,
• • All studied advantages are positively correlated with innovation of e-learning solutions used by university in which the given student studies.

The results confirm expectations E4, E5, and E6. The mentioned expectations were formulated as follows: E4—the better the student knows information technology, the higher the student evaluates the advantages of e-learning, E5—the better resources to participate in e-learning activities the student has, the higher the student evaluates the advantages of e-learning, 6—the more often innovative e-learning solutions are used in a given university, the better the student assesses the advantages of e-learning.

In the case of e-learning disadvantages, all correlation coefficients in Table 7 are statistically significant. The results for which statistical significance does not occur are marked with an asterisk.

The following relationships were observed in the research:

• • The studied disadvantages (except for two) are negatively correlated with the student’s knowledge of information technology;
• • All studied disadvantages are negatively correlated with the student’s possession of resources necessary for e-learning;
• • The studied disadvantages (except for one) are negatively correlated with the innovation of e-learning solutions used by university in which the given student studies.

The results of the research permit the conclusion that Polish university students’ knowledge of information technology and possession of resources necessary for e-learning are variables that positively affect the implementation of the e-learning process at a university. Students in Polish universities with the mentioned knowledge and resources assess the advantages of e-learning at a higher level and its disadvantages at a lower level. The efficiency of e-learning in Polish Universities is, to a large extent, conditioned by possession of the proper equipment which is sufficient for the comfortable e-learning and the level of knowledge and skills that allows for trouble-free operation during e-learning.

Another factor that positively influences the evaluation of e-learning by students in Polish universities is the use of innovative e-learning solutions at a given university. When such solutions are used at a given Polish university, students perceive all advantages of e-learning higher and evaluate most of its disadvantages lower.

5. Discussion and Conclusions

Many papers refer to advantages and disadvantages of innovative e-learning, but usually they are theoretical, descriptive, debatable, or review-based [ 2 , 4 , 5 , 9 ]—this refers also to the papers from the last two years, for example: [ 53 , 54 , 55 ]. In our research, the advantages and disadvantages were evaluated with a questionnaire. The students, as evaluators, were able to show their points of view on the advantages and disadvantages of e-learning. This research has been useful and justified to conduct since it provides measurable and quantitative data. A comparison of our research with the practical research of other authors is presented below.

In our research, the importance of advantages of innovative e-learning was rated higher than the importance of disadvantages. In the literature, there are also some research projects, in which the advantages are placed on the first place. Kaliyaperumal and Raman [ 49 ] investigated the satisfaction and sense of comfort with e-learning of nursing students in a Coimbatore college. The sample was 382 students. The students were highly satisfied with various aspects of the lecture, such as the teacher’s motivation, the question session at the end of the lecture, and the virtual film about the procedure, according to the results. Students were at ease attending e-learning classes since they are used to using a computer device, according to the findings. At this point, another research limitation can be identified. Our study referred to e-learning in general and was not focused on the given subject of study. Concentrating on the specific subjects, like mathematics, management etc. may bring different results. Other authors—Naveed et al. [ 50 ]—emphasize the advantages of e-learning, such as flexibility, no need to travel to school, and low costs. In another research study [ 51 ], the following positive aspects of online education were identified among teachers: the ease of teaching online, the flexibility of the work schedule, the adaptability to broad learning styles, the variety of tools available at hand, and the ease in monitoring and documenting teaching activities. The students and parents surveyed identified flexibility in work time, the comfort of working from home, as well as the variety of sources of documentation as the main advantages of the e-learning system. Gherheș et al. [ 52 ] also identified the advantages and disadvantages of e-learning. The main three advantages of e-learning, as pointed out by the respondents, were time efficiency, convenience, and accessibility. On the other hand, the respondents believed that lack of interaction was the main drawback of e-learning, supported by those who stated that they missed interacting with their peers. The rest of the important disadvantages were the technical problems encountered during the Internet connection, and lack of practical applications, which could mean a huge problem for students undertaking technical studies.

Our research has shown that in the case of Polish universities, the most important drawback of e-learning in the universities is the reduction of social contacts. This concerns contacts between students in the first place, but also includes contacts between the student and the lecturer. Rutkowska et al. [ 58 ] share the same opinion in their research. Isolation from peers and distance learning have significantly limited interpersonal contacts, which might have affected the mental well-being of students. The aim of their study was to investigate the prevalence of depressive symptoms and the level of perceived stress during e-learning among Slovak students and to identify the variables that have the most significant impact on mental health among students. The study included 3051 participants with a mean age of 22.37 years. Almost all study participants were characterized by an increased stress level and 47% of them were depressed. Furthermore, isolation affected women more, especially in terms of social life and economics. Other research has shown similar results [ 51 ]. According to them, students’ main dissatisfaction is the lack of student/teacher interactions, the lack of socialization with colleagues, and the lower level of quality of teaching.

Ibraheem et al. [ 59 ] in their paper described the results of a study using a method similar to the one that we used in our research. The research sample consisted of 199 male and female students from the College of Education for Human Sciences and College of Education for Pure Sciences, University of Basra, for the academic year 2020–2021. The results showed the following: the research sample does not suffer from social isolation; there are no statistically significant differences in social isolation according to the gender variable; there are statistically significant differences in social isolation according to the ‘class’ variable; there are no statistically significant differences in social isolation according to the field or specialization variable. To the contrary, Parte and Herrador-Alcaide [ 60 ] conducted isolation research during the COVID-19 pandemic among teachers. It was concluded that the isolation perception of tutors was not high, while the sense of belonging among the teaching community was high.

Article [ 57 ] summarizes the interviews of 15 respondents from Lithuanian higher education institutions and how their informants met changes, opportunities, and identified quality variables addressed to the successful e-learning during a pandemic period. Based on the results of this study, the advantages and disadvantages of e-learning can be identified. The research differs from ours because we utilized questionnaires and they employed interviews as a research method. Using only a questionnaire with closed questions can be assumed to be a research limitation. Extending the survey with, for example, interviews would further increase the quality of the research. The interviews allowed authors the collection of more detailed information and more subjective opinions from specific academics. However, the research was limited as it was carried out on only 15 people, while our research allowed more than 600 respondents to be examined. According to their results, e-learning has been a great opportunity and can bring many advantages. They emphasized flexible schedules and communication, time and cost savings, greater opportunity for post-graduate study, and better attendance at classes. It is worth noting that the authors found that theoretical lectures can be conducted at a distance, but that the laboratories and exercises should be offline. The interviewers claimed that in active classes there are things that cannot be changed due to the use of e-technology. In our research, the respondents did not consider the disadvantage of “difficulties with teaching practical subjects” to be very significant (average value 3.6, median value 4 out of 5). The reason for this difference in both studies is the respondents: in our research they were students, and in the authors’ research they were teachers. It means that teachers see more obstacles in learning practical subjects, whereas students find it easy to prepare and take on. It is because the perspectives of teaching and learning are different. Moreover, the authors also noticed that it is not possible to provide absolutely everything remotely because social skills will be lost. E-learning limits body language as well. For teachers, it is difficult to assess what they actually see on the other side of the screen. To the contrary, Bylieva et al. [ 46 ] concluded that an important parameter that influences the behavior of students and their educational progress in general is precisely the focus on practice. Thus, the predominance of the online component in blended learning is appropriate for practical courses. Within the theoretical and general education courses, the predominance of face-to-face learning can positively affect the educational process and results of learning. In this research, the authors have applied Moodle data mining from learning portfolios of 1500 students (N = 1500). Comparative analysis of the courses under review showed significant differences in the behavior of the same students. For the theoretical course, students spent less time than for the practice-oriented one. The progress of the students in the form of points and the demand for non-binding elements of the course differed significantly in favor of the practical course.

The issue of cheating in e-learning is interesting from the research point of view. The disadvantage of “lack of possibility to verify student’s knowledge/skills reliably (e.g., due to the ease of cheating during tests via the Internet)” was rated low (average value 2.72, median value 3) by the students. After conducting a literature review, it appeared that there are many papers on e-learning’s quality which refer to the e-cheating problem. The authors of other papers usually find e-cheating very easy and common. The authors of [ 2 ] claim that since tests for assessments in e-learning are possibly done with the use of a proxy, it is be difficult, if not impossible, to control or regulate bad activities like cheating. According to Jones et al. [ 61 ] cheating in e-learning is a major disadvantage and has a high risk of occurrence. The existence of a wealth of information on a wide range of topics helps, and at the same time, tempts. Connors [ 62 ] notices that academics who once praised the Internet for giving students more access to information are now worried it is providing students with easy access to pre-written essays. Using the Internet to cheat during online tests also poses the threat of collecting incorrect and unreliable information written by random people [ 63 ]. Nowadays, e-cheating is a subject of research; for example, Shoaib and Zahran [ 64 ] have concluded that academic misconduct was directly influenced by a rapid transition to e-learning, social culture, and subjective norms, all of which contributed to shifts in ethical perceptions, leading to increased reports of cheating. The study was carried out with ten graduates of the Saudi Arabian English as a Foreign Language program in a higher education institution through in-depth interviews through qualitative interpretative phenomenological analysis. Another research [ 65 ], in which 214 participants from different institutes and fields of study from Peter the Great St. Petersburg Polytechnic University took part, revealed that students do not notice any serious forms of deception and they evaluate the motives for cheating quite neutrally, but at the same time demonstrate their propensity and interest in the possibility of cheating. On the other hand, solutions are also sought to the apparent problems of online cheating. Some studies find ways to prevent cheating [ 66 , 67 ], and some work on smart cheating detection [ 68 , 69 ].

Because of the COVID-19 pandemic, universities around the world were forced to switch to e-learning. Innovative e-learning was a great opportunity to continue learning despite the limitations and restrictions related to the occurrence of the SARS-CoV-2 virus. In this paper, a study of the identification and evaluation of advantages and disadvantages of e-learning has been presented. The students considered as the most important the following advantages (average value rated over 4.0): lack of travel necessity (4.82), possibility of learning from own home country/city (4.62), saving time—4.54, lower costs (4.45), convenience (4.44), limiting the spread of the SARS-CoV-2 virus (4.37), easy access to materials (4.14). For all the variables mentioned above, the median value was 5—which is the highest possible level. As the most significant disadvantages, in turn, the students rated lack of direct contact with colleagues (3.71), difficulties with teaching practical subjects (3.60), lack of direct contact with the teacher (3.41), too much time spent in front of a computer/telephone or other mobile device (3.31). For the mentioned variables, the average value exceeded 3.0, and the median was 4.0. It is worth noting that the advantages of e-learning were evaluated as being more important than its disadvantages. It means that, according to the surveyed students, the positive sides of e-learning are much more important than its negatives. The results allow one to draw a conclusion of an overall positive assessment of e-learning used during the COVID-19 pandemic in Poland. The results confirmed that e-learning could also be used after the end of the pandemic. Its advantages may make it an alternative to traditional classes in some fields of study. It is worth noting that although it is not necessary for health safety reasons, some e-learning tools, for example the remote education platform, are used at our university all the time. Also, we should know that e-learning is especially effective when we use a mixed, open innovation approach using both internal and external knowledge.

Other important conclusions from the research include the following:

• • Innovative e-learning significantly reduces the cost of studying and facilitates studying for people from smaller towns, for whom the costs of travel and accommodation in a large city can be a great obstacle to studying in the case of traditional education;
• • Students satisfied with innovative e-learning assess the advantages highly and the disadvantages lower; on the contrary, students who are not satisfied with e-learning evaluate the disadvantages higher and the advantages lower;
• • Limiting the spread of the virus was rated only in the sixth place among the examined advantages. It proves that even though the pandemic initiated the widespread use of e-learning at universities, its use made students pay attention to other advantages of this type of learning;
• • Good contact with academic teachers has a significant impact on reducing the occurrence of e-learning disadvantages; the teachers must be properly prepared to give e-learning classes; classes must be easily accessible and enable students to quickly and separately contact the teacher and classmates;
• • Good contact with teachers as well as their high communication skills with the use of remote tools can significantly reduce the occurrence of many disadvantages of e-learning;
• • All the advantages of e-learning are positively correlated with the student’s assessment of the ease of acquiring content in e-learning by students, and negatively correlated with the student’s assessment of the ease of acquiring content in traditional education; the easier the student assimilates e-learning content, the higher the student evaluates the advantages of e-learning;
• • The disadvantages are positively correlated with the ease of acquiring the content in traditional learning, and negatively correlated with the ease of acquiring the content in e-learning; the worse the student assimilates e-learning content, the higher the student evaluates the disadvantages of e-learning;
• • Students who perceive e-learning content as difficult to absorb have low motivation to learn remotely; the perceived difficulties of the content discourage them from this type of learning and make them not motivated enough;
• • The better the student knows information technology, the higher the student evaluates the advantages of e-learning;
• • The better resources to participate in e-learning activities the student has, the higher the student evaluates the advantages of e-learning;
• • The more often innovative e-learning solutions are used in a given university, the better the student assesses the advantages of e-learning.

Author Contributions

Conceptualization, K.S. and R.W.; literature review, K.S. and R.W.; methodology, K.S. and R.W.; validation, K.S. and R.W.; formal analysis, R.W.; investigation, K.S. and R.W.; writing—original draft preparation, K.S.; writing—review and editing, K.S.; funding acquisition, K.S. and R.W. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Institutional Review Board Statement

According to our University Ethical Statement, following, the following shall be regarded as research requiring a favorable opinion from the Ethic Commission in the case of human research (based on document in polish: https://prawo.polsl.pl/Lists/Monitor/Attachments/7291/M.2021.501.Z.107.pdf ): research in which persons with limited capacity to give informed or research on persons whose capacity to give informed or free consent to participate in research and who have a limited ability to refuse research before or during their implementation, in particular: children and adolescents under 12 years of age, persons with intellectual disabilities persons whose consent to participate in the research may not be fully voluntary prisoners, soldiers, police officers, employees of companies (when the survey is conducted at their workplace), persons who agree to participate in the research on the basis of false information about the purpose and course of the research (masking instruction, i.e., deception) or do not know at all that they are subjects (in so-called natural experiments); research in which persons particularly susceptible to psychological trauma and mental health disorders are to participate mental health, in particular: mentally ill persons, victims of disasters, war trauma, etc., patients receiving treatment for psychotic disorders, family members of terminally or chronically ill patients; research involving active interference with human behavior aimed at changing it research involving active intervention in human behavior aimed at changing that behavior without direct intervention in the functioning of the brain, e.g., cognitive training, psychotherapy psychocorrection, etc. (this also applies if the intended intervention is intended to benefit (this also applies when the intended intervention is to benefit the subject (e.g., to improve his/her memory); research concerning controversial issues (e.g., abortion, in vitro fertilization, death penalty) or requiring particular delicacy and caution (e.g., concerning religious beliefs or attitudes towards minority groups) minority groups); research that is prolonged, tiring, physically or mentally exhausting. Our research is not done on people meeting the mentioned condition. Any of the researched people: any of them had limited capacity to be informed, any of them had been susceptible to psychological trauma and mental health disorders, the research did not concern the mentioned-above controversial issues, the research was not prolonged, tiring, physically or mentally exhausting.

Informed Consent Statement

Not applicable.

Data Availability Statement

Conflicts of interest.

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