importance of money during pandemic essay

How We’re Saving Money During the Pandemic

From fuel to clothing, lifestyle changes in COVID-19 present opportunities to cut spending

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When Lori Levy looks back at the past year, she’s painfully aware of what she’s missed out on because of the pandemic. Her son didn’t have an in-person high school graduation, and she’s gone nearly two years without seeing her daughter, who lives in California. 

“It’s just nice to know that you have that money when you need it,” said Levy, a nurse educator in the Clinical Education and Professional Development Department.

Throughout the pandemic, most Duke employees have seen their spending habits altered, resulting in opportunities to save money.

According to the  Federal Reserve Bank of St. Louis , Americans’ personal saving rate – the percentage of disposable income that’s saved – went from 8.3 percent in February of 2020 to 33.7 percent in April of 2020. In January of 2021, it remained high at 20.5 percent.

“On one hand, we have murky waters ahead, but on the other hand, people are finding themselves with extra cash,” said Benjamen Parker, a retirement planner with Fidelity, the primary record keeper for  Duke’s Faculty and Staff Retirement Plan . “So now, they want to know what they should do with this extra money?”

As you ponder how the pandemic has shaped your financial situation, consider how some colleagues have found ways to save money.

Be Smart with Extra Savings

When he speaks to Duke employees seeking financial advice, Parker often starts with recommending people  build a household budget .

If you haven’t done so already, a budget is the easiest way to see where your money goes and make sure that it covers important expenses and priorities, such as retirement and emergency savings. 

Fidelity recommends using  the 50/15/5 approach , where 50 percent of your income goes to essentials, 15 to retirement savings and five for emergency savings. The ideal amount of emergency savings would be enough to cover three-to-six months of expenses.

After a year-long suspension of contributions to the faculty and staff retirement plan due to the financial pressures of the COVID-19 pandemic, contributions will return  as scheduled on July 1, 2021.

Casual Savings on Clothing

With a whiteboard, multiple computer monitors and constellations of sticky notes on her wall, Emily Jackson has built a home workspace that has plenty of the touches of her on-campus office in Erwin Square.

Prior to the pandemic, Jackson spent around $30 to $50 per week on dry cleaning.

“That’s definitely a savings for me,” said Jackson, a senior regulatory coordinator for the Duke School of Medicine’s Pediatrics Department.

According to consumer spending data compiled by the  U.S. Bureau of Economic Analysis , Americans spent $23.9 billion less on clothing and footwear in the fourth quarter of 2020 than they did in the fourth quarter of 2019.

Jackson also said she’s appreciated not having to buy as many clothes, and if she ends up working on-site again, she hopes to keep her savings momentum going.

“When I look at my clothes, I just think, why did I need so much stuff?” Jackson said. “I think I’ll be more frugal once we go back.”

Fewer Trips to Gas Stations

When the COVID-19 pandemic struck, John Owens’ position as a senior IT analyst with Duke’s Office of Information Technology, went remote, meaning he no longer had to make the roughly 70-minute round trip commute from his home in Mebane to his office in the American Tobacco Campus.

Data from the U.S. Bureau of Economic Analysis shows that in the fourth quarter of 2020, Americans spent $88.2 billion less on gasoline and other energy goods than they did in the fourth quarter of 2019. 

The savings are just one of the positive developments Owens has experienced due to working remotely during the pandemic. Owens also appreciates having more time to get outdoors and walk and having the opportunity to eat healthier homemade meals instead of restaurant lunches at work, and 

“Obviously, all of us were scared at first because we didn’t know how this was going to go and how it would affect us individually,” Owens said. “But finding positives anywhere has definitely been good.”

Family Finances

Since the start of the pandemic, Kate Davies has worked from home in Wake County alongside her two children, who are doing school work online.

So in addition to saving about $150 per month on gas and another $20 per month for her campus parking permit, Davies doesn’t have to pay $100 per month for the before-school care. She’s been able to use those savings to take care of some debt and increase her contributions to her retirement account.

But for Davies, an administrative assistant with Duke Counseling & Psychological Services (CAPS), the money is not nearly a valuable as the gift of time with her kids.

“It’s lovely, actually,” Davies said. “I really enjoy it. I feel like I get to be a parent for the first time because I’m not shipping them off to somebody else to look after them. It’s been nice to see them learn, share meals together and take them to soccer practice, which was something I wasn’t able to do before.”

Fewer Lunches Out

Prior to the pandemic, Emily James, a regional development director for Duke University Development, would spend around half of her workdays on the road, strengthening Duke’s connections to alumni, parents and friends in places such as Chicago, Pittsburgh, Indiana, Iowa and South Carolina. The rest of the time, she’d be at her downtown Durham workspace.

“Our office was in One City Center, which was great because it gave us access to a million restaurants,” she said. 

Now that she’s working from home, James estimates that she’s saving around $30 to $50 per week by not eating out during the day. The U.S. Bureau of Economic Analysis reported that in the fourth quarter of 2020, Americans spent $194.9 billion less on food service and accommodations than they did in the fourth quarter of 2019.

James has been putting that savings to good use as it helped cover the cost of a tutor who would visit her house a few times a week to help her children who – until they returned to in-person learning in February – were completing their kindergarten and second grade schooling online.

“I was grateful to have her,” James said of the tutor. “She was a huge help.”

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Consumer Behavior

Health vs. wealth: how the pandemic changed our priorities, shopping, sharing, and savoring: balancing health and wealth..

Posted June 6, 2022 | Reviewed by Michelle Quirk

• The COVID-19 pandemic has uniquely impacted the value we place on both money and materialism.
• The pandemic produced materialistic values, such as consuming media, anxiety, stress, loneliness, and depressed mood.
• Contrary to expectations, focus on money actually decreased during the course of the pandemic.

During the early months of 2020, many people were reminded through both personal experience and global news reports of the critical importance of maintaining good health. As the pandemic progressed, we began to ask: but at what cost? We recognized that all the money in the world cannot buy good health, although good insurance helps. Flash forward several years, and we have clarified our priorities through our evolving practices of saving, sharing, and spending. As many people suspected, the COVID-19 pandemic has uniquely impacted the value we place on both money and materialism .

Shopping, Sharing, and Savoring

Olaya Moldes et al. (2022) examined how people changed their priorities over the course of the COVID-19 pandemic. 1 Focusing largely on money and materialism, they made some interesting observations that demonstrate how privately evolving priorities can impact public spending behavior.

Balancing Health and Wealth

Moldes et al. note that the pandemic produced an increase in the types of factors that usually accompany an endorsement of materialistic values, such as consuming more media, anxiety , stress , loneliness , and depressed mood. Although they found that increases in media consumption, anxiety, and stress predicted levels of materialism to an extent, they found such effects to be limited. Contrary to expectations, they found that our focus on money actually decreased during the course of the pandemic.

Moldes et al. recognized a research-based definition of materialism as “individual differences in people's long-term endorsement of values, goals , and associated beliefs that center on the importance of acquiring money and possessions that convey status” (Dittmar et al., 2014). They note that wealth and consumption are thought to be tied to personal achievement and happiness —even though materialism has been linked to lower well-being and higher degrees of compulsive buying. They also note that research shows that advocating materialistic values is influenced by a higher amount of media consumption as well as social and personal insecurities and negative emotions.

But, overall, Moldes et al. explained that their observed decrease in the importance people placed on money might be due to the COVID-19–triggered alterations in the values people held—which were in the opposite direction than were predicted. They also found that, contrary to expectations, people decreased the level of importance they placed on economic resources during the outbreak, despite experiencing more factors that facilitate and promote materialism. They note that these results may be due to prioritizing personal health and well-being, or emerging “collective social identities that promote social solidarity and cooperation ,” that have previously been observed in times of emergencies and environmental disasters—thus decreasing our focus on material and economic resources.

Resignation and Revival

Moldes et al. note that the COVID-19 pandemic has changed the ways in which people think about money. Commenting on what has been dubbed “The Great Resignation” observed in the United States and the United Kingdom, they note that exiting the workforce has been likely fueled by reflecting on life priorities during the pandemic.

One interesting point, however, was that, apparently, during the pandemic, people found money to be less important, despite an increase in factors that endorse materialism. Moldes et al. observed an overall decrease in reported pandemic shopping behaviors, but a higher instance of purchasing as a coping mechanism to deal with negative emotions and in pursuit of well-being.

As we move forward seeking to prioritize both health and wealth, we have gained a greater appreciation of the ageless adage that the most precious things in life are free.

1. Moldes, Olaya, Denitsa Dineva, and Lisbeth Ku. 2022. “Has the Covid‐19 Pandemic Made Us More Materialistic? The Effect of Covid‐19 and Lockdown Restrictions on the Endorsement of Materialism.” Psychology & Marketing, January. doi:10.1002/mar.21627.

Wendy L. Patrick, J.D., Ph.D., is a career trial attorney, behavioral analyst, author of Red Flags , and co-author of Reading People .

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Saving our livelihoods from COVID-19: Toward an economic recovery

We are now living through the most uncertain moment of our times. Many countries have been in lockdown since early March 2020. Even Japan, once a beacon of hope for controlling COVID-19, is now moving toward total isolation. Many political leaders realize that physical distancing might be the norm for at least several months. They wonder how—or if—they can maintain indefinite lockdowns without compromising the livelihoods of their people.

Political leaders aren’t alone in their fears. As the pandemic continues its exponential course, workers in most countries wonder what will become of their jobs when the lockdowns end. Businesses struggling to pay their employees and cover operational costs wonder if they will have clients or customers when they reopen. Banks and investors realize that many companies, especially small and midsize ones, will default and are trying to protect both financial stability and public savings. Meanwhile, governments are working to calculate the magnitude of the shock and sharpening their tools to save economies from collapse. They know that history will judge them by the decisions they make now.

This daunting scenario poses several basic questions. How can we save both lives and livelihoods? Which decisions are best managed by governments? How can they evaluate the risks that experts predict from a prolonged lockdown, such as starvation, domestic violence, and chronic depression—as well as protect jobs, income security, food supplies, and the general welfare of the most vulnerable people among us? How and to what extent should they try to save banks, prevent fiscal ruin, and safeguard future generations?

Governments could address all these questions strategically. In effect, they are caring for two patients who react to the same medicine—physical distancing—in very different ways. The first patient is the public-health system. Physical distancing might cure or alleviate its symptoms but could exacerbate those of the second patient, the economy. This trade-off suggests a physical-distancing strategy for governments: ensuring the health system’s ability to deal with COVID-19 and protecting the economy.

Exhibit 1 shows how different levels of physical isolation affect economic conditions. A recession could occur if faltering demand, restricted supply, and lost income reach critical levels. The differences between scenarios could be tenfold: a country that applies physical distancing in a lax way and ends it too soon could face zero GDP growth, but if the same country imposed a very strict and prolonged quarantine, GDP might plunge by 20 percent. In some Western economies, the latter scenario might increase government control of strategic sectors.

Countries can avoid the worst scenarios if they work quickly along three principal lines of action: first, minimizing the impact of physical distancing on the economy; second, spending deeply to keep it afloat; and third, spending even more to accelerate the crisis recovery and to close historical gaps.

Minimize the economic impact of physical distancing

In a recent article , we showed how different isolation strategies can have different effects on the ability of countries to save both lives and livelihoods. Policies for localized physical distancing at the regional, sectoral, or individual level might have better results than blanket lockdowns of entire countries. The time has therefore come to quantify the impact of lockdowns on people’s livelihoods.

Advanced analytics could help countries estimate—with a high level of confidence—the shock to the economy by aggregating data on power consumption, debit- and credit-card spending, applications for unemployment insurance, default rates, and tax collections. Exhibit 2 estimates the changes in demand for goods and services by using visits to Google services as a proxy. We calculate that the number of these visits in several countries fell by as much as 95 percent during the first two weeks of the lockdowns.

Individual countries that implement localized physical distancing might be able to keep track of how many people are in the streets at any given time and how much economic activity those people generate. But approaches to physical distancing will probably vary a good deal from country to country, depending on how they balance public-health issues with privacy concerns. Countries could plan prolonged lockdowns for the elderly and children and estimate their levels of consumption. They could quantify the number of employees in essential sectors that continue to operate (health, security, food and beverages, agriculture, utilities, and transportation). They could determine which regions or states should remain under complete lockdown and which sectors are operating under strict health protocols in other places. And they could track how many people are working from home in each sector and their contributions to the economy.

Analyzing a granular level of information might help countries quantify the weekly impact of physical distancing on various key indicators by region and by economic sector.

This granular level of information might help countries quantify the weekly impact of physical distancing on GDP, productivity, aggregated demand, income loss, unemployment, poverty, and fiscal-deficit levels by region and by economic sector (Exhibit 3). If countries knew all that information, they would know the cost of the lockdowns on the livelihoods of their people.

Spend deeply to keep the economy afloat

Armed with information on the economic impact of physical-distancing strategies, governments can prepare their next moves (Exhibit 4).

To recover from the pandemic’s health and economic consequences, we must uphold the social contract—the implicit relationship between individuals and institutions. The market economy and the social fabric that holds it together will be deeply compromised, or perhaps undermined, if massive numbers of jobs are lost, vendors can’t fulfill their contracts, tenants can’t make their rent, borrowers default at scale, and taxes go unpaid. Governments could therefore quantify the minimum level of income that households need to cover their basic necessities, the minimum level of liquidity that companies need to cover their costs (including payrolls) and to protect their long-term solvency, the minimum liquidity levels that banks need to support defaults, and the minimum amount of money that governments need to supply all those requirements. Let’s examine each of them.

Formal, informal, or independent workers will all have their own particular financial needs. So will vulnerable populations, such as people at higher risk of infection, which might not be able to return to work for some time. Leaders in the public sector should determine the level of support that each population segment requires and the appropriate distribution channels for fast delivery. Familias en Acción in Colombia and Janani Suraksha Yojana (JSY) in India, for example, are conditional-cash-transfer (CCT) programs that support millions of vulnerable people. Such programs could temporarily expand to cover other segments of the population, such as informal and independent workers. It might also be necessary to consolidate databases and information systems and to digitize all payments.

Since revenues have plummeted, many companies require help to safeguard employment. Their needs vary widely among sectors of the economy; professional-service firms, for example, usually have twice as many working-capital days as restaurants do. What’s more, physical distancing will affect different kinds of companies in different ways. As a first move to help them, several countries have already frozen short-term fiscal, parafiscal, and social-security payments. Some are using innovative instruments to irrigate money—for instance, capitalizing national reinsurance agencies to cover most of the expected losses from the new loans required to bridge payroll payments and working capital.

Banks can play a meaningful role during the crisis in two fundamental ways: lending money to companies in distress and recognizing that some companies simply can’t survive. If default rates on current loan portfolios skyrocket, the expected shock to incomes and to supply and demand could compromise the solvency of some banking systems. Besides thinking about loosening solvency and warranty regulations, governments might consider creative solutions, such as distinguishing among banks according to their credit portfolios to strengthen financial institutions’ balance sheets and injecting government-backed convertible loans against their long-term warrants and restructuring targets. (Governments implemented these mechanisms successfully in other financial emergencies, such as the 1997 Asian market crisis, the 1999 Latin American crisis, and, most recently, the 2008 crisis in Europe and the United States.)

Strengthening the balance sheets of banks might not be enough to deal with the aftermath of COVID-19; governments might have to use monetary expansion through debt and equity emissions backed by central banks. Countries with deeper capital markets could not only securitize loans and new instruments but also use the financial strength and long-term view of pension funds and other institutional investors to ease short-term crisis-related pressures on public finance.

Governments shouldn’t be shy about using such instruments extensively if that’s needed to keep economies running. Since such stimuli would have a cost, additional fiscal requirements could complement them in the medium term. To preserve national solvency, governments might also reexamine historical exemptions from taxation.

Spend more to accelerate the crisis recovery and close historical gaps

After countries estimate the size of the stimulus packages needed to help households, companies, and financial systems, they can start designing additional, customized programs to restore demand and accelerate recovery. People who receive direct subsidies to stay at home could gradually return to work as each sector of the economy introduced new health and behavioral practices. Meanwhile, as many workers as possible should receive new job opportunities. To provide them, governments could introduce innovative labor regulations and help companies operate 24/7 under flexible schemes. They might also turn old-fashioned CCT programs into universal-income alternatives linked to new jobs in ambitious, government-led programs for infrastructure, housing, and industrial reconversion. Each country could find its equivalent of Franklin Roosevelt’s New Deal.

Governments may also find it advisable to relax their regulatory regimes to help businesses not only reopen but also grow. Most countries have national, local, and sectoral regulations that were perfectly appropriate before the coming of COVID-19 but will be extremely expensive in the next normal. National programs to eliminate red tape at scale will help a good deal. Speed and flexibility are essential.

Businesses in sectors facing strict physical-distancing policies might need additional long-term capital. Governments could use innovative special-purpose vehicles to inject fresh equity and provide fiscal incentives to attract long-term investors. Businesses receiving that sort of aid should expect to commit themselves to restructuring: rescue packages could promote leaner operations, digital and industrial reconversions, the introduction of new channels, agile organizational structures, and innovative learning techniques. Governments could also ensure that such aid programs encourage competition—poorly designed policies that strengthen oligopolies and threaten the interests of consumers will be costly in the long run.

Although governments should carefully weigh the impact of their aggressive programs against long-term fiscal sustainability, they can play a significant role in restoring demand for goods and services and in fostering investment in new business models. Many initiatives—for instance, accelerating infrastructure projects; fast-tracking private investment to build hospitals, schools, and other social projects; encouraging urban renewal and very large housing projects; sponsoring the development of digital clusters to digitize government services; easing investment conditions to take advantage of global supply chains; capturing near-shore production opportunities; promoting large agribusiness developments; and stimulating exporting—could promote those goals. It is time to spend—but wisely.

The COVID-19 pandemic is a global tragedy. But that shouldn’t—and needn’t—prevent us from finding innovative ways to accelerate progress. It would not be the first disaster to do so. This may be the right time to introduce fiscal, labor, pension, social, environmental, and economic reforms to speed up progress toward sustainable development. Ameliorating poverty, diminishing inequality, and protecting the environment could figure prominently in global and national agendas. Governments, companies, and social organizations could act quickly to promote full financial inclusion, the transition to cashless economies, and the provision of better and more efficient social and public services. Political leaders might condition access to massive economic-stimulus programs on efforts to reduce informality, rethink healthcare systems, digitize entire sectors of the economy to accelerate productivity, and encourage digital innovation—especially high-quality public education with universal internet access.

Governments ought to act quickly. The first step is to understand the economic impact of the crisis in both the short and medium terms. Second, governments could inject the minimum viable liquidity to keep markets alive. Finally, they could expedite ambitious fiscal and monetary policies to accelerate recovery. In most economies and markets—national and international alike—ratios of debt to GDP will likely rise. Confidence that tax frameworks will gradually support next-normal debt levels will be necessary.

Once the pandemic ends, countries around the world will probably find themselves more in debt than ever. If they restructure and innovate, attract investment, and increase their productivity, a new era of human development will begin . But if they spend haphazardly and imprudently, economic and social development might falter for decades to come. The societies, governments, institutions, companies, and people of the Earth now face basic choices. Let’s hope they think about them seriously.

Andres Cadena and Fernando Ferrari-Haines are senior partners in McKinsey’s Bogotá office.

The authors wish to thank Andres Arboleda, Clara Gianola, Juan Martinez, and Sebastian Riomalo for their contributions to this article.

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The economics of COVID-19 pandemic: A survey

Rakesh padhan.

a Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana, 502285, India

K.P. Prabheesh

b Department of Liberal Arts, Indian Institute of Hyderabad, Kandi, Sangareddy, Telangana, 502285, India

Through a survey of the literature on the economics of the coronavirus (COVID-19) pandemic, this study explores the effects of the pandemic and proposes potential policy directions to mitigate its effects. Our survey reveals that adverse economic effects have been observed due to the COVID-19 pandemic in addition to fatalities. Furthermore, the survey indicates the need for greater coordination at national and international levels. This study concludes by suggesting coordination among monetary, macroprudential, and fiscal policies (trio) to mitigate the adverse economic effects of COVID-19. Finally, this study explores potential directions for future research.

1. Introduction

This paper undertakes a survey of literature on the economics of COVID-19 1 pandemic. 2 The goal is to explore the economic effects of the COVID-19 and suggest policy directions to mitigate its magnitude.

Clark (2016) opined that a pandemic is a serial killer that can have devastating consequences on humans and the global economy. For instance, the Spanish flu in 1918 killed 50 million people worldwide. In addition to fatalities, a pandemic can lead to economic and health crises. Furthermore, a pandemic can result in socio-psychological disturbances to the society wherein the poor witness the burden of the crisis more than their richer counterparts. The effects of a pandemic remain uncertain owing to the lack of a predictive pattern of its occurrence, particularly in the absence of a pharmaceutical invention.

Our study is motivated by the ongoing coronavirus pandemic and its multifaceted effects on the economies worldwide. At the beginning of December 2019, Wuhan City, China, witnessed the origin of the novel “coronavirus” (COVID-19 hereafter) at first. The COVID-19 is a highly transmittable and pathogenic viral infection. On March 11. 2020, the World Health Organization (WHO) declared the COVID-19 as a global outbreak of pandemic on March 11, 2020. The COVID-19 is considered to be a “once-in-a-century pathogen” owing to the following reasons. First, the fatality risk associated with the COVID-19 is 1%, which is more miserable than that of typical influenza, as it can kill healthy as well as elderly people. This fatality risk can be compared with that of the 1857 influenza pandemic (0.6%) and of the 1918 Spanish flu (2%). However, the actual fatality rate of the COVID-19 remains unpredictable, owing to the absence of pharmaceutical inventions. Second, the exponential rate of transmission of this disease indicates that the COVID-19 will be much more severe than any other pandemic.

The economic effects of the COVID-19 can be broadly categorized into supply and demand effects. Supply effects result from the loss of working hours, and the decline in aggregate demand results from the decline in income due to unemployment associated with lockdowns. Maliszewska et al. (2020) claimed that the pandemic affects the economy through the following channels: (1) the direct effect of a reduction in employment; (2) the increase in international transaction costs; (3) the sharp decline in travel, and (4) the decline in demand for services requiring proximity between people. First, reduction in employment leads to lower demand for capital, thereby resulting in output loss. Second, the rising costs of imports and exports for goods and services result in trade reduction and productivity loss. Third, the sharp decline in international tourism generates less revenue, thereby leading to production loss. Finally, the decline in demand by households, who purchase fewer services than before, considerably decreases the consumption of goods and services. In addition, the contraction in foreign direct investment, real effects of financial shocks, and falling oil prices widen the economic costs associated with the COVID-19. In this context, several questions arise: (1) What are the detrimental effects of COVID-19 pandemic? (2) What are the policy decision to be adopted for mitigating its effects?

Our approach in this study is as follows. First, we focus on the effects of the COVID-19 the world has experienced until now. Second, we extend the work of Maliszewska et al. (2020) to include the stock market, exchange rate, and oil market as the channels of economic consequences. Third, we emphasize four policy aspects in response to the COVID-19: monetary policy, macroprudential regulation, fiscal policy, and policy coordination. Finally, we establish a research agenda for future research.

Accordingly, we followed several steps: (1) we identified several literatures on pandemic and the COVID-19, thereby acquiring 80 papers. These papers were obtained from the Journal of Economic History, Applied Economic Letters, Asian Economic Letters, Economic Analysis and Policy, Emerging Markets Finance and Trade, Energy Economics, Energy Research Letters, Journal of Behavioral and Experimental Finance, and Finance Research Letters . Furthermore, we acquired 11 working papers from International Monetary Fund (IMF), National Bureau of Economic Research, CEPR, Bank for International Settlements, and World Bank ; content from the IMF blog; 3 books (IT Governance Publishing and VOX EU.); and 5 chapters and reports from the World Economic Outlook, Banks for International Settlements, and European Commission . This filter technique is attributed to the history and consequences of pandemics, including the COVID-19. Considering that the literature on the COVID-19 pandemic is evolving, we incorporated most papers published on or before December 10, 2020. These papers and journals were selected based on their relevance to the research questions of this paper. Further, this study encompasses different facets of economies and demonstrates the effects of the COVID-19 through a comparative analysis of the COVID-19 with earlier pandemics in terms of the number of fatalities. Accordingly, we selected ten economies with the highest number of cases until September 17, 2020, and indicated stock market indicators and exchange rate performance in the pre-COVID and the COVID-19 periods. (3) We emphasized four policies in response to COVID-19: monetary policy, macro prudential regulation, fiscal policy, and policy coordination. Finally, we identified the limitations of existing studies and created an agenda for future research.

This study contributes to the literature in many ways. First, this study is one of the first attempts to document the economic effects of the COVID-19 pandemic. Second, this study extends the work of Maliszewska et al. (2020) by incorporating the effects of the COVID-19 on the stock market, exchange rate, and oil market. Third, this study is the first attempt to propose a comprehensive policy direction in response to the COVID-19 by emphasizing policy coordination. Finally, our study is in line with Goodell (2020) , who conducted a comprehensive literature survey and highlighted unprecedented global economic loss due to the COVID-19.

This paper is organized as follows. Section  2 presents the effects of the COVID-19. Sections  3 , 4 indicate the effects of the COVID-19 on the stock market and exchange rate, respectively. Section  5 covers the effects of the pandemic on the oil market. Section  6 proposes policy suggestions. Section  7 highlights the limitations of the existing literature and offers future research directions. Finally, Section  8 concludes the study and suggests policy implications.

2. Effects of the COVID-19

The COVID-19 pandemic has resulted in an unprecedented decline in global activity. The intensifying pandemic in developed and emerging economies led to stringent lockdowns and large disruptions in economic activity at an extraordinary speed and scale ( Baldwin and di Mauro, 2020 , Gopinath, 2020 ). For instance, the global GDP declined by more than 4.9% in the second quarter of 2020 due to economic disruption. The decline in trade in goods and services was likely higher than that during the 2007–08 global financial crisis ( IMF, 2020 ). Consequently, the global trade contracted by 3.5% in the second quarter of 2020 due to weak demand and supply. The subsequent lockdown across economies due to the COVID-19 disrupted global supply chains, reducing the aggregate demand ( Vidya and Prabheesh, 2020 ). The consumption of goods and services witnessed a marked decline due to steep income loss and weak consumer confidence. Similarly, the consumers were reluctant to consume certain goods and services due to the fear of the COVID contagion ( Eichenbaum et al., 2020 ). Firms were required to cut back the investment due to a precipitous decline in demand, supply interruptions, and uncertain future earnings. The world lost nearly 300 million full-time jobs in the second quarter of 2020 from 130 full-time job losses in the first quarter of 2020 ( IMF, 2020 ). The decline in aggregate demand resulted in lower inflation and fuel prices ( IMF, 2020 ). The World Travel and Tourism Council (WTTC) estimated a 25% decline in global travel in 2020 due to the COVID-19 pandemic.

The emerging economies experienced significant capital outflows owing to the pandemic, thereby reducing investment and causing production loss ( BIS, 2019 ). During the COVID-19 period, Russia–Saudi Arabia oil war reduced the value of oil prices from $ 31.05 per barrel on March 8, 2020, to $ 19.23 per barrel on April 30, 2020. Similarly, stock markets worldwide started crashing from February 25th. For instance, Wall Street witnessed a large single-day drop in the stock price in the second week of March 2020 due to a lack of investor confidence after the US’s travel ban declaration and unchanged interest rate by the European central bank. Conclusively, the ongoing pandemic has adversely affected the global economy; these consequences may be more severe in the future considering the increasing fatalities.

2.1. A synthesis of empirical literature on the COVID-19

Existing literature on the effects of COVID-19 has emphasized various issues. For instance, Barro et al. (2020) , Choi (2020) , Iyke (2020c) , Jorda et al. (2020) , and Liu et al. (2020b) observed output and credit contraction due to the COVID-19. Liu et al. (2020c) , Maliszewska et al. (2020) , and Yu et al. (2020) demonstrated a decline in consumption and investment. Ertugrul et al. (2020) indicated an increase in consumption volatility. Bauer and Weber (2020) confirmed a decline in the labor force participation rate. Furthermore, the COVID-19 negatively affected firm and industry performances ( Gu et al., 2020 , He et al., 2020a , He et al., 2020b , Iyke, 2020a , Qin et al., 2020a , Xiong et al., 2020 ). In addition, the COVID-19 adversely affected corporate performance ( Shen et al., 2020 ), the insurance market ( Wang et al., 2020 ), herding behavior ( Espinosa-Méndez and Arias, 2020 ), and property price ( Wang et al., 2020 ). 3

Table 1 presents the details of the empirical literature on the effects of the COVID-19.

Empirical literature on the effects of COVID-19.

This table covers various empirical issues addressed in the context of the COVID-19 with the authors, data coverage, empirical findings, and channels/remarks. Further, it covers the tabulation of all cited papers on the empirical literature on the COVID-19.

3. COVID-19 and stock market

The outbreak of the COVID-19 pandemic has increased global financial risks, thereby adversely affecting the global financial markets ( Al-Awadhi et al., 2020 , Baker et al., 2020 , Cao et al., 2020 , Gil-Alana and Claudio-Quiroga, 2020 , Gormsen and Koijen, 2020 , Harjoto et al., 2020 , Liu et al., 2020a , Phan and Narayan, 2020 ). The COVID-19 negatively affected the stock market in the forms of uncertainty and reduction in stock return worldwide, thereby reducing capital flows. This reduction due to stock market uncertainty, eventually created obstacles in investment, project funding, and liquidity availability in the global financial system.

Empirical evidence suggests that the pandemic negatively affected stock market return ( Al-Awadhi et al., 2020 , Ambros et al., 2020 , Mishra et al., 2020 , Topcu and Gulal, 2020 )) and increased stock return volatility ( Corbet et al., 2020 , Haroon and Rizvi, 2020a , Haroon and Rizvi, 2020b , Sharma, 2020 , Zaremba et al., 2020 ). Akhtaruzzaman et al. (2020) and Corbet et al. (2020) confirmed the stronger role of financial contagion in generating stock return volatility. 4 Goodell (2020) affirmed that the decline in the stock market during the pandemic resulted from investors’ delay in investment decisions.

Fig. 1 exhibits the trends in the stock market of the top 10 5 economies affected by the pandemic. In the figure, a drastic decline can be observed during March. 6 Colombia and Spain experienced the highest decline. Furthermore, the experience of recovery of the stock market varies across these countries. For instance, the stock markets in Argentina, South Africa, and the US recovered within two months and reached the pre-crisis level at the end of May. The remaining seven countries have still not recovered from the negative effects of the pandemic. Clearly, these observations indicate that the COVID-19 pandemic adversely affected stock market performance.

Stock indices of most affected countries.

This figure indicates the plots of stock indices of the most affected countries during the COVID-19. It covers stock indices for Argentina, Brazil, Colombia, India, Mexico, Peru, Russia, South Africa, Spain, and the USA. The blue line indicates the data period’s division into two such as pre and during the COVID-19 period. We can observe that the stock indices experience high volatility during the COVID-19 period. The period spans from January 1, 2019, to September 17, 2020. The stock data are collected from the CEIC Database. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

4. COVID-19 and exchange rate

The exchange rate is crucial for maintaining an economy’s external stability. As exchange rate directly associates with trade balance, export competitiveness, foreign debt, and capital flows, maintaining a stable exchange rate is one of the policymakers’ major concerns. During this pandemic period, most economies have experienced exchange rate volatility and currency depreciation due to capital outflows and market sentiments. For instance, the negative sentiments associated with the COVID-19 substantially affected the financial markets ( Ali et al., 2020 , Fang and Zhang, 2020 , Fu and Shen, 2020 , Narayan, 2020c , Garg and Prabheesh, 2021 , Rai and Garg, 2021 ) and had a better predictive power over exchange rate volatility than return ( Iyke, 2020b ). Iyke (2020b) affirmed that the outbreak of the COVID-19 is associated with valuable information and can be effectively used to predict exchange rate return and volatility. The volatile exchange rate and currency depreciation could have detrimental effects on stock price, capital inflow, current account deficit, external debt obligations, and financial instability.

Fig. 2 illustrates excessive volatility in the exchange rate of most countries affected by the pandemic. All economies experienced a currency depreciation immediately after the outbreak of the COVID-19 until mid-April. Thereafter, most economies’ exchange rates significantly improved, excluding that of Argentina. More specifically, Spain witnessed a tremendous recovery in its exchange rate after mid-May. However, the figure depicts that none of these countries’ exchange rates reached their pre-crisis level by the end of September, implying the pandemic’s adverse effects on the exchange rates of the economies.

Exchange rate of most affected countries.

This figure indicates the plots of exchange rates of the most affected countries during the COVID-19. It covers stock indices for Argentina, Brazil, Colombia, India, Mexico, Peru, Russia, South Africa, Spain, and the USA. The period spans from January 1, 2019, to September 17, 2020. The exchange rate data are collected from the CEIC Database. The blue line indicates the data period’s division into two, such as the pre-COVID-19 and the COVID-19 period. The USA’s exchange rate is not considered as it is the benchmark currency for all other economies. We can observe that all the economies witness currency depreciation during the COVID-19 period. Most currencies witness depreciation till mid-April and show a slower improvement in the aftermath. However, the exchange rate of all economies witness high volatility except that of Argentina. Argentina indicates a steep increase in its exchange rate, implying continuous depreciation of the Argentinian Peso to the dollar in the COVID-19 period. In terms of recovery, all other economies’ currency is improving but far behind than the pre-COVID period. Surprisingly, Spain indicates tremendous appreciation after the mid-may period. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

5. COVID-19 and oil price

Negative supply and demand shocks can be observed in the oil market during the COVID-19 period. The reduction in labor availability, travel restrictions, and disruptions in transport and business, directly and indirectly, resulted in negative supply shocks. The negative demand shock is caused due to economic difficulties, and the disruption of global value chains, reducing oil demand ( Vidya and Prabheesh, 2020 ). These negative shocks on the oil are considered to reduce global consumption and investment.

Numerous studies have addressed the effects of the COVID-19 on the oil price. For instance, the decline in oil price due to the pandemic adversely affected the performance of the energy sector ( Apergis and Apergis, 2020a , Devpura, 2020 , Devpura and Narayan, 2020 , Fu and Shen, 2020 , Gil-Alana and Monge, 2020 , Huang and Zheng, 2020 , Kartal, 2020 , Narayan, 2020a , Polemis and Soursou, 2020 , Qin et al., 2020b ). Fu and Shen (2020) affirmed that COVID-19 negatively affected energy industries. Salisu and Adediran (2020) observed that market uncertainty can predict energy market volatility. Devpura and Narayan (2020) and Narayan (2020a) observed that COVID-19 cases and fatalities increased oil price volatility and largely affected oil prices. Huang and Zheng (2020) indicated structural changes in the relationship between investors’ sentiment and crude oil futures. Gil-Alana and Monge (2020) stated the inefficiency of the oil market due to the pandemic. Furthermore, the COVID-19 affected the dynamics between the oil and stock markets. For instance, Liu et al. (2020a) identified a negative relationship between oil and stock returns. Prabheesh et al., 2020a , Prabheesh et al., 2020b observed a positive relationship for net oil-importing and oil-exporting countries.

Fig. 3 illustrates that crude oil prices started declining during the outbreak of the COVID-19 from December 31, 2019, till the last week of April 2020. This was the first time in history that oil price became negative (US$ −36.98) on April 20th, 2020. Although the recovery can be observed from May, the price has not reached the pre-COVID period level.

Trends in oil prices.

The figure plots the oil prices from January 2, 2019, to September 15, 2020. WTI stands for West Texas Intermediate. The daily oil price is based on the West Texas Intermediate and collected from the Energy Information Administration. The blue line indicates the division of the data period into two such as pre and COVID-19 periods. We can observe that the oil prices during the COVID-19 period are lesser than the pre-COVID-19 period. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

Crude oil is one of the key ingredients of the production process. The decline in oil prices may reduce production costs and increase economic growth ( Filis, 2010 , Sadorsky, 1999 ) and affect monetary policy ( Prabheesh and Rahman, 2019 ). Thus, falling oil prices were beneficial for net-oil importing countries. In contrast, net-oil exporting countries witnessed a severe reduction in oil revenue, stock market crashes, and financial market volatility. The reduction in oil revenue resulted in an insufficient net export surplus, thereby leading to current account unsustainability ( Garg and Prabheesh, 2017 , Garg and Prabheesh, 2020 ) and insolvency ( Garg and Prabheesh, 2018 ). Oil-exporting countries experienced sharp recessions during the COVID-19 period, such as Russia (−6.6%), Saudi Arabia (−6.8%), and Nigeria (−5.4%).

6. COVID-19 and policy suggestions

This section discusses the relevance of four policy options to mitigate the effects of the COVID-19: monetary policy, macro-prudential regulation, fiscal policy, and policy coordination.

6.1. Monetary policy

Monetary policy could play a crucial role in mitigating the effects of the COVID-19. However, the nature of the adoption of monetary policy may differ across economies in terms of their economic condition during the ongoing pandemic. Hofmann et al. (2020) argued that the adoption of monetary policy by the emerging economies in response to the COVID-19 pandemic may not be effective due to excessive volatility in the exchange rates and capital flows. However, emerging economies can adopt a combination of inflation targeting and macroprudential tools as well as forex reserve accumulation as their policy framework to tackle the changes in capital flows and exchange rates ( BIS, 2019 ). Considering that this policy framework facilitates financial stability, the emerging economies can adopt the same combination of policies to respond to the instability caused by the pandemic. Inflation targeting could help mitigate the effects of exchange rate on inflation. Macroprudential tools promote the resilience of the financial system. Furthermore, the accumulation of reserves can help absorb shocks and alleviate financial stress on emerging economies as the central banks are capable of dealing with currency depreciation, default risk on external borrowings, and capital outflows ( Hofmann et al., 2020 , Prabheesh, 2013 ). The economies with large forex reserves would be able to manage their currency depreciation by intervening in the foreign exchange market during the pandemic. In this context, the central banks of emerging economies have to adopt monetary policies by considering domestic liquidity and foreign exchange market condition.

As the COVID-19 is associated with lower inflation in advanced economies, expansionary monetary policy could facilitate higher economic growth and higher investment in the productive sector. However, the monetary policies of advanced and emerging economies are not independent of each other. The global monetary policy and its shocks play a dominant role in determining domestic macroeconomic conditions and monetary policy. Accordingly, the adoption of monetary policy in advanced economies influences the emerging economies’ monetary policy decisions ( Prabheesh and Vidya, 2018 , Shareef and Prabheesh, 2020 ). Furthermore, the role of trade and financial integration fosters shock transmission and creates the fear of a financial contagion ( Padhan and Prabheesh, 2019 ). Therefore, the effectiveness of the domestic monetary policy will depend on shock transmissions from the advanced economies. In this context, the adoption of monetary policy with macroprudential measures could improve an economy’s policy effectiveness.

6.2. Macroprudential regulation

Considering financial instability caused by the COVID-19, macroprudential policies could help maintain stability and reduce systematic risk in the financial system. Accordingly, a broad range of macroprudential measures can enhance resilience to global financial shocks. For instance, these measures include the tools that boost bank capital and liquidity, limit foreign exchange exposures, and prevent risky credit ( Drehmann et al., 2020 , Restoy, 2019 ). These tools have a heterogeneous effect in reducing the global financial shocks hitting an economy. Furthermore, macroprudential regulation reduces the sensitivity of domestic credit to global financial shocks. This claim is in line with the hypothesis that a stronger bank balance sheet leads to a steadier credit supply. In addition, macroprudential regulation stabilizes nominal and real exchange rates as a safer financial system that reduces currency premium volatility ( IMF, 2020 ).

Macroprudential regulation will help control fluctuations in exchange rates and capital flows that may undermine financial stability. In this situation, monetary policy along with macroprudential regulation can reduce the negative effects of the COVID-19 and promote higher economic growth. Accordingly, a possible channel could be the adoption of countercyclical monetary policy along with macroprudential regulation in response to global financial shocks. At a higher level of macroprudential regulation, central banks respond more counter-cyclically by lowering policy rates to maintain stability in exchange rates and capital outflows ( IMF, 2020 ).

6.3. Fiscal policy

Fiscal policy can effectively protect people, stabilize demand, and facilitate recovery across economies during the ongoing pandemic as well as in the aftermath of this event. Considering the continuity of lockdowns across economies, fiscal policies should be accommodated to healthcare services to provide emergency lifelines to protect people ( Chakraborty and Thomas, 2020 ). While lockdowns are easing, fiscal policies should be aimed at household supports and firms to take care of the informality of the economy. Furthermore, employment support measures could help encourage the safe return to jobs and facilitate structural shift for the quick recovery of the economy after the pandemic. Once the pandemic slows down, the fiscal stimulus will be crucial for public investment, healthcare systems, and physical and digital infrastructure. In the case of limited fiscal space, economies should generate revenue, increase spending, and promote productive investment. All the policy measures need to be organized in a medium-term fiscal framework with transparent management to mitigate fiscal risks ( IMF, 2020 ).

6.4. Policy coordination

A need for domestic as well as global efforts is felt to mitigate the effects of the COVID-19. In the context of global policy change, World Economic Outlook (June 2020) has considered the effects of the COVID-19 as “A Crisis Like No Other, An Uncertain Recovery” and listed few policy actions to mitigate its adverse effects.

• 1. Fiscal Monitor Database of Country Fiscal Measures (June 2020) announced an amount of $11 trillion for fiscal measures worldwide.
• 2. According to the Global Financial Stability Report (June 2020), major central banks experienced a rise in liquidity and borrowing costs. Some emerging economies adopted quantitative easing 7 for the first time, whereas some advanced economies increased the scale of asset purchases. Portfolio flows into emerging economies re-established after the outflows during February–March, and currency bond insurance became stronger for economies with strong credit ratings. Furthermore, modification of bank loan repayment terms and release of capital and liquidity buffers increased the supply of credit globally.
• 3. Oil prices increased in May–June close to stable current spot prices after West Texas Intermediate witnessed a negative value on April 20, 2020.
• 4. As of mid-June, several currencies for advanced and emerging economies weakened substantially. A need for systematic intervention exists to face the challenges associated with currency depreciation.

The magnitude of economic costs necessitates international policy coordination to respond to the pandemic. Chakraborty and Thomas (2020) highlighted the need for more fiscal policy–monetary policy coordination to boost policy response to the COVID-19. Furthermore, a need for global coordination exists in health and medical infrastructure as well as in trade, finance, and macroeconomic policies.

In the context of domestic policy effort at the national level, policy coordination among the trio, i.e., monetary, macroprudential, and fiscal policies, could effectively reduce the effects of the COVID-19.

The macroprudential policy’s major objective is to ensure financial stability and avoid systematic risk, whereas the monetary policy aims to maintain price stability and manage liquidity. The objective of fiscal policy is to boost aggregate demand and facilitate fiscal buffer. All three have different tools such as loan-to-value, debt-to-income, and leverage ratios (macroprudential policy); CRR, SLR, the repo rate, and reverse repo rate (monetary policy), and tax and discretionary countercyclical measures (fiscal policy). Time inconsistency problems 8 exist between macroprudential and monetary policies under a central bank’s dual objective to promote price and financial stability ( Ueda and Valencia, 2014 ). Thus, these two policies can be used ex-ante and ex-post simultaneously. As per BASEL III, one group of economists supports the major benefits of implementation, whereas another group of specialists opposes the adoption of the new rule due to higher implementation costs. Conclusively, higher policy coordination would yield higher policy effectiveness in mitigating the effects of the COVID-19.

Suppose, if policymakers have the motive of implementing monetary policy to reduce the value of public debt by generating higher inflation, the fall in the real interest rate due to expansionary monetary policy will lead to more capital outflow and exchange rate depreciation. In that case, the prime solution is to stabilize the exchange rate by depletion of reserves. A country should have enough reserves to undertake the stabilization process in the world market. Differently, in the case of expansionary fiscal policy, an increase in fiscal deficit reflects an increase in the current account deficit by supporting the “twin deficit hypothesis. 9 ” The country has to borrow or print money to finance the deficit, which may either increase foreign debt level or inflation. Furthermore, the increase in foreign debt may lead to debt sustainability, whereas an increase in inflation leads to capital outflows due to a fall in the real interest rate. In this context, the macroprudential policy tools help reduce the cost of intermediation and support price stability and debt sustainability. The tools of macroprudential, monetary, and fiscal policies must act together by promoting policy coordination to mitigate the costs of the COVID-19 and achieve price stability, financial stability, and a sustainable level of debt. Under a strong financial system, the adoption of liquidity circulation and fiscal buffer could mitigate the consequences in the post-pandemic period.

7. The missing link? A direction to future research

The existing studies on the COVID-19 have identified the facets of consequences caused by this pandemic. However, they have several shortcomings. First, existing studies have either focused on the effect of the government’s adopted policies on the COVID-19 or on macroeconomic and financial issues caused by the COVID-19. However, they have failed to trace a balance between these two. Policies should be framed to tackle the health crisis and macroeconomic and financial issues simultaneously. Second, existing studies have not addressed any theoretical background of health crisis and their occurrence pattern. Finally, although the macroeconomic effects of the COVID-19 can indicate the consequences of a health crisis, existing studies have failed to determine the explanatory variables of health crisis and economic transmission channel across economies.

In this context, several missing links have been identified, which pave the way for future research. The first missing link is the balance between the government’s adopted policies on the COVID-19 and macroeconomic and financial issues. Maintaining a balance between these two policies is challenging for policymakers and a key challenge for future research. The second missing link is the absence of theoretical background to health crisis and occurrence patterns. The occurrence pattern of the financial crisis can never be compared with that of the health crisis, calling for a separate section of theories to explain the health crisis’ economic channels. Given that the occurrence pattern of a health crisis differs, the advancement of theoretical models on health crisis could be crucial to explain the occurrence pattern of a pandemic. The third link revolves around the explanatory variables of health crisis and identification of economic transmission channel. A comparative analysis with the previous pandemic could no longer explain the explanatory variables and transmission channels because of the different situations and types of economic channels. Therefore, identifying the explanatory variables of health crisis and transmission channels needs serious progress. Finally, modeling the economic channels will be a daunting task in the absence of a theoretical explanation of a health crisis. This opens up avenues for greater future research, and researchers should focus on resolving the above ideas.

8. Conclusion and policy implications

The COVID-19 pandemic has caused unprecedented damage to the global economy in terms of human tolls and economic consequences. It posed a greater challenge for the investors and policymakers to mitigate the consequences of this pandemic.

This study has highlighted the economic effects of the COVID-19 and emphasized policy options to reduce its effects. The study concludes that through monetary, macroprudential, and fiscal policies can independently help mitigate the effects; the combined trio could be more effective in the post-pandemic period. Therefore, coordination is required among “trio”, i.e., monetary, macroprudential, and fiscal policies, to reduce the effects of the COVID-19.

This study has several policy implications. The monetary expansion will increase aggregate demand and induce firms to boost their investment from the monetary policy perspective. From the fiscal policy perspective, government policies such as subsidizing firms’ investment and the introduction of public investment programs could help promote investment. Independently, monetary expansion could fall into expectation-driven stagnation traps, 10 adversely affecting the growth fundamentals of an economy. Accordingly, conventional macroeconomic theories should be modified as per the situation and coordinated to maintain the aggregate demand–supply equilibrium effectively. Apparently, conventional macroeconomic policies cannot be restricted only to conventional measures. It should complement social policies such as a whole government approach 11 to face the health emergency caused by the COVID-19. Conventional macroeconomic policies need to be organized into relief measures, recovery policies, and international coordination measures.

Future research should focus on the effects of the COVID-19 on capital flows, exchange rates, and various sectors of the economy. It will be a challenging task for the policymakers to face the health crisis or to correct the macroeconomic and financial issues posed by the COVID-19. Furthermore, there is greater scope for future research to examine how the developed and emerging economies function in the pandemic situation and adopt policies to face the health crisis as well as macroeconomic and financial issues.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgment

This research did not receive any special grant from funding agencies in the public, commercial, or not-for-profit sectors. The earlier version of this paper was presented at the 14th Bulletin of Monetary Economics and Banking International Conference, Bali, Indonesia (Webinar).

1 The short from COVID-19 is used for the Coronavirus disease of 2019, throughout the paper.

2 The word pandemic is derived from the Greek word “Pandemos”, which means ‘common to all people’. The World Health Organization affirm that a pandemic is a situation of the global spread of a new disease. Cholera in 1817, Spanish flu in 1918, Asian flu in 1957, and the H1N1 pandemic in 2009 are the few examples of pandemic events that the world has already witnessed earlier.

3 It cannot be generalized that the COVID-19 has only adverse repercussions. For instance, Ming et al. (2020) indicated that the COVID-19 pandemic has improved air quality, which can be helpful for improving GDP later. Appiah-Otoo (2020) indicated that the COVID-19 positively affected domestic credit. Apergis and Apergis (2020b) supported the positive effects on inflation expectations. Differently, Salisu and Akanni (2020) constructed a global fear index and indicated its significance in predicting stock returns and improving forecast performance. As a mitigating force, lockdowns, travel restrictions, and economic stimulus package positively affected the stock market in G7 countries ( Narayan, 2020b ). In case of forex market, Narayan et al. (2020) affirmed the depreciation leads to fall in Japanese stock returns. Narayan (2020b) confirmed that Yen had a transitory effect and that the COVID-19 changed the resistance of the yen to shocks. Salisu and Sikiru (2020) supported the hedging potential of Asia-Pacific Islamic stocks, whereas Ferriani and Natoli (2020) confirmed investors’ preference for low ESG risk funds. Further, Mariana et al. (2020) and Mnif et al. (2020) supported the efficiency of cryptocurrency as a safe haven. Erdem (2020) affirmed that freer countries are associated with smaller increase in volatility. In the context of the capital market, Prabheesh (2020) confirmed that foreign portfolio investment improved the predictability of stock market returns. Chen et al. (2020b) confirmed the positive effect on remittance inflows. In case of government decision, Haldar and Sethi (2020) indicated that demographic and government policies significantly determine the COVID-19. Further, see Sha and Sharma (2020) for more details.

4 Chen et al. (2020a) , Conlon and McGee (2020) , and Grobys (2020) confirmed that Bitcoin is no longer a safe haven during this pandemic period, indicating a significant fall in portfolio diversification.

5 The top 10 economies were selected based on the no. of confirmed cases until September 17th, 2020. Further, 6 out of 10 selected economies are also ranked in terms of fatalities. See Appendix A , Appendix B for more details.

6 Stock markets witnessed (global stock market crash) Black Monday on March 9, 2020.

8 Time inconsistency is a situation in which preference of decision makers changes over time.

9 The “twin deficits hypothesis” indicates that there is a connection between fiscal and current account deficits..

10 It refers to a situation where the inflation and unemployment remain steadily high, whereas economic growth remains low. The conventional monetary policy operating in the zero lower bound will not be effective to counteract the drop in demand. This will eventually lead to fall in employment, investment, and economic activity. This will result in self-fulfilling pessimistic expectations of weak growth once the fundamentals are too weak, leading to expectation driven stagflation trap.

11 It refers to all social and economic policies like social protection, urban management, public communication, and financial and goods market under same roof.

7 Quantitative easing is an unconventional monetary policy adopted by central banks to increase money supply in the economy.

Appendix A. Pandemics: A historical perspective

The earliest known pandemic, Black Death in 1331, is considered to be the costliest pandemic, with 75 million fatalities out of 450 million in the world. The Spanish flu in 1918 that occurred during the 20th century was classified as “severe”, followed by the Asian flu in 1957 and Hong Kong flu in 1968. The H1N1 pandemic in 2009 was the first pandemic in the 21st century, with more than 2 million fatalities. From the table below, we can observe that every pandemic has resulted in millions of fatalities (see Table A.1 ).

Historical footprints on pandemics.

This table covers the historical record of large pandemic events with at least 100,000 deaths. We can observe that the Spanish Flu was the largest in terms of death, followed by Black Death.

Appendix B. COVID-19: A novel experience

The COVID-19, the 2nd pandemic of the 21st century, has driven all attention of policymakers and is set to become the most devastating pandemic that the world has witnessed so far. In the context of the historical pandemics, Ferguson et al. (2020) considered COVID-19 as the most serious pandemic since the Spanish flu in 1918. The absence of pharmaceutical inventions will contribute to the death tolls and could make the COVID-19 the most devastating pandemic event of the 21st century (see Table B.1 ).

As of September 17, 2020, COVID-19 has affected 213 countries with 937,391 fatalities and 29,737,453 confirmed cases reported by the WHO. The following table shows the top 10 worst-affected countries with the most cases due to COVID-19.

The table shows that the USA experienced the largest effect in the world and ranks first in terms of confirmed cases and death. India becomes the second most affected country in terms of confirmed cases and third in terms of fatalities. Brazil ranks third in terms of confirmed cases and second in terms of fatalities. Further, out of the top 10 most affected countries in terms of confirmed cases, 6 are ranked in terms of fatalities. Surprisingly, China does not occupy any place in rankings either in terms of confirmed cases or fatalities, indicating improved COVID conditions and medical facilities. Major economies like the USA, India, Russia, Mexico, and Spain witnessed the severity of COVID-19 and may experience more economic consequences in the future. Among the top 10 economies, the major economies like the USA (center economies), Russia (oil-exporting economies), and India (one of the Asian giants and large market) would lead to more downturn in production, investment, and consumption, resulting in a downturn in the global economy.

Statistics on COVID-19 and countries’ ranking.

This table covers no. of confirmed cases and death due to COVID-19 till September 17, 2020. Ranking 1 is done on the basis of no. of confirmed cases, whereas ranking 2 is based on the no. of fatalities caused by this disease.

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5 Truths about Money During the Pandemic

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While many people talk about the health crisis brought on by the outbreak of COVID-19, that is not the only challenge causing stress. People are also worrying about their finances, both short-term and long-term. Recent statistics revealed that nearly 40 million people had lost their jobs since the pandemic began.

Here are 5 truths about money during the coronavirus pandemic:

The stimulus . In late March, U.S. President Donald Trump signed into law an unprecedented $2.2 trillion stimulus package to help keep the economy alive amid the deadly coronavirus outbreak that has shuttered countless businesses and put millions of Americans out of work. The Coronavirus Aid, Relief and Economic Security Act or CARES, contains $560 billion that directly benefit individuals in the form of cash payments of up to $1,200. The legislation also expands unemployment and paid sick/family leave benefits, waives penalties on some early retirement withdrawals, and offers student loan relief and protections for renters. The stimulus is widely seen as a lifeboat; in other words, a fairly short-term solution to financial problems. Advisors suggest that people should use the money to consider their personal-finance needs first, like paying bills and boosting emergency funds.

The impact . Experts, including Benjamin Lockwood, a Wharton professor of business economics and public policy , are worried about the impact that the coronavirus crisis will have on income inequality, which refers to the distribution of wealth and is also sometimes called the income gap. Typically, it means that there is a large gap between people who have money and those who don’t. Will income inequality increase? For Lockwood, this question is especially important because even though America enjoyed record low unemployment before the pandemic, there were already economic red flags. An increasing number of people — about 40% of the income distribution — were a paycheck away from homelessness, hustling gig jobs without benefits, working without paid sick leave and living in a general state of financial despair. “Despite how good things looked at the outset, we were actually still pretty fragile in the face of something like this,” Lockwood said. While the stimulus will help some people pay bills or pay for their car to get to and from work, the longer-term effects could cause that income inequality gap to widen.

Relief from retirement funds? Millions of Americans find themselves strapped for cash with reduced work or lost jobs as the coronavirus pandemic hurts the economy. The Coronavirus Aid, Relief and Economic Security Act offers some help with the promise of direct checks of $1,200 for individuals ($2,400 for couples) with an additional $500 for each child, and expanded unemployment insurance benefits. It also opens up a bigger cash window by waiving the 10% penalty on withdrawals of up to $100,000 from 401k retirement accounts by those below 59.5 years of age. But should you actually use the money squirreled away in your retirement fund to help you get through this crisis? Olivia S. Mitchell, a Wharton professor of business economics and public policy who is known for her pension and finance research, cautions against it. “Withdrawing assets from retirement plans should be a last resort, done only after using up the household’s emergency funds, taking a bank loan , or borrowing from family if possible,” she said during an interview on the Wharton Business Daily radio show on SiriusXM . “It has tax consequences, and it may lead to a much poorer retirement.” Those premature withdrawals will not just erode individuals’ money saved for retirement: Those who lose their jobs after they withdraw from those retirement funds will have to either repay that amount within three years or pay additional taxes.

Longer-term look . For many, the level of financial stress will depend on employment trends as the pandemic crisis eases and the economy improves. Nothing is a sure thing, suggest researchers. Industries like the leisure and hospitality sectors have been especially hit hard (think hotels and restaurants). Wharton management professor Matthew Bidwell said, “It will take the economy “a while” before it bounces back to pre-pandemic levels. Many people are likely to be rehired after the social-distancing restrictions ease up. However, Bidwell does not expect all laid-off workers to regain their jobs. “[That is] both because business owners do not want to fully staff up until they know what demand will be like, and because some of their businesses may have gone bankrupt or closed down in the meanwhile.” Still, the hope is that generous unemployment benefits will help people pay for rent, food and health care in the short-term and then they will ideally return to the longer-term stability of their jobs once the quarantine is lifted. “Whether this will be a temporary blip is, of course, the multi-trillion-dollar question,” said Bidwell.

Social Security shortfall . Social security, the federal U.S. program that provides money to senior citizens who are no longer working through taxes that are collected from the nation’s employees, could run out four years sooner than predicted, according to an analysis by the Penn Wharton Budget Model, which provides economic forecasts. Revenue into Social Security has been steadily declining since the start of the coronavirus pandemic, partly because “the loss of jobs, especially concentrated among low-wage workers, reduces payroll tax revenues .” The Penn Wharton Budget Model previously predicted that Social Security would run out in 2036. Its latest report predicts either 2034 or 2032, depending on the type of recovery we have coming out of an economy impacted by COVID-19. The Budget Model’s report on “The Impact of the Coronavirus Pandemic on Social Security’s Finances” provides all the details.

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Conversation Starters

What is income inequality? Do you think the pandemic will widen the gap?

Has your family struggled financially during the pandemic? What have you learned about finances during this time?

How will COVID-19 make us smarter money managers? What lessons can we carry forward so we are better prepared for another pandemic?

24 comments on “ 5 Truths about Money During the Pandemic ”

Great piece! Income inequality is the unequal distribution of income and the distribution of wealth. Will the coronavirus pandemic widen the current gap of inequality? Perhaps, but it is unlikely. Historically, economic recessions tend to shrink the wealth gap. On October 19th, 1987, for example, U.S. markets fell by over 20% in a single day! In the following years, GDP and employment also took significant downturns. While most Americans were affected by this drop, wealthy Americans who owned most of the country’s stocks were the ones who were most affected. From 1987 to 1991, the richest 1% of Americans/ share of national income decreased from 14.8% to 13.9%. The poorest 50% of Americans’ share of national income only decreased from 17.7% to 17.4% (according to the Los Angeles Times). Other groups of high and low-income Americans generally followed similar proportional changes in both income and wealth. In conclusion, the 1987 stock plunge in addition to the recession in the early 1990s that followed decreased the wealth and income gaps in America because the country’s wealthy population lost wealth at a higher rate than the poorest 50%, 25%, 10%, and so on.

Black Monday of 1987 is only one example, however. Historically, income inequality rises when the economy and stock market do well (both are directly correlated), but it decreases during recessions or bear markets. The same trend happened as stock prices soared in the late 1990s, as the technology bubble popped at the turn of the century, during the real estate boom, the 2007-8 Financial Crisis, and the economic boom of the last decade. Considering that U.S. GDP is projected to fall considerably (some accounts estimating up to 40%), it would make sense that in the coming years, income inequality in the United States should fall.

Although major American stock indices have not reflected recent economic hardships, the companies that make up the major indices are taking significant hits to revenue and net income, which would decrease the value of those very stocks (even if they do not do the same on paper).

While income inequality directly relates to the Culture of Poverty theory, the US has experienced a continual widening of the gap between the rich and poor. Covid has just accelerated the widening of the gap. The DOW is still at 27K, and fairly healthy, but this isn’t a true reflection on the state of income in our country. The middle-to-lower class section of our society isn’t heavily invested in stocks and many live paycheck to paycheck. So when broad sections of industries (restaurants, hotels, entertainment, etc,) cut millions of jobs, this will most definitely widen the gap.

As for my family’s experience during the pandemic, we, fortunately, had begun building a business that tied into helping local service businesses a few years prior. So our business wasn’t severely affected. I can say we’ve learned to minimize our expenses where possible.

While Covid has really made many families focus on eliminating unnecessary spending, this is one of the reasons for the softer economy we’re seeing. However, with the shift in the way everyone is living, this presents an excellent opportunity for people to look for different career paths and ways to excel. While income inequality directly relates to the Culture of Poverty theory, the US has experienced a continual widening of the gap between the rich and poor. Covid has just accelerated the widening of the gap. The DOW is still at 27K, and fairly healthy, but this isn’t a true reflection on the state of income in our country. The middle-to-lower class section of our society isn’t heavily invested in stocks and many live paycheck to paycheck. So when broad sections of industries (restaurants, hotels, entertainment, etc,) cut millions of jobs, this will most definitely widen the gap.

While Covid has really made many families focus on eliminating unnecessary spending, this is one of the reasons for the softer economy we’re seeing. However, with the shift in the way everyone is living, this presents an excellent opportunity for people to look for different career paths and ways to excel.

Covid-19 will go down as one of the most memorable events of the 21st century. David nailed the analysis of the article and seemed to portray a theme of uncertainty throughout his comment, which is probably what most Americans felt. David was also very observant of changes and continuities throughout the pandemic. He noticed that just by looking at the stock market, one could not tell there was a recession. For instance, he pointed out the fact that despite the Dow Jones Industrial Average was around 27k while the actual economy was not doing well. During the middle of the pandemic, when your comment was written, unemployment was at its highest at a shocking statistic of 40 million, Covid was spreading the fastest at this point. There was $864 billion added to the national debt in just one month; however, the S&P 500 ETF Trust fund shoots up to $300 from $228. I remembered that I was shocked when I checked the Dow Jones and Nasdaq. Each day they were all booming and even surpassing pre-pandemic numbers. Looking back at it now, it was crystal clear that a booming economy was part of Trump’s reelection plan. Since the comment and the article relate to money during the Pandemic, I think it will be interesting to look at a current money issue post-pandemic: Inflation. During this past pandemic, or throughout President Trump and President Biden’s terms they, passed a total of two covid relief bills that pumped 4.2 trillion dollars intended to relieve the American economy by handing money directly into the hands of taxpayers and giving a larger cut to big corporations, small corporation, and devoting the rest to education and public health. However, every action has a reaction, and a topic on the rise concerns inflation. Right now we have a high inflation rate of 5% while the inflation rate is much higher than the normal 2%. We could very well be heading into stagflation or, even worse, a depression, and it is better to be prepared than not prepared. David, it was great to read that your family’s business is unaffected by the pandemic, and your comment provides a great insight into a common misconception people had about the market.

The economic consequences of COVID-19 have been significant for the country and every state. The number of jobs lost and the decline in economic output were catastrophic, and many people were hurt financially, in many cases severely. The level of human deprivation was much less than it would have been, however, because of substantial intervention by the federal government.

This actually helped me a lot and with the methods i need to do to make money and save money. the pandemic gave free money basically and it helped many people out.

COVID 19 brought about a lot of different resource skills out of lots of different people. Though it may have been harder to make money around this time people pulled out a bunch of different skills they didn’t even know they have to stabilize their money and support families.

COVID-19 Will make us smarter money managers because it will make us smarter in spending our money because essentials like paper tiles and toilet paper has become high in demand so people would have to save up more money to buy things these essentials

I found all the issues and problem to be real truth about the pandemic however I thought the article fell short in how is affected many peoples mental health

i find everything in the article true but i feel as thigh it was lack of information

This has been very helpful to me because during this time period a lot of people are having problems with their finances.

I think it was really helpful.

this has helped me because people like me have problems with money and finances and how they spend it without runnning threw it

i think in the was useful but in time it wont really mean anything

My family has taken a hit because of the pandemic because of all the stress. I didn’t really learn about finances during this time. I think COVID has taught us that we need multiple streams of income.

This was very helpful for me.

this article was ok just was missing a lot about when covid hit . when we were going through the pandemic my family faced finance issues and schooling was so different i didn’t like doing home school i felt like i really wasn’t learning how i needed to in school

This article thoroughly explained the difficulties during COVID-19. Me personally, I went through a hard time with online schooling because I knew I was benefiting more than being taught in-person.

I think this article is very true although I slightly disagree on some parts like during Covid 19 it was hard for people to get money, because they were losing their jobs and couldn’t provide for their family’s and it was a terrible struggle

This article has a lot of information that really explained many situations that occurred with a number of families during the pandemic.

I think this article is very true although I slightly disagree on some parts like during Covid 19 it was hard for people to get money, because they were losing their jobs and couldn’t provide for their family’s and it was a terrible struggle it showed also t was very hard to prodive for famliys with no money

nd couldn’t provide for their family’s and it was a terrible struggle it showed also t was very hard to prodive for famliys with no money

During the pandemic i didn’t really struggle my only concerns were anyone i knew getting sick or me getting sick.

My family did struggled during the pandemic because we couldn’t really go outside to buy food because everybody was sick. I learned that budgeting wisely, and always be prepared for anything. Covid-19 has taught us the value of saving, and adapting to a new environment. We can carry always having a savings account just incase you ever need money and in a few years cash wouldn’t have any real value.

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Household Generosity During the Pandemic

Social and behavioral sciences can help us understand why COVID-19 is making giving practices more localized and expansive.

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By Sevda Kilicalp Jan. 19, 2021

A few weeks ago, a close friend approached me to join in a giving circle supporting families facing financial hardship in the face of the COVID-19 pandemic. I accepted the invitation without a second thought. And I was not the only one: In less than 24 hours, a circle of 25 donors from my friend’s personal networks was formed, with monthly giving orders placed to regularly meet the needs of a group of vulnerable families identified by volunteers. No questions were asked, nor concerns raised about how the money would be spent. The first family received assistance the following day.

If I had been solicited to donate directly to individual victims before the pandemic, I would not only have declined, but I would have tried to convince my friend to give to a charity working for the eradication of poverty, in a systematic manner, advocating for policy change or holding government to account for its responsibility to take care of those who are in need of social assistance. And as someone who has studied and promoted strategic giving and development of organized civil society for more than 15 years, I still strongly believe in the importance of supporting systems change work that attacks root causes of problems rather than treating symptoms of the problems through the acts of benevolence.

However, I am not the only person who has gone far outside of their usual donation path during the pandemic. The pandemic and related lock-down not only gave rise to charitable giving but triggered a different type of generosity compared to other disasters and difficult times in history.

Here are some highlights about how COVID-19 is shifting household giving:

Pressing Needs Lifted Up Causes Linked to the Crisis … While Leaving Others Behind

The amount donated to charities in the UK on Giving Tuesday was up by almost half this year despite the restrictions on in-person fundraising activities. But this doesn’t mean that households increased their giving to the same causes they used to support: Support grew for causes linked to the crisis, while causes like animal shelters, disability support groups, and homeless shelters saw a big hit to donations (even while facing extraordinary new financial pressures). Similarly, 21 percent of US households indicated that their giving to charitable organizations focused on purposes besides basic needs/health and religion (e.g., education, arts, the environment) decreased during the COVID-19 pandemic. US households prioritized giving to meet the pressing needs of those in their area.

While all nonprofits face new challenges, the financial impact of the crisis has been uneven: Environmental, education, arts and culture organizations are least likely to get gifts while charitable giving for social services remains steady. Since donations make up an important part of small to mid-size nonprofit revenues, nonprofits that see a serious drop in donations may have to shift focus and approach following the current changes in the nature of charitable giving. While some of them resort to layoffs, reduce operations, or merge with other organizations in order to survive, for others it will be almost impossible to recover, and they will be forced to shut their doors. This requires those that are not providing direct COVID-19 relief to communicate effectively with donors regarding the interconnectedness between their causes and the challenges we are all experiencing during the pandemic.

Mutual Aid Is Rising

So many mutual aid groups have been flourishing over the pandemic. Mutual aid, far from being a new concept, means voluntary and reciprocal exchanges of resources and services, often among members of struggling communities for meeting their own needs and addressing underlying social causes behind hardship based on principles of cooperation, solidarity, care, and direct action. Most recently, in the context of pandemic, we see more and more ordinary people come together in the spirit of solidarity and engage in mutual support to protect the most vulnerable in their community and beyond. Inspiring stories have been emerging about neighbors helping neighbors with hardship. Mutual aid groups took on various tasks such as collecting groceries, supplying masks, sanitizers, and medicine, sharing information, offering emotional support, tutoring children.

This highly localized approach to supporting communities seems to be working because smaller mutual aid groups are able to act quickly and provide locally specific support. Mutual aid is also distinguished from top-down resource distribution by its focus on reciprocity, horizontality, and equality. Mutual aid groups remove the divide between helper and helped and dismiss means test to assess whether the person effectively lacks sufficient resources. In this way, they not only reach out to people left behind by other relief programs but also go beyond crisis relief and offer community empowerment.

The question is whether mutual aid groups will be dissolved after the end of the crisis, if the sense of urgency disappears and people go back to their routine, or whether the rediscovery of mutual aid in the northern hemisphere signals the start of a long-term phenomenon. If mutual aid is here to stay, nonprofit practitioners will need to figure out whether mutual aid expands the civic space or crowds out the support for top-down, professionally-organized civil society by applying more participatory, inclusive, and hands-on methods and engaging ordinary people in community affairs.

Solidarity Is Coming Together With Social Justice Activism

Some commentators argue that these self-organized, spontaneous community efforts serve to compensate for states’ failure or unwillingness to provide welfare functions. While some of the mutual aid groups are less ideological and view their activities in terms of short-term crisis response, others see COVID-19 aid as an opportunity to work towards transformative change . Although I am cautious about the risk of instrumentalization of mutual aid by governments to pursue their own political agendas, I firmly believe in the potential of mutual aid for creating new commons and building bottom-up structures of cooperation. Even the very simple act of building social relations among neighbors from diverse backgrounds in our polarized societies can be considered a form of everyday activism .

This renewed sense of community and alternative social relationships based on solidarity, reciprocity, and inclusion can change prevailing ideas about how society works and sow the seeds of long term social and political change. In addition to prefiguring a radically different society, mutual aid shifts our understanding of inequalities in access to basic services and rights away from abstract societal issues toward local realities affecting real people living in our geographic proximity. This kind of awareness and personal connection with social justice causes is likely to increase people’s civic and political engagement.

More Expansive Forms of Generosity Are Emerging

Just as the pandemic is unlike anything we’ve seen in our lifetimes, the responses to it are different, more creative and resourceful. According to a recent report from Indiana University Lilly Family School of Philanthropy’s Women’s Philanthropy Institute, nearly half of households in the USA gave indirectly in response to the pandemic during the early months of the crisis (for example, by ordering takeout to support restaurants and their employees or continuing to pay individuals and businesses for services they could not render). The share of households participating in these unique forms of philanthropy far surpassed the share of those giving directly to charitable organizations, individuals, or businesses in response to the crisis during this time. This is an important finding to show that declines in measured household giving do not mean less generosity, care for one’s fellow citizens, or support for communities. We need to start recognizing and celebrating different kinds of informal giving and develop adequate measures.

Likewise, another study with young Americans (ages 18-30) in April 2020, found that these individuals engaged in a variety of activities to help others during the crisis, including starting to purchase or increasing their purchase of local products or services (26 percent), donating goods or services (24 percent), and posting or sharing content on social media about COVID-19 prevention (21 percent). Taking all these acts of kindness into consideration, our understanding of generosity behavior becomes much richer, inclusive, and complete than formal measures of household giving.

Insights From the Social and Behavioral Sciences

The conditions created by the pandemic influence how much people give, whom to give, what to give, and how to give. Of course, several factors, such as age, gender, economic stability, and exposure to COVID-19 have an influence on our pro-social behavior, so do neural, biological, and emotional mechanisms. Insights from the social and behavioral sciences can be useful for understanding why charitable giving is changing and becoming more localized and expansive.

1.  Social distancing urges us to reconnect with others to cope with psychological distress. While social distancing has been effective at flattening the curve of infection, it has had significant negative effects on mental health (leading to psychological distress like depression, anxiety, and stress) as found in recent research . Humans are by their nature social animals and have a fundamental need for connection with one another: As neuroscientist and social psychologist Matthew Lieberman explains, evolution made us more social, more connected to and dependent on the social world to ensure that humans thrive as a species; hence our brains suffer from threat to social bonds in much the same way we experience physical pain.

The neural link between social and physical pain urges us to reach out to and interact with others. Caring for others, especially informal helping , increases the sense of social connectedness and becomes the best way to combat social pain and loneliness. By engaging in acts of kindness we are not contributing to the common good but responding to our survival need.

2.  Reawakening to our collective vulnerability creates a sense of collaboration. Not everyone reacts to stress in the same way, whether fight-or-flight or tend-and-befriend mode. But the tend-and-befriend response to COVID-19 involves caring for ourselves and those close to us, as well as building collective self-help networks to reduce vulnerability and exchange resources and responsibilities. Alex Evans of Collective Psychology Project suggests that the pandemic incites our “tend-and-befriend” nature to the extent that we consider ourselves part of a larger us, feel like we can shape our lives and have mental space to deliberatively reflect on and choose how to react to events instead of being driven by fear and anxiety.

3.  The problem of numbers . Some argue that the surge of generosity during the COVID-19 pandemic is due to the sheer magnitude of the crisis , but the brain’s inability to make sense of big numbers makes it difficult to process tragedy of this scale, and concern for those in distress does not tend to rise in parallel to the increase in cases. On the contrary, the more our attention is divided by multiple victims, the less emotion we feel and action we take to support them. Individual stories of pain and small groups of victims trigger more empathy and compassion than statistics.

In addition to numeracy bias, a false feeling of inefficacy has an enormous impact on how and whether people provide aid. Thinking about one’s inability to remedy all sufferings triggers feelings of hopelessness and diminishes the warm glow from helping an individual victim. As a result, individuals tend to give toward identifiable victims rather than statistical victims. This may be one reason why households prefer helping people in their surrounding environment.

4.  Feeling collective . The notion that “we’re all in this together” and the virus threatens everyone (although not equally) creates a collective emotional experience. Research shows sharing adverse experiences may increase cooperative behavior within groups, leading individuals to mutually seek and provide support to one another. While these negative experiences enhance ingroup cooperation, they also fuel polarization , and intergroup bias toward outgroup members, thus contribute to conflict, discrimination, and exclusion.

We Need Critical Reflection About the Localization of Charitable Giving

COVID-19 has driven a surge in “localism” around the world, bringing increased attention to pressing needs within our communities and the responsibility to take care of one another as well as fears about the end of globalization . As The Economist wrote, “Wave goodbye to the greatest era of globalization—and worry about what is going to take its place.” Similar concerns have been echoed in the philanthropic community.

However, we don’t need to feel threatened by the localization of philanthropy or the rise of new forms of giving; we simply need to recognize various ways in which individuals express their charitable impulses. These are important developments for nonprofits to watch and understand not only to remain relevant and resonate with citizens but also to build on these recent practices to empower communities. Much attention has been placed on responses of institutional philanthropy and how philanthropic foundations do/can support the resilience of nonprofits. How charitable giving by households—as we know it—has been changing amid the COVID-19 pandemic has been overshadowed by these discussions.

In the face of growing critiques of big-money philanthropy, there have been calls to extend our definition and understanding of philanthropy beyond formalized actions and recognize the value of everyday giving by ordinary people. Making philanthropy more democratic, accessible, and inclusive is necessary not to tackle philanthropy’s “image problem,” rather to bring back the classic notion of civil society response to local problem solving, which will be more needed than ever for regenerating trust and collective sense of caring in the post-COVID era.

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Research essay: should we save lives — or save the economy.

The COVID-19 crisis puts all policymakers in a difficult position. In addition to the great uncertainty about the parameters of the pandemic and about the short-term and long-term consequences of the economic slump, there is an ethical dilemma: how to balance the value of saving human lives against the value of preserving people’s livelihoods. In the United States, the debate has been raging between those who say “the cure cannot be worse than the disease,” and those who say “we are not going to put a dollar figure on human life.”

Whether they like it or not, policymakers must address this difficult trade-off. In theory, separating every person from everyone else for two or three weeks would immediately stop the infection spread at little economic cost. This is totally impractical, but less extreme lockdown measures observed in many countries do reduce the reproduction rate of the pandemic to such low numbers that this, actually, would fully extinguish the pandemic within two or three months. It is also possible, under a more lenient approach, to keep the pandemic under control by a stop-and-go policy of repeated lockdown episodes of a few weeks each until a vaccine is found. The problem is: Are all these measures worse than the health crisis itself?

When Princeton students were sent back home, just before the spring break, I was intrigued by this exceptional situation and built a model on a simple Excel spreadsheet, first for my own curiosity, but also as a possible teaching tool for my Woodrow Wilson School class on the microeconomic evaluation of public policy. Several friends and colleagues have helped me improve it, including my daughter, a physicist. 

The model simulates the pandemic as well as the lockdown and testing policies available, and includes a set of evaluation tools for the comparison of various policy options. You can download it from https://bit.ly/fleurbaey . (Users can change all parameters and assumptions and determine the timing and intensity of contact reduction and testing policies.) In a rough but informative way, the model takes account of inequalities in income and life expectancy across social groups and allows for various assumptions about the distribution of the economic cost and the fatality burden among these groups. Such assumptions relate to policy choices about social protection, income support, and access to health care.

The evaluation tools included in the model belong to two ethical approaches, which are the most common for such assessments. To be clear, yes, these methods all “put a dollar figure on human life,” but they do so in a principled way. The main reason they put a value on human life is that each one of us does it all the time. We all take risks every day, implicitly deciding that life is not worth more than the value of the risk taken. I used to ride my bike to the University even though the risk of a fatal accident, while low, was much higher than the risk I’d face driving my car. I thought the advantages of bike-riding — such as exercise and long-term health benefits — outweighed the greater risk I was taking on. Similarly, the main agencies of the federal government use a key number, the “Value of a Statistical Life,” to assess the benefits of various programs with consequences on population health and compare these benefits to the program costs. Without such a number, they would have no idea whether a safety program is worth the cost.

The ethical calculus based on the value of a statistical life is straightforward. In the current pandemic, the number of deaths avoided by the various measures taken by most governments is very high: about 1 percent of the population in developed countries. This huge number — more than 3 million people in the U.S. — comes in part from the overwhelmed hospitals being unable to receive all patients when the “curve” is not “flattened.” The value of a statistical life in the U.S. is generally taken to be around 150 times the annual per-capita income, or about $10 million. Therefore, the health benefits of avoiding all these deaths are worth about 150 percent of a year of income: more than $30 trillion! Assuming that the serious recession that would have occurred in absence of any government intervention is worsened only by about 10 percent of a year of income under the lockdown policy, the conclusion is obvious. The cure is vastly better than the disease.

An evaluation that gives special priority to the worse-off will favor policies granting all people equal access to health care and guaranteeing a lifeline to economically vulnerable workers and small businesses.

However, there are several issues with this overly simple approach. First, it does not account for the fact that the victims are mostly elderly people who do not lose many years of life. There is another number called the “Value of a Statistical Life-Year,” which can be used to assess the years lost instead of the lives lost. Considering that the average victim loses 10 years of life, and that the value of a statistical life-year is about three times the annual income per capita in the U.S., one obtains an estimate of the health benefits of about 30 percent of a year of income. This is still much greater than the predicted economic cost, but in the same order of magnitude — therefore, one should pay close attention to how the health and economic consequences unfold in the coming months. 

Another ethical problem with the Value of Statistical Life approach is that it does not pay attention to the unfair distribution of background conditions (such as income and life expectancy) among social groups, or to the distribution of the health and economic burdens of the ongoing crisis among them. In the U.S., in particular, disadvantaged communities are paying a heavy price on all fronts. These communities often include workers who are exposed to the virus or are among the first to be laid off or lose their businesses.

This is why I prefer an alternative approach that makes an evaluation of the well-being of the population, taking account of these fairness issues in the distribution of burdens and benefits. This “social well-being” approach is more demanding because it requires more data and more detailed predictions of the consequences of the crisis and the policies for different groups, but it provides more relevant evaluations. In particular, it allows the decision-maker to pick a key ethical parameter: the degree of priority granted to the worse-off. An evaluation that gives special priority to the worse-off will favor policies granting all people equal access to health care and guaranteeing a lifeline to economically vulnerable workers and small businesses. It will give more weight to health benefits if the victims of the virus are among the worse-off, and more weight to economic costs if the burden falls on the most disadvantaged. My colleagues and I are debating whether the elderly victims of the virus are really among the worse-off, since they include many pensioners who do not risk losing their jobs and who have been lucky to live to an old age — the average age of a COVID victim in developed countries is close to 80. That’s similar to the life expectancy of the population, which means that, on average, those who do not die from the virus will not live longer than the average victim of the virus. On the other hand, the average COVID victim has lived during times that were much less economically affluent than recent years. 

At any rate, in the current crisis both approaches — in all their variants — strongly favor an ambitious public-health policy combining strict shutdown, widespread testing, and universal mask wearing to promptly quash the spread of the virus at relatively little economic cost. Not many countries have succeeded in achieving this feat, but some have, including some low-income nations. It requires swift action and works best with clear vision, great transparency, a high level of trust and cooperation of everyone involved, and extensive support measures to help the economically vulnerable to go through the hiatus. This is really hard to achieve because the policy appears very painful in the moment, and if relaxation of the effort comes too early, most of the effort will have been done in vain and the pandemic will restart. When the pandemic remains rampant and one has to examine new measures as cases spike again, the question of the hard trade-off between lives and livelihoods reemerges. The tools offered in this model can be applied again and may help us better understand how to navigate this crisis of historic proportions. 

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The Coronavirus Crisis

Flattening a pandemic's curve: why staying home now can save lives.

Maria Godoy

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As the coronavirus continues to spread in the U.S., more and more businesses are sending employees off to work from home. Public schools are closing, universities are holding classes online, major events are getting canceled, and cultural institutions are shutting their doors. Even Disney World and Disneyland are set to close . The disruption of daily life for many Americans is real and significant — but so are the potential life-saving benefits.

It's all part of an effort to do what epidemiologists call flattening the curve of the pandemic. The idea is to increase social distancing in order to slow the spread of the virus, so that you don't get a huge spike in the number of people getting sick all at once. If that were to happen, there wouldn't be enough hospital beds or mechanical ventilators for everyone who needs them, and the U.S. hospital system would be overwhelmed. That's already happening in Italy.

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Comic: i spent a day in coronavirus awareness mode. epidemiologists, how did i do.

"If you think of our health care system as a subway car and it's rush hour and everybody wants to get on the car once, they start piling up at the door," says Drew Harris, a population health researcher at Thomas Jefferson University in Philadelphia. "They pile up on the platform. There's just not enough room in the car to take care of everybody, to accommodate everybody. That's the system that is overwhelmed. It just can't handle it, and people wind up not getting services that they need."

Harris is the creator of a widely shared graphic visualizing just why it is so important to flatten the curve of a pandemic, including the current one — we've reproduced his graphic at the top of this page. The tan curve represents a scenario in which the U.S. hospital system becomes inundated with coronavirus patients.

However, Harris says, if we can delay the spread of the virus so that new cases aren't popping up all at once, but rather over the course of weeks or months, "then the system can adjust and accommodate all the people who are possibly going to get sick and possibly need hospital care." People would still get infected, he notes, but at a rate that the health care system could actually keep up with — a scenario represented by the more gently sloped blue curve on the graph.

Singapore Wins Praise For Its COVID-19 Strategy. The U.S. Does Not

These two curves have already played out in the U.S. in an earlier age — during the 1918 flu pandemic. Research has shown that the faster authorities moved to implement the kinds of social distancing measures designed to slow the transmission of disease, the more lives were saved. And the history of two U.S. cities — Philadelphia and St. Louis — illustrates just how big a difference those measures can make.

In Philadelphia, Harris notes, city officials ignored warnings from infectious disease experts that the flu was already circulating in their community. Instead, they moved forward with a massive parade in support of World War I bonds that brought hundreds of thousands of people together. "Within 48, 72 hours, thousands of people around the Philadelphia region started to die," Harris notes. Within six months, about 16,000 people had died.

Meanwhile, officials in St. Louis, Mo., had a vastly different public health response. Within two days of the first reported cases, the city quickly moved to social isolation strategies, according to a 2007 analysis.

"They really tried to limit the travel of people and implement Public Health 101 — isolating and treating the sick, quarantining the people who have been exposed to disease, closing the schools, encouraging social distancing of people," Harris says. "And, of course, encouraging hand hygiene and other individual activities."

As a result, St. Louis suffered just one-eighth of the flu fatalities that Philadelphia saw, according to that 2007 research. But if St. Louis had waited another week or two to act, it might have suffered a fate similar to Philadelphia's, the researchers concluded.

At the time the 2007 research was released, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a leading adviser in the U.S. response to COVID-19, the disease caused by the current coronavirus, said the evidence was clear that early intervention was critical in the midst of the 1918 pandemic.

As for just how big the current coronavirus pandemic will be in America? "It is going to be totally dependent upon how we respond to it," Fauci told Congress earlier this week.

"I can't give you a number," he said. "I can't give you a realistic number until we put into [it] the factor of how we respond. If we're complacent and don't do really aggressive containment and mitigation, the number could go way up and be involved in many, many millions."

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Many Americans say they have shifted their priorities around health and social activities during COVID-19

The coronavirus outbreak has transformed many aspects of public life since 2020, including how Americans work, go to school and attend religious services. More recently, restrictions on public activities in many places have been lifted , and Americans are increasingly more comfortable with returning to normal activities.

To gain insight into how Americans view the impact of COVID-19 in their lives, a recent Pew Research Center survey asked respondents to describe – in their own words – what rose and fell in importance to them during the pandemic. (A random subset of survey respondents described what has become more important to them and another random subset described what has become less important.)

For many Americans, the pandemic – which has taken more than a million lives in the United States alone – has brought a new sense of trade-offs between protecting one’s health and participating in social activities as part of daily life. Here are some of the key themes that emerged in Americans’ open-ended responses.

Pew Research Center conducted this analysis to understand how Americans’ priorities have shifted since the coronavirus outbreak. Open-ended responses come from a Center survey of 10,282 U.S. adults conducted May 2-8, 2022. Some responses quoted here have been lightly edited for style, brevity and readability.

Everyone who took part in the survey is a member of the 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 .

Here are the questions used for this report , along with responses, and its methodology .

What’s become more important

Many Americans – 26% of those who responded – say keeping healthy became more important to them during the COVID-19 outbreak, whether that involved following public health precautions or putting more emphasis on a healthy lifestyle.

Some described the precautions they took to maintain their health as newly important. One respondent said, “Keeping a safe distance from people in the stores and places I shop or eat. Make sure to wash my hands enough especially before eating.” Others framed this in more general terms, such as “staying healthy, exercising, eating right and watching out for my mental health.”

Roughly two-in-ten (21% of those who gave a response) talked about their renewed appreciation for social activities. Most in this group said participating in large gatherings and in-person visits with friends and family were more important to them now than before the outbreak. One person described their shift in appreciation this way: “Quality time with the people I love, attending large events whenever the opportunity presents itself.”

A smaller share (9% of those answering) referred to not going out and staying home – steps to prevent risk of infection – as more important priorities since the COVID-19 outbreak. One person described the change as “staying out of public places and crowded places.” Another said, “I stay at home more, avoid crowds and public spaces. I also shop earlier to avoid people, buy more in bulk so I don’t have to go out as often.” Center surveys have shown widespread changes in Americans’ work lives during the pandemic. Some open-ended responses also spoke to people’s reevaluation of broader life priorities, especially in connection with a decreased focus on work life or being in the office.

One-in-ten of those responding described having more appreciation for life and a comparatively lower priority on work life today. One survey respondent summed up their new priorities this way: “When I worked from home, I was able to be very efficient and finish work during my contract hours. Now that I am back to commuting and interacting with colleagues, that is more difficult to do, but I do not take home work tasks any longer. What gets done at work gets done, and everything else waits for the next business day. My family time is too valuable.”

Fewer respondents mentioned frustrations with advice from public health officials or an active rejection of efforts to protect themselves from coronavirus. Just 2% of those responding said this had become more important to them. (Another 1% made a general negative remark about public health officials.)

What’s become less important

Americans who were asked what has decreased in importance to them during the outbreak also frequently cited social interactions. About a third (35% of those responding to this question) said socializing and going out had decreased in priority to them.

As one person put it, “Being social in large crowds is less important now. It’s less important to go out.” Another said, “I am not going out as much to crowded areas and it’s not really my priority . ” Other activities that Americans volunteered as less important to them personally included “traveling and vacations,” “going out for shopping” and “going to the movies.”

Some respondents (9%) mentioned a devaluation of work when thinking about things that have become less important to them during the pandemic. This included people who said that their job or going to work in person had become less important. One respondent said, “It became less important for me to be in the office. I can handle the same responsibilities being remote.” Among the other things that Americans mentioned as less important to them: “Putting in long hours at work” and “being defined by [their] job.”

A small share of Americans (4% of those who responded) said that listening to public health officials had become less important to them. One respondent phrased it as having “lost all faith in the medical community, the CDC, FDA, etc.”

Partisan differences over public health guidelines, social gatherings

Throughout the coronavirus outbreak, wide partisan differences have emerged over efforts to mitigate its effects. Partisan differences also appear in Americans’ open-ended survey responses to the Center’s recent survey, particularly when it comes to health guidelines and social gatherings.

Democrats and independents who lean to the Democratic Party were about twice as likely as Republicans and Republican leaners (32% vs. 17%) to mention taking health precautions and following public health guidance or other efforts to improve health as being more important to them since the outbreak.

On the flip side, Democrats (45% of those responding) were also more likely than Republicans (22%) to talk about decreased importance of socializing in large gatherings or going out since the outbreak began. Note: Here are  the questions used for this report , along with responses, and  its methodology .

• Coronavirus (COVID-19)
• COVID-19 & Politics
• COVID-19 & Science

How Americans View the Coronavirus, COVID-19 Vaccines Amid Declining Levels of Concern

Online religious services appeal to many americans, but going in person remains more popular, about a third of u.s. workers who can work from home now do so all the time, how the pandemic has affected attendance at u.s. religious services, mental health and the pandemic: what u.s. surveys have found, most popular.

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Essential but undervalued: Millions of health care workers aren’t getting the pay or respect they deserve in the COVID-19 pandemic

Subscribe to the brookings metro update, molly kinder molly kinder fellow - brookings metro @mollykinder.

May 28, 2020

• 20 min read

This is the second post in a series on COVID-19 frontline workers. Read the stories of the workers profiled here .

Introduction

Underpaid, undervalued, and essential.

• A policy agenda for essential, low-wage health workers:

Keep all health workers safe

Introduce hazard pay, raise pay to a permanent living wage, expand paid leave, give workers the respect they deserve.

The COVID-19 pandemic has inspired an outpouring of public appreciation for the country’s frontline heroes, from television ads to firefighter salutes to essential worker toys . But while doctors and nurses deserve our praise, they are not the only ones risking their lives during the pandemic—in fact, they represent less than 20% of all essential health workers.

Too often, we overlook the heroism and dignity of millions of low-paid, undervalued, and essential health workers like Sabrina Hopps, a 46-year-old housekeeping aide in an acute nursing facility in Washington, D.C.

“If we don’t clean the rooms correctly, the pandemic will get worse,” said Hopps. She cares deeply about the patients she works with, and knows that the value of her job goes well beyond cleaning. “It’s me and the other housekeepers who sit and talk with [patients] to brighten up their day, because they can’t have family members visiting.”

Despite her contributions, she doesn’t feel recognized. “Housekeeping has never been respected,” she told me recently. “When you think about health care work, the first people you think about are the doctors and the nurses. They don’t think about housekeeping, maintenance, dietary, nursing assistants, patient care techs, and administration.”

Hopps is one of millions of low-wage essential health workers on the COVID-19 front lines. Like the higher-paid doctors and nurses they work alongside, these essential workers are risking their lives during the pandemic—but with far less prestige and recognition, very low pay, and less access to the protective equipment that could save their lives. They are nursing assistants, phlebotomists, home health aides, housekeepers, medical assistants, cooks, and more. The vast majority of these workers are women, and they are disproportionately people of color. Median pay is just $13.48 an hour.

Over the last several weeks, I interviewed nearly a dozen low-wage health workers on the front lines of COVID-19. ( You can read their stories here . ) Despite being declared “essential,” the workers I interviewed described feeling overlooked and deprioritized, even expendable. They spoke with pride about their work, but few felt respected, even as they put their lives on the line. Many expressed frustration—and sometimes anger—over their lack of life-saving protective equipment.

It is long past time that these workers are treated as truly essential. This starts with simply recognizing the value of workers like Hopps—but we can and must do more. The policy recommendations in this report aim to keep these workers safe on the job, compensate them with a living wage, support them if they fall ill, and give them the respect and appreciation they deserve.

Back to top ⇑

The underpaid but essential health care workforce in America comprises nearly 7 million people in low-paid health jobs in these three categories:

• Health care support workers assist health care providers such as doctors and nurses in providing patient care. Roles include orderlies, medical assistants, phlebotomists, and pharmacy aides.
• Direct care workers such as home health workers, nursing assistants, and personal care aides provide care to individuals with physical, cognitive, or other needs.
• Health care service workers include housekeepers, janitors, and food preparation and serving workers employed in health care settings such as hospitals and nursing homes.

More people are employed in health care support, service, and direct care jobs than in all health care practitioner and technician jobs (doctors, nurses, EMTs, lab technicians, etc.). In fact, more people work in hospitals as housekeepers and janitors—like Sabrina Hopps—than as physicians and surgeons. The size of this low-wage health workforce exceeds the size of most other occupational groups of essential workers. It employs more people than the entire transportation and warehousing industry and more than twice as many people as the grocery industry .

Median wages in health care support, service, and direct care jobs were just $13.48 an hour in 2019—well short of a living wage and far lower than the median pay of doctors (over $100 per hour) and nurses ($35.17 per hour). Home health and personal care workers earn even less, with a median hourly wage of only $11.57. The wages are so low that nearly 20% of care workers live in poverty and more than 40% rely on some form of public assistance. These fields are some of the fastest-growing of all occupations, with more than a million new jobs projected by 2028.

Table 1. Demographic profile of workers in the health care and social assistance industry, 2019

Source: Brookings analysis of U.S. Bureau of Labor Statistics’ Occupational Employment Statistics and the U.S. Census Bureau’s Current Population Survey.

Over 80% of health care support, service, and direct care workers are women. They are also disproportionately people of color. Like other low-wage jobs where women and people of color are concentrated , many of these positions are plagued by underinvestment and a lack of benefits. Now, these jobs pose an even greater risk to workers’ lives.

Despite being undervalued, low-wage health workers make essential contributions during the pandemic and beyond. “Nobody is insignificant,” said Tony Powell, a 62-year-old administrative coordinator of a hospital surgical unit in Washington, D.C. “Without environmental service, without dietary, without secretaries, without medical and surgical techs and certified nursing assistants (CNAs), it wouldn’t be a hospital.” Home health workers, for instance, provide the first line of defense against COVID-19 for millions of elderly and vulnerable people living at home. Without that, the limited capacity of hospitals today would be stretched even further.

A policy agenda for essential, low-wage health workers

Policymakers, employers, and the general public should each do their part for low-wage essential health workers during COVID-19 and beyond. The following policy recommendations are aimed at keeping these workers safe on the job, compensating them with a living wage, supporting them if they fall ill, and giving them the respect and appreciation they deserve.

A first-order priority for policymakers and employers should be keeping frontline health workers safe on the job. Dire shortages of life-saving personal protective equipment (PPE) such as surgical masks, N95 respirators, isolation gowns, gloves, and face shields are jeopardizing workers’ lives. One poll showed that two-thirds of health care workers reported insufficient face masks as recently as early May. Frustrated nurses and doctors have made urgent appeals to the federal government to activate the Defense Production Act to mobilize production of needed supplies.

While most news coverage highlights only the risks to nurses and doctors, PPE shortages are also a matter of life and death for millions of health care support, service, and direct care workers on the COVID-19 front line. These workers are at a lower priority for the already-insufficient supplies, meaning that hospitals and health care facilities sometimes overlook their safety as they ration PPE and prioritize vulnerable clinical staff who treat infectious patients.

The workers I interviewed expressed a range of emotions—from fear to frustration to anger—over their lack of access to PPE. David Saucedo, a 52-year-old cook at a Baltimore nursing home, said his supervisors initially denied his requests for PPE.

“Just because I am not a nurse or nursing assistant doesn’t mean I don’t come in contact with patients,” Saucedo told me. “Every footstep a nurse, nursing assistant, or doctor takes in that facility, I actually walk right behind them.” His Alzheimer’s patients, he noted, do not understand social distancing: “They just come up to you, grab you, and sit and talk to you.”

Saucedo had to argue his case to two supervisors before he was finally given the PPE that nurses in his facilities automatically access. “It’s like they prioritized them and forgot about everyone else,” he told me. “It makes me feel like I am secondary, not equal. You are expendable, in a way.”

Andrea (who preferred we only use her first name), a 29-year-old housekeeping aide in a hospital operating room and mother of two young children, had a similar experience. After a patient in a room she was responsible for cleaning was suspected of having the coronavirus, Andrea asked her charge nurse to be fit-tested for an N95 mask. Andrea said the nurse’s response was, “No, these are for special people.”

“One minute you are important enough,” she told me. “The next minute it is like, no you aren’t that important to get the proper equipment, but you are important enough to clean it for the next patient.”

Home care workers face additional hurdles to accessing PPE. Their employers are much lower in priority for state and federal PPE supplies than hospitals, nursing homes, and emergency services, leaving many agencies struggling to procure equipment on their own and pay for its skyrocketing costs on the private market. A recent survey found more than 75% of home care agencies face shortages of masks and sanitizer.

Like others in her field, Elizabeth Peachy, a 49-year-old home health aide in Virginia, received no PPE, COVID-19 training, or supplies from her employer. She described driving to towns across Virginia and West Virginia in search of her own equipment. Yvette Beatty, a 60-year-old home health aide in Philadelphia, said her employer was unable to access PPE despite concerted efforts.

“I would love to see us have hazard masks, instead of putting cloths over our face, or going to the Dollar Store and buying dollar masks,” Beatty told me. “We need equipment. They need to give equipment to agencies. We are running around with cloths, no protective gear. We need the exact same thing as everyone else.”

» Policy recommendations to keep workers safe:

• The federal government should fully utilize the Defense Production Act to mobilize manufacturers across the country to increase the supply of PPE. Until every health care worker has sufficient access to PPE, their lives are at risk.
• State governments should encourage companies to increase PPE supplies and help home health agencies access supplies and finance costs. They can follow the lead of Washington state, which recently added home health workers and other long-term care providers to the top tier of priority for PPE.
• Home care agencies should increase training, information, and resources to frontline workers, so home care workers do not feel like they are navigating a pandemic on their own.

The extremely low pay that health care support, service, and direct care workers earn has long been woefully inadequate. During a pandemic, it is morally reprehensible. Congress should enact hazard pay to ensure that no worker risking his or her life during this crisis is paid less than a family-sustaining wage.

For workers in health jobs, federal funding for hazard pay is especially important. Hospital finances have been hit hard by the pandemic. Home care agencies are limited in their ability to raise pay due to Medicaid reimbursement rates, a major systemic impediment to improving job quality for millions of care workers. Hazard pay for health workers has lagged behind temporary pay increases for workers in sectors such as retail and grocery.

Lawmakers on both sides of the aisle have offered proposals for federally funded hazard pay. In April, President Donald Trump signaled his support for extra compensation to doctors, nurses, and health workers. On May 15, the House of Representatives passed the HEROES Act, which included $200 billion for hazard pay for essential workers. Despite this momentum, U.S. lawmakers have not passed hazard pay into law. In Canada, however, Prime Minister Justin Trudeau announced a $4 billion commitment to increase pay for essential workers. He singled out low-paid essential workers as a priority, saying that minimum-wage workers risking their health during the pandemic deserve a raise.

The workers I interviewed expressed a strong desire for hazard pay. David Saucedo likened the hazards of his job as a nursing home cook to the risks he faced during his military service: “When I was in the Navy, when we went to war, I was getting paid hazardous duty pay. To me, it is a hazardous job right now. We should be getting paid hazardous pay.” Saucedo noted that additional compensation could be life-saving, affording his colleagues the chance to take a taxi instead of risking exposure to COVID-19 on public transit. “Everybody is contagious on buses,” he said. “The best thing you can do is limit their amount of exposure for a cook or anyone else.”

Housekeeping aide Sabrina Hopps agreed that additional compensation could be life-saving. “If pay was better, I would be able to live on my own and so could my children,” she told me. “What I make, it is not enough. So, I am forced to share an apartment with my son and daughter and my granddaughter. Going back and forth to work, I am jeopardizing their lives.” Hopps is especially concerned for her son, who has asthma and is a cancer survivor. Her employer recently introduced a new bonus for employees providing direct patient care, but excluded housekeepers and other low-paid service workers from the additional compensation.

»  Policy recommendations for introducing hazard pay:

• Congress should pass federally mandated hazard pay for at-risk essential workers in the next pandemic relief bill, with a priority for lower-paid workers. Hazard pay should double the wages of low-wage workers. In the HEROES Act legislation, House Democrats included $200 billion for hazard pay through a “Heroes Fund” that would administer grants to employers of essential workers. Their proposed rate of an additional $13 per hour is roughly equivalent to the median wage of health care support, service, and direct care workers.

COVID-19 has laid bare the wide gap between the value that health care support, service, and direct care workers bring to society and the extremely low wages they earn in return. Short-term fixes such as hazard pay are urgently needed. But policymakers and employers should also make lasting changes so that these essential workers finally earn a permanent living wage .

Hospital administrative coordinator Tony Powell explained why wage increases are so critical for low-paid health workers: “They have to realize that these people, just like any other people—doctors, nurses, whoever—they have families. They have to raise their families, too. If you are working just at the poverty level, that is giving you enough to get to work, get lunch, and try to send your kids to school. But without a living wage, it’s not going to mean anything.”

Pauline Moffitt, a 50-year-old direct care worker in Philadelphia, is barely surviving on the poverty wages she earns caring for immunocompromised and elderly residents. At $9 an hour, her pay is so low that Moffitt and her recently laid-off husband cannot make ends meet, even as she commutes nearly three hours each way on five bus and train transfers. “It is a struggle,” she told me. “I have to pay a lot of bills. What am I supposed to do? I pray always: Lord, please stretch my pay. Please .”

Pennsylvania, where Moffitt works, is one of the 21 states that has not mandated a minimum wage above the federal rate of $7.25 per hour. She wants to see permanent pay increases. “I just wish they would raise it and give us a little more,” she said. “Not just for me, but all the other home health aides that are in the same situation.”

»  Policy recommendations for permanently boosting pay:

• The federal government and state and local governments should raise the minimum wage to at least $15 per hour.
• State governments and the federal government should increase Medicaid funding to allow employers of home care workers to provide a living wage and offer benefits.

While workers of all incomes are vulnerable to COVID-19, low-wage workers have the least access to paid leave if they fall ill. In 2019, less than a third of workers in the bottom 10% of income earnings had access to paid sick leave, compared to nine out of 10 higher-paid workers in the top quarter of income earnings. The gaps for essential workers like home health aides are particularly large—a 2017 survey of 3,000 home care workers found that less than one in five care workers had access to paid leave.

“We don’t get any benefits,” said Elizabeth Peachy, a 49-year-old home health aide who earns $9 an hour. The funding for her work caring for geriatric patients comes through the state of Virginia, but she is not employed directly by the state. “They have us work as independent contractors,” she told me. “And that way, we get no sick leave, no overtime, no benefits at all. This is pretty standard.”

Peachy thinks policymakers should make changes: “In reality, it is a lot cheaper to pay us a little more money, give us some benefits, and allow us to take care of those patients, keep those patients from being in an ER or a nursing home, and help them have a good quality of life in their own home.”

Low-wage health workers without paid leave are in an impossible position . They face some of the highest risks of exposure to COVID-19, but have little or no ability to stay home to care for themselves or their loved ones. The public health stakes during a pandemic are high—rushing back to their jobs before they are fully recovered jeopardizes workers’ well-being and risks spreading the coronavirus to patients and colleagues. “The problem is you are going to have some workers who are still going to go to work,” said Peachy. “And they shouldn’t, because they may be sick and they may get the person sick. It would be better to have paid sick days because we need these workers to go into homes and take care of the thousands of high-risk people.”

The Families First Coronavirus Response Act took steps to temporarily address this disparity and expand paid sick leave and family and medical leave to workers during the pandemic. However, two gaps in the legislation undermine these benefits for low-wage health workers. First, the legislation only applies to employers with less than 500 employees, which could exclude upwards of half of all workers . It also stipulates that employers may exempt “health care providers,” broadly defined by the Department of Labor to include workers across health care institutions and home care settings.

»  Policy recommendations for expanding paid sick leave:

• In the next pandemic relief bill, Congress should revoke exemptions for large employers and expand access to temporary paid sick leave and family and medical leave to all workers. The HEROES Act, passed on May 15, removes the employer size exemption as well as the health care provider exemptions.
• State governments and the federal government should increase Medicaid funding to allow employers of home care workers to offer benefits such as paid leave, alongside a living wage.

Long before COVID-19, 53-year-old Yolanda Ross felt her work as a home health worker outside Richmond, Va. was not respected. She told me that low-wage health workers like her are “underpaid, overlooked and forgotten about, but yet depended upon,” while others on the front line who are deemed “important” are valued differently.

Ross’s experience is reflected in the data. Brookings’s Richard V. Reeves (who is  writing about the importance of respect  more generally) and Hannah Van Drie recently analyzed data on the perceived social standing of essential jobs. They found a staggering gap between the high prestige of doctors and nurses and the low prestige of lesser-paid but essential hospital workers, including housekeepers.

In interviews, these workers shared stories that bring to life the lack of respect they experience. Several wondered why low-wage essential workers are never included in TV commercials that applaud doctors and nurses. ICU worker Andrea told me her charge nurse calls her “housekeeping” and still hasn’t bothered to learn Andrea’s name despite working together for seven years. Ditanya Rosebud, a 46-year-old cook and hostess at a Baltimore nursing home said her employer responds to her sacrifices by simply telling her, “This is what you signed up for.”

Rosebud and her colleagues are working extra shifts and risking their family’s lives during the pandemic. “We are just another body,” she explained. “That’s it. No more, no less.”

Workers also shared stories of life-saving PPE being reserved for “important people,” wages that do not even cover even basic expenses, hazard pay that is given only to clinical colleagues, and a lack of appreciation for workers’ sacrifices. “People are not looking at people like us on the lower end of the spectrum,” said hospital administrative coordinator Tony Powell. “We’re not even getting respect. That is the biggest thing: We are not even getting respect.”

The COVID-19 pandemic has already upended so many aspects of society, the economy, and our lives. Yolanda Ross hopes that it will also upend our long-standing notions of who deserves to be valued. “I pray there is a redirection,” she said. “That we stop doing things the same old way and listen to those who don’t have a real voice.”

» Recommendations for giving workers respect:

• Government and other civic leaders can do more to recognize the contributions of low-wage workers and give their work public visibility. A collaboration between city leaders in New York and workforce partners around the social media effort #ValueDirectCareWorkers is an example.
• The general public can do more to include lower-wage workers in their recognition of essential workers, including actions such as meal donations to hospitals, public demonstrations of thanks and support, and social media messages.
• The media should address the imbalance in coverage of workers, and publish stories, perspectives, and images of lower-wage health workers on the COVID-19 front line.
• Employers should provide low-wage health workers with respect, appreciation, more equitable pay and support, and opportunities for training, advancement, and better job quality.

It is long past time that low-wage workers who are essential to our society are treated with dignity. Employers, colleagues, policymakers, and the general public have their parts to play in finally giving these workers the respect they have always deserved. “It can change,” Yolanda Ross reminded me. “There is hope.”

Policy recommendations overview

Click here to download a shareable version of this table.

These interviews were conducted between April 1, 2020 and April 28, 2020. Participants have provided permission to Brookings to use their names, likenesses, job titles, location and transcribed words.

We are enormously grateful to Tony Powell, Andrea, Yvette Beatty, David Saucedo, Sabrina Hopps, Elizabeth Peachy, Pauline Moffitt, Ditanya Rosebud, and Yolanda Ross for sharing their stories. We thank and each and every worker on the front lines for the sacrifices they are making.

Thanks to PHI, SEIU, SEIU Local 1199, Angelina Drake, Tatia Cooper, Yvonne Slosarski, Leslie Frane, and LaNoral Thomas for their collaboration with the worker interviews. Thanks to Richard V. Reeves, Angelina Drake, Tiffany Ford, Ai-jen Poo, Greg Larson, Alan Berube, Morgan Welch, Claudia Balog, and Vicki Shabo for substantive comments and thoughtful input.

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Frontier Nursing University

Distance Education from the Birthplace of Nurse-Midwifery and Family Nursing in America

What the Pandemic Taught Us About the Changing Role of Nurses

By Dr. Susan Stone, CNM, DNSc, FAAN, FACNM ,  President, Frontier Nursing University

Even before the start of the COVID-19 Pandemic, it was well-known that the U.S. was facing a health care provider shortage. This trend was verified in a June 2020 report by the Association of American Medical Colleges^, which estimated the U.S. faces a potential physician shortage of 37,800 to 124,000 by 2034.

Partly because of this growing need, nurses are increasingly serving as primary caregivers in hospitals and clinics across the country. There are more than 3.8 million registered nurses in the United States and nurses comprise the largest component of the nation’s healthcare workforce*.

Necessity is not the only reason more patients are turning to nurses for primary care. Nurse-midwives and nurse practitioners have a core focus on promoting optimal health, not only caring for the sick but also providing guidance to assist in long-term health. This model of care forms a partnership between nurse and patient with a focus on promoting ongoing health in addition to treating illness. The focus on health maintenance is a core characteristic of the practice of nurse-midwives and nurse practitioners. A study on the prevention of chronic disease by Ritsema TS, Bingenheimer JB, Scholting P, et al.+ concluded that “across all conditions, NPs provide health education to patients more frequently than physicians.” Midwifery care as defined by the American College of Nurse-Midwives includes health promotion, disease prevention, wellness education and counseling, and full-scope primary care services including maternity care. Midwifery care has been shown to decrease cesarean section rates, decrease interventions and decrease preterm birth^^.

Midwifery and nurse practitioner care do not replace physician care. Health care services are complex and one type of provider cannot provide all services needed. It takes a team of different types of providers to provide the full complement of services needed. One study demonstrated that patients receiving care from primary care physicians received only 55% of recommended chronic and preventive services. The gap is attributed to physicians being overworked. The study further estimated that 50-70% of preventative services and 25%-47% of chronic care services could be done by nurse practitioners or physician assistants. By working together, we can assure that patients receive all of the recommended and preventive and chronic care services**.

Nurses’ expertise and versatility were brought into focus during the height of the pandemic. As hospitals and clinics overflowed, the healthcare system was stretched to its limit. Nurses were called on to assume additional responsibilities and leadership roles, such as organizing drive-through testing and vaccination sites or directing clinics. Some traveled, leaving their families for weeks or months at a time to care for patients in locations both rural and urban where additional care was most needed.

While provider shortages have been amplified during the pandemic, this shortage was a known issue before the pandemic and will persist after. Most at risk due to the provider shortage are those in underserved populations and rural communities. The previously mentioned report by the Association of American Medical Colleges concluded that “If underserved populations were to experience the same health care use patterns as populations with fewer barriers to access, current demand could rise by an additional 74,100 to 145,500 physicians. This analysis underscores the systematic differences in annual use of health care services by insured and uninsured individuals, individuals in urban and rural locations, and individuals of differing races and ethnicities.”

Frontier Nursing University is proud to be a leader in the changes needed to address healthcare provider shortages. Frontier’s mission is “to provide accessible nurse-midwifery and nurse practitioner education to prepare competent, entrepreneurial, ethical, and compassionate leaders in primary care to serve all individuals with an emphasis on women and families in diverse, rural, and underserved populations.” Our students are graduate-level students seeking advanced nurse practitioner and nurse-midwifery degrees. For many, taking two years off work to pursue an advanced degree is not an option. They must be able to continue to work where they live while pursuing advanced degrees at the same time.

FNU was founded in 1939 in rural Hyden, Kentucky, and our impact, though significant, was limited in scope due to our remote location. In 1989 we introduced a distance learning model that allowed students nationwide to attend FNU from their home communities, requiring only a few trips to campus. Today, 70% of FNU’s more than 2,500 students live in health professional shortage areas (HPSA) as defined by the Health Resources and Services Administration (HRSA), demonstrating the potential impact of FNU graduates within these underserved communities.

Many of our 8,000 alumni have been serving on the front lines of the pandemic. Some have worked as travel nurses in pandemic hot zones, while others delivered the first vaccine doses by boat to remote villages in Alaska. Some developed procedures to help patients avoid crowded lobbies. Others accomplished the remarkable feat of opening their own clinics during the height of the pandemic. Meanwhile, FNU’s distance learning model allowed the majority of our students to continue their progress without interruption.

The pandemic has brought to light much of what we already knew. It has further demonstrated the need for change in our healthcare system and proved that nurse-midwives and nurse practitioners must play increased roles in the health and well-being of our communities. The pandemic reminded us that primary care services provided by advanced practice nurses and nurse-midwives are safe and effective. It is now more clear than ever that nurse-midwives, nurse practitioners, and physicians must work together to attain optimum health outcomes for our country.

^ IHS Markit Ltd. The Complexities of Physician Supply and Demand: Projections From 2019 to 2034. Washington, DC: AAMC; 2021.

*Smiley, R.A., Lauer, P., Bienemy, C., Berg, J.G., Shireman, E., Reneau, K.A., & Alexander, M. (October 2018). The 2017 National Nursing Workforce Survey. Journal of Nursing Regulation, 9(3), supplement (S1-S54).

+Ritsema TS, Bingenheimer JB, Scholting P, et al. Differences in the delivery of health education to patients with chronic disease by provider type, 2005–2009. Prev Chronic Dis 2014; 11: 130175. – PMC – PubMed

^^ Loewenberg Weisband Y, Klebanoff M, Gallo MF, Shoben A, Norris AH. Birth Outcomes of Women Using a Midwife versus Women Using a Physician for Prenatal Care. J Midwifery Women’s Health. 2018 Jul;63(4):399-409. doi: 10.1111/jmwh.12750. Epub 2018 Jun 26. PMID: 29944777.

**Altschuler J, Margolius D, Bodenheimer T, Grumbach K. Estimating a reasonable patient panel size for primary care physicians with team-based task delegation. Ann Fam Med. 2012;10(5):396-400. doi:10.1370/afm.1400

++IHS Markit Ltd. The Complexities of Physician Supply and Demand: Projections From 2019 to 2034. Washington, DC: AAMC; 2021

FNU Information

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Frontier Nursing University has been approved to participate in the National Council for State Authorization Reciprocity Agreements.

2050 Lexington Road Versailles, KY 40383 (859) 251-4700

For education verification requests: • Web: degreeverify.org • Mail: National Student Clearinghouse, 2300 Dulles Station Boulevard, Suite 220, Herndon, VA 20171

For program inquiries: [email protected] or 859-279-0890

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With over 15 years of experience in public health and nursing, Nikia has dedicated herself to advancing reproductive rights and justice, birth justice, and midwifery. Her passion for midwifery shines through in her commitment to diversifying the workforce of midwives and birth workers, especially in the southern United States. As a fervent disruptor of the current healthcare system, Nikia is pioneering new models of care that prioritize midwifery and center
the needs of Black and brown communities. Every day, she works Tirelessly to ensure that all individuals have the agency and resources to make informed decisions about their sexual and reproductive health.

At CHOICES Center for Reproductive Health, Nikia serves as the Chief Clinical Officer, spearheading initiatives that have led to the establishment of the first nonprofit comprehensive reproductive health care center, the first Black midwifery fellowship program and the city’s inaugural birth center. Beyond her clinical leadership, Nikia sits on the Board of Directors for both the American College of Nurse Midwives and SisterReach, Tennessee’s foremost Reproductive Justice organization.

Driven by a profound sense of purpose, Nikia Grayson is transforming the landscape of reproductive healthcare, leaving an indelible mark on the lives of those she serves and the communities she uplifts.

All new alumni are automatically welcomed into the FNU Alumni Association. We appreciate the commitment and dedication of our alumni who play an integral role carrying out the FNU mission in everyday practice.  Visit our Alumni Association page .

View information including eligibility criteria and ceremony preparation and sign up to participate. August 18, 2023 is the last day to RSVP via the self-registration dashboard (MarchingOrder).

Coming Soon!

New FNU graduates and their guests are invited to join us for a celebration event on the FNU campus following the commencement ceremony, 2:00 p.m. – 6:00 p.m. EST. (will include sign-up Google form link when ready so we can tailor appropriate follow-up)

Local Attractions

Rupp Arena, part of The Lexington Center, is located in a very walkable area of downtown Lexington, KY. The Center is conveniently situated within 10 miles from both I-64 and I-75, and just under 6 miles from Blue Grass Airport. There are numerous hotels and restaurants within easy reach. Below are some links to help you plan your trip:

• Rupp Arena   (our event venue)
• VisitLex.com
• KentuckyTourism.com
• Blue Grass Airport

Area Lodging

The following hotels offer special pricing and courtesy holds for FNU commencement guests:

Best Western Parkside Inn – Frankfort

80 Chenault Road, Frankfort, KY 40601 (23.7 miles from the venue, via I-64 E) – 20 rooms per day held for the following 2023 dates: 9/22 & 9/23. Room type(s): Double Queen. Rate: $102 + tax. A credit card is required for a security guarantee. Book by phone: 502.695.6111.  You must mention “Frontier Nursing University” to book with this offer . The offer ends on 7/22/2022 or when rooms are filled, whichever comes first.

Holiday Inn Express – Versailles

365 Commerce Drive, Versailles, KY 40383 (12.4 miles from the venue, via US 60) – 10 rooms per day held for the following 2023 dates: 9/22 – 9/23. Room type(s): 5 Single King ($164 + tax) or 5 Double Queen ($174 + tax). A credit card is required for a security guarantee. Refunds are available if requested within the cancellation window.  CLICK HERE  to book online or call 859-873-5501.  When calling, you must mention “Frontier Nursing University” to book with this offer . The offer ends on 8/22/2022 or when rooms are filled, whichever comes first.

Candlewood Suites – Lexington

603 Adcolor Drive, Lexington, KY 40511 (2.0 miles from the venue, via Newtown Pike) – 10 rooms per day held for the following 2023 dates: 9/22 – 9/23. Room type(s): Single Queen Studios Rate: $159 + tax. A credit card is required for a security guarantee. Refunds are available if requested within the cancellation window.  CLICK HERE  to book online or call 859-967-1940.  When calling, you must mention “Frontier Nursing University” to book with this offer . The offer ends on 8/31/2022 or when rooms are filled, whichever comes first.

Homewood Suites by Hilton – Lexington/Hamburg

2033 Bryant Road, Lexington, KY 40509 (6.9 miles from the venue, via Sir Barton Way & Winchester Rd) – 10 rooms per day held for the following 2023 dates: 9/22 & 9/23. Room type(s): King one-bedroom Suite Rate: $175 + tax. A credit card is required for a security guarantee. Refunds are available if requested within the cancellation window.  CLICK HERE  to book online or call 859-543-0464.  When calling, you must mention “Frontier Nursing University” to book with this offer . The offer ends on 8/31/2023 or when rooms are filled, whichever comes first.

Holiday Inn – Lexington/Hamburg

1976 Justice Drive, Lexington, KY 40509 (6.7 miles from the venue, via Sir Barton Way & Winchester Rd) – Rooms held for the following 2023 dates: 9/22 & 9/23. Room type(s): 10 single King/ 10 double Queen; Rate: $149 + tax. A credit card is required for a security guarantee. Refunds are available if requested within the cancellation window. Group Code: FRN  CLICK HERE  to book online or call 1-888-HOLIDAY.  When calling, you must mention “FRN” to book with this offer . The offer ends on 9/8/2023 or when rooms are filled, whichever comes first.

Commencement Ceremony Timeline – Saturday, September 23, 2023:

• 9:00 a.m. EST – doors open at Rupp Arena (ceremony venue)
• 9:00 – 10:30 a.m. EST – Graduate Check-In 
• 10:40 – 10:50 a.m. – Lineup for Processional
• 11:00 a.m. EST – Ceremony Processional
• Approx. 1:30 p.m. EST – Ceremony Recessional
• 2:00 – 6:00 p.m. EST – FNU campus celebration event for all new graduates & their guests

The first dancer to be named People Magazine “Women Changing the World,” and named InStyle Magazine Badass 50, Adidas “women reimagining sport,” CBS News “People Making a Difference”, and featured on Good Morning America and NBC Today, Marisa is an award-winning Transformational Movement Artist, Speaker, and Changemaker dedicated to creating a more inclusive just world where we can each feel alive, not just survive.

Marisa’s lived experiences of her body repeatedly not being accepted as a dancer, her Japanese American identity not fitting the box in many spaces, and surviving a stroke that initially paralyzed her from the neck down, eventually led her to create Infinite Flow, an award-winning nonprofit dance company that employs disabled and nondisabled artists with diverse, intersectional identities with a mission to use dance as a catalyst to dismantle biases and promote inclusion.

During the last year, Marisa was diagnosed with two invisible disabilities: PTSD and Autism. The diagnoses brought much clarity to the challenges she’s coped with throughout her life.

Marisa is passionate about transforming forward-thinking businesses through keynotes, performances, and content that inspire inclusivity and move hearts, bodies, and minds, so that their teams become more connected, purpose-driven, and alive. She has brought unique unforgettable keynote presentations and performances to some of the biggest enterprises in the world, including Meta, Apple, Red Bull, NBCUniversal, Deloitte, PayPal, International Monetary Fund, Farmers Insurance, Kaiser Permanente, Porsche, McKinsey & Co, Clifford Chance, amongst other brands. Marisa made history along with wheelchair dancer Piotr Iwanicki by becoming the first dancer to perform at Apple’s Steve Jobs Theater, sharing the stage with Apple CEO Tim Cook.

Since 2015, Marisa has led Infinite Flow to perform at over 160 events, from large global events to local school assemblies & community festivals. Heading the creative & artistic direction, Infinite Flow’s videos have tracked over 100 million views on Facebook alone. During the Covid-19 pandemic, Marisa spearheaded Infinite Flow to turn its in-person elementary school assembly program into a virtual program, launching Scoops of Inclusion, a 47-minute short film celebrating diversity and empowering kids to take an active role in creating a more inclusive world where we each feel we belong.

Marisa is bilingual and bicultural. She completed her BA & MA from Keio University, Tokyo. She is an Honorary Member (Distinguished Artist) of the International Association for Dance Medicine and Science. She is a speaker, thought leader, performing artist, and multi-dimensional creator on the rise, seeking to creatively inspire inclusion, innovation, and transformation through movement, dance, and storytelling.

More on Marisa at MarisaHamamoto.com.

Lucero, Robert J. PhD, MPH, RN, FAAN

Associate Dean for Diversity, Equity, and Inclusion

Professor of Nursing, and Audrienne H. Moseley Endowed Chair in Diversity, Equity and Inclusion

University of California, Los Angeles, School of Nursing

My research program focuses on improving health outcomes of vulnerable populations using innovative health systems and informatics approaches. Two prominent themes of my work are: enhancing the quality of care for hospitalized older adults and improving self-management of chronic health conditions among Hispanic, African-American, and LGBTQ+ populations. My research is distinguished by interdisciplinary team science, which bridges nursing, medicine, psychology, computer science, and engineering, health systems, communities, and other academic institutions. 

My research is leading the way to inform infrastructure development for data-driven knowledge generation that serves as a model for organizations across the United States (US) to improve the quality of care for hospitalized older adults. I am leveraging electronic patient, clinical, and administrative data and data science methods to identify valid, modifiable factors that predict hospital-acquired falls (HAF), which affect annually approximately one million US hospitalized patients. Studies I have published show that, in 168 US hospitals, poor nursing care quality was associated with more adverse patient events, including HAF. Using artificial intelligence approaches with electronic health record (EHR) data, I have discovered a set of six new clinical and organizational factors that can predict HAF. These findings were among the most downloaded in 2019, and have widespread implications since hospital patient falls continue to be a significant clinical concern internationally in healthcare systems. My lab also explores the use of registered nurses’ (RNs’) progress notes, or text data on patient observations, to predict HAF. We were the first to publish that RNs’ notes contain information about clinical, environmental, and organizational factors that can predict fall risk. I am Principal Investigator (PI) of a 5-year $2.57 million award from the National Institute on Aging. This cutting-edge health systems project is exploiting the use of text and structured EHR data to validate predictors of HAF and hospital-induced delirium. This study will expand the University of Florida Health EHR research infrastructure for data-driven knowledge generation. 

The other cornerstone of my research program is developing health information technology (HIT) to promote chronic disease self-management. I pioneered and published a HIT design approach, known as Consumer-centered Participatory Design (C2 PD). Unlike other design approaches, C2 PD provides public health and community-based organizations, academic researchers, and commercial designers with a theoretically informed approach that engages consumers throughout the development and evaluation of HIT. C2 PD builds on the strengths and resources within a community, promotes a collaborative learning and empowering process, facilitates collaborative partnerships, and incorporates four components of HIT design, namely; user preferences, functions, tasks, and representational requirements, to develop highly usable systems. We introduced this innovative approach and presented our findings to informaticians at the International Medical Informatics Association Nursing Informatics Congress in 2012. We demonstrated that using the C2 PD approach resulted in a highly useful and usable fall prevention self-management system for English- and Spanish-speaking older adults. Since then, multiple investigators of HIT development and systematic review articles have referenced the use of the C2 PD approach. The C2 PD approach has been the basis of my other funded studies, including a $2.8 million National Institute of Nursing Research and $1.0 million Agency for Healthcare Research and Quality award. I have disseminated further wide-ranging use of the C2 PD method, including creating a mobile Health (mHealth) application (app) interface for Hispanic caregivers of persons with dementia to self-manage chronic stress and burden and an mHealth app to support African American caregivers of children with chronic asthma and obesity. The lessons I learned developing the C2 PD approach are represented in a paper I co-authored that focuses on using HIT to engage communities to improve health and reduce health disparities in populations. This is significant to the work I am conducting among people living with HIV. A study I published showed that a large proportion (85.5%) of people living with HIV are interested in using a mHealth app that supports HIV self-management, including functions to identify health services, provide health tips and medication reminders, communicate with healthcare providers, track their mood and emotions, and engage in social networking. My lab is expanding this research with funding from the Health Services and Resources Administration (HRSA) and the Florida Department of Public Health to inform creating and testing a technology-enabled self-management intervention. 

I have developed an independent and externally funded health services and informatics research program of over $8.85 million as PI. I publish in high impact journals and researchers and scholars in nursing, health services, and informatics cite my research regularly according to citation analytics (>1024, h-index:14, i10-index:18). Additionally, federal government agencies have recognized my research. I was a standing member of the Agency for Healthcare Research and Quality HIT Research review panel from 2016-2020, and served on multiple NIH Special Emphasis Review Panels. My peers have recognized the impact of my research nationally, and I am disseminating my research program internationally. I am a Fellow of the American Academy of Nursing and the New York Academy of Medicine. In 2019, I received a 3-year UF Term Professorship that acknowledged my academic accomplishments in shaping the UF College of Nursing and the nursing discipline. I am currently the Associate Dean for Diversity, Equity, and Inclusion; Professor of Nursing (with tenure); and, the Adrienne H. Mosely Endowed Chair in Diversity, Equity and Inclusion at the University of California, Los Angeles, School of Nursing.

Born in Orange, California and raised in the beautiful state of Oregon, Rebekka Eshler has had an adventurous life. Being raised by her wonderful grandmother, she learned valuable life lessons earlier than her peers. After graduating high school and a few confusing years in college, Rebekka decided it was time to make a change and decided to join the United States Army and becoming a Fire Support Specialist Paratrooper. Rebekka was stationed all the way up in the last frontier state of Alaska. Even before transitioning, she was embraced by the LGBTQIA’s community.

After leaving the service, Rebekka delayed her transition as she started her professional piloting career at University of Alaska Anchorage. After many nights of deep thought and struggle, Rebekka decided that she loved helping people and redirected her efforts towards a Political Science Degree. She also took biology and chemistry classes because she fell in love with medicine after becoming an Emergency Medical Technician. While at UAA Rebekka’s passion for helping others and leadership got even stronger. She was participated in many different student leadership organization and even became the Student Veterans of America Chapter President at UAA. Rebekka also began working as a volunteer for the Non Governmental Organization Mobile Medics International, that provides medical response to natural disasters and humanitarian crises around the world.

After coming out as a proud trans woman in 2018, Rebekka began reconnecting with her local LGBTQIA community in Anchorage. She began being a major voice for the LGBTQIA Community in her final year of college. From being the first openly transgender SVA UAA Chapter President, to working at the homeless shelter as an EMT, Rebekka wasn’t afraid to speak up and make sure that everyone was receiving equal treatment. After Graduating in 2020, during the pandemic, Rebekka decided it was time to be more active and joined the board of Transgender American Veteran Association as the Director of Strategic Partnerships and Collaborations. In this role she built relationships with other Veteran organizations and LGBTQIA organizations.

Rebekka represented her state as Miss Trans Alaska 2022 and won Miss Congeniality at the national Miss Trans USA 2022 pageant. She is currently serving as the National President of The Transgender American Veteran Association.

Shea Rose has held a variety of titles throughout her career, including singer-songwriter, yogi, style icon, and music curator, to name a few. Her music, influenced by soul, hip-hop, rock, and folk, addresses identity, self-acceptance, and spiritual transformation. Former Boston Globe music critic Steve Morse described her as “that rare artist who can bridge diverse styles such as soul, funk, rock, rap, and jazz — and bring her unique stamp to each.”

Rose is a featured songwriter and vocalist on two Grammy Award-winning jazz albums by legendary drummer Terri Lyne Carrington, The Mosaic Project, and Money Jungle: Provocative in Blue. She has received numerous accolades for her musical abilities, including multiple Boston Music Awards, a SESAC National Performance Activity Award, the Songwriters Hall of Fame’s Abe Olman Scholarship, and, most recently, the Andrea C. Silbert Rising Star Award from the Center for Women & Enterprise for her Embodied Voice & Yoga business.

Rose has independently released three full-length solo projects: Little Warrior Mixtape, Rock’ n Rose EP, and D.T.M.A. (Dance This Mess Around) EP. In 2020, Rose recorded a cover of Sinéad O’Connor’s “Black Boys on Mopeds,” a powerful commentary on police brutality in black communities. The music video was published and promoted by TEDxTalks. Rose has performed in Barbados, Cuba, Jamaica, Italy, Greece, and Romania, as well as at Symphony Hall in Boston, the Blue Note Jazz Club, and SXSW.

Rose is an Assistant Professor at Berklee College of Music. When she’s not on the stage offers Embodied Voice & Yoga coaching and consulting to individuals and organizations. Embodied Voice & Yoga Coaching by Shea Rose is a certified Women and Minority Owned Business whose mission is to empower brown and black women and girls to communicate their highest goals with courage, compassion, and clarity. 

For more on Shea Rose visit: 

www.shearose.com

www.instagram.com/shearose

Patricia K. Bradley PHD, RN, FAAN is an Associate Professor and the Inaugural Associate Dean of Inclusive Excellence at the Fitzpatrick College of Nursing (FCN) at Villanova University. 

Dr. Bradley’s current work focuses on diversity, equity and inclusion and fostering cultural humility in students, faculty, staff, and healthcare providers. Her research and service activities represent her commitment and contribution to ensuring a “voice for the voiceless” and to developing a culture of trust with vulnerable populations who lack access to address their concerns.

Dr. Bradley is a fellow in the American Academy of Nursing. She is the immediate past Chair of the Academy’s Health Equity Expert Panel and a mentor for the Academy’s Jonas Policy Scholars Program’s National Policy Mentoring Council (NPMC). 

A graduate of the American Association of Colleges of Nursing’s (AACN) 2022 Diversity Leadership Institute, Dr. Bradley is the chair elect for AACN’s Diversity Equity and Inclusion Leadership Network (DEILN) and a contributor to the Diversity, Equity, and Inclusion Faculty Tool Kit. 

At Villanova Dr. Bradley serves as faculty co-advisor for the newly formed Multicultural Student Nurses Organization (MSNO), a service organization developed by students and dedicated to fostering an inclusive environment for historically underrepresented nursing students. Dr. Bradley is also chair of a parallel program, the FCN’s steering committee for Healthy Work Environment Initiatives working with faculty and staff to foster an inclusive environment where all faculty, staff, and students are respected, accepted, and valued.

Dr. Vicki Hines-Martin is a Professor and the Associate Dean, Office of Community Engagement and Diversity Inclusion in the University of Louisville School of Nursing. In addition, she holds a joint appointment as the Director of Community Outreach in the UofL Health Sciences Center Office of Diversity and Inclusion which serves the schools of dentistry, medicine, nursing, and public health. Dr. Hines-Martin is an associate director in the NIEHS funded UofL Center for Integrative Environmental Health Sciences and a Commonwealth Scholar in the Kentucky Commonwealth Institute. She has been a psych-mental health clinical nurse specialist for 36 years. Her area of scholarship includes mental health disparities, culture, social justice/equity, and community engagement.  

Dr. Hines-Martin has numerous presentations and publications which include the Routledge Handbook of Global Mental Health Nursing: Evidence, Practice and Empowerment . New York, NY: Routledge/Taylor & Francis Group (Yearwood, E. & Hines-Martin [Eds], 2017).  Dr. Hines-Martin has received many awards and recognitions for her work from organizations such as The Global Alliance for Behavioral Health and Social Justice. Dr. Hines-Martin served as the President of the International Society for Psychiatric Mental Health Nursing and is a Fellow in the American Academy of Nursing.

Michelle DeCoux Hampton, RN, PhD, MS is the Director of Academic Nursing and Patient Care Research in the Office of Research Patient Care Services at Stanford Health Care. Dr. Hampton formerly served in a variety of academic roles at Samuel Merritt University (2005-2018) including Professor and Director of the Doctor of Nursing Practice program and at San Jose State University (2018-2022) as Professor and Doctor of Nursing Practice Program Coordinator in the Valley Foundation School of Nursing, as well as Assessment Facilitator and Special Director of Diversity, Equity and Inclusion in the College of Health and Human Sciences. 

Her expertise and experience includes psychiatric mental health nursing and research methods for undergraduate, master’s and doctoral students with knowledge of student engagement in various modalities including face-to-face, hybrid, online, and simulation. Her research and service interests are focused on promoting health equity for underserved populations, in part by increasing access to health professional education for members of underrepresented communities, and by educating current students and practicing professionals regarding health equity. As an Advisory Council Member for the Salvation Army, Garden Street Center in Oakland, she spearheaded an initiative to create a certified nursing assistant program within the vocational education program as an entry point to the nursing profession for shelter residents and others in the local community. She also serves as a holistic admissions review consultant for the American Association of Colleges of Nursing providing training for faculty and administrators in US nursing programs. Workshops educate participants in methods to increase diversity within nursing programs that are considering or have already implemented holistic admissions review and/or evaluation.

Kendra M. Barrier. PhD, MSN, RN, CNE

Louisiana State University Health Sciences Center-New Orleans School of Nursing (LSUHSC-NO SON)

Dr. Barrier is an Assistant Professor of Clinical Nursing, serving as the Inaugural Associate Dean for Diversity, Equity, and Inclusion (2021 to present) and the former Assistant Dean for Student Services (2015-2021) at the Louisiana State University Health Sciences Center-New Orleans School of Nursing (LSUHSC-NO). She is also an Associate Faculty for the School of Graduate Studies at LSUHSC-NO, a National League for Nursing (NLN) Certified Nurse Educator, an American Association of Colleges of Nursing (AACN) Diversity Leadership Institute Fellow, and an AACN Elevating Leaders in Academic Nursing (ELAN) Fellow. She a mentor for the third cohort of AACN Diversity Leadership Institute. She provides a strategic vision and leadership by engaging in quality improvement and programmatic development by promoting a culture of inclusive excellence. She is currently piloting the Diversity, Equity, and Inclusion Elements Tool (DEIET), threading DEI through the SON curricula. She is a mentor and coach, and is passionate about the academic success of underrepresentative minority students. 

Externally, Dr. Barrier is the President for New Orleans District Nurses Association (2020 to present). An active member several committees and taskforce for the Louisiana State Nurses Association; the Chair of the AACN DEI Leadership Network; and a member of the AACN Organizational Leadership Network (OLN) Steering Committee and Co-Chair of the Communications Committee; a member of the National League for Nursing Education Awards Committee; a member of the American Nurses Association (ANA), a member of the Epsilon Nu Chapter-at-Large of Sigma Theta Tau International (STTI), and a member of the Southeastern Conference (SEC) DEI Collaboration. Dr. Barrier also serves as the Presidential Consultant for the Louisiana Association of Student Nurses. Lastly, she is a member of the New Orleans (LA) Chapter of The Links Incorporated.

Dr. Barrier has presented diversity, equity, and inclusion content, diversity leadership vision, and where DEI fits into Academic Nursing Education locally, regionally, and nationally. She has also been a member of several DEI panel presentations. 

She earned her BSN (2000) and MSN (2009), in Nursing Education, from LSUHSC, and received a PhD (2016), in Nursing Education and Administration, from William Carey University.

Jean Edward , PhD, RN, CHPE, is an Associate Professor and Assistant Dean for Diversity, Equity, and Inclusion at the College of Nursing, and Nurse Scientist for UK HealthCare’s Markey Cancer Center.

Dr. Edward’s program of research is focused on promoting equity in healthcare access, affordability, and health outcomes for underserved communities by intervening on the social determinants of health. She utilizes mixed methods and implementation science approaches to design and implement sustainable multi-level interventions that promote equity in access to and affordability of care. She has implemented several nationally funded oncology financial navigation programs to address financial toxicity of cancer experienced by pediatric and adult patients, survivors and caregivers. Dr. Edward has been funded by the National Cancer Institute, Robert Wood Johnson Foundation, American Cancer Society, Kentucky Nurses Association, Sigma Theta Tau International, and the Kentucky Pediatric Cancer Trust Fund. Her work has been published in over 40 peer-reviewed publications and presented at over 70 national, regional, and local conferences. She is the Associate Editor of Clinical Nursing Research and a fellow of the American Association of Colleges of Nursing’s Diversity Leadership Institute.

Heidi Loomis, DM, CRNP, CNM  enjoys supporting clinical midwifery and women’s health nurse practitioner students and their preceptors in her role as Regional Clinical Faculty at Frontier Nursing University. She recently completed a Doctorate of Midwifery degree at The Midwifery Institute at Jefferson. Her doctoral research focused on biases that midwifery students across the U.S. experience in their clinical settings – the types and prevalence of bias as well as its impact on midwifery students’ commitment to the completion of their academic programs and to the profession of midwifery. Part of her research also included the emotional responses and behavioral coping mechanisms employed by students in response to bias, whether midwifery students witnessed anyone intervening, and whether or not students reported experiences of bias. For this work, Heidi received the American College of Nurse-Midwives Foundation’s 2022 W. Newton Long Award for the Advancement of Midwifery. Heidi has been interested in culturally respectful care and the growth of midwifery for decades. She has presented to academic, government, non-governmental, and private institutions on topics including anti-racism, privilege, and midwifery. Heidi also enjoyed clinical practice as a family nurse practitioner and certified nurse-midwife for over 30 years in Pennsylvania, Massachusetts, and Connecticut. She is a graduate of Juniata College, Yale School of Nursing, Frontier Nursing University, and The Midwifery Institute at Jefferson, College of Health Professions, Thomas Jefferson University in Philadelphia.