essay about life after covid 19

Life after COVID: most people don’t want a return to normal – they want a fairer, more sustainable future

Chair of Cognitive Psychology, University of Bristol

Professor of Cognitive Psychology and Australian Research Council Future Fellow, The University of Western Australia

Disclosure statement

Stephan Lewandowsky receives funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 964728 (JITSUVAX). He also receives funding from the Australian Research Council via a Discovery Grant to Ullrich Ecker, from Jigsaw (a technology incubator created by Google), from UK Research and Innovation (through the Centre of Excellence, REPHRAIN), and from the Volkswagen Foundation in Germany. He also holds a European Research Council Advanced Grant (no. 101020961, PRODEMINFO) and receives funding from the John Templeton Foundation (via Wake Forest University’s Honesty Project).

Ullrich Ecker receives funding from the Australian Research Council.

University of Western Australia provides funding as a founding partner of The Conversation AU.

University of Bristol provides funding as a founding partner of The Conversation UK.

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We are in a crisis now – and omicron has made it harder to imagine the pandemic ending. But it will not last forever. When the COVID outbreak is over, what do we want the world to look like?

In the early stages of the pandemic – from March to July 2020 – a rapid return to normal was on everyone’s lips, reflecting the hope that the virus might be quickly brought under control. Since then, alternative slogans such as “ build back better ” have also become prominent, promising a brighter, more equitable, more sustainable future based on significant or even radical change.

Returning to how things were, or moving on to something new – these are very different desires. But which is it that people want? In our recent research , we aimed to find out.

Along with Keri Facer of the University of Bristol, we conducted two studies, one in the summer of 2020 and another a year later. In these, we presented participants – a representative sample of 400 people from the UK and 600 from the US – with four possible futures, sketched in the table below. We designed these based on possible outcomes of the pandemic published in early 2020 in The Atlantic and The Conversation .

We were concerned with two aspects of the future: whether it would involve a “return to normal” or a progressive move to “build back better”, and whether it would concentrate power in the hands of government or return power to individuals.

Four possible futures

In both studies and in both countries, we found that people strongly preferred a progressive future over a return to normal. They also tended to prefer individual autonomy over strong government. On balance, across both experiments and both countries, the “grassroots leadership” proposal appeared to be most popular.

People’s political leanings affected preferences – those on the political right preferred a return to normal more than those on the left – yet intriguingly, strong opposition to a progressive future was quite limited, even among people on the right. This is encouraging because it suggests that opposition to “building back better” may be limited.

Our findings are consistent with other recent research , which suggests that even conservative voters want the environment to be at the heart of post-COVID economic reconstruction in the UK.

The misperceptions of the majority

This is what people wanted to happen – but how did they think things actually would end up? In both countries, participants felt that a return to normal was more likely than moving towards a progressive future. They also felt it was more likely that government would retain its power than return it to the people.

In other words, people thought they were unlikely to get the future they wanted. People want a progressive future but fear that they’ll get a return to normal with power vested in the government.

We also asked people to tell us what they thought others wanted. It turned out our participants thought that others wanted a return to normal much more than they actually did. This was observed in both the US and UK in both 2020 and 2021, though to varying extents.

This striking divergence between what people actually want, what they expect to get and what they think others want is what’s known as “ pluralistic ignorance ”.

This describes any situation where people who are in the majority think they are in the minority. Pluralistic ignorance can have problematic consequences because in the long run people often shift their attitudes towards what they perceive to be the prevailing norm. If people misperceive the norm, they may change their attitudes towards a minority opinion, rather than the minority adapting to the majority. This can be a problem if that minority opinion is a negative one – such as being opposed to vaccination , for example.

In our case, a consequence of pluralistic ignorance may be that a return to normal will become more acceptable in future, not because most people ever desired this outcome, but because they felt it was inevitable and that most others wanted it.

Ultimately, this would mean that the actual preferences of the majority never find the political expression that, in a democracy, they deserve.

To counter pluralistic ignorance, we should therefore try to ensure that people know the public’s opinion. This is not merely a necessary countermeasure to pluralistic ignorance and its adverse consequences – people’s motivation also generally increases when they feel their preferences and goals are shared by others. Therefore, simply informing people that there’s a social consensus for a progressive future could be what unleashes the motivation needed to achieve it.

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How Life Could Get Better (or Worse) After COVID

How do pandemics change our societies? It is tempting to believe that there will not be a single sector of society untouched by the COVID-19 pandemic . However, a quick look at previous pandemics in the 20th century reveals that such negative forecasts may be vastly exaggerated.

Prior pandemics have corresponded to changes in architecture and urban planning, and a greater awareness of public health . Yet the psychological and societal effects of the Spanish flu, the worst pandemic of the 20th century, were later perceived as less dramatic than anticipated, perhaps because it originated in the shadow of WWI. Austrian psychoanalyst Sigmund Freud described Spanish flu as a “ Nebenschauplatz ”—a sideshow in his life of that time, even though he eventually lost one of his daughters to the disease. Neither do we recall much more recent pandemics: the Asian flu of 1957 and the Hong Kong flu from 1968.

Imagining and planning for the future can be a powerful coping mechanism to gain some sense of control in an increasingly unpredictable pandemic life. Over the past year, some experts proclaimed that the world after COVID would be a completely different place , with changed values and a new map of international relations. The opinions of oracles who were not downplaying the virus were mostly negative . Societal unrest and the rise of totalitarian regimes, stunted child social development, mental health crises, exacerbated inequality, and the worst economic recession since the Great Depression were just a few worries discussed by pundits and on the news.

Other predictions were brighter—the disruptive force of the pandemic would provide an opportunity to reshape the world for the better, some said. To complement the voices of journalists, pundits, and policymakers, one of us (Igor Grossmann) embarked on a quest to gather opinions from the world’s leading scholars on behavioral and social science, founding the World after COVID project.

The World after COVID project is a multimedia collection of expert visions for the post-pandemic world, including scientists’ hopes, worries, and recommendations. In a series of 57 interviews, we invited scientists, along with futurists, to reflect on the positive and negative societal or psychological change that might occur after the pandemic, and the type of wisdom we need right now. Our team used a range of methodological techniques to quantify general sentiment, along with common and unique themes in scientists’ responses.

The results of this interview series were surprising, both in terms of the variability and ambivalence in expert predictions. Though the pandemic has and will continue to create adverse effects for many aspects of our society, the experts observed, there are also opportunities for positive change, if we are deliberate about learning from this experience.

Three opportunities after COVID-19

Scientists’ opinions about positive consequences were highly diverse. As the graph shows, we identified 20 distinct themes in their predictions. These predictions ranged from better care for elders, to improved critical thinking about misinformation, to greater appreciation of nature. But the three most common categories concerned social and societal issues.

1. Solidarity. Experts predicted that the shared struggles and experiences that we face due to the pandemic could foster solidarity and bring us closer together, both within our communities and globally. As clinical psychologist Katie A. McLaughlin from Harvard University pointed out, the pandemic could be “an opportunity for us to become more committed to supporting and helping one another.”

Similarly, sociologist Monika Ardelt from the University of Florida noted the possibility that “we realize these kinds of global events can only be solved if we work together as a world community.” Social identities—such as group memberships, nationality, or those that form in response to significant events such as pandemics or natural disasters—play an important role in fostering collective action. The shared experience of the pandemic could help foster a more global, inclusive identity that could promote international solidarity.

2. Structural and political changes. Early in the pandemic, experts also believed that we might also see proactive efforts and societal will to bring about structural and political changes toward a more just and diversity-inclusive society. Experts observed that the pandemic had exposed inequalities and injustices in our societies and hoped that their visibility might encourage societies to address them.

Philosopher Valerie Tiberius from the University of Minnesota suggested that the pandemic might bring about an “increased awareness of our vulnerability and mutual dependence.”

Fellow of the Royal Institute for International Affairs in the U.K. Anand Menon proposed that the pandemic might lead to growing awareness of economic inequality, which could lead to “greater sustained public and political attention paid to that issue.” Cultural psychologist Ayse Uskul from Kent University in the U.K. shared this sentiment and predicted that this awareness “will motivate us to pick up a stronger fight against the unfair distribution of resources and rights not just where we live, but much more globally.”

3. Renewed social connections. Finally, the most common positive consequence discussed was that we might see an increased awareness of the importance of our social connections. The pandemic has limited our ability to connect face to face with friends and families, and it has highlighted just how vulnerable some of our family members and neighbors might be. Greater Good Science Center founding director and UC Berkeley professor Dacher Keltner suggested that the pandemic might teach us “how absolutely sacred our best relationships are” and that the value of these relationships would be much higher in the post-pandemic world. Past president of the Society of Evolution and Human Behavior Douglas Kenrick echoed this sentiment by predicting that “tighter family relationships would be the most positive outcome of this [pandemic].”

Similarly, Jennifer Lerner—professor of decision-making from Harvard University—discussed how the pandemic had led people to “learn who their neighbors are, even though they didn’t know their neighbors before, because we’ve discovered that we need them.” These kinds of social relationships have been tied to a range of benefits, such as increased well-being and health , and could provide lasting benefits to individuals.

Post-pandemic risks

How about predictions for negative consequences of the pandemic? Again, opinions were variable, with more than half of the themes were mentioned by less than 10% of our interviewees. Only two predictions were mentioned by at least ten experts: the potential for political unrest and increased prejudice or racism. These predictions highlight a tension in expert predictions: Whereas some scholars viewed the future bright and “diversity-inclusive,” others fear the rise in racism and prejudice. Before we discuss this tension, let us examine what exactly scholars meant by these two worries.

1. Increased prejudice or racism. Many experts discussed how the conditions brought about by the pandemic could lead us to focus on our in-group and become more dismissive of those outside our circles. Incheol Choi, professor of cultural and positive psychology from Seoul National University, discussed that his main area of concern was that “stereotypes, prejudices against other group members might arise.” Lisa Feldman Barrett, fellow of the American Academy of Arts & Sciences and the Royal Society of Canada, echoed this sentiment, noting that previous epidemics saw “people become more entrenched in their in-group and out-group beliefs.”

2. Political unrest. Similarly, many experts discussed how a greater focus on our in-groups might also exacerbate existing political divisions. Past president of the Society for Philosophy and Psychology Paul Bloom discussed how a greater dismissiveness toward out-groups was visible both within countries and internationally, where “countries are blaming other countries and not working together enough.” Dilip Jeste, past president of the American Psychiatric Association, discussed his concerns that the tendency to view both candidates and supporters as winners and losers in elections could mean that the “political polarization that we are observing today in the U.S. and the world will only increase.”

These predictions were not surprising— pundits and other public figures have been discussing these topics, too. However, as we analyzed and compared predictions for positive and negative consequences, we found something unexpected.

The yin and yang of COVID’s effects

Almost half of the interviewees spontaneously mentioned that the same change could be a force for good and for bad . In other words, they were dialectical , recognizing the multidetermined nature of predictions and acknowledging that context matters—context that determines who may be the winners and losers in the years to come. For example, experts predicted that we may see greater acceptance of digital technologies at home and at work. But besides the benefits of this—flexible work schedules, reduced commutes—they also mentioned likely costs, such as missing social information in virtual communication and disadvantages for people who cannot afford high-speed internet or digital devices.

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Amid this complexity, experts weighed in on what type of wisdom we need to help bring about more positive changes ahead. Not only do we need the will to sustain political and structural change, many argued, but also a certain set of psychological strategies promoting sound judgment: perspective taking, critical thinking, recognizing the limits of our knowledge, and sympathy and compassion.

In other words, experts’ recommended wisdom focuses on meta-cognition, which underlies successful emotion regulation, mindfulness, and wiser judgment about complex social issues. The good news is that these psychological strategies are malleable and trainable ; one way we can cultivate wisdom and perspective, for example, is by adopting a third-person, observer perspective on our challenges.

On the surface, the “it depends” attitude of many experts about the world after COVID may be dissatisfying. However, as research on forecasting shows, such a dialectical attitude is exactly what distinguishes more accurate forecasters from the rest of the population. Forecasting is hard and predictions are often uncertain and likely wrong. In fact, despite some hopes for the future, it is equally possible that the change after the pandemic will not even be noticeable. Not because changes will not happen, but because people quickly adjust to their immediate circumstances.

The future will tell whether and how the current pandemic has altered our societies. In the meantime, the World after COVID project provides a time-stamped window into experts’ apartments and their minds. As we embrace another pandemic spring, these insights can serve as a reminder that the pandemic may lead not only to worries but also to hopes for the years ahead.

About the Authors

Igor Grossmann

Igor Grossmann, Ph.D. , studies people and cultures, sometimes together, and often across time. He is an associate professor of psychology at the University of Waterloo, where he directs the Wisdom and Culture Lab.

Oliver Twardus

Oliver Twardus is the lab manager for the Wisdom and Culture lab and an aspiring researcher. He will be starting his master’s in neuroscience and applied cognitive science in September 2021.

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Life after COVID-19: Making space for growth

In this time of grief, the theory of post-traumatic growth suggests people can emerge from trauma even stronger

Vol. 51, No. 4

In the traditional Japanese art of kintsugi, artisans fill the cracks in broken pottery with gold or silver, transforming damaged pieces into something more beautiful than they were when new. Post-traumatic growth is like kintsugi for the mind.

Developed in the 1990s by psychologists Richard Tedeschi, PhD, and Lawrence Calhoun, PhD, the theory of post-traumatic growth suggests that people can emerge from trauma or adversity having achieved positive personal growth. It’s a comforting idea in the best of times. But it holds particular appeal as we live through a pandemic that’s upending lives for people around the globe.

Growing from trauma isn’t unusual, says Tedeschi, now a professor emeritus at the University of North Carolina Charlotte and chair of the Boulder Crest Institute for Posttraumatic Growth in Bluemont, Virginia. “Studies support the notion that post-traumatic growth is common and universal across cultures,” he says. “We’re talking about a transformation—a challenge to people’s core beliefs that causes them to become different than they were before.”

And the COVID-19 pandemic may have the ingredients to foster such growth. “We’re still in the middle of this situation, and we don’t know yet what might happen—but there will be serious challenges to people’s lives,” Tedeschi says. While those effects may be devastating, it’s possible to emerge from such adversity for the better, he adds. “For some people, this event may be a shock to their core belief system. When that’s the case, it has the potential to result in s­ignificant positive changes.”

Resilience vs. post-traumatic growth

Research across a variety of disasters has shown that there are different trajectories for recovery, says Erika Felix, PhD, a psychologist at the University of California, Santa Barbara, who treats and studies trauma survivors. Some people need time to recover from a trauma before returning to normal functioning. A portion of people experience negative mental health impacts that become chronic, but the majority of people bounce back from a trauma pretty quickly, she says. “Most people will be resilient and return to their previous level of functioning.”

Resilience and post-­traumatic growth are not the same thing, however. In fact, people who bounce back quickly from a setback aren’t the ones likely to experience positive growth, Tedeschi explains. Rather, people who experience post-traumatic growth are those who endure some cognitive and emotional struggle and then emerge changed on the other side.

This experience is measured by Tedeschi and Calhoun’s Post­traumatic Growth Inventory (PTGI) ( Journal of Traumatic Stress , Vol. 9, No. 3, 1996), which evaluates growth in five areas: appreciation of life, relating to others, personal strength, recognizing new possibilities and spiritual change. It’s not necessary or even typical to show change in all five areas, Tedeschi says. But growth in even one or two of those realms “can have a profound effect on a person’s life,” he says.

Some psychologists say the evidence for post-traumatic growth isn’t yet as robust as it could be. For example, Patricia Frazier, PhD, at the University of Minnesota, and colleagues followed undergraduates before and after a trauma. They found that participants’ self-reported perceived growth didn’t align with actual growth as measured by the PTGI. And while actual growth was related to positive coping, perceived growth was not, suggesting the construct may not fully reflect the way people are transformed by trauma ( Psychological Science , Vol. 20, No. 7, 2009).

But other evidence suggests that people do grow from trauma. A 2018 book by Tedeschi and colleagues summarizes more than 700 studies related to post-traumatic growth, including Tedeschi’s own research and work from other scientists (“ Posttraumatic Growth: Theory, Research, and Applications ,” Routledge, 2018). “When you look at how people respond to traumatic events, post-traumatic growth seems to be fairly common,” he says.

Planting the seeds for positive change

Post-traumatic growth isn’t something psychologists can prescribe or create, Tedeschi says. But they can facilitate it. “We see it as a natural tendency that we can watch for and encourage, without trying to make people feel pressured or that they’re failures if they don’t achieve this growth,” Tedeschi explains.

Most evidence-based trauma treatments provide a “manualized approach” to alleviating stress and symptoms such as anxiety, Tedeschi says. The post-traumatic growth framework he uses is an integrated approach that includes elements of cognitive-behavioral therapy, along with other aspects that emphasize personal growth. “It has elements of narrative and existential aspects, too, because traumas often present people with existential questions about what’s important in life.”

One way to help clients see the possibilities for growth is to be an “expert companion” during their struggle, he says. “That’s someone who accompanies their trauma, listens carefully to their story and learns from them about what has happened in their lives. By being that kind of expert, people start to open up and look at the possibilities in their lives more thoroughly.”

Yet post-traumatic growth isn’t something that can be rushed, and it often takes a long time to come to fruition. “As a clinician, you can plant the seeds that may germinate later,” Tedeschi says.

As we emerge from the COVID-19 crisis, clinicians and their clients may have opportunities to help those seeds begin to sprout. “This situation presents a challenge to people’s lives, and some people will be able to emerge from this for the better,” Tedeschi says.

One doesn’t necessarily need to experience trauma and existential struggle to learn from this crisis, however. For many people, the pandemic is shining a light on the things that are most important. “We might be making more time for things we find meaningful, simplifying our lives and making time for being connected in our relationships,” Felix says. “A stressor like this makes all of us think: What does this slowdown mean for our lives? We might be fundamentally changed in some ways that are beneficial.”

The Posttraumatic Growth Workbook Tedeschi, R.G., & Moore, B.A. New Harbinger Publications, 2016

The Posttraumatic Growth Inventory: A Revision Integrating Existential and Spiritual Change Tedeschi R.G., et al., Journal of Traumatic Stress , 2017

Do Levels of Posttraumatic Growth Vary by Type of Traumatic Event Experienced? An Analysis of the Nurses’ Health Study II Lowe, S.R., et al., Psychological Trauma , 2020

Resiliency and Posttraumatic Growth Despotes, A.M., et al. In Wilson, L.C. (Ed.)The Wiley Handbook of the Psychology of Mass Shootings, John Wiley & Sons, 2017

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The Next Normal: Emerging stronger from the coronavirus pandemic

Our ‘Before’ No Longer Makes Sense. How Do We Live Now?

By Elizabeth Dias and Audra D. S. Burch April 5, 2021

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As we look ahead to life after the pandemic, many people are wondering what will be different in our lives.

Will we go back to living the way we did before? And what if we do? Do we risk losing something we’ve learned from one long and terrifying year?

For some the ordeal brought inner reflection about the meaning and shape of life.

An awakening.

“I don’t think I can go back to a ‘before.’ I don’t think I fit into that life anymore.”

Mary Fugate, Punxsutawney, Pa.

“I care much more about being with people who make me feel whole now. The pandemic scraped away all facades we’ve built around our lives.”

Elena K. Cruz, Washington, Mo.

“It has made me realize that I am no more than human, and that there is nothing I can think or do to change that, and that I must embrace that for whatever it means.”

Lucas Jakobi, Tustin, Calif.

Who We Are Now

By Elizabeth Dias and Audra D. S. Burch

Photographs by Amr Alfiky, Rose Marie Cromwell, Ryan Jenq and Elliot Ross

Produced by Heather Casey, Rebecca Lieberman and Eden Weingart

Certain moments in life have the power to shift our core sense of being. The death of a parent. The birth of a child. An incurable disease diagnosis.

The coronavirus pandemic and all it has wrought is such a moment. Everyone knows someone who got sick or died or lost her job. Everyone has a personal “before” and “after.” It has been a collective near-death experience, for those lucky enough to survive.

People have found themselves close to life’s deepest questions, those forced by an apocalypse. Questions about how we live, how we suffer, and how we make meaning of our short time here on this earth.

Who am I? Who are we? Who are we becoming? How have we been transformed?

Through it all, the world has not stopped. The killing of George Floyd. The Capitol siege. More mass shootings. For some, facing trauma feels too hard. Others have found unexpected resilience and courage, rage or stillness. Transformation was forced on some, and for others it was chosen. For many, the suffering of this past year has birthed an awakening.

The questions of how we have changed will be with us in the months, and years, ahead. The process of reflection is just beginning. Where it takes us remains to be seen.

But the clarity that comes with intense suffering often clouds as time moves on. We have a window now to look at our lives anew.

This is the story of how America is beginning that journey, in her own words.

“You do what you need to do for the people you love.”

Mary Fugate, 31, who works in higher education, moved home from Cincinnati to Punxsutawney, Pa.

I spent most of 2020 dying for human interaction. I lived on the top floor of a duplex, I had this gorgeous front porch. There were so many birds. I downloaded an app to learn all of their songs. I learned the barn owl and the mourning dove and house sparrows. They would be constant friends to me — my mourning dove, she always sings between 7 a.m. and 11 a.m.

Then in the summer my sister in New Mexico was hospitalized with a cyst that could have been cancerous. She just got really sick really quickly. We had had a falling out and weren’t speaking. When I offered to go, I was expecting her to say no. I am thankful we are back to being sisters.

The exact moment I knew I was going to be OK was when I was driving to New Mexico and realized, “I’m the girl that despite all challenges will drive across the country in a freaking pandemic to be with the people she loves most.”

That was a moment of such clarity. I had been diagnosed with PTSD, and wearing a mask is very triggering for trauma. If I couldn’t even leave my house to get groceries, how could I drive across the country? You do what you need to do for the people you love. Realizing that strength — that was such a changing moment in my life.

In the hospital, with my sister 10 hours a day, it became almost a meditation: I am the girl who can wear a mask for the people she loves. I am the girl that can go to the pharmacy for the people that she loves. It has become something I say to myself.

It was the utter dark loneliness of coming back to an empty apartment that made me decide to move home to my parents.

I got in my car and did one final lap around my neighborhood, and then I just started driving. I cried the whole time. Grief over the future I thought I was having, grief over not just being able to tough it out and stay. Grieving the loss of my independence.

One of the first days back, I heard a mourning dove, and instantly started to cry. It meant a lot to know its song, and to realize I am in a completely different physical location, and the birds are still familiar to me.

I don’t know who I am becoming. I like who I am becoming, I just haven’t fully met her yet.

I don’t think I can go back to a “before.” I don’t think I fit into that life anymore. I’ve just grown and changed, and many priorities and values have shifted. My peak excitement right now is getting ready for baby ducks on the farm in spring. I like the slowness of things right now.

There are parts of 2020 that I never want to talk about again in my life, the dark moments. There were moments I thought I was going to lose my sister, moments I thought I would lose myself. There were moments that propelled me to where I am now. I don’t want to give 2020 credit, but I feel it put me on a conveyor belt to transformation that I wouldn’t have had without it.

“My husband quit his job and we moved to his hometown. No one yells every day anymore. I have come to the realization that maybe I deserve to be happy too.”

Erin Peregrine Antalis, Lincoln, Neb.

“We had an unplanned pregnancy. I’ve experienced grief because I never realized what you give up to be a new parent. But I would give up all of those things again and again for my son. I think the pandemic helped this new transition. We had so much we had to give up that it softened the blow a bit.”

Angela Windnagel, St. Paul, Minn.

“I applied to over 400 jobs in 2020 alone. It feels like there’s no way to catch up, let alone get ahead. I focus on enjoying the little things, because those are things I can control.”

Morgan Anderson, Palatine, Ill.

“The pandemic has forced me into the present. It’s the meditation I never wanted but have come to appreciate. That said, last week I kicked a hole in the bathroom door.”

Jessica Berta, Milwaukee

“I made a vow to not skip another Christmas or Japanese New Year with my parents. I don’t know how many I’ll have left with them.”

Paige Bowman, Washington, D.C.

“I just couldn’t deal with the lack of empathy. Now I have very few people who survived on my list of friends. And my phone is a whole lot quieter. But I honestly wouldn’t have it any other way.”

Iara Diaz-Araujo, Orlando, Fla.

“I don’t skip walks with my husband just because I am tired.”

Rebecca Vaughan-Geib, Herndon, Va.

“I know I am becoming someone different.”

Joelle Wright-Terry, 47, a hospice chaplain from Clinton Township, Mich., is a Covid survivor. She lost her husband to the virus last April.

Our Covid story started with us both having a horrific cough. My husband had Type 1 diabetes. I had a fever of 104. I have never been that sick in my life.

My husband drove me to the hospital. I came back the same day. That night, he drove himself back to the hospital. Before he left, he turned to the boys and told them to take care of your mom. A couple of days later, the doctors put him on oxygen. His chest was hurting so bad and by that time, my Covid had kicked in full force. We could barely talk to each other. We basically suffered in silence. Then he started to really decline.

We FaceTimed and told him how good a husband and father he was. And we reminded him how much we loved him. That was at one o’clock on the 2nd of April. My husband let go at 8:50 that evening.

I honestly thought I was going to pass away at home. I kept saying I do not want to leave the boys, I do not want to die in front of them. Covid is a kind of warfare that changes you. The only thing that got me through was Psalms 57.

It attacks your mind. It attacks your muscles. It attacks your joints. It attacks your lungs. It is a pain that I’ve never felt in my life. And I’ve had surgeries. And I have had cancer. You can’t go back to living the same life after surviving Covid.

My husband took care of us. He never missed a beat with the boys, going to their school functions. He worked as a business owner, making gravestones and monuments. He left behind at least 100 orders — some Covid victims. I looked at the number of orders and I began to pray. I emptied out my entire savings to try to save our business and keep his legacy going. Now we, the boys and I, are learning the gravestone business.

I have been strengthened by the testimonies of other widows who have come into my shop, and we sit there and we grieve together. If it had not been for the Lord on my side, I am not sure how I would have made it.

We had a small private funeral. He passed away by himself. And I didn’t want him laid to rest inside of a cemetery where he would be alone. I believe I will eventually move South again to be closer to my family. And I did not want to leave him alone again, so I had my husband cremated so he can always be with me.

I am a volunteer minister at my church. I often presided over the funerals. Never in a million years did I think that I would be sitting on the front pew, you know, with my husband lying before me, as other families have done. I never, never imagined that I would be sitting there with a minister speaking Scripture and praying and eulogizing as I have done for families. The pandemic, my husband’s death and God have taught me to appreciate our loved ones. I’ve already told my boys, we’ve got to figure out a way to get to Alabama to see my mother and sisters more often because family is just so important.

My husband died a year ago. I know I am becoming someone different. I just don’t know what that difference will be yet. I know I was a wife. And now I am 47 years old and a widow.

“I no longer have any clear trajectory, and I am learning to make peace with that.”

G.J. Hodson, Arlington, Texas

“I broke up with my boyfriend of almost four years. I’m trying to take it one day at a time, but also still feeling so lost because I still don’t have an ‘after’ defined.”

Jamie Tylicki, New York

“Coming out of this, I realized emotions can’t wait for another day. I am calling my parents more, and expressing my love and gratitude to them.”

Vaneet Singh, Memphis

“I am not going to try to be polite anymore. I am going to hopefully become a less behaved, less likable, ballsier, more outspoken, more dangerous woman. All these rules I had followed, these rules will not save me.”

Aline Mello, Marietta, Ga.

“I really feel like I learned a lot during the pandemic, but this new feeling has this real feeling of emptiness I’ve never felt before.”

Justin Parker, New York

“I’ve completely lost interest in traveling. I think most about wanting to have friends over in our home. For me, looking forward is all about making my deep roots here even deeper.”

Namir Yedid, San Diego

“My church has been paying for my rent, utilities and food while I am living with no paycheck. This year has stripped me from so much, but it also allowed me to focus and evaluate the big picture of my life. What kind of legacy do I want to leave behind?”

Beca Bruder, Alexandria, Va.

“I finally started looking at myself.”

Melva James, 42, is a cybersecurity consultant who grew up in Jackson, Miss., and lives in Massachusetts. The tumult of the past year inspired a dramatic life change.

One of my best friend’s mothers passed away of Covid. And a friend committed suicide during the pandemic. There’s been a lot of suffering around me.

The other thing that was happening, was all this stuff around the police killings and the fear of the Trump presidency and all of the hatred he was fomenting. I was feeling very unsafe, particularly as a Black person. And I was like, you know what, life could end at any moment. I need to figure out how to enjoy my life with whatever time I have left. How do I make my life more complete?

In October or November I started identifying as nonbinary. Before that, I identified as a woman, as a gay person. I think I’ve been trying to find myself for a long time.

People talk about feeling like they were mismatched or that they were really a boy, but they had been assigned as a girl. That was not my experience. I was just totally estranged from my body, I did not think about it at all and that’s an important distinction.

There is a major turning point in my life that I feel is connected. The death of my mother. Her death marked the end of my childhood though I was, on paper, a grown person. It was unmooring. It was this sense of being alone in the world, even though my dad was still alive. But he was grieving and I did not want to lean on him. So what I feel like I’ve experienced during the pandemic and what I experienced at that time was the same sense of, I could die at any time and I don’t want to die not knowing how to be happy.

I talk a lot about “being happy” and “learning to be happy,” which implies my life has a lot of sadness. This is not my day-to-day experience. Happiness versus sadness is not what I’m thinking when I’m saying that. What I’m thinking is the difference between surviving and thriving, between living and being truly alive.

The pandemic has forced me to spend so much time alone. Last year, I started taking yoga two or three days a week. In doing my yoga practice, I became physically stronger, as well as more aware of my body and aware of my breathing and I paid attention to myself in a way that I hadn’t before. I learned how to stand up straight. I used to brush my teeth and wash my face every day, but I did not look at myself. I finally started looking at myself. And when I looked at my face, I was like, I want a more masculine face. I naturally grow hair on my chin and I always shaved it and I stopped trying to make it disappear. And I’m like, this is what my face looks like. And I would be happy if I had a mustache. Me spending time with me and my body and learning how to stand up straight and learning how to see what other people see when they look at me — that’s how it began to happen.

Especially with regard to my physical self, I’ve felt a lot of nothing in the past. Depression, so often, is less about feeling sad and more about feeling nothing. Living inside my body and getting to know my full self is part of my journey from nothingness to joy. I’m so excited and hopeful about what life has to offer now that I don’t feel like I’m just existing.

“I have hands, I have work I can do.”

Maria Judith Alvarez Quiroz, 41, of Glenwood Springs, Colo., is a medical assistant from Mexico who has lived in the United States for the past 15 years.

In December 2019, right before the pandemic, I was laid off.

Before, I had a good job. We bought a trailer home and two cars and we had two telephones, one personal, one for work. It was the first year that we were by ourselves. We had always lived with other people, family. My husband did not have a job and was depressed. I got therapy and started working again with a doctor as his assistant in a clinic.

At the end of March my husband became ill and was hospitalized. They moved him to another hospital 90 minutes away, for two weeks. It took me three hours to go there and back. My son was not able to go with me. My husband was not diagnosed with Covid, but I didn’t understand why there was a problem with his lungs. He had fluid and blood coming out. He never recovered. We were married 15 years.

I lost a lot of weight after the loss. When I would take a shower, I would think of him and that is when I would cry. The hospital bills, I cannot begin to tell you.

I am completely different. After the pandemic I have decided to forgive everyone I can, treat them like family, brothers and sisters. Life is too short. It can change in a moment. You can’t go around with resentment in your heart.

When we moved into the trailer home, I’d said, Why would we fix ours up? We don’t even know if we will stay here or not. But the thing is, you have to live each day.

I was a general doctor in Mexico. As a doctor I know you have to take care of your health, so I started eating healthier, and I got closer to God.

When I was little I had poliomyelitis in one foot. That was a pretty big trauma for me. I fought with God, because I would say: Why me? Why can’t I play or run or jump or dance like other kids? When my husband died, I fought with God again. But afterwards, I forgave him. I don’t fight with him anymore. I just go on. If a job comes along and I get it, I say thank you. If he takes it away, I say OK.

When my husband died I felt like I had lost everything. I had nothing left to lose except my son. When I moved here from Mexico 15 years ago, I lost my dream of being a doctor. I work with the doctor in the clinic and it makes my heart happy, but I don’t treat the patients. But I thought, I have hands, I have work I can do, and if I can help people, that will be good.

That gives my life some sense. I am able to earn money to take care of my son, my family, my parents in Mexico. This is the first year I was able to send money to my parents so they could buy gifts for poor kids for the Day of the Magi.

The Latino community has suffered quite a bit with Covid, because we don’t have information. We don’t have information because we are afraid. We are not here legally, this is not our country.

I’d like to be a leader in my community. I don’t talk very much in meetings, and I’d like to talk more to be able to work with others and resolve the inequities in society.

I have discovered that really, we are all leaders.

“While I was just a few weeks into maternity leave, I was the first person to be let go from my office. It’s a disgusting feeling — nausea followed by rage. My husband and I are running a business together now. But one thing is clear: We will never be someone else’s employees again.”

Sarah S., New Orleans

“It forced me to let go of any notion that I could hold myself together and get on with the show. But it also made room for me to fall fully apart and look at the pieces. Since then, I’ve changed my housing, my church, my career plans, and the family and friends I allow in.”

Shelby Doyle, Melrose, Mass.

“There was a moment where I walked by my neighbor and asked her how she was doing. She was 82 at the time and in a sad, but very honest way, she told me that she was prepared to die. It wasn’t that she didn’t love life, I think she was afraid that in this year, life wouldn’t love her back. After listening to what she said, I felt guilty for being so unfazed by death.”

Gabriel Murphy, Winthrop, Mass.

“I am falling back in love with myself, taking extra time each day to care for my African violets and orchids. How I plan to live my life moving forward: no more doing for others what I do not want to do. I am centering my attention on the things that give me peace.”

Jeffreen Hayes, Chicago

“I’ve had such toxic assumptions about work, what ‘hard work’ is and how if you do it, it means you are a good person. Now I’m not even sure the ‘work’ I do in a day means anything. It has shown me how fallible all our thinking is.”

Annick Dall, Minneapolis

“Nobody will take care of me other than myself. We need to take responsibility not only for ourselves but for others.”

Huangliang Chen, Boston

“I had to close my small flower shop. In June I made $400. I do not want to go back to before. There is a lack of compassion and help. It is all about money. When I see such inequality, unfairness, sometimes I am like: Why are we doing all this?”

Yasmine Karrenberg, New York City

“How do we go forward?”

Ramah Commanday, 70, a ceramist, delayed a cross-country move to stay safe during the pandemic. Then, on the eve of Yom Kippur, the Glass Fire destroyed her home in St. Helena, Calif.

It burned when it burned. Just before the time the heavens are supposed to open up and we are supposed to be inscribed in the Book of Life. I had to leave immediately. I didn’t grab anything. It was up to the powers. By nightfall, my world of home and objects was gone.

I went back to the site, to see what remained, if anything. What I was able to dig up was a ruined, a completely ruined version of itself. It was like viewing the body. It is a task you have to do.

My kiln remained. I actually found a few pieces of my work that were intact, and a few more that were repairable, which I did. The act of repairing the broken pieces was healing. The rest I just walked away from.

What this did unexpectedly was refocus me, without even my conscious effort in doing so. It refocused me on what I had, as opposed to what I had lost.

The intensity of that refocus really took me by surprise. I am as amazed as anybody. How can I possibly weep for an armchair when so many people have lost multiple members of their own families?

I feel braver than I did before all of this happened. This is a kind of resilience that is real, and I am not alone in it. Maybe I am more glad that I know these things about myself than I am sorry to have lost a bunch of stuff. If this is what it took to put me in this place in my life’s journey, this is what it took.

I was born in 1950. I am Jewish. A lot of the Holocaust stories, apart from stories of unthinkable cruelty and destruction, are stories of strength, if not grace. The people who go through it due to various kinds of courage and iterations of kindness, and intelligence and resilience. If your parents’ generation can do that, then you can get through this.

We are living through a sea change that is just so dizzying, it will take a lot to process it. I will never forget the apocalyptic experience aspect of things. The big turning point for everyone was the year 2020. The new political realities created by the Trump phenomenon. The environmental climate change crisis. With Texas freezing. California burning. The mask requirements. The virus realities.

It is like how the world changed irretrievably after the world wars. We are facing a very stark question as individuals. How do we go forward? Do we give up or not? And if you choose not to give up, how do you keep going?

There are the people who are creating their own personal bunkers, either literally or metaphorically. Then there are people who just figure, we have to find a way of joining hands and plodding forward. What do we have as human beings that is not evil, that is not destructive, that is the opposite? What about art? What about kindness? What do we have that we can call on so we can live out our lives, deriving as much joy and positive experience as we can? Because wasting our lives, or living our lives in a state of misery insofar as we have any control over it, is unbearable.

This is what is driving me forward. There is nothing I can do about the stuff that burned up. Everything has a life span. I can look at this as the end of the world, apocalypse, but really, our worlds all end when we die. And in the meantime, I am alive, I am still here, and what can I do about it?

Additional research by Susan Beachy.

Photographs by:

Amr Alfiky/The New York Times

Rose Marie Cromwell for The New York Times

Ryan Jenq for The New York Times

Elliot Ross for The New York Times

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

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

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

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

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Read More: The Family Time the Pandemic Stole

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Life After the COVID-19 Pandemic

• 1 O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC

After 2 years of a seemingly relentless pandemic that has upended work, education, and social interactions, the questions many are asking are when will we get back to normal and what will life be like after the COVID-19 pandemic? In truth, science cannot fully predict what SARS-CoV-2 variants will arise and the trajectory of the pandemic. Yet, history and informed scientific observations provide a guide to how—and when—society will return to prepandemic patterns of behavior. There will not be a single moment when social life suddenly goes back to normal. Instead, gradually, over time, most people will view COVID-19 as a background risk and abandon the trappings of pandemic caution.

Pandemic to Endemic

The Great Influenza Pandemic of 1918 offers a historical guide to transitioning from a pandemic to an endemic infection. That pandemic began to subside after an estimated 500 million people —one-third of the world’s population—became infected, conferring high population immunity. (Approximately 50 million died worldwide, including 675 000 in the US.) The virus also mutated and became less pathogenic. Influenza H1N1 eventually reached an equilibrium, spreading among pockets of susceptible individuals without taking the lives of most.

SARS-CoV-2 may be following a similar trajectory. An estimated 94% of people in the US now have at least some vaccine- or disease-induced immunity against COVID-19. The highly contagious Omicron variant may speed transition to an endemic phase, with more than 100 million US residents becoming infected. Omicron also appears less pathogenic than previous variants. Thus far, booster doses of messenger RNA COVID-19 vaccines are conferring robust protection, with COVID-19 hospitalizations 16 times higher for unvaccinated adults than for fully vaccinated persons in December 2021.

COVID-19 will not be eliminated, and certainly not eradicated, in the foreseeable future. Intermittent surges will occur, driven by viral evolution and colder weather keeping individuals indoors. Ongoing vaccination will be needed because of waning immunity and viral mutations. COVID-19 will also require surveillance similar to the Global Influenza Surveillance and Response System , a global platform for monitoring influenza epidemiology and disease that is used in formulating seasonal influenza vaccines.

A Cautionary Tale

There are major caveats to when the pandemic will wane, including the unknown duration of vaccine- or disease-induced immunity. Billions of people worldwide still are unvaccinated, facilitating rapid viral mutations. In 1920, a variant of influenza emerged that caused an outbreak so severe it could have been considered another pandemic wave. And a pandemic H1N1 strain emerged in 2009 .

Although the Omicron variant appears to cause milder disease, future mutations may not be less severe. Viral evolution is not linear as many assume, with various strains likely to emerge. Vaccinating the world’s population will remain a major priority, along with effective COVID-19 therapeutics.

Scientific uncertainty also exists about the causes, and frequency, of long COVID, or post-COVID conditions , in which chronic symptoms persist beyond the infection’s initial phase . Reinfections are now common, raising concerns about chronic disease. Research into risk factors and clinical management of long COVID will be important.

Living With COVID-19

Endemic is an epidemiologic term, whereby overall infection rates stabilize . The US Centers for Disease Control and Prevention (CDC) defines endemic as “the constant presence or usual prevalence of a disease or infectious agent in a population within a geographic area.” Endemicity is also determined by when countries decide to move from emergency response toward longer-term control programs. Several high-income countries are already developing postpandemic plans. During endemic phases, most people return to prepandemic patterns of behavior, depending on personal risk tolerance.

COVID-19 management will likely resemble influenza-like illness surveillance. In the US influenza surveillance system—which itself requires modernization as well as improvement of data systems—the CDC partners with states, laboratories, and hospitals to detect influenza outbreaks, viral strains, and disease severity. COVID-19 management will require rapid identification of case clusters and variants. Outbreaks may trigger testing, contact tracing, and isolation. Isolation duration might be reduced based on case and hospitalization rates as well as social and economic needs. South Africa, for example, recently announced it will not require isolation of asymptomatic SARS-CoV-2–positive cases .

Periodic COVID-19 vaccinations, modified as new variants circulate, will remain a major control strategy. Vaccine mandates may resemble those for influenza, covering high-risk settings such as hospitals and nursing facilities. Proof of vaccination for dining, entertainment, shopping, and travel may eventually be retracted. It is unclear whether, or when, the CDC will add COVID-19 to its recommended list of school vaccinations. Currently, only California and Louisiana require COVID-19 vaccinations for school entry , although some localities mandate them for activities such as sports.

Mandates regarding the wearing of masks and social distancing may soon be relaxed, depending again on levels of risk. COVID-19 mitigation strategies could be rapidly reimplemented to counter outbreaks, and then retracted when the threat subsides—requiring effective communication. Absent mandates, pandemic behaviors such as wearing masks may continue for vulnerable or risk-adverse individuals, especially in crowded places such as movie theaters and concert venues.

The public may no longer accept the most severe COVID-19 strategies such as school closures, lockdowns, and travel bans. Denmark recently removed all COVID-19 restrictions and Colorado’s governor declared “the emergency is over.” Highly restrictive measures pose significant social, educational, and economic costs .

A Return to Socialization

COVID-19 risk mitigation resulted in profound social isolation and loneliness, evidenced by increased anxiety, depression, substance abuse, and suicidal thoughts . The public yearns for simple joys, such as embracing family members or friends, dining out, or seeing a smile unhidden by a protective mask. Humans are intrinsically social beings . It was not long after the 1918 pandemic when the US resumed intense socialization, with the Roaring 20s bringing people together in crowded dance halls, movie palaces, and speakeasies.

Some pandemic behaviors may continue, at least in part, if there is social utility. Hybrid working (remote and in-person) could outlast the pandemic, offering many employees a better balance between family and career and more choice in where to live. Air travel may also remain stagnant for the immediate future. By December 2021, international travel was 72% below 2019 levels , and it may not recover until 2024.

Eroding Public Health

It seems intuitive that a pandemic would increase reliance in, and trust of, public health agencies. That intuition appears mistaken. Trust in public health agencies declined significantly during the pandemic in the context of intense politicization over mitigation measures and confusing CDC guidance. States have enacted more than 100 new laws limiting health emergency powers, banning mask or vaccination mandates, and limiting governors’ emergency powers. The judiciary also curtailed public health powers, including the US Supreme Court’s decision to block the Occupational Safety and Health Administration’s vaccine-or-test mandate . The Supreme Court also overturned social distancing orders that placed limits on religious services .

The COVID-19 pandemic has challenged society to reexamine the balance between personal freedom and public health in a postpandemic era. It may be too soon to shift to an endemic phase while Omicron-related hospitalizations remain high and effective therapeutics are scarce. The US has far higher death rates and lower vaccination rates than peer nations. But a gradual transition to normal will likely occur in the coming months, bringing back social activities that individuals have dearly missed. The ability of public health agencies to help society return safely to a new normal will remain critically important.

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2022 Gostin LO. JAMA Health Forum .

Corresponding Author: Lawrence O. Gostin, JD, Georgetown University Law Center, 600 New Jersey Avenue NW, Washington, DC 20001 ( [email protected] ).

Conflict of Interest Disclosures: None reported.

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Gostin LO. Life After the COVID-19 Pandemic. JAMA Health Forum. 2022;3(2):e220323. doi:10.1001/jamahealthforum.2022.0323

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The World We Want to Live in After COVID

In 1909, the French ethnographer Arnold van Gennep published a book called “ The Rites of Passage .” In it, he explored the rituals that cultures use to transition people from one stage of life to the next. Birth, puberty, graduation, religious initiation, marriage, pregnancy, promotions, the seasons—we’re always on the threshold of one phase or another. How do communities shepherd individuals from the pre- to the post-?

Van Gennep argued that certain universal principles underlie rites of passage across cultures and eras. First, there’s the “pre-liminal” phase, in which “rites of separation” detach individuals from their earlier thoughts, feelings, and perspectives: the Old You dies. Next comes the “liminal” phase, a volatile interregnum that’s simultaneously disorienting and ambiguous, destructive and constructive, during which “rites of transition” open up the possibility of a new and different future. Finally, in the “post-liminal” phase, the “rites of incorporation” allow one to reënter society somehow changed. A New You is inaugurated. “Life itself means to separate and to be reunited, to change form and condition, to die and to be reborn,” van Gennep wrote. “It is to act and to cease, to wait and to rest, and then to begin acting again, but in a different way.”

Van Gennep’s observations were a landmark in the nascent field of anthropology. “Elements of ceremonial behavior were no longer the relics of former superstitious eras,” the anthropologists Richard Huntington and Peter Metcalf later wrote, but “keys to a universal logic of human social life.” In the century since, scholars have applied van Gennep’s framework not just to individuals but to societies in times of turmoil and transformation. Famines, wars, political revolutions, economic downturns, civil-rights movements—societies, too, move from one way of life to another, often experiencing intense periods of renunciation, restructuring, and rebirth.

2020, when the pandemic began, was a pre-liminal year—a headlong, vaccine-less descent away from normality and into calamity. We were torn from our established ways, undergoing separation, loss, and upheaval. 2021 was a liminal year—neither here nor there, not quite normal but not wholly abnormal, either. The inauguration of Joe Biden , the widespread availability of vaccines, and the return of weddings, dining, travel, and sports all coexisted alongside vaccine holdouts, breakthrough infections, new variants, booster shots, and regional surges.

Today, Omicron might make it feel as though we’re still squarely in the liminal phase. But, in fact, we may soon be tipping into a post-liminal paradigm. Omicron’s extraordinary contagiousness—combined with rising vaccination and booster rates—could mean that, in the coming months, nearly all Americans will have some level of immunity to COVID . Repeat infections and breakthrough cases will still occur, but, as our individual and collective immunity broadens, these will become milder and less disruptive. The influenza pandemics of the twentieth century each lasted around two years; now, twenty-one months into our battle with the coronavirus, Omicron is accelerating what could be this pandemic’s final chapter. It’s becoming possible to ask, and perhaps answer, some broad questions: Where will we end up in our attitudes toward ourselves and the social web in which we live? Who will we be on the other side of our transition?

The coronavirus crisis is first and foremost a health crisis, and many of the most obvious changes in our attitudes have to do with health. Some of us have come to reflect more regularly on our age and medical conditions. We’ve gained familiarity with obscure scientific jargon, from PCR tests to mRNA. We meditate on the trade-offs involved in social events, examine the threats we pose to others (and vice versa), and judge people for their choices. Americans differ hugely on what to think and do about all this—the behavior of people in one community can seem unfathomable to those in another—but, at least for now, health has shifted from a narrow individual consideration to a more expansive, social one. Going to work, attending a concert, hosting a dinner party, boarding a flight—if you have a cough, a fever, or just the sniffles, these activities now carry an ethical dimension. Will this remain true after the acute threat of COVID -19 has subsided? We may return to inflicting colds, flus, and various G.I. bugs on one another—or, possibly, we’ll adopt some version of the physician’s oath to do no harm.

The sense that making others sick is an action we’ve taken—and that, conversely, it’s within our power to avoid becoming agents of contagion—reflects a more general paradox of the pandemic. Since COVID arrived, we’ve been both powerless and empowered. Many aspects of our lives have been changed by events beyond our control; at the same time, we have sometimes been pushed to make consequential decisions and chart our own course. Over the past two years, for instance, Americans have quit their jobs in record numbers; in some cases, they’ve been forced to do so—perhaps by medical vulnerability, or unprecedented disruptions in schooling—while, in others, the pandemic’s chaos presented an opportunity to reëvaluate priorities. Regardless, faced with historical circumstances, they made big changes. In this crisis, as in many rites of passage, we don’t just passively recite our lines; we write them, taking vows that may reverberate for decades.

One of the questions we face now is whether we can make such changes on a social level, in addition to an individual one. The pandemic’s school disruptions are the result not just of a novel virus but of years of underinvestment that have yielded underpaid teachers, crowded classrooms, and poorly ventilated buildings. We’ve seen the same pattern in many aspects of our pandemic experience. Decades of investment in basic science allowed American scientists to race from genomic sequencing to an effective COVID vaccine in less than a year—but, during the same period, a public-health system that had been neglected for decades hampered our ability to contain the virus at every turn. We’ve made real changes in our lives. Can we make them in our society, too, building capacity so that our institutions can be more resilient and flexible?

The pandemic has posed similar questions for the world as a whole. COVID -19 struck during the seventy-fifth anniversary of the creation of the United Nations, and arrived at a moment characterized by a sharp rise in nationalism and a broadening skepticism about the international arrangements that have governed since the Second World War. Even before the virus, the multilateral system of international coöperation was fraying. After the 2008 financial crisis, Americans had grown increasingly suspicious of globalization and frustrated by their leaders’ failure to address its consequences: inequality, job displacement, social atomization. Now the coronavirus has shown that globalization moves not just goods and people across borders but pathogens, too.

In March, the National Intelligence Council released a report arguing that, in the coming years, the world will face global crises—pandemics, extreme-weather events, technological disruptions—with growing frequency. At the same time, greater international fragmentation and tension will impede our ability to respond to them. The report outlined several possible futures. In the optimistic scenario, called the “renaissance of democracies,” the world settles into a new equilibrium characterized by technological progress, rising incomes, and responsive democratic governance, led by the U.S. and its allies. In another future, “a world adrift,” the international system is “directionless, chaotic, and volatile”; global problems are largely ignored, and multilateral institutions lose their influence.

At a global level, as at the national one, the health crisis of the pandemic has put another preëxisting crisis into sharper relief. Effective pandemic response requires coördination across nations; this is the work of the World Health Organization, of which America has long been the largest funder. In 2019, the U.S. contributed more than four hundred million dollars to the W.H.O., but in April, 2020, Donald Trump announced that the U.S. would stop its funding. For much of the year, the U.S. also declined to join COVAX , the world’s primary global vaccine-distribution mechanism. Today less than nine per cent of people in low-income countries have received a single dose of a COVID vaccine; the rise of ever more concerning variants, such as Delta and Omicron, is due, in part, to a failure of the U.S. and other wealthy countries to vaccinate the world.

Recently, the G-20—a forum comprising nineteen nations and the European Union, which together account for ninety per cent of the world’s economic output—proposed key steps for strengthening the global response to future infectious threats: higher and more consistent funding for the W.H.O.; greater collaboration between governments and the W.H.O. on data collection, humanitarian support, and vaccine development; and the establishment of global norms for the reporting of emerging pathogens. Will countries unite in making such changes? That depends, in large part, on their willingness to act multilaterally—to see that their own security is interwoven with the security of others. It’s an issue that’s larger than the virus. COVID -19, like the Second World War, has created a hinge in the history of the world, which could swing either toward greater cohesion or toward disarray.

In 1954, a researcher named Muzafer Sherif conducted what would become one of the most famous experiments in social psychology. Sherif was interested in the dynamics of group conflict: how easily loyalties form; how little it takes for rival factions to quarrel; what, if anything, can be done to repair relations. As my colleague Elizabeth Kolbert wrote recently, in a piece on political polarization , Sherif invited twenty-two fifth-grade boys to a summer camp at Robbers Cave State Park, in southeastern Oklahoma. The boys were all white, from middle-class, Protestant, two-parent households. Sherif and his team divided them into two groups, each unaware that the other was housed in a cabin at another end of the camp. In the first phase of the study, lasting about a week, the groups, which named themselves the Eagles and the Rattlers, bonded over shared interests and activities—hiking, swimming, a treasure hunt with a ten-dollar reward. In the second phase, the groups were brought together in a series of zero-sum competitions: baseball, tug-of-war, touch football. The researchers, who doubled as camp counsellors, orchestrated hijinks. One group was delayed in arriving at a picnic; when they got there, they were led to believe that the other group had eaten their food. Tensions rose. The Eagles burned the Rattlers’ flag; the Rattlers raided the Eagles’ cabin. Researchers had to step in to break up fights. Division had set in.

The goal of the third phase was to defuse the animosity. As a first step, the researchers organized a series of noncompetitive activities. The boys shared meals, watched a movie together, and celebrated the Fourth of July. Little changed. Only when the campers were given tasks requiring collaboration on a common endeavor—restarting a stalled food truck, pitching a tent with missing supplies, raising money for a movie night—did conflict decline. In the end, one group bought the other malted milk.

The findings of the Robbers Cave experiment have become a staple of undergraduate seminars and psychology textbooks. But they appear not to apply to our current moment. Never before has it been so clear that our work, behavior, and fates are inextricably linked to those around us. Working together to control the virus should have been the ultimate shared goal. And yet, facing viral invasion, Americans couldn’t agree not to sneeze on one another. While fighting the pandemic, America has remained one of the world’s most polarized nations.

It turns out that the Robbers Cave experiment doesn’t tell the whole story. As Gina Perry explains in her book “ The Lost Boys ,” Sherif had conducted a near-identical experiment the year before, in 1953. He’d invited a similar cohort of boys to a camp in upstate New York and divided them into groups: the Panthers and the Pythons. The researchers had carried out a similar series of conflict-generating shenanigans: they’d stolen clothes, ransacked tents, and broken a boy’s ukulele. This time, however, the boys caught on—they realized that they were being manipulated. Instead of fighting one another, they turned on the adults. “Maybe you just wanted to see what our reactions would be,” one boy suggested to a researcher. ​​One of the groups decided that their clothes must have gone missing because of a laundry mishap; both sides worked together to restore an overturned tent. As the experiment unravelled, Sherif began drinking heavily. He grew so despondent that he nearly punched a research assistant in the face. The experiment was stopped early; Sherif never published the findings.

In an era of social-media virality, cable-news punditry, and political celebrity, we, too, are being manipulated. The ire we direct at one another is, at least in part, a result of forces that aim to extract political or financial gain by stoking division and appealing to our basest instincts. Despite knowing better, people in power traffic in half-truths, adding to the cacophony of conflict. They reflect our discord but also create it. We don’t yet know what post-liminal life looks like—but recognizing that truth may be the first step to healing the divide.

More on the Coronavirus

How China’s response set the stage for a worldwide wave of censorship .

Why are preschoolers subject to the strictest COVID rules in New York City ?

Ecuador’s largest city endured one of the world’s most lethal outbreaks .

What it was like to treat some of the oldest and sickest people in New York’s jails .

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In the COVID era, the success of the chickenpox vaccine is staggering to contemplate.

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• PERSPECTIVES
• SUBMIT A PERSPECTIVE
• A NEW MAP OF LIFE

THE NEW MAP OF LIFE

AFTER THE PANDEMIC

It is said that culture is like the air we breathe. We don’t notice it until it’s gone.

The COVID-19 pandemic is bringing into focus a once invisible culture that guides us through life. Seemingly overnight, we experienced profound changes in the ways that we work, socialize, learn, and engage with our neighborhoods and larger communities.

For a short time, before new routines and practices replace familiar old ones, we can see with greater clarity the positive and negative aspects of our former lives. The suddenness and starkness of this transformation allows us to examine daily practices, social norms and institutions from perspectives rarely allowed.

The fragility of the global economy becomes glaringly apparent as critical supply chains faulter, unemployment surges, and markets vacillate. Tacit assumptions about health care systems become clear as we see how they function, fail to function, and have long underserved large parts of the population. Just as sure, sheltering in place allows us to appreciate precious details of our lives that we have taken for granted: the appeal of workplaces, the comfort of human touch, dinner parties, travel, and paychecks. Indeed, through ambivalent eyes we also recognize ways that life is better as we shelter in place.

The premise of the New Map of Life:™ After the Pandemic project is that we have a fleeting window of time that affords us an unprecedented opportunity to examine our lives.  Going forward, life will be different and by compiling the insights we have today we can inform and guide the culture that will inevitably emerge from our collective experience. Your insights can contribute to the reshaping of social norms, systems, and practices that shape our collective futures.

Since the founding of the Stanford Center on Longevity, we have advocated for a major redesign of life that better supports century-long lives. More recently, we undertook the New Map of Life ™ initiative, which focuses on envisioning a world where people experience a sense of purpose, belonging, and worth at all stages of life. As tragedies unfold before our eyes, we aim to capture the lessons they teach. With your help, we can compile current insights, fleeting thoughts and deeper reflections about the ways we live now so that going forward we bolster, modify and reinvent cultures that improve quality of life for ourselves, our children, and future generations.

The opinions, beliefs, and viewpoints expressed by the various authors on this website do not necessarily reflect the opinions, beliefs and viewpoints of the Stanford Center on Longevity or official policies of the Stanford Center on Longevity. 

When Computer Bugs Were Actual Insects

Extreme natural phenomena, openmind books, scientific anniversaries, a loop towards the extinction of species,the other ‘butterfly effect’, featured author, latest book, a changing world: life after covid-19, understanding as a way to reinvent ourselves following a lethally smart virus.

It happened in the blink of an eye, to put it metaphorically.  Suddenly, the virus had made its home in the body of more than hundreds, if not thousands, of people in different countries around the world. The coronavirus that started in the city of Wuhan, China, according to official sources , on December 31, 2019, which is where it got the name COVID-19, followed its natural course, ignoring borders, customs and tariffs.  

The part about following its natural course refers to a Chinese proverb that has become something like the slogan of the so-called chaos theory , developed by the mathematician and meteorologist Edward Lorenz in the 1960s, together with other scientists, which tries to answer the following question: Is it possible for a butterfly flapping its wings in Sri Lanka to cause a hurricane in the United States? If we interpret and adapt the chaos theory and butterfly effect to the current situation we are globally experiencing, this new outbreak of coronavirus, it could lead us to give the answer that an event, regardless of how unlikely it may seem, does not mean it is impossible for it to occur.

Proof of this is that the disaster is already upon us, shaking our political, social and economic gears as never before. So how can an invisible virus be defeated when it does not seem to produce symptoms in the people who carry, or carried, it the most? Furthermore, even though some insist with all their might on denying the obvious, the truth is that the virus does not care about social class, race, gender or other labels that divide us. COVID-19 has once again put Darwin’s hypothesis of “survival of the fittest” in style, which does not necessarily have to correspond to the strongest. In fact, it is Trump’s America that is the country that has been hit the hardest by COVID-19, and Italy and Spain have the highest number of deaths in Europe.

Going back in time to take stock of the situation

Media coverage of disasters or health crises is no simple task when right in the middle of them. However, it is important to analyze and clear up certain unknowns to the extent possible . That’s why, one of the key questions in this global pandemic is whether it could have been avoided. If it could not have been avoided, it could fall under the category of what the Lebanese-American philosopher and researcher Nassim Nicholas Taleb calls a black swan. 

This concept is a metaphor that  Taleb developed in his 2007 book entitled The Black Swan: The Impact of the Highly Improbable. A black swan is a surprising event (for the observer) that has a great socioeconomic impact and after it happens it is rationalized retrospectively (making it seem predictable or explainable and giving the impression that it was expected to occur). In addition, these types of incidents considered extremely atypical, collectively play much bigger roles that regular events. 

For Taleb, examples of “black swans” throughout the history of humankind have included: the start of World War I, the Spanish flu , or the September 11, 2001 terrorist attacks. That said, what do you think Taleb said about whether COVID-19 is another black swan? The answer, which is in this video published on March 31st, is no, as the author feels that the pandemic could have been prevented.

However, although COVID-19 does not meet all the requirements for Taleb’s theory to be considered a real black swan, we cannot deny the evidence that we are facing an event that is disruptive on a planetary scale, whose future consequences we are not currently able to make out.  If there are documented facts, who in the past could have warned about the possibility of a pandemic outbreak of this magnitude?

Coronavirus pandemic: an overlooked reality

In October 2007, the academic journal Clinical Microbiology Reviews published that it is specializing in analysis of the most innovative developments in the areas of clinical microbiology and immunology in an article called: Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection . In its introduction, it says: “The rapid economic growth in southern China has led to an increasing demand for animal proteins including those from exotic game food animals such as civets. Large numbers and varieties of these wild game mammals in overcrowded cages and the lack of biosecurity measures in wet markets allowed the jumping of this novel virus from animals to human. Its capacity for human-to-human transmission, the lack of awareness in hospital infection control, and international air travel facilitated the rapid global dissemination of this agent.” The conclusion of the same article says: “The possibility of the reemergence of SARS and other novel viruses from animals or laboratories and therefore the need for preparedness should not be ignored.”

In the year 2013, German authorities published the 2012 Report on risk analysis in civil protection ( Bericht zur Risikoanalyse im Bevölkerungsschutz 2012 ). One of the sections of this official document described a simulation of a hypothetical outbreak of coronavirus around the world. The researchers who carried out this “simulation game” were a group or researchers led by the Robert Koch Institute . This is Germany’s public health agency, as well as the research center in charge of controlling and preventing diseases. On April 7th, the German magazine Der Spiegel published an article in which the author asked the following question, which is exactly what many people are thinking, and which can be extrapolated beyond Germany: “Why wasn’t Germany better prepared if it knew that this kind of scenario could occur? And therefore, what was the purpose of the report?” 

Meanwhile, Luis Enrique Martín Otero , colonel veterinarian and coordinator of VISVET at the Network of Biological Alert Laboratories (RE-LAB), who at the same time was Technical Director on a national level of the 2001 anthrax crisis, wrote the following article near the end of March: Covid19: silent biological threat . The first paragraph of this article has the following: 

In this fragment, Martín Otero also makes it clear that this pandemic was not a black swan. He argues the following: “ As long as nothing happens, politicians do not value the importance of constantly researching these biological threats. Those of us working on them know that they will occur, but we don’t know when.” 

However, humans are not the only ones who have been making forecasts about a possible global pandemic from coronavirus. So have some  AI based computer programs , as described by Ramón López de Mántaras Badia , Director of the CSIC Institute for Artificial Intelligence , which anticipated the outbreak, but the use of these data was not completely smart and effective. It was missing a human mind, as Ramón clarifies, or more precisely, a group of them spaced out over the world in order to interpret and manage the data or conclusions obtained from the machines. 

On a sinking ship, focus on what is important 

Apparently, for some unknown reason, deciphering the future continues to be humans’ great dream. So far, we have been chasing this goal, and continue to do do, still drunk on a sort of blind hope. 

Some of the hypothetical causes that could have led to this scenario could stem from: the very limits of human understanding of reality and human nature, which have led us to not have appropriate mechanisms to manage these kinds of incidents; perhaps out of some kind of ignorance or arrogance; together with an implemented technology that is even baptized with the name artificial intelligence, which is not yet as intelligent as previously believed, as it has not been adapted to the basic needs of a globalized, constantly evolving world. This could be due once again to the knowledge, understanding or more precisely, the design of artificial intelligence itself, as more than betting on implementing technology that lowers the weaknesses we face as a species, we have attempted, and continue to attempt, to only simulate some aspects of our human intelligence, playing some sort of Homo Deus. 

If the famous cult of reason and the systematization of science, which is so important to the method and for scientific progress is combined with the impetus to continue deciphering the role that human emotions play to a greater extent, as well as the nature of our fear of uncertain events, the origin of power struggles, our systems of beliefs and values, of our decision-making and therefore of our identity, we will have managed to make a qualitative evolutionary leap. 

However, these more profound causes will be better analyzed and studied after the fact, when we are able to take stock of this historic period with more perspective, understood as from a distance, with the calmness and tranquility that no one currently possesses as we are completely immersed in the fight for survival. However, if we don’t do it, our eternal great enemy will have won the battle: oblivion. 

Rosae Martín Peña

Related publications.

• What’s Next: the (In)Equality to come
• 3 Historic Discoveries That Allow Us to Fight Against COVID-19
• How Science can Defeat the Coronavirus: Challenges and Tools

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In Their Own Words, Americans Describe the Struggles and Silver Linings of the COVID-19 Pandemic

The outbreak has dramatically changed americans’ lives and relationships over the past year. we asked people to tell us about their experiences – good and bad – in living through this moment in history..

Pew Research Center has been asking survey questions over the past year about Americans’ views and reactions to the COVID-19 pandemic. In August, we gave the public a chance to tell us in their own words how the pandemic has affected them in their personal lives. We wanted to let them tell us how their lives have become more difficult or challenging, and we also asked about any unexpectedly positive events that might have happened during that time.

The vast majority of Americans (89%) mentioned at least one negative change in their own lives, while a smaller share (though still a 73% majority) mentioned at least one unexpected upside. Most have experienced these negative impacts and silver linings simultaneously: Two-thirds (67%) of Americans mentioned at least one negative and at least one positive change since the pandemic began.

For this analysis, we surveyed 9,220 U.S. adults between Aug. 31-Sept. 7, 2020. Everyone who completed the survey is a member of Pew Research Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories.  Read more about the ATP’s methodology . 

Respondents to the survey were asked to describe in their own words how their lives have been difficult or challenging since the beginning of the coronavirus outbreak, and to describe any positive aspects of the situation they have personally experienced as well. Overall, 84% of respondents provided an answer to one or both of the questions. The Center then categorized a random sample of 4,071 of their answers using a combination of in-house human coders, Amazon’s Mechanical Turk service and keyword-based pattern matching. The full methodology  and questions used in this analysis can be found here.

In many ways, the negatives clearly outweigh the positives – an unsurprising reaction to a pandemic that had killed  more than 180,000 Americans  at the time the survey was conducted. Across every major aspect of life mentioned in these responses, a larger share mentioned a negative impact than mentioned an unexpected upside. Americans also described the negative aspects of the pandemic in greater detail: On average, negative responses were longer than positive ones (27 vs. 19 words). But for all the difficulties and challenges of the pandemic, a majority of Americans were able to think of at least one silver lining. 

Both the negative and positive impacts described in these responses cover many aspects of life, none of which were mentioned by a majority of Americans. Instead, the responses reveal a pandemic that has affected Americans’ lives in a variety of ways, of which there is no “typical” experience. Indeed, not all groups seem to have experienced the pandemic equally. For instance, younger and more educated Americans were more likely to mention silver linings, while women were more likely than men to mention challenges or difficulties.

Here are some direct quotes that reveal how Americans are processing the new reality that has upended life across the country.

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Life before and after COVID-19: The ‘New Normal’ Benefits the Regularity of Daily Sleep and Eating Routines among College Students

Catalina ramírez-contreras.

1 Department of Nutrition, Food Science, and Gastronomy, Food Science Torribera Campus, University of Barcelona, 08921 Barcelona, Spain; [email protected] (C.R.-C.); [email protected] (M.F.Z.-R.)

2 Nutrition and Food Safety Research Institute, INSA-UB, 08921 Barcelona, Spain

María Fernanda Zerón-Rugerio

Maria izquierdo-pulido.

After the COVID-19 lockdown, a ‘new normal’ was established, involving a hybrid lifestyle that combined face-to-face with virtual activity. We investigated, in a case-control study, the impact of the ‘new normal’ on daily sleep and eating routines, compared with pre-pandemic conditions. To do this, we propose using social and eating jet lag as markers of the regularity in daily routines. Additionally, we studied whether the ‘new normal’ had an impact on the body mass index (BMI), diet quality, and other health-related variables. This study included 71 subjects in the pre-pandemic group, and 68 in the ‘new normal’ group (20–30 years). For all participants, we evaluated social and eating jet lag, BMI, diet and sleep quality, eating behaviors, physical activity, and well-being. General linear models were used to compare outcome variables between pre-pandemic and ‘new normal’ groups. The results revealed that the ‘new normal’ was associated with greater regularity in daily sleep and eating routines (−0.7 h of social jet lag (95% CI: −1.0, −0.4), and −0.3 h of eating jet lag (95% CI: −0.5, −0.1)), longer sleep duration on weekdays (1.8 h (95% CI: 1.5, 2.2)), and lower sleep debt (−1.3 h (95% CI: −1.7, −0.9)). Regarding BMI and other health-related variables, we observed that these variables were similar between ‘new normal’ and pre-pandemic groups. These findings indicate that the ‘new normal’ had a positive impact on daily sleep and eating routines. Additionally, our results indicated that the ‘new normal’ offered college students a more sustainable lifestyle, which was associated with more hours of sleep during the week and lower sleep debt. This, in the long run, could have a positive impact on BMI and overall health.

1. Introduction

In modern societies, infrastructure development and urbanization have positively influenced people’s lifestyles by allowing greater access to food and education [ 1 ]. However, these factors can also work in the opposite direction through exposure to artificial light at night, long working hours, longer commutes, and increased general stress associated with living in urban areas [ 1 , 2 ]. Not surprisingly, evidence has shown that the modern lifestyle is associated with obesity, unhealthy eating patterns, and a sedentary lifestyle [ 1 , 3 ]. Furthermore, the modern lifestyle can also have an adverse impact on our daily sleeping and eating routines, which include “when” we sleep, and “when” we eat. Note that access to artificial light at night has allowed us to eat and stay awake at almost any time of the day, associating the latter with late sleep onset, short sleep duration, and also with a mismatch between internal circadian rhythms and external time (known as circadian misalignment) [ 2 , 4 , 5 ].

In the general population, the most extreme example of circadian misalignment is seen among shift-workers. However, college students, who usually push activities to a later clock time, are prone to a mild type of circadian misalignment, denominated social jet lag [ 4 , 5 , 6 , 7 , 8 ]. The latter arises from the accumulated sleep debt throughout the week, especially since school schedules tend to start early, which forces them to align their waking hours with the social obligations of the weekdays [ 5 , 7 ]. Nevertheless, since sleep debt is unsustainable, young people generally prolong sleep duration on weekends, resulting in a discrepancy in their sleep routines on weekends versus weekdays [ 6 , 9 ]. Note that social jet lag is considered a potential risk factor for obesity [ 6 , 7 , 10 , 11 ] and unhealthy eating habits among college students [ 6 , 11 ]. In this context, insufficient sleep is one of the main mechanisms that trigger these associations [ 7 ]. In particular, the short duration of sleep is related to a higher food intake [ 12 ], mainly due to alterations in appetite hormones (e.g., ghrelin and leptin), hedonic eating, and a longer time awake, which translates into more opportunities to eat and snack [ 12 , 13 , 14 ].

Furthermore, it has been reported that individuals with the greatest social jet lag are also those who eat breakfast and dinner later [ 11 ]. Our group has demonstrated that irregularity in the timing of meals throughout the week, especially at breakfast time, is significantly associated with a greater social jet lag [ 9 ]. Due to its resemblance with social jet lag, we denominated this irregularity in eating routines as ‘eating jet lag’. In this regard, we have shown that a greater eating jet lag was significantly associated with a higher body mass index (BMI) among college students. Similar to the circadian desynchrony that arises from social jet lag, we hypothesized that eating jet lag could be linked to circadian misalignment, and therefore has a negative impact on BMI [ 9 ]. It should also be noted that a greater ‘jet lag’ at the time of the first meal has also been associated with a higher BMI and waist circumference among women [ 15 ].

In light of the evidence, it seems reasonable to recommend maintaining regular sleep and eating routines throughout the week, which would presumably be associated with a lower BMI and healthier eating habits. However, due to the modern lifestyle, this seemed impossible. It was not until the social restrictions issued in response to the COVID-19 pandemic showed that a greater flexibility in social schedules and less time spend commuting had positive changes in terms of sleep routines [ 2 , 16 , 17 , 18 ]. Specifically, studies showed that lockdown was associated with later wakeup time, longer sleep duration, and lower social jet lag [ 2 , 16 , 17 , 18 ]. However, the benefits of regular daily sleep and eating routines on BMI and diet quality remain to be studied. To our knowledge, only Blume et al. [ 17 ] found that regular sleep routines (given by lower social jet lag) limited the decline in sleep quality and well-being during lockdown.

In our country, after the strict lockdown period, economic and social activities resumed at the end of June 2020. Therefore, a ‘new normal’ was established, which included, among others, a hybrid lifestyle that combined face-to-face with virtual activity [ 19 ]. Implicitly, the need to resume life after COVID-19 lockdown through the ‘new normal’ meant that, in relation to pre-pandemic conditions, there would be a before and after in terms of daily sleeping and eating routines, and their regularity. Therefore, the objective of our research was to evaluate the impact of the ‘new normal’ on daily sleep and eating routines in relation to pre-pandemic conditions. To do this, we propose using social and eating jet lag as markers of regularity in daily sleep and eating routines. We hypothesized that, compared with pre-pandemic conditions, the ‘new normal’ would be associated with lower social and eating jet lag, and thus, greater regularity in sleep and eating routines. In addition, we analyzed whether the ‘new normal’ had an impact in BMI, diet quality, and other health-related variables (including eating behaviors, sleep quality, physical activity, and well-being).

2. Materials and Methods

2.1. study design and participants.

Undergraduate students (aged 20–30 years) of the Bachelor’s Degree in Human Nutrition and Dietetics at the University of Barcelona (Barcelona, Spain) were recruited in November 2019 (pre-pandemic) and November 2020 (‘new normal’) for a case-control study. Note that in Catalonia (Spain), the ‘new normal’ included the mandatory use of face-masks, social distancing, and a hybrid lifestyle that combined face-to-face with virtual activity. Additionally, starting in October 2020, this ‘new normal’ also included a curfew from 22:00 to 6:00, prioritizing the home-office when possible, and, at university, classes were taught online [ 19 ]. Social life and leisure time were allowed (at least in gatherings of fewer than six people), restaurants and cultural activities were opened from 6:00 to 21:30, and individual outdoor exercise was allowed [ 19 ].

2.2. Recruitment

Recruitment consisted of an informative talk, in which the details of the research were explained to the students, and they were invited to participate in the study. The eligibility criteria included college students enrolled in the University of Barcelona aged between 20 and 30 years old. Exclusion criteria consisted of unwillingness to participate in the study, and the participants who provided incomplete information required for the development of the study. Based on these criteria, a total of 150 subjects were included in the study, all of whom gave written informed consent. Furthermore, we excluded subjects with missing information ( n = 11), which resulted in a final analytical sample of 139 subjects. All study procedures were performed according to the ethical guidelines of the Declaration of Human Studies of Helsinki, and were approved by the Ethics Committee of the University of Barcelona (IRB00003099).

2.3. Data Collection

We used Open Data Kit (ODK) [ 20 ], which is an open-source software, to design an online screening tool, where we included a series of validated questionnaires (detailed below) to evaluate the chronotype, diet quality, eating behaviors, physical activity, and well-being. ODK has a user-friendly web interface for designing web forms and programming simple logic.

2.4. Markers of Daily Routines

2.4.1. sleep routines.

Participants completed a sleep diary during seven consecutive days, where they recorded bedtimes and wakeup times. From these data, we calculated the following variables:

• i. Sleep duration (h), calculated as the difference between bedtime and wakeup time.
• ii. Social jet lag (h), calculated as the difference between each participant’s midpoint of sleep on weekdays and midpoint of sleep on weekends [ 5 ]. All analyses were performed using the absolute value of social jet lag [ 5 ].
• iii. Sleep debt (h), calculated as the difference in sleep duration between weekends and weekdays [ 21 ].

2.4.2. Eating Routines

Participants completed a meal timing diary during seven consecutive days, where they reported the timing of the meals (breakfast, lunch, dinner, or any other meal). From these data, we calculated the following variables:

• i. Eating duration (h), calculated as the length between the first and the last caloric event [ 11 ].
• ii. Eating jet lag (h), calculated as the difference between each participant’s eating midpoint on weekends and eating midpoint on weekdays [ 9 ]. All analyses were conducted using the absolute value of eating jet lag.

2.5. Anthropometric Parameters

Weight was measured with a body composition analyzer (InBody 720, Biospace, Seoul, Korea), with the subjects wearing light clothing and without shoes, to the nearest 0.1 kg. Height was determined using a fixed wall stadiometer (Seca 217, Seca, Hamburg, Germany) to the nearest 0.1 cm. Body mass index (BMI) was calculated as weight (kg) divided by height squared (m).

2.6. Health-Related Variables

2.6.1. diet quality.

Diet quality was evaluated using the Mediterranean Diet Quality Index (KIDMED), which has been validated in the Spanish population [ 22 ]. The KIDMED test is based on the principles that underpin Mediterranean dietary patterns and those that undermine it. Briefly, the KIDMED test includes questions such as: ‘Do you have fruit or fruit juice every day?’, ‘Do you have fresh or cooked vegetables regularly once a day?’, ‘Do you consume nuts regularly (at least 2–3 times per week)?’, and ‘Do you go more than once a week to a fast-food (hamburger, pizza) restaurant? ’ . Items denoting lower adherence to the Mediterranean diet were assigned a value of −1, and those related to higher adherence were scored +1. KIDMED scores range from −4 to 12 points, where the higher the score, the better the diet quality.

2.6.2. Eating Behaviors

Eating behaviors were assessed using the Three Factor Eating Questionnaire (TFEQ-R21C) [ 23 ]. Briefly, the TFEQ-R21C includes 21 items such as: ‘I’m always hungry enough to eat at any time’, ‘I start to eat when I feel anxious’, ‘I take small portions on purpose to control my weight’, ‘When I feel lonely, I console myself by eating’, ‘I don’t eat some food because they make me fat’. These items are used to evaluate the following dimensions of eating behavior:

• i. Cognitive restraint, understood as the conscious efforts of individuals to control what they eat to maintain or lose weight.
• ii. Uncontrolled eating, which expresses the tendency to eat excessively in response to the loss of control over the food itself.
• iii. Emotional eating, understood as the need to overeat when individuals are unable to cope with emotionally negative situations and moods.

The TFEQ-R21C consists of 21 items that are scored on a four-point Likert scale ranging from 1 (‘Definitely true’) to 4 (‘Definitely false’). Scores are calculated separately for each dimension as a mean of all items, where the higher the score, the greater the emotional eating, the cognitive restraint, and/or the uncontrolled eating [ 23 , 24 ].

2.6.3. Physical Activity

The level of physical activity was evaluated using the short version of the International Physical Activity Questionnaire (IPAQ) [ 25 ]. This version of the IPAQ questionnaire has been validated in the Spanish population, in which a good correlation with accelerometer data was obtained. The IPAQ contains questions such as: ‘During the last 7 days, on how many days did you do vigorous physical activities like heavy lifting, digging, aerobics or fast bicycling?’, ‘How much time did you usually spend doing vigorous physical activities on one of those days’, ‘During the last 7 days, on how many days did you do moderate physical activities like carrying light loads, bicycling at a regular pace, or doubles tennis? Do not include walking’, ‘How much time did you usually spend doing moderate physical activities on one of those days’, ‘During the last 7 days, on how many days did you walk for at least 10 minutes at a time?’, and ‘How much time did you usually spend walking on one of those days?’. The physical activity score was calculated in Metabolic Equivalents of Task (MET)-minutes per week. In this case, the higher the score, the more intense the level of physical activity.

2.6.4. Sleep Quality

Additionally, sleep quality was evaluated with the Pittsburg Sleep Quality Index (PSQI) [ 26 ], which has been validated in Spanish population [ 27 ]. The PSQI contains questions such as: ‘during the past month, how often have you had trouble sleeping because you had bad dreams?’, ‘during the past month, how would you rate your sleep quality overall?’, ‘during the past month, how often have you had trouble staying awake while driving, eating meals, or engaging in social activities?’. The PSQI consists of 19 items, each rated on a four-point scale (0–3), grouped into seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleeping medications, and daytime dysfunction. Scores range from 0 to 21, where the higher the score, the worse the sleep quality.

2.6.5. Well-Being

This variable was assessed using the World Health Organization-5 (WHO-5) Well-Being Index [ 28 ]. The WHO-5 includes five statements: ‘I have felt cheerful and in good spirits’, ‘I have felt calm and relaxed’, ‘I have felt active and vigorous’, ‘I woke up feeling fresh and rested’ and ‘My daily life has been filled with things that interest me’. The respondent is asked to rate, on a five-point Likert scale (from 0 ‘at no time’ to 5 ‘all the time’), how well each of the five statements apply to him or her when considering the last 14 days. The total raw score is multiplied by 4 to obtain a final score on the scale from 0 to 100, where the higher the score, the higher the well-being.

2.7. Statistical Analyses

Normality was confirmed through histograms and Q–Q plots. Descriptive characteristics are presented for all participants, including mean and standard deviation for continuous variables, and proportions for categorical variables. A chi-squared test was used to compare gender between pre-pandemic and ‘new normal’ groups. Meanwhile, General Linear Models (GLMs) were used to compare age, and sleep and eating routines between pre-pandemic and ‘new normal’ groups. In addition, we used GLMs to calculate adjusted differences in variables related to sleep and eating routines (reference category ‘pre-pandemic’). Subsequently, we compared BMI, diet quality, eating behaviors, physical activity, and well-being variables between pre-pandemic and ‘new normal’ groups using GLMs. All p -values were corrected using the Benjamini–Hochberg method, assuming a False Discovery Rate (FDR) of 5%. All analyses were adjusted for age and gender, and were performed with the SPSS statistical computer software, version 25.0 (IBM SPSS Statistics, Armonk, NY, USA). Significance testing was considered when p < 0.05.

A total of 139 college students were included in this case-control study. The mean age of the participants in the pre-pandemic group ( n = 71) was 22.5 ± 2.3 years, whereas the subjects in the ‘new-normal’ group ( n = 68) were 22.8 ± 3.1 years old ( p = 0.446). Regarding gender, most of the participants were women (pre-pandemic 81.7%, and ‘new normal’ 88.2%), with no statistically significant differences between groups ( p = 0.281).

Regarding sleep routines, our results revealed that though bedtime was similar between pre-pandemic and ‘new normal’ groups, wakeup time differed significantly on weekdays (06:44 ± 00:59 vs. 08:19 ± 00:57, p < 0.001). Specifically, we observed that during the ‘new normal’, participants woke up 1.6 h (95% CI: 1.3, 1.9) later on weekdays ( Figure 1 ). In addition, we observed a significant increase in sleep duration on both weekdays and weekends during the ‘new normal’. However, the greatest increase was found on weekdays, when sleep duration was 1.8 h longer (95% CI: 1.5, 2.2) ( Figure 1 ).

Changes in sleep routines between ‘new normal’ and pre-pandemic groups. General linear models were used to calculate adjusted differences in sleep routines between ‘new normal’ and pre-pandemic conditions (reference group “pre-pandemic”). Analyses were adjusted for age and gender. p -values were corrected using the Benjamini–Hochberg method, assuming a False Discovery Rate (FDR) of 5%. ** p < 0.01, *** p < 0.001.

Interestingly, our results showed a significant reduction in social jet lag and sleep debt during the ‘new-normal’ compared to pre-pandemic conditions. In this regard, we noted that the participants reduced their social jet lag to almost one hour (−0.7 h (95% CI: −1.0, −0.4)), whereas sleep debt was reduced by 1.3 h (95% CI: −1.7, −0.9) ( Figure 1 ).

As for eating routines ( Table 1 ), we observed that eating jet lag was significantly reduced in the ‘new normal’ (−0.3 h (95% CI: −0.5, −0.1)). We also found a slight advance in dinner time during weekdays ( p < 0.05), in which case, dinner was 0.2 h earlier (95% CI: −0.44, −0.04) in the ‘new normal’. In addition, and despite the significant difference in wakeup time on weekdays, we observed that breakfast time on weekdays was similar between the pre-pandemic and ‘new normal’ groups ( Table 1 ).

Comparison of eating routines between pre-pandemic and ‘new normal’ groups.

Values are mean and standard deviation (SD) for continuous data. a Statistical analyses: general linear models were used to compare eating routines between pre-pandemic and ‘new normal’ groups. Analyses were adjusted for age and gender. p -values were corrected using the Benjamini–Hochberg method, assuming a False Discovery Rate (FDR) of 5%. Significant p -values are shown in bold.

Our results also indicated that BMI and diet quality were similar between the pre-pandemic and ‘new normal’ groups ( Table 2 ). Regarding eating behaviors, the results showed that cognitive restraint was reduced by 0.2 points (95% CI: −0.4, −0.1) in the ‘new normal’, whereas no differences were found in emotional and uncontrolled eating scores. Regarding sleep quality and physical activity, we did not observe any significant difference between groups ( Table 2 ). Likewise, we observed that well-being was similar between the pre-pandemic and ‘new normal’ groups.

Comparison of pre-pandemic and ‘new normal’ conditions in body mass index and health-related variables.

Values are mean and standard deviation (SD). MET, metabolic equivalent of task. a Statistical analyses: general linear models were used to compare body mass index and health-related variables between pre-pandemic and ‘new normal’ groups. Analyses were adjusted for age and gender. p -values were corrected using the Benjamini–Hochberg method, assuming a False Discovery Rate (FDR) of 5%. Significant p -values are shown in bold.

4. Discussion

Our findings revealed that, relative to pre-pandemic conditions, the ‘new normal’ had a positive impact in terms of regularity in daily sleep and eating routines. Therefore, the greater flexibility in social schedules provided by the ‘new normal’ was significantly associated with lower social and eating jet lag (−0.7 h and −0.3 h, respectively). Furthermore, our results suggest that in the ‘new normal’, the sleep routines followed by college students on weekdays were more sustainable. Note that in the ‘new normal’, participants slept 1.8 h more, and sleep debt was reduced by ~1.3 h.

These findings are in line with the conclusions drawn from COVID-19 lockdown studies indicating that greater flexibility in social schedules, possibly due to online learning and the elimination of commute time, had a positive impact on daily sleep routines [ 2 ]. This is supported by the significant decrease in sleep debt and social jet lag found during the ‘new normal’. Furthermore, our results showed that the ‘new normal’ lifestyle could mitigate the misalignment between biological and social clocks [ 2 , 16 , 17 , 18 ]. It should be noted that circadian misalignment has been associated with obesity and metabolic alterations [ 6 , 7 , 10 , 11 ], as well as with unhealthy eating habits [ 6 , 29 ]. Therefore, it is plausible that, in the long term, regularity in daily sleep routines could have a positive impact on body weight and other health-related variables in college students. However, evidence from longitudinal studies needs to be warranted.

Regarding eating routines, we noticed a slight advance in dinner timing on weekdays (~0.24 h). Note that advancing dinner time would allow postprandial blood glucose to return to fasting values before the rise in endogenous melatonin levels [ 30 ]. In fact, having dinner closer to bedtime is associated with obesity and metabolic alterations [ 4 , 30 , 31 ]. Furthermore, this subtle shift in dinner timing plus the regularity in daily sleep routines seen in the ‘new normal’ are related to a lower eating jet lag. Regularity in daily eating routines is crucial to maintaining optimal nutrient utilization [ 32 , 33 ]. Note that, when eating occurs at an expected (or regular) time, the circadian system ensures that the proper pathways that help to assimilate the nutrients begin to increase in anticipation of food intake [ 32 ]. However, when food intake occurs at an unexpected (or irregular) time, nutrient sensing pathways act on the peripheral clocks so that food is anticipated at the new mealtime in the following days [ 32 ]. Thus, eating can independently activate nutrient-sensing pathways, compromising the way food is processed during the postprandial period. Not surprisingly, the irregularity in daily eating routines (given by a greater eating jet lag) has been associated with obesity [ 9 , 15 ].

It is worth noting that regularity in daily sleep and eating routines might explain why BMI was similar between the ‘new normal’ and the pre-pandemic groups. We cannot ignore that the COVID-19 lockdown was a stressful time that, among others, had a negative impact on what we ate, how well we slept, and how much exercise we practiced [ 17 , 34 , 35 , 36 ]. Unsurprisingly, during the COVID-19 lockdown, people were more likely to gain weight. In fact, a recent systematic review and meta-analysis found that body weight and BMI increased significantly (~1.57 kg and ~0.31 kg/m 2 , respectively) during the lockdown period compared with pre-pandemic conditions [ 37 ]. Thus, our results suggest that the measures that characterized the ‘new-normal’ (such as prioritizing online classes, allowing individual exercise, and letting people have some sort of social life) may have helped college students to maintain and/or recover their weight once they returned to ‘normal’ life.

In line with the above, we observed that diet quality was similar between the ‘new normal’ and pre-pandemic groups. Our hypothesis was that schedule flexibility could play a role in maintaining diet quality, as having online classes could give college students more time to do other activities, such as cooking. This trend was also observed in young Spanish adults during the COVID-19 lockdown [ 34 ]. The authors reported that 57% of the population studied increased their home cooking practices [ 34 ], which could favor the consumption of healthier homemade foods [ 38 ]. It is worth mentioning that meals prepared and eaten at home are associated with higher-quality diets and better health outcomes [ 39 , 40 , 41 ]. Specifically, Larson et al. [ 39 ] showed that young adults who frequently bought their own food and prepared meals at home had a better diet quality. Interestingly, adherence to a healthy diet could play a significant role in the prevention and predisposition to viral infections, such as COVID-19 [ 42 , 43 ]. According to recent reviews, special attention should be paid to nutrients that play a role in regulating the immune response [ 43 ]. For example, Messina et al. [ 42 ] hypothesized that omega-3 polyunsaturated fatty acids could be used to reduce inflammation, as well as to ameliorate lung damage that occurs after coronavirus infection.

It is also worth noting that in the ‘new normal’, college students were more relaxed in terms of their diet, without compromising diet quality. It is noteworthy that our results showed that cognitive restraint was significantly lower in the ‘new normal’ compared with the pre-pandemic group. Importantly, less cognitive restraint does not necessarily imply that the subjects are prone to increase their body weight, but quite the opposite [ 44 , 45 ]. In fact, previous research performed by our group showed that a greater dietary restraint is associated with a higher BMI among college students [ 45 ].

Along these lines, we observed that the flexibility provided by the ‘new normal’ could have helped to maintain sleep quality, despite the stressful pandemic context. This would also be in line with the findings of Blume et al. [ 17 ] during COVID-19 lockdown. According to the authors, the reduction in sleep debt and social jet lag limited the decline in sleep quality during lockdown. Furthermore, Pilz et al. [ 46 ] suggested that it is not the delay in sleep timing that affects sleep quality, but rather the social jet lag. The authors explained that the combination of late sleep schedules with the time constrains of the social clock could explain why subjects who had a preference for late sleep schedules usually showed the worst sleep quality.

Regarding other health-related variables, our results revealed that physical activity was similar between the ‘new normal’ and pre-pandemic groups (~2242.8 vs. ~2193.9 MET-minutes/day, respectively). This can be attributed to the fact that, despite the restrictions, in the ‘new normal’, exercise was allowed. Importantly, Zhang et al. [ 47 ] observed that during COVID-19 lockdown, performing 2500 METs/week of physical activity (equivalent to a moderate level of physical activity [ 48 ]) alleviated negative emotions in college students, which could also be in line with our results regarding well-being. It is worth noting that despite social restrictions and the curfew issued in the ‘new normal’, well-being remained similar between the ‘new normal’ and pre-pandemic groups. It is also plausible that the consistency of daily sleep routines could also be associated with the maintenance of well-being in the ‘new normal’ [ 2 , 49 ].

Our study has certain limitations, starting with the observational nature of the study, that prevent us from claiming causation. Additionally, we acknowledge as a limitation that our sample consisted mostly of women and undergraduate students of the Bachelor’s Degree in Human Nutrition and Dietetics, which is not representative of the entire population. Furthermore, the representativeness of our results is limited to students living in an urban area. We also acknowledge our results are based upon a cohort of healthy young adults, who may not be representative of the entire population in terms of sleep and meal timing. Nonetheless, the strength of our study is that this is the first research to study the effects of the ‘new normal’ on daily sleep and eating routines, BMI, and health-related variables in college students.

5. Conclusions

In summary, our findings indicate that the ‘new normal’ was associated with greater regularity in daily sleeping and eating routines. Additionally, we observed that BMI, diet and sleep quality, the level of physical activity, and well-being were similar between the ‘new normal’ and pre-pandemic groups. Although, we did observe that college students were less restrictive in terms of their diet, without compromising diet quality. It is also worth noting that the ‘new normal’ offered college students a more sustainable lifestyle, which was reflected in longer sleep duration on weekdays, as well as with less social and eating jet lag. These findings point to the need to rethink the possibility of combining face-to-face activities with remote work and online education, which could be associated with more hours of sleep during weekdays, and the regularity of daily sleep and eating routines. However, more studies are needed to investigate the long-term potential benefits of regular sleep and eating routines on BMI and other health-related variables. Finally, our findings could help formulate public health recommendations for future pandemics where social distancing measures are needed to halt the spread of a virus.

Author Contributions

Conceptualization and methodology, M.I.-P. and M.F.Z.-R.; investigation, formal analysis, data curation, and writing—original draft preparation, C.R.-C. and M.F.Z.-R.; writing—review and editing, M.I.-P.; supervision, project administration, and funding acquisition, M.I.-P. All authors have read and agreed to the published version of the manuscript.

CRC was supported by the National Agency for Research and Development (ANID)/Scholarship Program/DOCTORADO BECAS CHILE/2019–72200134.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of the University of Barcelona (IRB00003099, 20 May 2020).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Conflicts of Interest

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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At the door of the clinic, we stand looking out at two older women chatting outside the doorway, oblivious. Do I wave them away? Call out that they should get far away, go home, wash their hands, stay inside? Instead we just stand there, awkwardly, until they move on. Only then do we step outside to begin the long three-block walk home. I point out the early magnolia, the forsythia. T says he is cold. The untrimmed hairs on his neck, under his beard, are white. The few people walking past us on the sidewalk don’t know that we are visitors from the future. A vision, a premonition, a walking visitation. This will be them: Either T, in the mask, or — if they’re lucky — me, tending to him.

Essayist Leslie Jamison writes in the New York Review of Books about being shut away alone in her New York City apartment with her 2-year-old daughter since she became sick:

The virus. Its sinewy, intimate name. What does it feel like in my body today? Shivering under blankets. A hot itch behind the eyes. Three sweatshirts in the middle of the day. My daughter trying to pull another blanket over my body with her tiny arms. An ache in the muscles that somehow makes it hard to lie still. This loss of taste has become a kind of sensory quarantine. It’s as if the quarantine keeps inching closer and closer to my insides. First I lost the touch of other bodies; then I lost the air; now I’ve lost the taste of bananas. Nothing about any of these losses is particularly unique. I’ve made a schedule so I won’t go insane with the toddler. Five days ago, I wrote Walk/Adventure! on it, next to a cut-out illustration of a tiger—as if we’d see tigers on our walks. It was good to keep possibility alive.

At Literary Hub, novelist Heidi Pitlor writes about the elastic nature of time during her family’s quarantine in Massachusetts:

During a shutdown, the things that mark our days—commuting to work, sending our kids to school, having a drink with friends—vanish and time takes on a flat, seamless quality. Without some self-imposed structure, it’s easy to feel a little untethered. A friend recently posted on Facebook: “For those who have lost track, today is Blursday the fortyteenth of Maprilay.” ... Giving shape to time is especially important now, when the future is so shapeless. We do not know whether the virus will continue to rage for weeks or months or, lord help us, on and off for years. We do not know when we will feel safe again. And so many of us, minus those who are gifted at compartmentalization or denial, remain largely captive to fear. We may stay this way if we do not create at least the illusion of movement in our lives, our long days spent with ourselves or partners or families.

• What day is it today?

Novelist Lauren Groff writes at the New York Review of Books about trying to escape the prison of her fears while sequestered at home in Gainesville, Florida:

Some people have imaginations sparked only by what they can see; I blame this blinkered empiricism for the parks overwhelmed with people, the bars, until a few nights ago, thickly thronged. My imagination is the opposite. I fear everything invisible to me. From the enclosure of my house, I am afraid of the suffering that isn’t present before me, the people running out of money and food or drowning in the fluid in their lungs, the deaths of health-care workers now growing ill while performing their duties. I fear the federal government, which the right wing has so—intentionally—weakened that not only is it insufficient to help its people, it is actively standing in help’s way. I fear we won’t sufficiently punish the right. I fear leaving the house and spreading the disease. I fear what this time of fear is doing to my children, their imaginations, and their souls.

At ArtForum , Berlin-based critic and writer Kristian Vistrup Madsen reflects on martinis, melancholia, and Finnish artist Jaakko Pallasvuo’s 2018 graphic novel Retreat , in which three young people exile themselves in the woods:

In melancholia, the shape of what is ending, and its temporality, is sprawling and incomprehensible. The ambivalence makes it hard to bear. The world of Retreat is rendered in lush pink and purple watercolors, which dissolve into wild and messy abstractions. In apocalypse, the divisions established in genesis bleed back out. My own Corona-retreat is similarly soft, color-field like, each day a blurred succession of quarantinis, YouTube–yoga, and televized press conferences. As restrictions mount, so does abstraction. For now, I’m still rooting for love to save the world.

At the Paris Review , Matt Levin writes about reading Virginia Woolf’s novel The Waves during quarantine:

A retreat, a quarantine, a sickness—they simultaneously distort and clarify, curtail and expand. It is an ideal state in which to read literature with a reputation for difficulty and inaccessibility, those hermetic books shorn of the handholds of conventional plot or characterization or description. A novel like Virginia Woolf’s The Waves is perfect for the state of interiority induced by quarantine—a story of three men and three women, meeting after the death of a mutual friend, told entirely in the overlapping internal monologues of the six, interspersed only with sections of pure, achingly beautiful descriptions of the natural world, a day’s procession and recession of light and waves. The novel is, in my mind’s eye, a perfectly spherical object. It is translucent and shimmering and infinitely fragile, prone to shatter at the slightest disturbance. It is not a book that can be read in snatches on the subway—it demands total absorption. Though it revels in a stark emotional nakedness, the book remains aloof, remote in its own deep self-absorption.

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

In an essay for the Financial Times, novelist Arundhati Roy writes with anger about Indian Prime Minister Narendra Modi’s anemic response to the threat, but also offers a glimmer of hope for the future:

Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.

From Boston, Nora Caplan-Bricker writes in The Point about the strange contraction of space under quarantine, in which a friend in Beirut is as close as the one around the corner in the same city:

It’s a nice illusion—nice to feel like we’re in it together, even if my real world has shrunk to one person, my husband, who sits with his laptop in the other room. It’s nice in the same way as reading those essays that reframe social distancing as solidarity. “We must begin to see the negative space as clearly as the positive, to know what we don’t do is also brilliant and full of love,” the poet Anne Boyer wrote on March 10th, the day that Massachusetts declared a state of emergency. If you squint, you could almost make sense of this quarantine as an effort to flatten, along with the curve, the distinctions we make between our bonds with others. Right now, I care for my neighbor in the same way I demonstrate love for my mother: in all instances, I stay away. And in moments this month, I have loved strangers with an intensity that is new to me. On March 14th, the Saturday night after the end of life as we knew it, I went out with my dog and found the street silent: no lines for restaurants, no children on bicycles, no couples strolling with little cups of ice cream. It had taken the combined will of thousands of people to deliver such a sudden and complete emptiness. I felt so grateful, and so bereft.

And on his own website, musician and artist David Byrne writes about rediscovering the value of working for collective good , saying that “what is happening now is an opportunity to learn how to change our behavior”:

In emergencies, citizens can suddenly cooperate and collaborate. Change can happen. We’re going to need to work together as the effects of climate change ramp up. In order for capitalism to survive in any form, we will have to be a little more socialist. Here is an opportunity for us to see things differently — to see that we really are all connected — and adjust our behavior accordingly. Are we willing to do this? Is this moment an opportunity to see how truly interdependent we all are? To live in a world that is different and better than the one we live in now? We might be too far down the road to test every asymptomatic person, but a change in our mindsets, in how we view our neighbors, could lay the groundwork for the collective action we’ll need to deal with other global crises. The time to see how connected we all are is now.

The portrait these writers paint of a world under quarantine is multifaceted. Our worlds have contracted to the confines of our homes, and yet in some ways we’re more connected than ever to one another. We feel fear and boredom, anger and gratitude, frustration and strange peace. Uncertainty drives us to find metaphors and images that will let us wrap our minds around what is happening.

Yet there’s no single “what” that is happening. Everyone is contending with the pandemic and its effects from different places and in different ways. Reading others’ experiences — even the most frightening ones — can help alleviate the loneliness and dread, a little, and remind us that what we’re going through is both unique and shared by all.

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A Year After Coronavirus: An Inclusive ‘New Normal’

Six months into a new decade, 2020 has already been earmarked as ‘the worst’ year in the 21st century. The novel coronavirus has given rise to a global pandemic that has destabilized most institutional settings. While we live in times when humankind possesses the most advanced science and technology, a virus invisible to the naked eye has massively disrupted economies, healthcare, and education systems worldwide. This should serve as a reminder that as we keep making progress in science and research, humanity will continue to face challenges in the future, and it is upon us to prioritize those issues that are most relevant in the 21st century.

Even amidst the pandemic, Space X, an American aerospace manufacturer, managed to become the first private company to send humans to space. While this is a tremendous achievement and prepares humanity for a sustainable future, I feel there is a need to introspect the challenges that we are already facing. On the one hand, we seem to be preparing beyond the 21st century. On the other hand, heightened nationalism, increasing violence against marginalized communities and multidimensional inequalities across all sectors continue to act as barriers to growth for most individuals across the globe. COVID-19 has reinforced these multifaceted economic, social and cultural inequalities wherein those in situations of vulnerability have found it increasingly difficult to get quality medical attention, access to quality education, and have witnessed increased domestic violence while being confined to their homes. 

Given the coronavirus’s current situation, some households have also had time to introspect on gender roles and stereotypes. For instance, women are expected to carry out unpaid care work like cooking, cleaning, and looking after the family. There is no valid reason to believe that women ought to carry out these activities, and men have no role in contributing to household chores. With men having shared household chores during the lockdown period, it gives hope that they will realize the burden that women have been bearing for past decades and will continue sharing responsibilities. However, it would be naïve to believe that gender discrimination could be tackled so easily, and men would give up on their decades' old habits within a couple of months. Thus, during and after the pandemic, there is an urgent need to sensitize households on the importance of gender equality and social cohesion.

Moving forward, developing quality healthcare systems that are affordable and accessible to all should be the primary objective for all governments. This can be done by increasing expenditure towards health and education and simultaneously reducing expenditure on defence equipment where the latter mainly gives rise to an idea that countries need to be prepared for violence. There is substantial evidence that increased investment in health and education is beneficial in the long-term and can potentially build the basic foundation of a country. 

If it can be established that usage of nuclear weapons, violence and war are not solutions to any problem, governments (like, for example, Costa Rica) could move towards disarmament of weapons and do their part in building a more peaceful planet that is sustainable for the future. This would further promote global citizenship wherein nationality, race, gender, caste, and other categories, are just mere variables and they do not become identities of individuals that restrict their thought process. The aim should be to build responsible citizens who play an active role in their society and work collectively in helping develop a planet that is well-governed, inclusive, and environmentally sustainable.

 ‘A year after Coronavirus’ is still an unknown, so I think that our immediate focus should be to tackle the complex problems that have emerged from the pandemic so that we make the year after coronavirus one which highlights recovery and acts as a pathway to fresh beginnings. While there is little to gain from such a fatal cause, it is vital that we also use it to make the ‘new normal’ in favour of the environment and ensure that no one is left behind.   

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

Joint statement by ilo, fao, ifad and who.

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

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

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

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

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

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

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

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

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

Media Contacts

Kimberly Chriscaden

Communications Officer World Health Organization

Nutrition and Food Safety (NFS) and COVID-19

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Life After COVID-19

COVID-19 is significantly impacting the lives of all people on the globe. Strict quarantine measures changed the attitude towards such simple things as walking in the park, talking to strangers, working, and studying in a team. What is more, people started to value the work of medics as keen as never before. Unfortunately, many nurses become victims of this virus. The current paper discusses the impact of COVID-19 on the loss of nurses on personal and professional levels.

The loss of nurses caused by the death from the coronavirus leads to the shortage of labor in health institutions. Someday, the pandemic will come to an end, and people will return to the usual lifestyle; however, the losses of nurses are irretrievable. During the pandemic situation, some countries such as China, Russia, Japan, the US send their medics to foreign countries. This help is relevant during these hard times. Nevertheless, after the pandemic, other states will hardly share their nurses, medical equipment, and medicines. The shortage of nurses will cause a higher workload on the doctors to whom they usually assist. It would be harder to take care of inpatients since nurses do a great job helping doctors to monitor them.

On a personal level, I admire medical staffers who work with people infected with the virus. They wear special costumes that minimize the probability of getting infected. Notwithstanding this fact, the statistics indicate how significant are the losses among the nurses. Grace Oghiehor-Enoma, a nurse from New York, compared physicians with fighters on the battlefield. She says: “You see the fire, and you are running into the fire, not thinking about yourself. That is the selflessness that you can see in nursing today” (World Health Organization, 2020). People used to underestimate the importance of nurses while now see who the saviors of humanity are.

To sum up, the work of nurses is an excellent feat. They are an example of people whom we must take an example. From the very beginning of the pandemic, it was apparent that the losses among nurses are inevitable. Nevertheless, no one could expect that these losses will be that big. Still, all of us could help them just staying home and minimizing the probability of getting infected.

World Health Organization. (2020). Support Nurses and Midwives through COVID-19 and beyond . Web.

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• Volume 76, Issue 2
• COVID-19 pandemic and its impact on social relationships and health
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• http://orcid.org/0000-0003-1512-4471 Emily Long 1 ,
• Susan Patterson 1 ,
• Karen Maxwell 1 ,
• Carolyn Blake 1 ,
• http://orcid.org/0000-0001-7342-4566 Raquel Bosó Pérez 1 ,
• Ruth Lewis 1 ,
• Mark McCann 1 ,
• Julie Riddell 1 ,
• Kathryn Skivington 1 ,
• Rachel Wilson-Lowe 1 ,
• http://orcid.org/0000-0002-4409-6601 Kirstin R Mitchell 2
• 1 MRC/CSO Social and Public Health Sciences Unit , University of Glasgow , Glasgow , UK
• 2 MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing , University of Glasgow , Glasgow , UK
• Correspondence to Dr Emily Long, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR, UK; emily.long{at}glasgow.ac.uk

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

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

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

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

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Introduction

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

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

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

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

Social networks

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

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

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

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

Social support

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

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

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

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

Social and interactional norms

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

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

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

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

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

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

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

Recommendations and conclusions

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

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

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

Recommendation 2: intelligently balance online and offline ways of relating

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

Recommendation 3: build stronger and sustainable localised communities

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

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

Ethics statements

Patient consent for publication.

Not required.

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

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

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

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

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• The vacuum of...

The vacuum of information about covid’s prevalence puts me at risk—bring back better data collection

• Related content
• Peer review
• Janet Gunter 1 2
• 1 Patient author, UK
• 2 Long Covid SOS, Nottingham, UK

The UK’s new government should commit to public health, starting with better data collection on the prevalence of covid in the community, writes Janet Gunter

A few weeks ago, my partner tested positive for covid-19 for the first time. I’ve never recovered after being infected by covid during the first wave of the pandemic, so this is a big deal for us. The prospect of reinfection and a worsening of my symptoms is deeply troubling, and I spent weeks quarantining and apprehensively waiting to see if I would catch covid again. It’s maddening to know that all of this, including my partner’s infection, could have been avoided if we'd only had access to better data on the prevalence of covid.

We already lead a very covid-cautious life because I do not want to get worse with another infection. I’ve had debilitating long covid symptoms since I first became ill in 2020: extreme fatigue, frequent crashes that leave me bed-bound, pain, cognitive impairment, and disrupted sleep are everyday experiences for me. I live a shadow of my former life, unable to travel much, socialise, or work more than part time.

My partner goes to the office one or two days a week, masking in common spaces, and using a personal air filter at her desk. We mask indoors in public and avoid crowded spaces. Previously, we’ve used data to help us make decisions about how to go about our lives: when we knew the prevalence of covid was high, we’d avoid any extra activity that might expose us to infection.

We got caught out this summer because of a vacuum of information about covid prevalence in England. Before, we could count on data from the Office for National Statistics (ONS) and crowdsourced data by the ZOE app. Both were defunded by the previous government. 1 2

The ONS Covid Infection Survey was one of the few “world-beating” initiatives of the government during covid. 3 4 Experts praised it for setting the gold standard, by going out into the community and testing. Currently, the government shares infection data collected almost exclusively at hospitals, and this does not tell us much about covid's spread in the community. Unlike many countries, England doesn't even collect wastewater data. 5

Now my partner and I rely on Christina Pagel's Substack and Scottish wastewater data to judge how much of a risk covid poses. 6 7 But it simply isn't enough. We had believed that summer infections had peaked in early July, but, anecdotally, it seemed to be everywhere in August, including Olympic changing rooms. 8

My partner and I took risks that we absolutely would not have taken with better prevalence data, and the consequence was bringing covid into our house.

The ability to quarantine is a privilege, but that didn’t stop it being extremely difficult for us and very stressful for me, as I wanted to avoid reinfection at all costs. I did manage to avoid it, but all of our efforts to avoid each other and masking took a toll on my physical and mental health.

My partner had to take a week off work; multiplying that at a national scale, and with multiple infections, can give us an idea of how covid is still damaging productivity. The Economist ’s Economist Impact estimated that long covid will cost the UK economy roughly 0.5% of GDP in 2024. 9 With better prevalence data, employers could prevent covid’s spread by encouraging people to work from home during waves of infection, redoubling efforts to ventilate workplaces, and postponing crowded events.

But beyond productivity, covid continues to kill and disable people. Our new parliamentary undersecretary of state for public health and prevention, MP Andrew Gwynne, knows this firsthand. He has long covid and said in May in Parliament “I have managed to control my long covid for the best part of two years, but this week has been a very bad week for me; I was in bed for all of today, and I have only come in to give this speech.” 10 His words are a reminder of the ongoing, but often invisible, burden of the disease.

The free circulation of a virus that leaves people with these debilitating symptoms, and the failure to monitor it with surveillance systems, is an ongoing public health disaster. The previous government placed all responsibility for preventing covid on the individual but refused to give us the tools to limit our own personal risk. We need this government to bring back a commitment to public health, starting with better data collection on covid prevalence in the community so that we can save lives, prevent disability, and maintain economic productivity. The moment demands courage and care.

Competing interests: JG is a volunteer for Long Covid SOS.

Provenance and peer review: Not commissioned; not peer reviewed.

• ↵ Wakefield J. Zoe Covid-tracking app loses government funding. BBC News 11 March 2022. https://www.bbc.co.uk/news/technology-60708330
• ↵ Wilkinson E. ONS to stop Covid infection weekly data report at end of month. Pulse 14 March 2023. https://www.pulsetoday.co.uk/news/clinical-areas/respiratory/ons-to-stop-covid-infection-weekly-data-report-at-end-of-month/ .
• ↵ Office for National Statistics. Coronavirus (COVID-19) Infection Survey, UK Statistical bulletins. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveypilot/previousReleases .
• ↵ World Health Organization. WHO COVID-19 dashboard. Wastewater environmental surveillance. https://data.who.int/dashboards/covid19/wastewater
• ↵ Pagel C. Diving into Data & Decision making. Substack. https://christinapagel.substack.com/
• ↵ Scottish Environment Protection Agency. RNA Monitoring. Project Overview. https://informatics.sepa.org.uk/RNAmonitoring/
• ↵ Baxa M. An incomplete picture: understanding the burden of long COVID. Economist Impact 29 April 2024. https://impact.economist.com/perspectives/health/incomplete-picture-understanding-burden-long-covid .
• ↵ UK Parliament. World ME Day. Volume 749: debated on Wednesday 1 May 2024. https://hansard.parliament.uk/commons/2024-05-01/debates/9BE269EC-BE67-439A-9546-7C72A7043C59/WorldMEDay