covid 19 socio economic challenges essay

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Socio-economic impact

The  UN’s Framework for the Immediate Socio-Economic Response to the COVID 19 Crisis  warns that “The COVID-19 pandemic is far more than a health crisis: it is affecting societies and econ­omies at their core. While the impact of the pandemic will vary from country to country, it will most likely increase poverty and inequalities at a global scale, making achievement of SDGs even more urgent.

Assessing the impacts of the COVID-19 crisis on societies, economies and vulnerable groups is fundamental to inform and tailor the responses of governments and partners to recover from the crisis and ensure that no one is left behind in this effort.

Without urgent socio-eco­nomic responses, global suffering will escalate, jeopardizing lives and livelihoods for years to come. Immediate development responses in this crisis must be undertaken with an eye to the future. Development trajectories in the long-term will be affected by the choices coun­tries make now and the support they receive.”

The United Nations has mobilized the full capacity of the UN system through its 131 country teams serving 162 countries and territories, to support national authorities in developing public health preparedness and response plans to the COVID-19 crisis.

Over the next 12 to 18 months, the socio-economic response will be one of one of three critical components of the UN’s COVID-19 response, alongside the health response, led by WHO, and the Global Humanitarian Response Plan.

As the technical lead for the socio-economic response, UNDP and its country offices worldwide are working under the leadership of the UN Resident Coordinators, and in close collaboration with specialized UN agencies, UN Regional Economic Commissions and IFIs, to assess the socio-economic impacts of the COVID-19 pandemic on economies and communities. The assessment reports available on this site contain the preliminary findings of regional and country analyses.

Massive production disruptions that started in China have led to a lower supply of goods and services that reduces overall hours worked, leading to lower incomes.

Briefs and Reports

Brief #2: Putting the UN Framework for Socio-Economic Response to COVID-19 into Action: Insights

Across the globe, the UN is supporting countries in preparing assessments of the socio-economic impacts of Covid-19. What are these assessments saying and what are the key socio-economic issues caused by the pandemic that the UN and its partners are seeing on the ground?

On behalf of the UN, UNDP prepares the monthly briefs  Putting the UN Framework for Socio-Economic Response to Covid-19 Into Action  exploring latest trends and providing key insights and analysis on the socio-economic impacts of Covid-19 on economies and societies.

The Economic Impact of COVID-19 around the World

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

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

INTRODUCTION

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

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

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

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Chapter 1. The economic impacts of the COVID-19 crisis

The COVID-19 pandemic sent shock waves through the world economy and triggered the largest global economic crisis in more than a century. The crisis led to a dramatic increase in inequality within and across countries. Preliminary evidence suggests that the recovery from the crisis will be as uneven as its initial economic impacts, with emerging economies and economically disadvantaged groups needing much more time to recover pandemic-induced losses of income and livelihoods . 1

In contrast to many earlier crises, the onset of the pandemic was met with a large, decisive economic policy response that was generally successful in mitigating its worst human costs in the short run. However, the emergency response also created new risks—such as dramatically increased levels of private and public debt in the world economy—that may threaten an equitable recovery from the crisis if they are not addressed decisively.

Worsening inequality within and across countries

The economic impacts of the pandemic were especially severe in emerging economies where income losses caused by the pandemic revealed and worsened some preexisting economic fragilities. As the pandemic unfolded in 2020, it became clear that many households and firms were ill-prepared to withstand an income shock of that scale and duration. Studies based on precrisis data suggest, for example, that more than 50 percent of households in emerging and advanced economies were not able to sustain basic consumption for more than three months in the event of income losses . 2 Similarly, the average business could cover fewer than 55 days of expenses with cash reserves . 3  Many households and firms in emerging economies were already burdened with unsustainable debt levels prior to the crisis and struggled to service this debt once the pandemic and associated public health measures led to a sharp decline in income and business revenue.

The crisis had a dramatic impact on global poverty and inequality. Global poverty increased for the first time in a generation, and disproportionate income losses among disadvantaged populations led to a dramatic rise in inequality within and across countries. According to survey data, in 2020 temporary unemployment was higher in 70 percent of all countries for workers who had completed only a primary education. 4   Income losses were also larger among youth, women, the self-employed, and casual workers with lower levels of formal education . 5   Women, in particular, were affected by income and employment losses because they were likelier to be employed in sectors more affected by lockdown and social distancing measures . 6

Similar patterns emerge among businesses. Smaller firms, informal businesses, and enterprises with limited access to formal credit were hit more severely by income losses stemming from the pandemic. Larger firms entered the crisis with the ability to cover expenses for up to 65 days, compared with 59 days for medium-size firms and 53 and 50 days for small and microenterprises, respectively. Moreover, micro-, small, and medium enterprises are overrepresented in the sectors most severely affected by the crisis, such as accommodation and food services, retail, and personal services.

The short-term government responses to the crisis

The short-term government responses to the pandemic were extraordinarily swift and encompassing. Governments embraced many policy tools that were either entirely unprecedented or had never been used on this scale in emerging economies. Examples are large direct income support measures, debt moratoria, and asset purchase programs by central banks. These programs varied widely in size and scope (figure 1.1), in part because many low-income countries were struggling to mobilize resources given limited access to credit markets and high precrisis levels of government debt. As a result, the size of the fiscal response to the crisis as a share of the gross domestic product (GDP) was almost uniformly large in high-income countries and uniformly small or nonexistent in low-income countries. In middle-income countries, the fiscal response varied substantially, reflecting marked differences in the ability and willingness of governments to spend on support programs.

Figure 1.1 Fiscal response to the COVID-19 crisis, selected countries, by income group

Similarly, the combination of policies chosen to confront the short-term impacts differed significantly across countries, depending on the availability of resources and the specific nature of risks the countries faced (figure 1.2). In addition to direct income support programs, governments and central banks made unprecedented use of policies intended to provide temporary debt relief, including debt moratoria for households and businesses. Although these programs mitigated the short-term liquidity problems faced by households and businesses, they also had the unintended consequence of obscuring the true financial condition of borrowers, thereby creating a new problem: lack of transparency about the true extent of credit risk in the economy.

Figure 1.2 Fiscal, monetary, and financial sector policy responses to the COVID-19 crisis, by country income group 

The large crisis response, while necessary and effective in mitigating the worst impacts of the crisis, led to a global increase in government debt that gave rise to renewed concerns about debt sustainability and added to the widening disparity between emerging and advanced economies. In 2020, 51 countries—including 44 emerging economies—experienced a downgrade in their government debt risk rating (that is, the assessment of a country’s creditworthiness) . 7

Emerging threats to an equitable recovery

Although households and businesses have been most directly affected by income losses stemming from the pandemic, the resulting financial risks have repercussions for the wider economy through mutually reinforcing channels that connect the financial health of households, firms, financial institutions, and governments (figure 1.3). Because of this interconnection, elevated financial risk in one sector can spill over and destabilize the economy as a whole. For example, if households and firms are under financial stress, the financial sector faces a higher risk of loan defaults and is less able to provide credit. Similarly, if the financial position of the public sector deteriorates (for example, as a result of higher government debt and lower tax revenue), the ability of the public sector to support the rest of the economy is weakened.

Figure 1.3 Conceptual framework: Interconnected balance sheet risks

This relationship is, however, not predetermined. Well-designed fiscal, monetary, and financial sector policies can counteract and reduce these intertwined risks and can help transform the links between sectors of the economy from a vicious doom loop into a virtuous cycle.

One example of policies that can make a critical difference are those targeting the links between the financial health of households, businesses, and the financial sector. In response to the first lockdowns and mobility restrictions, for example, many governments supported households and businesses using cash transfers and financial policy tools such as debt moratoria. These programs provided much-needed support to households and small businesses and helped avert a wave of insolvencies that could have threatened the stability of the financial sector.

Similarly, governments, central banks, and regulators used various policy tools to assist financial institutions and prevent risks from spilling over from the financial sector to other parts of the economy. Central banks lowered interest rates and eased liquidity conditions, making it easier for commercial banks and nonbank financial institutions such as microfinance lenders to refinance themselves, thereby allowing them to continue to supply credit to households and businesses.

The crisis response will also need to include policies that address the risks arising from high levels of government debt to ensure that governments preserve their ability to effectively support the recovery.   This is an important policy priority because high levels of government debt reduce the government’s ability to invest in social safety nets that can counteract the impact of the crisis on poverty and inequality and provide support to households and firms in the event of setbacks during the recovery. 

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The impact of the COVID-19 pandemic on socio-economic and sustainability

• Research Article
• Open access
• Published: 15 July 2021
• Volume 28 , pages 68251–68260, ( 2021 )

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• Xueli Wei 1 , 2 ,
• Lijing Li 1 &
• Fan Zhang 1  

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The COVID-19 pandemic has adversely affected the lives of people around the world in millions of ways . Due to this severe epidemic, all countries in the world have been affected by all aspects, mainly economic. It is widely discussed that the COVID-19 outbreak has affected the world economy. When considering this dimension, this study aims to examine the impact of the COVID-19 pandemic on the world economy, socio-economics, and sustainability. In addition, the research focuses on multiple aspects of social well-being during the pandemic, such as employment, poverty, the status of women, food security, and global trade. To this end, the study used time series and cross-sectional analysis of the data. The second-hand data used in this study comes from the websites of major international organizations. From the analysis of secondary data, the conclusion of this article is that the impact of the pandemic is huge. The main finding of the thesis is that the social economy is affected by the pandemic, causing huge losses in terms of economic well-being and social capital.

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Introduction

As the new coronavirus rages and affects people on all continents exponentially, the entire world is in a state of panic and pain. It is difficult to point out that a country has not been affected by this deadly virus. Few single epidemics have a serious and lasting impact on the world economy, global health, and human life as a whole.

The Great Influenza Pandemic broke out from 1918 to 1920, which was considered as the fourth-largest macroeconomic shock that affected the economy adversely after the two World Wars and The Great Depression (Barro and Weng 2020 ). It has been found using geographic mortality variation that during the pandemic of 1918, the areas of the USA which were exposed to the pandemic experienced a persistent and steep decline in the economic activities (Sergio et al. 2020 ; Sundararaj et al. ( 2018 ) Rejeesh 2019 ; Sundararaj et al. 2018 ; Vinu 2019 ; Sundararaj 2016 ; Tiwari et al. 2021 ; Sundararaj and Rejeesh 2021 ).

The world is expected to face a severe recession even if the spread of the virus is controlled. The effects of this pandemic will haunt mankind for several years in terms of employment, health care systems, income, and human development.

Even though not many people are dying due to the infection of the deadly virus, the number of people that are being affected in a region are causing health systems to break down resulting in more deaths. To deal with the COVID-19 outbreak, strong prevention measures such as strengthening the immune system and improving the proper sanitary conditions which are often lacking in most middle- and low-income countries should be stressed. Thus, the people at the lowest rung of the economy are more vulnerable to the virus. Developing countries were already facing shortage of funds to undertake developmental and infrastructure projects. Due to the pandemic, more funds are now being allotted to emergency health care systems making these projects all the more difficult to undertake. Generally, 3–4% of the gross domestic product of a country is spent on costs related to illnesses resulting from high fatality scenarios, especially during the pandemic times. It is found that the percentage is higher for extreme pandemics (Smith et al. 2009 ).

To contain the spread of the virus, most countries have implemented lockdown measures. However, lockdown measures have severely affected the economy and a large number of people. Several people lost their jobs while several others are undergoing pay-cuts, which is affecting the income of their respective families. Essential services such as logistics have been halted due to the strict measures implemented in the pandemic times. Even education is being compromised, and, as a result, schools, colleges, and universities are closed. If widespread behavioral changes take place due to the lockdown and large-scale absence from work is persistent, the economic damage will be far greater than the health benefits (Smith et al. 2009 ).

Economic conditions across the world are also in a state of destitution. Global production has suffered, along with various service industries primarily including tourism and airlines, due to strict lockdown measures. Since the future is uncertain, investment rates will remain low. However, private investments will be extremely important, especially in developing countries because governments are already running out of funds, as they are dealing with the pandemic and will thus be unable to take up investment projects.

Social and humanitarian aspects of the pandemic are also causing stress and anxiety in the public. Women, children, and the elderly are highly exposed to the virus, as they are among the weaker sections of the society and thus are more vulnerable. The lockdown has also compromised the safety of women, and increased cases of domestic violence have been reported. Refugees, informal sector workers, and the unemployed often find it hard to access government-provided health care schemes and other benefits. It is noted that the above listed people were the most affected by the pandemic.

Therefore, the COVID-19 situation has left its mark on every part of our society and has changed our way of life forever.

Materials and methods

Data description.

Quarterly GDP

Gross domestic product (GDP) is the standard measure of the value-added created through the production of goods and services in a country. As such, it also measures the income earned from the production or the total amount spent on final goods and services (fewer imports). While GDP is the most important indicator to capture economic activity, it falls short of providing a suitable measure of people’s material well-being for which alternative indicators may be more appropriate. This indicator is based on real GDP (also called GDP at constant prices or GDP in volume), i.e., the developments over time are adjusted for price changes. The numbers are also adjusted based on seasonal influences. The indicator is available in different measures: percentage change from the previous quarter, percentage change from the same quarter of the previous year, and volume index. All OECD countries compile their data according to the 2008 System of National Accounts (SNA).

Unemployment rate

Unemployment rate forecast is defined as the projected value for the number of unemployed people as a percentage of the labor force, where the latter consists of the unemployed plus those in paid or self-employment. Unemployed people are those who report that they are without work, that they are available for work, and that they have taken active steps to find work in the last 4 weeks. When unemployment is high, some people get discouraged and stop looking for work; they are then excluded from the labor force.

Global activity indicator

Air pollution is the change in NO2 emissions from January 1 to May 28 in 2019 and 2020.

Retail and recreation mobility is the change in percent from May 21, 2020, from baseline, which is the median value for the corresponding day of the week during the 5-week period January 3–February 6, 2020, based on data from Google.

Flight cancellations show the cancellations relative to total planned flights based on comparing currently operating flights in 2020 with flights that were operating 52 weeks ago in 2019 as of May 27, 2020.

OpenTable reservations show the change in seated dinners at restaurants on the OpenTable network on May 27 in 2019 and 2020.

This study employs out both time series and cross-sectional analysis of data. The data used in this study are secondary and have been sourced from the websites of major international organizations.

Let us look at the effects of the COVID-19 pandemic on various aspects of sustainability and social economy.

Global poverty is defined as the share of the population of the world earning less than 1.9 dollars a day.

The World Bank estimates that the COVID-19 pandemic will push about 40 to 60 million people into extreme poverty (Gerzon Mahler et al. 2020 ). The Global Economic Prospects (World Bank 2020 ) forecast two scenarios of the effect that the pandemic might have on poverty. One in which the outbreak remains at the current expected level and economic activities recover during the latter part of this year and another in which the outbreak continues for a longer period of time to force the introduction and furthering of lockdown measures. The former will contract global growth by about 5% in 2020 while the latter will lead to a growth contraction of 8%.

Figure 1 shows the quarterly GDP for the first quarter of 2020 for 41 countries based on the availability of data (see Table 1 in the Appendix for tabulated values) (OECD 2020a ).

Quarterly GDP for 2020

Figure 2 shows the aggregate OECD GDP for a period of 21 years (2000–2020) (see Table 2 in the Appendix for tabulated values) (OECD 2020a ).

Aggregate OECD GDP

If the outbreak persists, vulnerable households will reduce consumption by a great margin and firms in critical conditions will exit markets. Increased financial stress will be experienced by middle- and low-income countries.

For the first time, global poverty is forecasted to increase, since 1998. It is forecasted that it will increase to 8.6% in 2020 from 8.2% in 2019. In absolute terms, the number will rise to 655 million people from 632 million (Sumner et al. 2020 ).

Global growth is also forecasted to fall by the World Bank.

Figure 3 shows the aggregate growth rates calculated using GDP weights at 2010 prices and market exchange rates for 12 years (2010–2021) (data for 2019 are estimates) (see Table 3 in the Appendix for tabulated values) (Global Economic Prospects 2020 ).

Global growth rates

OECD Economic Outlook projects the global GDP to fall in 2020 by more than 7%. In OECD countries, the situation is worse. OECD GDP is forecasted to fall by more than 9% in 2020. Under the single hit scenario, global GDP is anticipated to drop by 6% and OECD GDP by more than 7% in 2020. In the second quarter of 2020, world output is forecasted to be more than 12% lower than in the previous quarter (OECD 2020b ).

Unemployment

Employment is a primary aspect of sustainable development in any society. It is essential for people to have respectable jobs for them to enjoy the growth of the economy (Osmani 2003 ; Monia and Rim 2018 ; Kabanda 2016 ;Messkoub 2018 ; Alauddin 2016 ; Padovan et al. 2019 ).

The coronavirus pandemic has exposed the world to the biggest decline in employment since the Second World War. Since all activities came to a halt due to the global pandemic, employment experienced a massive and halting blow. Most people working in the informal sector have a little or no savings at all. Due to the recent COVID-19 crisis, they lost almost 60% of their income (World Bank Predicts Sharpest Decline of Remittances in Recent History 2020 ).

Figure 4 shows the unemployment rate for the first quarter of 2020 for 31 countries based on the availability of data (see Table 4 in the Appendix for tabulated values) (OECD 2020b ).

Unemployment rate for countries

Figure 5 shows the aggregate unemployment rate in OECD countries for a period of 21 years (2000–2020) (see Table 5 in the Appendix for tabulated values) (OECD 2020c ).

OECD employment rates

The lockdown has been in effect in several countries along with school and workplace closures, travel restrictions, and social distancing policies. By the beginning of April, almost 81% of the total workforce in the world experienced workplace closures. Even though these measures were necessary, they adversely affected firms and workers.

Figure 6 shows the percentage change in global activities indicators around the world, namely, air pollution retail and recreation mobility, flight cancellations, and OpenTable reservations (see Table 6 in the Appendix for tabulated values) (Global Economic Prospects 2020 ).

Percentage change in global activity indicators

The ILO (International Labour Organization) has projected the global work hours around the world to decrease by 4.5% in the first quarter of 2020 and 10.5% in the second amounting to 305 million workers working 48 h a week. This outpaces the fall in employment during the Global Financial Crisis of 2008–09 (ILO 2020 ).

The impact on women

Seventy percent of the people working in the health care and social sector are women (United Nations 2020 ). Front-line health workers including nurses and midwives are mostly women. They also form a majority of the service staff in the health care sector like laundry, catering, and cleaning. Thus, they are more vulnerably exposed to the virus.

Women undertake thrice as much unpaid work as men. The situation is projected to get worse under the COVID-19 pandemic because children will remain out of school, older persons will require attentive care, and the health service will collapse under severe conditions of the pandemic (UN Women Headquarters 2020 ).

Women generally live close to poverty and hold insecure jobs. They earn less and save less. The compounded economic hardships resulting from the pandemic will thus have severe effects on women.

Gender-based violence is increasing exponentially with social isolation measures and restrictions in movement. Due to the lockdown effect, women are being forced to stay at home with their abusers. Also, services to offer assistance to the survivors are also being disrupted, in these pandemic times. Various countries around the world have reported an increase in the number of complaints related to domestic violence.

Women have unique health needs. However, they have lost access to quality health services, reproductive and maternal health care, and essential vaccines and medications. Gender stereotypes and restrictive social norms can also adversely affect the accessibility of health services to women.

Global trade

Because of the coronavirus pandemic, global trade is also experiencing a halting effect. It is estimated that within the first quarter of 2020 the volume of goods and services traded have suffered a fall of 3%. This is because international travel has been restricted to contain the spread of the virus.

Demand has collapsed and supplies disrupted due to the cessation of international travel. International freight traffic in 2020 has been 30% lower than that of the previous year and international passenger traffic is 98% lower than the previous year.

Global export figures reached an all-time low in April 2020 and remained weak throughout May. Almost all the countries reported significant declines in trade values. Countries with relatively light containment measures are also suffering because of reduced external demand due to the pandemic.

UNCTAD nowcasts for global trade values in the first quarter of 2020 fell by 3% with respect to the previous quarter.

UNCTAD’s Free Market Commodity Price Index (FMCPI) lost 1.2% of its value in January, 8.5% in February, and 20.4% in March. The FMCPI never fell by 20% in a single month before this. The closest case was during the time of the Global Financial Crisis of 2008–09 when it decreased by 18.6% (Back-of-the-Envelope Estimates of Next Quarter’s Unemployment Rate 2020 ; COVID-19 and the St. Louis Fed 2020 ; Possible Fiscal Policies for Rare, Unanticipated, and Severe Viral Outbreaks 2020 ; COVID-19 2020b ; Inanc 2020 ; St-Denis 2020 ; Social Distancing and Contact-Intensive Occupations 2020 ; Adams-Prassl et al. 2020 ; Dasgupta and Murali 2020 ).

Food security

Under the present circumstances, the COVID-19 pandemic will double the number of people facing food crisis. UN forecasts that 265 million people in middle- and low-income countries are at the risk of facing acute food insecurity by the end of 2020. At present, 135 million people are acutely facing food security. They are spread across 55 countries across the world and are in urgent need of humanitarian food and nutrition assistance (UNWTO reports 2020; Unwto Reports 2020; COVID-19 2020a ). They are the most vulnerable to the virus as they have little or no capacity to deal with the socio-economic and health aspects of the pandemic (FSIN. Global Report on Food Crises 2020 ; Global Report on Food Crises 2020 ; HLPE 2020 ).

Countries suffering from acute food security are facing a terrible trade-off between saving people from the virus and to have them die from hunger. The health systems in these countries are already overstretched with an acute shortage of equipment, doctors, and medicines. The poorer sections of the society often lack sufficient financial means to access health care and/or live in remote areas where these services never reach.

Food insecure people generally have higher rates of underlying health problems including malnutrition and other non-communicable diseases which weaken the immune system and make these people more vulnerable to the coronavirus. Movement restrictions, strained health systems, and falling incomes have increased rates of malnutrition especially among lactating and pregnant women, children, and the elderly. Families which entirely rely on the feeding programs of schools to fill food gaps are also on the verge of facing acute food insecurity.

Even though the 2020 harvest has been good and the outlook for stable crops is quite promising, movement restrictions have disrupted the transport and processing of food crops along with other essential items. The availability of basic food items has also been compromised due to increased delivery times.

We can thus conclude that the most severe effects of the COVID-19 pandemic have been felt by the weaker sections of the society including women, the unemployed, and the poor. The virus has left its mark on all aspects of social well-being and has adversely affected the sustainability of the earth. Keeping in mind the huge amount of losses different sectors had to incur due to the pandemic, careful measures must be taken to fight the current pandemic and prevent future pandemics. The worst affected areas of the social economy include poverty, employment, women’s well-being, and global trade. These are perhaps the most important aspects of human development and the pandemic undid most advancement made in these sectors.

Data availability

The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.

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Wei, X., Li, L. & Zhang, F. The impact of the COVID-19 pandemic on socio-economic and sustainability. Environ Sci Pollut Res 28 , 68251–68260 (2021). https://doi.org/10.1007/s11356-021-14986-0

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"The recovery from the COVID-19 crisis must lead to a different economy"

About the author, antónio guterres.

António Guterres is the ninth Secretary-General of the United Nations, who took office on 1st January 2017.

31 March 2020

The world is facing an unprecedented test.  And this is the moment of truth.

Hundreds of thousands of people are falling seriously ill from COVID-19, and the disease is spreading exponentially in many places,

Societies are in turmoil and economies are in a nose-dive.

The International Monetary Fund has reassessed the prospect for growth for 2020 and 2021, declaring that we have entered a recession – as bad as or worse than in 2009.

We must respond decisively, innovatively and together to suppress the spread of the virus and address the socio-economic devastation that COVID-19 is causing in all regions.

The magnitude of the response must match the scale of the crisis -- large-scale, coordinated and comprehensive, with country and international responses being guided by the World Health Organization.

And it must be multilateral, with countries showing solidarity to the most vulnerable communities and nations.

The message of the report we are issuing today is clear: shared responsibility and global solidarity in response to the impacts of COVID-19.

It is a call to action.

We must see countries not only united to beat the virus but also to tackle its profound consequences.

First, for an immediate coordinated health response to suppress transmission and end the pandemic. 

A response that scales up health capacity for testing, tracing, quarantine and treatment, while keeping first responders safe, combined with measures to restrict movement and contact.

A response that delivers universal access to treatment and vaccines, when they are ready.

It is essential that developed countries immediately assist those less developed to bolster their health systems and their response capacity to stop transmission.

Otherwise we face the nightmare of the disease spreading like wildfire in the global South with millions of deaths and the prospect of the disease re-emerging where it was previously suppressed.

Let us remember that we are only as strong as the weakest health system in our interconnected world.

I am particularly concerned with the African continent, and I strongly encourage the G20 to move ahead with a G20 Africa initiative as proposed at the Summit.

Second, we must tackle the devastating social and economic dimensions of this crisis, with a focus on the most affected: women, older persons, youth, low-wage workers, small and medium enterprises, the informal sector and vulnerable groups, especially those in humanitarian and conflict settings.

That means designing fiscal and monetary policies able to support the direct provision of resources to support workers and households, the provision of health and unemployment insurance, scaled up social protection, and support to businesses to prevent bankruptcies and massive job losses.

What is needed is a large-scale, coordinated and comprehensive multilateral response amounting to at least 10 per cent of global GDP.

Developed countries can do it by themselves, and some are indeed doing so.

But we must massively increase the resources available to the developing world by expanding the capacity of the International Monetary Fund, namely through the issuance of special drawing rights, and the other international financial institutions to rapidly inject resources into the countries that need them.

Coordinated swaps among central banks can also bring liquidity to emerging economies.

Debt alleviation must be a priority – including immediate waivers on interest payments for 2020. 

The United Nations system is fully mobilized, providing guidance for global efforts, supporting country responses and placing our supply chains at the world’s disposal. 

And to support our efforts, the United Nations is establishing a new multi-partner Trust Fund for COVID19 Response and Recovery to support low- and middle-income countries to respond to the emergency and recover from the socio-economic shock.  

UN Resident Coordinators worldwide will be the drivers of the UN response on the ground, ensuring that the wide and diverse expertise and assets of the United Nations system are used in the most efficient and effective way to support countries.   

Finally, when we get past this crisis -- which we will -- we will face a choice.

We can go back to the world as it was before or deal decisively with those issues that make us all unnecessarily vulnerable to crises.

Our roadmap is the 2030 Agenda and the 17 Sustainable Development Goals.

The recovery from the COVID-19 crisis must lead to a different economy.

Everything we do during and after this crisis must be with a strong focus on building more equal, inclusive and sustainable economies and societies that are more resilient in the face of pandemics, climate change, and the many other global challenges we face.

What the world needs now is solidarity. 

With solidarity we can defeat the virus and build a better world.

Download the report and more:

• Shared Responsibility, Global Solidarity: Responding to the socio-economic impacts of COVID-19   ( Download EPUB file )
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• The Secretary-General’s UN Response and Recovery Fund   ( Download EPUB file )
• Press release: United Nations Secretary-General launches plan to address the potentially devastating socio-economic impacts of COVID-19

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Dr. David Nabarro has dedicated his life to global health. After a long career that’s taken him from the horrors of war torn Iraq, to the devastating aftermath of the Indian Ocean tsunami, he is still spurred to action by the tremendous inequalities in global access to medical care.

“The thing that keeps me awake most at night is the rampant inequities in our world…We see an awful lot of needless suffering.”

:: David Nabarro interviewed by Melissa Fleming

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

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

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

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

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

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

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

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

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

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

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Nutrition and Food Safety (NFS) and COVID-19

ORIGINAL RESEARCH article

Socio-economic implications of covid-19 pandemic in south asia: emerging risks and growing challenges.

• International Centre for Integrated Mountain Development, Kathmandu, Nepal

The dramatic spread of COVID-19 has threatened human lives, disrupted livelihoods, and affected trade, economy and businesses across the globe. The global economy has begun to show major disruptions and is heading toward a severe recession with an unprecedented economic crisis. As the global economy is highly integrated and interdependent through the global supply chains, it has been profoundly affected by the COVID-19 pandemic. Although all countries have faced difficulties due to Covid-19, South Asian countries in particular have had to deal with a more challenging situation due to their large population, weak health facilities, high poverty rates, low socio-economic conditions, poor social protection systems, limited access to water and sanitation, and inadequate living space, necessary to maintain physical distancing and take other required measures to contain this pandemic. To contain the spread of the virus, South Asian countries have imposed stringent lockdowns, which have consequently affected the lives and livelihoods of millions of people in the region, where a third of world’s poor live. Against this backdrop, this paper examines the existing and prospective impacts, risks and challenges of Covid-19 on key social and economic sectors including migration, tourism, informal sector, agriculture and rural livelihoods. The analysis revealed that COVID-19 is likely to affect economic growth, increase fiscal deficit and monetary burden, increase the risks of macroeconomic instability, decrease migration and remittance, reduce income from travel and tourism, and result in dwindling micro-small and medium industries and informal businesses. This is likely to deepen poverty and increase unemployment and the risks of hunger and food insecurity. If not addressed properly, this may reinforce existing inequalities, break social harmony, and increase tension and turbulence. The economic and social costs of the COVID-19 outbreak are therefore likely to be significant and long-lasting in South Asia.

Introduction

The escalating spread of COVID-19 has posed the gravest threat not only to the world economy but also to lives and livelihoods. What started as a health shock has now been transformed into a global economic crisis. In a heavily globalized and interconnected world, this has translated into a state of unparalleled economic recession ( Ozili and Arun 2020 ). COVID-19 has become a global systemic economic risk as it has affected almost all the economies of the world, no matter how small or large they are. Because of high globalization, economic integration and interconnectedness among the different sectors of economy, a change in any part of the economy or any country now affects other sectors of the economy in other parts of the world as well. Like climate change, pandemics are now global risks as it can spread around the world quickly, regardless of where it originates ( Acharya and Porwal, 2020 ; Ibn-Mohammed et al., 2020 ).

COVID-19 has posed unique challenges to the South Asian economies due to the region’s large population and high rates of poverty, deplorable health infrastructures, poor socio-economic conditions, inadequate social protection systems, limited access to water and sanitation facilities and inadequate living space arrangements ( Rasul, 2020 ; Hossain, et al., 2020 ). South Asia is one of the poorest regions in the world: about one-third of the world’s poor live in this region with about 70 per cent living in rural areas and primarily dependent on agriculture. Before the COVID-19 pandemic, 649 million people in South Asia were moderately or severely food insecure and 271 million were severely food insecure. Similarly, 36 percent of the children were stunted and 16 percent were acutely malnourished. The situation is likely to worsen further due to the effect of COVID-19 ( Rasul, 2020 ).

The world’s many megacities such as Delhi, Mumbai, Karachi and Dhaka are in this region and their population density is extremely high. In many countries, people lack access to basic services such as clean water, sanitation and hygiene facilities. For example, close to 42% of households in Afghanistan are compelled to use unsafe drinking water and more than 50% do not have access to water and soap to wash hands ( ICIMOD, 2020 ). Furthermore, high population density, poor working conditions and inadequate living space make social distancing very difficult. The world’s largest slums are in South Asia and many of these are home to huge numbers of people, for example the Orangi area in Karachi, Pakistan (2.5 million), Dharavi in Mumbai, India (1 million), and the Rohingya camps in Cox’s Bazaar, Bangladesh (about one million) ( Rasul, 2020 ). These overcrowded living spaces and limited, and often shared, water and sanitation facilities have made physical distancing and self-isolation difficult, consequently increasing the risks of exposure and vulnerabilities ( Hossain, et al., 2020 ). Because of the already strained economic conditions, the majority of the people in this region have few resources and weak capacity to cope with the exposures of a pandemic shock. The challenges are reinforced by the fact that a large share of population make their living through informal sectors or self-employment, without any health or social protection ( ICIMOD, 2020 ).

Being concerned with the fast spread of COVID-19, a few scholars, particularly in India, have made efforts to understand the nature dynamics of the COVID-19 pandemic to model and forecast the pace of transmission and rates of mortality ( Khajanchi and Sarkar, 2020 ; Samui et al., 2020 ; Khajanchi et al., 2020 ). Similarly, Acharya and Porwal (2020) have also assessed whether the population’s vulnerability of being infected and the rates of mortality due to the infection depend on the demographic composition of the population in the different states of India. All these studies emphasized the need for maintaining physical distance and contract tracing to control the spread of the corona virus. Realizing the importance of maintaining physical distance, the governments of this region have imposed strong lockdowns to save people’s lives.

Although South Asian countries have been relatively successful in containing the spread of the virus and saving people’s lives in the early months of the pandemic (both infection and loss of lives are relatively low in South Asia compared to many developed economies), the success has come at a high economic cost due to extended lockdowns which directly impacted economic activities. Simulation results suggest that lockdown of any economy for a month might result in an annual GDP loss of 1.5%–2.0%. It is estimated that the Indian economy incurs a loss of US$ 4.64 billion for locking down the economy for a single day ( Acuité Ratings, 2020 ).

South Asian countries have poor health care systems. Afghanistan has only 2.8 physicians per 10,000 people, Bhutan 3.8, Bangladesh 5.3, and Nepal 6.5, a 10th of the number in more advanced countries. Even India, which has one of the strongest health systems in the region, has only 7.8 physicians per 10,000 people ( Rasul, 2020 ). The South Asian countries, due to weak health facilities and resources, have taken very stringent policy measures to contain the spread of the corona virus and save people’s lives. Except a few essential services, the economic activities have shutdown, travels are banned, movement of goods and services are restricted and cross-border movements are closed. Labor, the main factor of production, has been quarantined, borders have been closed and national, regional and global supply chains have been disrupted mostly in the South Asian region.

While the current policy measures of physical distancing and lockdown are critical for saving people’s lives and in combatting the spread of the corona virus, these measures have affected the lives and livelihoods of millions of people in the South Asian region, which is home to one third of world’s poorest population ( ESCAP, 2020 ). The stronger the lockdown, the greater the economic impacts are. In this backdrop, this paper briefly examines the following questions: What are the existing and prospective economic impacts of COVID-19 pandemic in South Asia, what are the challenges and issues faced by the poor vulnerable population, and what are the likely impacts in the near future—short, medium and long-term? How the economic sectors like, migration, tourism, the informal sector, and agriculture and rural livelihoods will be affected by this pandemic? What are the key measures and actions taken by South Asian countries to address these challenges? What policy responses are needed by national, regional and global communities to address these challenges?

The paper is organized as follows. After this introduction, Economic Impacts of COVID in South Asia assesses the macro-economic impacts of COVID in South Asia, particularly on vulnerable economic sectors. Emerging Social Risks and Vulnerabilities , examines the cascading effects and emerging social risks and vulnerabilities. Emerging Opportunities discusses emerging opportunity to use the disruptive forces of the COVID-19 pandemic and the associated policies for recovery. Government and Civil Society Responses , discusses government responses and the final section of the paper draws a conclusion and suggest policy measures that are required to address these challenges.

Economic Impacts of COVID-19 PANDEMIC in South Asia

South Asian countries took various stringent measures to contain the spread of COVID-19 . Key measures undertaken by different countries included closure of offices, restaurants, hotels, schools, colleges and education institutions, international borders, suspension of visas, imposition of complete international and domestic travel bans, and ban on public gatherings ( Table 1 ). While these measures significantly helped control the coronavirus spread in South Asia, they also imposed huge economic and social cost at the society. Tourism, exports and remittances, which are important sources of foreign exchange earing for South Asian countries, have also been affected significantly. South Asian economies are likely to shrink for the first time in 4 decades ( IMF, 2020 ). This section summarizes key socio-economic impacts that South Asian countries faces due to the Covid-19 pandemic.

TABLE 1 . Measures taken by the Governments in South Asia to contain spread of COVID-19 in early stage of infection.

Increasing Risks of Macroeconomic Instability

Declining GDP growth : While the pandemic is still developing and the actual economic impact has yet to be fully known, different forecasts suggest that the South Asian countries will experience the worst economic performance in the last 40 years due to COVID-19. The magnitude of the economic impact will depend upon the duration and severity of the health crisis, the duration of the lockdown, and the manner in which the situation unfolds once the lockdown is lifted. As per the International Monetary Fund’s forecast, the overall GDP growth rate for the South Asian countries is expected to be in the range of -18% (Maldives) to 3.8% (Bangladesh) in 2020, where five countries are expected to have negative growth trajectory ( Table 2 ). A sharp fall of GDP or negative growth of GDP means that a significant part of the population would lose income during 2020. While population is growing and inflation is raising ( Table 1 ), the reduction in GDP means that the per capita income will decline further, which will affect the livelihoods of the general public. If the global economy recovers rapidly, the South Asian region is also expected to have better growth prospect in 2021, where Maldives is expected to lead the region with 12.7% growth followed by India (8%).

TABLE 2 . Macro-economic indicators of South Asia -Real GDP Growth, Inflation, and Current Account Balance.

Declining trade volume: COVID-19 has severely disrupted international and regional trade and supply chains ( Baldwin and Tomiura, 2020 ). Many countries have temporarily closed their borders, reduced or halted non-essential imports, and canceled import orders from other countries. South Asian countries' growth in the last few decades were fueled by their export growth. The USA, Europe and China are the main trading partners of the South Asian countries, and have themselves been affected badly by the pandemic with their economies slowing down. Because of the sharp drop in external demand, trade and exports contracted sharply as well. COVID-19 has thus heavily impacted both the export and import of South Asian countries. While exports have been growing steadily in recent decades, this year it is expected to be less than that of 2019 in all of the South Asian countries. Overall in South Asia, export growth will be from −6.8 to −3.9% and import growth from −7.3 to −6.2% due to reduced external demand, which will be low even beyond the lockdown period in 2021 ( World Bank, 2020a ). The reduced export earning is likely to compound the economic crisis in other sectors, like employment and household income. For instance, the textile and garments sector, which employs millions of people and contributes a lion's share of the export earning, is heavily dependent on external markets and will suffer heavily.

Inflation : The South Asian countries are expected to experience a slightly higher inflation in 2020 owing to the impact of COVID-19. Except Pakistan (10.7%), all other South Asian countries are expected to have a low level of inflation (0.40% in Maldives to 6.4% in Nepal) in 2020, which is comparable to 2019 inflation rates ( Table 1 ). The current account balance (% of GDP) is expected to be negative for all South Asian countries in 2020, except Afghanistan. The deficit however is expected to be slightly lower than 2019 because of the sharp fall in oil price as well as due to the disruption in global supply chain, where imports are expected to be reduced more than the reduction in exports for most of the countries. South Asia region is a net oil importer and oil occupies the lion's share of the import bill.

Macroeconomic consequences . Lower revenue collection and higher recurrent spending are likely to increase the fiscal deficit to 7.7 percent of the GDP in 2020 ( World Bank, 2020a ). The high fiscal deficits in the region are adding to public debt, affecting fiscal sustainability. Low or negative GDP growth, declining export earnings and increased fiscal deficit have serious implication to household income and poverty. Over time, the macroeconomic crisis will translate to broader macroeconomic challenges that will lead to falling demand and mobility disruptions. The existing macroeconomic crisis may cascade to different economic sectors and compound the impacts at local economy and unfold many economic crizes through both forward and backward linkages and impact both supply (national, regional and global supply chains) and demand (consumption, saving and investment) as well as change prices. If the crisis prolongs, many SMEs may not survive and migrant workers will not be able to return to their original jobs; the recovery could take even longer and these economies may enter into the worst economic recession. The governments of the South Asian countries, therefore, face huge challenges in managing this unprecedented situation, which has major implication for the poor and marginalized communities. With temporary sealing of the border and restriction of the movements, informal cross-border trade is heavily affected, not only putting a number of informal enterprises involved in the supply chain of those goods at a higher risk, but also leading to shortage of groceries, particularly for landlocked countries like Bhutan and Nepal that are heavily dependent on import of basic goods from India.

Impact on Migration and Remittances

Due to restrictions in travel, mobility and gatherings, the most affected sectors are tourism, sports, entertainment (cinema), education, transport, manufacturing, migration and remittances. South Asian countries rely on foreign remittances as one of the main sources of foreign exchange earnings and household income. With closure of the remittance transfer businesses, loss of employment abroad, and absence of travel back home, remittance inflow in South Asia is expected to decline significantly.

Migration and the resulting remittance is one of the important sources of livelihoods for millions of poor households in the region ( KNOMAD, 2020 ; World Bank, 2020c ). The inward remittance from migrant workers serves as a lifeline for their families and as an important source of foreign currency, which contributes significantly to the national economy. For instance, in Nepal, remittance contributes about 27% of the national GDP (2019). India is the largest receiver of international remittance, not only in the region but globally, with US$ 83 billion in 2019. Remittance is also an important source of household income in other South Asian countries where the remittance-GDP ratio was 8.2% in Sri Lanka, 7.9% in Pakistan, 5.8% in Bangladesh and 4.6% in Afghanistan in 2019 ( World Bank and KONOMAD, 2020 ). Like external migration, internal migration also contributes significantly to support families and ensure food and nutrition security for the poorer sections in the rural areas. The rural poor migrate to urban centers and support their families residing in rural areas. India has over 100 million internal migrants, who are also in huge numbers in other countries. The COVID-19 outbreak has placed many internal migrant workers in dire conditions, with many losing their (mostly informal) jobs and unable to return home due to disruptions in public transport services and movement restrictions. This is the reality for most migrant workers, especially those working in the informal sector and living in overcrowded slums. Lockdowns, travel bans, and social distancing measures in response to the COVID-19 crisis have disproportionately affected poor and vulnerable internal migrant workers, who have found themselves stranded, unable to return either to their places of work or their communities of origin. A number of newspaper articles reveal that thousands of workers marched to their villages from cities, despite movement restrictions and lockdowns. Without adequate access to housing, basic water and sanitation, health facilities, or social safety nets to help them survive in such restrictions, these migrant workers have become even more vulnerable to contagion risks. A recent survey in Bihar and UP in India reported that 73% of the respondent migrant households have lost their jobs or main income source ( Population Council, India, 2020 ).

The migration and remittance sectors have been affected heavily by the COVID-19 pandemic. The initial estimates suggest that remittances will fall sharply in all of South Asian countries in 2020. The remittance flow will drop about 23% in comparison to 2019 in India, Pakistan, and Bangladesh. In Nepal is expected to fall by 14%. In total, in S outh Asia, remittance flow is likely to decline from US$ 140 billion in 2019 to US$ 135 billion in 2020 and projected to decline to US$ 120 billion in 2021 ( World Bank and KNOMAD, 2020 ). The coronavirus related global economic slowdown, falling oil prices and travel restrictions may also affect the demand for migrant labor and migratory movements, and this is likely to keep remittances subdued even in 2021. These forecasts were done in the initial phase of the lockdown, but recent data suggest that the remittance inflow may not be affected as much when compared to 2019. However, many migrant workers from the region are infected with the virus in their work destinations with some causalities and with millions stranded in need of repatriation, which poses huge challenges and risks.

Losing Jobs in Informal Sector and MSMEs

In South Asia, a majority of the population is either self-employed or engaged in agricultural and related activities. Service and industry sectors are other major employers in the region, while micro, small and medium enterprises (MSMEs) and the informal sector services engage the largest workforce. ( Figure 1 ).

FIGURE 1 . Informal employment in South Asia in agriculture, industry and service sectors. Source: ILO, 2018 .

For instance, in India 36 million MSMEs employed 60 million people and contributed significantly in national economy ( Dev and Sengupta, 2020 ). In Nepal, MSMEs generates over two million jobs and contributes 22% of the country’s GDP ( Shrestha, 2020 ). In other South Asian countries, MSMEs also play a very important role in providing employment and income, contributing to exports and earning foreign currency.

The informal sector in general and MSMEs in particular have been hit hard by COVID-19 across the South Asia. The informal enterprises and wage labourers face daunting challenges. Many MSMEs are now closed as they could not sustain themselves through the lockdown, leaving many informal sector workers unemployed; economic losses accumulated due to reduced demand, restriction of movement, lack of access to markets, and the loss of mobility of people and goods have all affected workers ( ILO, 2020a ). COVID-19 restrictions have brought major economic activities to a standstill and have closed the operation of almost all MSMEs except a few health related enterprises. For example, in Nepal, more than a million informal sector workers have lost their jobs temporarily or permanently and are in need of relief materials from the state ( Awasthi, 2020 ). Since hotels and restaurants have been closed for months, demand for food and related materials have also declined sharply.

In Pakistan, about 12 million workers were likely to face layoffs due to lockdown and the country’s sluggish economic recovery ( PIDE, 2020 ). It is also anticipated that if COVID-19 induced situation restricts the GDP growth rate between 0 and 1.5%, it is likely to increase the percentage of poor population (of income poverty) from 25% to around 55% ( PIDE, 2020 ).

The high rate of layoffs and closure of a considerable portion of business will have multiplier effects on employment, household income, food and nutrition security and livelihood security. As most of the workers in the informal sector are poor and the majority of them are women, it has significant implications to poverty, gender and food and nutrition particularly for the marginalized communities who engage heavily on the sector for cash income and livelihood. Food insecurity is another major challenge caused by the disruption of agricultural production, food supply chains, and loss of income across different countries due to the pandemic. At the same time due to the low supply of agricultural production, food prices have been increased leading to severe impacts on household food security. The most vulnerable population in South Asia are those exposed to weather related disasters (flood, droughts), conflict or are living in extreme poverty in countries with weak social protection programs. The strain on incomes resulting from the decline in economic activity will devastate workers close to or below the poverty line and will bring additional people under poverty.

Inadequate Social Security Coverage

All South Asian countries have lower than world average public health expenditure ( Table 3 ). As percent of the gross domestic product (GDP), the Maldives has the higher share of public health expenditure (5.2%) while Bangladesh has the lowest share (0.47% of GDP). A recent study shows that the some of the cities in South Asia (Karachi in Pakistan and Delhi in India) severely lack intensive care beds, healthcare workers and financial resources to meet the growing demand for healthcare services due to the coronavirus transmission ( Davies et al., 2020 ). Other than Sri Lanka (24%), Bhutan (14%) and India (10%), social security coverage of the workers is quite low where less than 4% of the workers have some kind of social security. Around 140 million workers are expected to lose their jobs in the region ( ILO, 2020b ; UNESCAP, 2020 ).

TABLE 3 . Basic facilities in health sector and Social Security Coverage in South Asian countries.

The following table ( Table 4 ) shows the average score of Global Health Security (GHS) index for South Asian countries. The global average of the GHS score is 40.2. Among the South Asian countries, India and Bhutan are above the global average while the remaining countries (Pakistan, Nepal, Bangladesh, Maldives and Afghanistan) are below the global average score.

TABLE 4 . Health security ranking and score of South Asian countries.

Effect on Travel and Tourism

Some of the most affected sectors in South Asia due to COVID-19 are tourism, hotel and restaurant, manufacturing, construction and real state, agriculture, transport, trade and so forth ( ESCAP, 2020 ). In the region, travel and tourism sector created around 50 million jobs in 2018 ( Table 3 ), contributing significantly to the national GDPs. For instance in India, tourism and travel services employ about 43 million people contributing over 9% of the GDP; in Pakistan, it contributes over 7% of the GDP; and in Nepal, it employs over one million people contributing about 8% of the GDP ( Table 5 ).

TABLE 5 . Employment and economic contribution of tourism and travel industry in South Asia.

The COVID-19 mitigation measures including social distancing and travel restrictions have affected the travel and tourism sector the most. Demands in the tourism, travel, hotel and restaurant sectors collapsed immediately after the spread of the coronavirus, which consequently affected the travel and tourism industry severely. For instance, on March 12, the Nepal government canceled all Everest expeditions slated for 2020 spring season. In the previous years, the Department of Tourism used to collect approximately US$ 4 million annually in royalties from Everest climbing permits. In addition to permits, each climbing team used to spend US$ 40,000–90,000 for other expenses ( ICIMOD, 2020 ). The tourism sector, which generates huge revenue and provide employment to a considerable portion of people, has therefore been extremely affected ( ICIMOD, 2020 ).

It is estimated that in the trekking sector alone, thousands of people will be severely affected while approximately 20,000 tour guides will lose their jobs ( De Silva, 2020 ). The hospitality sector, which employs up to 60,000 workers in Kathmandu, Pokhara and Chitwan, has already been severely impacted by the drop in tourism ( Shrestha, 2020 ). Similarly in India, 40–50 million job cuts are imminent from big hotels, travel agencies and tour operators ( Dev and Sengupta, 2020 ). Bhutan incurred a loss of US$ 4.4 million and Bangladesh lost US$ 470 million from both domestic and international tourism (UNWTO, 2020). Because of the travel ban, the airlines industry is the hardest hit and unlikely to recover soon.

The COVID-19 pandemic is expected to affect the tourism demand and supply in South Asia differentially. At the demand side, international inbound tourists are expected to be reduced, while regional and domestic tourists to be increased. From the supply perspective, loss of jobs and closure of businesses run by MSMEs in the short term, are expected to recover and revive from the medium term onwards due to a growth in regional and domestic tourism in the region.

Impact on Agriculture and Rural Livelihoods

Due to the COVID-19 pandemic, agricultural value chains and livelihoods of the agriculture dependent population has been suffering ( Morton 2020 ; Sulser and Dunston, 2020 ). In South Asia, majority of the rural population depend on agriculture and agri-related activities. Agriculture in this region is labor intensive and employs over 50% of the respective countries' labor force. Because of its high labor intensity, agriculture based rural economy and livelihoods are disrupted by COVID-19 and resultant quarantine, restrictions on movement of goods and services and closure of cross-border trade ( Sulser and Dunston, 2020 ; Rasul, 2021 ). The COVID-19 induced disruption affects the agriculture and the entire food system – the production, transportation, marketing, distribution and consumption. Out of panic, even a few grain exporting countries in the early months of covid-19 restrictions have restricted their exports, which disrupted the international trade, eroded confidence on the global food market and cultivated insecurity (IFPRI, 2020).

COVID-19 has disrupted agricultural operation in the South Asian region because of shortages of labor and inputs, as shut-downs extended to rural areas, village roads, transportation and marketing of goods, all to control the movement of people in order to effectively curb the spread of the pandemic. The outbreak was initially experienced during the planting and harvesting season of many crops, including wheat and paddy, the two major staple foods in the region ( Rasul, 2020 ).

Most affected sub-sectors are fruits, vegetables, poultry and dairy. For example, the poultry sector in Nepal has been losing Rs 220 million per day in recent months ( Shrestha, 2020 ). Fruits are the major cash crops in the region, and the sector was affected badly due to transportation ban and lack of storage and processing facilities. Similarly, dairy farmers could not sell milk; beekeepers could not migrate their bees for spring blooms or get buckets for collection/storage of harvested honey and perform honeybee colony multiplication work/queen rearing, and people could not collect/harvest non-timber forest products (NTFPs) either.

Shocks in Agriculture and Food Security due to the COVID-19

Although in developed countries the impact of COVID-19 on agriculture is relatively less, in South Asia the impact is substantial because of less mechanization and high labor intensity in agriculture. Across South Asia, rural populations depend on agriculture and agriculture-related activities for their livelihoods; about 50% of the workers are engaged in agriculture ( Rasul, 2020 ; Rasul, 2021 ). While the current policy measures of social distancing and lockdown are critical to save people’s lives and for combating the spread of the corona virus, these measures have affected the agricultural operations with many migrant workers unable to participate in agricultural activities. The disruptions arising from COVID-19 responses have impacted agricultural activities and its supply chain, including the marketing, transportation, distribution and consumption of agricultural goods and inputs in South Asia ( Rasul, 2021 ).

The intensity of COVID-19 shocks on agriculture in the South Asian countries is high because the timing of the COVID-19 pandemic outbreak coincided with the planting and harvesting season of many crops including wheat, paddy, fruits and vegetables. For instance, in Bangladesh, farmers could not deliver harvested watermelon to markets due to transportation bans ( Das et al., 2020 ; ICIMOD, 2020 ; van Bodegom, and Koopmanschap, 2020 ). According to FAO (2020), the pandemic restrictions in Bangladesh severely hampered the country’s export of tropical fruits. Additionally, due to travel restrictions, seasonal labourers could not reach the agricultural sites for the Boro rice harvest, which accounts for over half the nation’s rice production. Marketing and selling of poultry, dairy and fruits have also been affected severely in many South Asian countries, particularly the hill and mountain regions. Despite government many efforts, urban poor households in Bangladesh faced acute food insecurity during the lockdown period ( Das et al., 2020 ).

COVID-19 has disrupted food transportation and supply chain in different parts of South Asia. Because of transport restriction and market disruptions, prices of farm products have collapsed and farmers have had to sell their harvested products at very low rates. For instance, farm prices for wheat in India have declined substantially due to lack of facilities to transport the harvest to the markets ( Dev and Sengupta, 2020 ). Similarly, demand for poultry has also shrunken considerably. While prices of farm products have declined, the consumer price of many essential food items increased in almost all the South Asian countries during the initial outbreak of the COVID-19. During the lockdowns most of the countries experienced higher prices of food items and even shortage of food. The situation was further aggravated by the restriction of cross-border movement of goods and trade. A few of the major grain-exporting countries also restricted their exports out of fear of domestic food shortages, which disrupted international trade and regional food markets, and caused acute scarcity in import dependent countries. Border restrictions furthermore affected the transport of agricultural inputs such as chemical fertilizers, seeds, and farm equipment. A decline in food and inputs trade affected food availability in remote areas and may have caused price hike in food importing countries like Afghanistan, Bhutan, Maldives and Nepal ( ICIMOD, 2020 ). For instance, in Afghanistan, initially food prices increased by 30% in Kabul when its border with Pakistan closed, with wheat flour prices increasing by 80–100% in March ( Rahim, 2020 ). Meeting food and nutritional requirements in many South Asian households has been a challenge due to the increasing food prices and loss of jobs during the period of the lockdown. Many poor households have been pushed to cut their expenditure on food items which has compromised their nutrition. Several households have even been forced to borrow money or use their savings to buy food. As estimated by the United Nations University, the COVID-19 pandemic will push 16 million people in South Asia into extreme poverty ( Sumner et al., 2020 ; UNESCAP, 2020). Moreover, a global economic slowdown is highly likely to force international migrant workers to return to their home countries, thus drying up vital foreign exchange resources in many South Asian countries which will consequently affect their food purchasing power.

Socio-Cultural Impacts

Physical isolation caused by the lockdowns has impacted social relationships, social interactions, and shed light on deep-rooted social norms and exclusions all over the world including South Asia. Sudden layoffs and loss of work have led to depression, alcoholism, substance abuse, and in some cases suicides ( Hossain et al., 2020 ). Although poor and disadvantaged groups suffers more. Newspaper reports and videos circulating on social media record thousands of migrant workers stuck at national and international borders, unable to return to their own homes expressing a sense of abandonment, unfair treatment, and rage. The negative psychological impacts of the pandemic and measures to contain it are raising concerns about mental wellbeing, especially that of senior citizens, frontline healthcare providers, and individuals with existing health problems. The restricted mobility caused by lockdowns has been especially challenging for chronic patients and the differently abled who require regular medical care, but in many cases, have been unable to access it. There is very little public information available regarding the conditions of those living in state institutions—prisons, mental health institutions, shelter homes, and orphanages ( ICIMOD, 2020 ). Many students whose campuses are closed find themselves stranded, often very far from their homes and many express a sense of hopelessness. Sudden layoffs and loss of work have led to depression, alcoholism, substance abuse, and in some cases, suicides. Closure of schools has also denied to children of poorer households, access to mid-day meals which could have adverse effects on nutrition, resulting in increased rates of stunting (UNESCAP, 2020). It is also reported domestic abuse of women has sharply increased during the lockdown period in many parts of South Asia ( ICIMOD, 2020 ). The covid-19 pandemic has intensified the existing inequalities and further creating new forms of exclusion.

Emerging Social Risks and Vulnerabilities

Social protection system is very limited across the South Asian countries, where vulnerable population is expected to face unprecedented challenge due to the COVID-19 pandemic at their own expense. A huge share of populations in the region is involved in informal work with daily wage labor. The COVID-19 pandemic is likely to bring additional risks and challenges for South Asia, impacting communities and households through multiple channels. The poorest of the poor households and communities have already been impacted through the collapse/reduction of tourism, sharp fall in migration and remittances (both external and internal), and loss of jobs in the urban areas. Informal jobs in the cities and urban areas have evidently shrunk. Large numbers of internal migrant workers have returned back home and many international migrants are also returning or will have to return to their respective countries of nationality in the short- or medium-term. These initial impacts of COVID-19 will, however, permeate to other sectors including agriculture.

Besides the loss of income from job and migration, the South Asian population will suffer from the dampened demand of their products and services due to fall in aggregate demand and avoidance behavior (e.g., tourism, travel, recreation) due to ongoing risks of contracting the virus. Moreover, the loss of income and fall in remittances may increase indebtedness and force households to sell their productive assets and/or severely restrict the ability of the poor households to invest in education of their children, and/or compromise on their nutrition, which will have long-lasting effects. This may deepen poverty, inequalities and vulnerabilities in the region. The economic and social costs of the COVID-19 outbreak are likely to be significant and long-lasting.

Besides few online schooling, most of the schools are closed and millions of children are out of school. It is expected that many children, especially girls, marginalized communities, and the disabled may not be back to school, as they will be forced to make up for their household income loss caused by the pandemic. Table 6 presents the existing drivers, emerging risks and challenges, and potential implications for South Asia.

TABLE 6 . Emerging social risks and challenges and possible socio-economic implications.

It is evident from Table 4 that the Covid-19 pandemic has led to multiple risks and challenges. Due to the restriction on travel, tourism, and gathering of people to maintain physical distancing, the demand for all kinds of goods and services are suppressed due to forward and backward linkages. As a result, trade volumes (both imports and exports) have declined considerably. However, the domestic spending on health sector, and social security has been increased, but tax revenue declined which have macroeconomic implications.

As a large share of economic activities in South Asia are informal, the closure of factories and restaurants, and the decline of tourism and demand for goods and services, has shrunk the region’s labor absorption capacity. As a result, unemployment rates have soared while incomes have declined ( CMIE, 2020 ). This has made millions of households vulnerable to poverty.

When factories, construction sites, travel and tourism sectors closed, migrant workers returned back to their villages. This return-migration trend is also taking place at the international level, where migrant workers working in foreign countries have lost their jobs and are returning back home. Returnee migrants need additional support for their survival and in the absence of such support system, their families are more likely to be vulnerable to poverty since households not only need to support additional members but have also lost remittances. Covid-19 is likely to deepen poverty and reinforce inequality, increase social tension, disturbances and crimes in South Asia.

Emerging Opportunities

The current situation provides a unique opportunity to use the disruptive forces of the COVID-19 pandemic and the associated policies for recovery; to accelerate the transition to more sustainable and resilient societies ( Rasul, 2020 ). Some of the short-term measures to address the challenges of COVID-19 can be linked to economic growth by investing in natural capital to improve the long-term productivity and resilience in the region. This requires strategic thinking and strategies for long-term investment to ensure that short-term actions result in long-term benefits. Short-term support can be linked to long-term socio-economic growth through appropriate planning and strategizing which will improve the social and environmental conditions for the sustainable recovery of the health and economic sectors ( Rasul, 2020 ). For example, food for work programs can be linked to programs that construct or maintain local infrastructure such as roads, irrigation canals, management of watershed thus helping poor households to cope with vulnerability while building assets that are essential for society. Similarly, requirements to include energy efficiency in building designs can be linked to support provided to building construction companies to restore jobs, thus providing job restoration in the short-term and climate benefits in the long-term.

Leveraging Civil Society and Private Innovation

The lockdown has also prompted actors involved in supply chains to adapt a number of important private sector innovations to cope with the pandemic restrictions ( Sulser and Dunston, 2020 ). E-commerce has been growing steadily in the recent years in South Asia due to increased digital connectedness and the development of information and communications technologies. During this period, for instance, consumer-led groups on Twitter, Facebook, and WhatsApp have organized with Farmer Producer Organizations in several countries to find ways of bringing food to markets ( Narayanan and Saha, 2020 ). Many farmers began delivering produce directly using WhatsApp to secure aggregated orders in housing cooperatives in nearby cities ( Narayanan, 2020 ). In India, Swiggy, a fast-growing food delivery app and logistics company, delivers for 40,000 restaurant partners, helping them with its “jumpstart package” to recover sales, while the Swiggy Capital Assist Program helps pay for hygiene and distancing upgrades. During the farmers’ markets shut down, some farmers traveled to cities to set up shop at roadsides maintaining physical distance. In India, Flipkart is growing fast during the COVID-19 crisis and developed a “hyperlocal delivery”grocery service linking SME suppliers with domestic supermarket chains like Vishal Mega Mart with its e-commerce operations ( The Economic Times, 2020 ). Nepal’s nascent e-commerce sector has also growing steadily since the lockdown started.

Global energy demand has declined sharply due to the mitigation measures of COVID-19 and energy price is also going down sharply. Since most of the South Asian countries are net energy importers, the falling oil price could benefit these countries. The reduced oil prices will not only lower the import bill but also help save foreign exchange and will have positive impacts on the current account balance. For example, India is the fourth largest consumer of oil in the global market and a rough estimate suggests that “a US$ 10 fall in crude could reduce the current account deficit by approximately 0.5% of GDP and the fiscal deficit by around 0.1% of GDP” (Sandeep Nayak, The Economic Times, January 12, 2015). The lower oil prices will have positive impacts on manufacturing, cost of fertilizer production for agriculture, costs of transportation and many other energy dependent sectors. The Pakistan government has already declared a reduction in oil prices by Rs. 20 per liter ( DAWN, 2020 ). The decrease in oil prices will decrease production cost and can have positive impacts on managing inflation and living expenses.

Another sector with future growth potential is health services and medical goods and services. Because of COVID-19 pandemic, people are now more conscious about health and the governments may thus invest more in strengthening health facilities. This is likely to increase the demand for health and medical products, including food items with health benefits. This could create an increased demand for health and medicinal products, including the foods with nutritional benefits. The pandemic and resultant disruption in supply chain has created a need for proper development of local economy, local food system, and both on- and off-farm activities. Other important areas of emerging opportunities could be the development of internet-based service sectors. The pandemic has created additional demand for internet-based economic activities, such as online shopping, distance education, as well as online medical services and work from home, which may change the demand for office space and travel needs. Policies that reduce job market frictions and facilitate labor adaptation to these job opportunities would be needed, once the pandemic is controlled in working toward a self-reliant economy for the region.

The COVID 19 pandemic also provides an opportunity to build resilience in the most vulnerable region through the use of stimulus packages to tackle the poverty and other issues. The government may plan strategically to prevent risks and improve resiliency, for instance by promoting sustainable development to reduce the impact of other shocks, such as natural disasters, in the future. As South Asian countries have committed to meet the SDGs by 2030, the governments should utilize their resources and invest in assisting the people affected by the COVID-19.

Government and Civil Society Responses

The governments of South Asian countries have responded promptly and adopted several policy measures to contain the spread of the COVID-19, support the poor people to ensure food, and provide stimulus to economic sectors. In this section, we briefly present the economic response measures taken by South Asian countries.

Response to Support Vulnerable People

The major focus of government response on preparations to contain the spread of the virus, increase resources for the health-care system including financial support for medical testing and treatment of the disease, as well as fiscal support for emergency public interventions to increase hospital capacity and medical supplies. All the governments have strengthened their social protection programmes (cash and asset transfer, including food) and provided resources for supporting poor and vulnerable groups, and provided wage support to low-wage workers. For instance, the Government of Afghanistan allocated US$ 15 million to contain corona virus; the Government of Bangladesh allocated US$ 29 million to fund the COVID-19 preparedness and response; the Government of India allocated US$ 22.6 billion to provide essential food items, health facilities, fuel and direct cash to support the poor people and senior citizens; and the Government of Pakistan introduced a relief package worth US$ 7 billion for next three months. The governments of Bhutan, and Nepal also adopted different social protection measures to support poor and vulnerable groups. For example, Nepal government took full responsibility of bearing the cost of testing and treatments of people who have been infected by the coronavirus. In some of these countries, monetary incentives and support was also provided to encourage people to comply with the quarantine efforts. Besides government support, NGOs, civil societies, private sector and religious organizations also extended their support in providing food and essential items to the poor. In Pakistan, government has Ehsaas program to strengthen coordination with NGOs and other civil bodies to target the poor population for delivery of rations more effectively.

Response to Minimize the Short-Term Economic Pain

Besides supporting vulnerable people, governments of South Asian countries have also adopted various fiscal and monetary measures to minimize the short-term economic pain and to inject liquidity into the financial system. The governments have adopted different measures including concessional lending to prioritized sectors, reduced restrictions on payments such as forbearance of taxes, rent and utility payments and deadlines for loan payments to make liquidity available and to provide flexibility for debtors. For instance, the Reserve Bank of India rolled out a plan of 1.8% of GDP to increase liquidity in the financial sectors. In addition to the central government efforts, some States in India also adopted stimulus measures to sustain economic activities and support the poor. For instance Kerala State has announced US$ 2.6 billion package (2.5% of the state GDP) for economic recovery and some direct transfers to poor households ( World Bank, 2020a ). Similarly, Government of Pakistan introduced a huge stimulus package and financial support including US$ 600 million support to SMEs and tax refunds to the export industry ( World Bank, 2020a ). Government of Bangladesh announced the plan of US$ 588 million salary support to garment and other export industries to support their workers. Government of Nepal also introduced concessional loans for SMEs to pay their workers.

Response to Reopen and Revitalize Economy

Different countries adopted different strategies for gradual opening of the economies and providing financial support to priority sectors to revive economic activities. Government of India has adopted a measure of zoning the country based on the prevalence of the coronavirus cases to relax the lockdown and gradually restart economic activities in areas where the virus is absent or low in number, yet taking stringent measures in the hotspot areas. The state government of Assam, India has constituted a task force to design strategies to revive the state's economy. India’s central bank has introduced measures to increase liquidity to increase access to credit for the pharmaceutical, construction and tourism industries. Bangladesh government is providing 50–70% subsidy to farmers for buying harvesters to address the challenges of labor shortage in paddy harvesting. The governments of Bhutan, Myanmar and Nepal have also rolled out different measures to stimulate SMEs ( World Bank, 2020a ). It is heartening that Benapole- Petrapole land border between Bangladesh and India has opened recently after three weeks of lockdown to facilitate movement of people on emergency ground ( ICIMOD, 2020 ).

Conclusion and Policy Recommendations

The COVID-19 pandemic has posed a huge risk and severely impacted the socio-economic condition and livelihood of people in South Asia. The coronavirus is still spreading and it is difficult to predict when it will be completely contained. The unprecedented challenge posed by the COVID-19 pandemic calls for very urgent and decisive actions to ensure that people’s lives are saved, livelihoods are protected and the economy recovers. The Covid-19 outbreak has caused direct high costs on human health and economic activities, and poses the most adverse effects on livelihoods of the poor and the most vulnerable communities. This study discusses some of the crucial key points that may help assist vulnerable group of people who are suffering from this pandemic. Since the coverage of social security system is minimal or absent altogether in most of the South Asian countries, the government should manage to give some sort of social security facilities to the poorest population, more specifically when they lose their informal employment opportunities. Improving saving habits of the poor and providing access to banking services would, for instance, provide safety nets during times of crisis.

As health, environment and social issues are interconnected, concerted efforts are required to mitigate and recover from the damages brought by the COVID-19 on our societies and economies. Governments need to prioritize their activities for short, medium, and long-term. Regional and global cooperation is also necessary to address the ripple effects of COVID-19 on different societies. The countries of South Asia must act collectively to address their challenges and to create favourable conditions for economic recovery. Importantly, innovative strategies and approaches are needed to address the coronavirus challenges. The governments of the South Asian countries may consider the following policy measures to mitigate the negative impacts of the pandemic on the poor and most vulnerable sections of the society and to promote economic recovery.

1 Plan for an economic recovery from COVID-19 to develop a strategy to adapt quickly based on the situation, avoiding blanket lockdowns so that areas with low intensity risk are not affected due to closure of the local economies, since blanket shutdown of the economy has taken a devastating toll on the economy and people’s livelihoods. The Indian approach of categorization of the country based on the prevalence of the corona virus cases and opening the economic activities in areas where virus is absent or low, and introducing stringent measures in hotspot areas could be a good starting point. Detailed guideline, however, is necessary to operationalize such policies, such as following clear protocol developed based on local condition and evidence as well as clear strategies for containing the virus after opening. Due to the lack of such protocols, the risk of resurgence of the COVID-19 virus is quite high in these countries, as it is has evidently been occurring in the United States and European countries. It is important to use the media intensively to raise awareness among public and disseminate targeted health care education and self-protection as well as supporting mental health ( Khajanchi et al., 2020 ).

2 Develop roadmap for achieving short, medium, and long-term goals to revitalize the national and sub-national economy by taking into account the specific condition and needs of the poor and vulnerable groups at sub-national level. In the short term, focus should be on addressing the immediate health crisis, ensuring food and nutritional security, shorter-term job creation and transferring incomes to the needy population to survive the economy. Medium term focus should be on boosting economic activities to recover the economy and in designing and implementing the best possible stimulus to achieve financial recovery. The long-term goal should be t ransforming or bouncing the economy forward by promoting long-term sustainable growth and poverty reduction.

3 O rchestrate the fiscal, monetary and development interventio n in an integrated and coordinated manners so that different policy measures complement each other and multiply their effects in economic recovery. While the short-term focus will be on addressing the impacts of the pandemic and restoring jobs and employment, the long-term focus could be on improving long-term productivity and resilience by investing in a balanced portfolio of physical, human, social and natural capitals, which will build capacity to deal with future challenges and mitigate the impact of future pandemics and other socio-economic shocks. For example, investment in health, education, skills development, innovation, technological upgrading, and green infrastructure and natural capital will increase the productive capacity of the population and provide sustainable returns for future generations.

4 Redouble the efforts of social protection to protect the poor, vulnerable groups, and migrant workers and compensate the loss of income so that they can maintain minimum standard of living and do not slide back to poverty. Investment in social protection and job creation will be needed to protect the vulnerable in the short term, but policy priorities could gradually shift to reducing the environmental risks affecting human health and vulnerability to climate change. Protecting and enhancing natural capital such as forests, soils, water resources, ecosystems, biodiversity, air quality, and climate can support human health and productivity and improve long-term resilience. For example, investment in green infrastructure such as renewable energy can supply clean energy and improve air quality, which leads to long-term health benefits and positive climate outcomes

5 Boosting economic activity and i nvesting in job creation in areas where poor and lowly skilled workers can participate and get benefits. In striving for sustainability, policy choices, and investment decisions should be arranged strategically in such a way that they not only address immediate problems but also build long-term resilience, strengthen the existing poverty alleviation program and targeted poverty reduction programs in asset building and economic recovery.

6 Promote regional cooperation to facilitate expedient cross-border movement of essential goods and services including medicines, medical equipment, foods, and other essential items. South Asian countries must work together to address the challenge of pandemic and fast and sustainable economic recovery.

7 Review and revise the policy priorities by withdrawing subsidies from fossil fuels and providing subsidies to green recovery, improving health facilities, boosting economic activities, and focusing on programs that alleviate poverty and vulnerabilities. The drop in oil prices offers an opportunity to withdraw the existing subsidies on oil and other fossil fuels and invest more on renewable energy sectors that support green jobs. Local food system should also be strengthened at community levels to improve local food self-sufficiency and nutritional outcomes.

Data Availability Statement

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

Author Contributions

GR, conceptualization, writing and rewriting; AN, AH, AM, SR, AL, PG, FA, AM, ES provided inputs.

Conflict of Interest

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

Acknowledgments

This research was supported under ICIMOD’s core fund. ICIMOD gratefully acknowledges the support of its core donors: the Governments of Afghanistan, Australia, Austria, Bangladesh, Bhutan, China, India, Myanmar, Nepal, Norway, Pakistan, Sweden, and Switzerland. The views and interpretations in this publication are those of the authors and are not necessarily attributable to ICIMOD or its member countries.

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Keywords: COVID-19, socio-economic impact, public health, Poverty and inequality, South Asia

Citation: Rasul G, Nepal AK, Hussain A, Maharjan A, Joshi S, Lama A, Gurung P, Ahmad F, Mishra A and Sharma E (2021) Socio-Economic Implications of COVID-19 Pandemic in South Asia: Emerging Risks and Growing Challenges. Front. Sociol. 6:629693. doi: 10.3389/fsoc.2021.629693

Received: 15 November 2020; Accepted: 15 January 2021; Published: 24 February 2021.

Reviewed by:

Copyright © 2021 Rasul, Nepal, Hussain, Maharjan, Joshi, Lama, Gurung, Ahmad, Mishra and Sharma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Golam Rasul, [email protected] , [email protected]

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

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Economic Development

Understanding the economic consequences of the covid-19 pandemic.

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Emi is a Global Health Manager in the Health Policy and Insights team at Economist Impact. Emi is a global health equity specialist with a focus on the social determinants of health and has a wealth of experience in global health research, policy and programming. Her expertise in global health advisory, program design and healthcare communications means that Emi brings a breadth of experience to the team across technical areas. Her current role involves exploratory research using economic models, rapid reviews of scientific papers and the development of a global index on health inclusivity. Emi also designs and works on longer-term research assignments across the international development sphere, including related to Education and WASH. Emi has experience working across sectors, having held various roles across the health and social care industry, serving as a Health Inequalities Manager within the UK Department of Health and Social Care, Consultant Epidemiologist with the World Health Organisation under the Health Securities and Preparedness Division and as a Technical Delivery Officer with UNICEF. Emi has an undergraduate degree in Biomedical Science from the University of Warwick, a Master's in Public Health from Imperial College London and is currently completing a PhD in Health Equity at the University of Exeter.

The covid-19 pandemic cannot be seen solely as a global health crisis; the impact on the health, livelihoods and functioning of individuals and global economies deems it a humanitarian and economic crisis. It is estimated that an additional half a billion people have fallen into poverty due to the pandemic [1] . In addition to the significant loss of life—the number of deaths has reached over 6.7m—the destruction of industries and broadscale impacts on healthcare systems globally demonstrates the extensive impact of the pandemic at all levels of society [2] .

Transmission of SARS-CoV-2 (the virus which causes covid-19) across communities persists despite significant efforts and investment to stop the virus in its tracks. By the end of November 2022, over US$4trn had been invested in response and recovery packages in the US alone, through the Coronavirus Aid, Relief and Economic Security (CARES) Act, supplemental legislation and the American Rescue Plan Act [3] . Alongside direct medical costs, indirect costs attributed to the spread of the virus include disruption to millions of children’s education, unemployment, lost earnings and lost economic output [4] . The pandemic has resulted in global economic shifts, responsible for one of the largest global recessions since the second world war. In addition to the 2020 stock market crash (the largest stock market decline since the financial crisis of 2007-08), economies faced a global supply-chain crisis, global panic buying and price gouging [5] .

While many reports have highlighted the current and historic economic consequences of the pandemic to date, fewer studies have explored potential future impacts of covid-19 from a global perspective. Estimating the potential future impact of persistent covid-19 in a global context will enable governments, multilateral organisations, individuals and civil society to better prepare and take action to minimise the consequences of ongoing covid-19 challenges and other future health emergencies. The aim of this study is to quantify the future economic implications of ongoing covid-19 transmission by considering the following research questions:

• What is the future economic impact of persistent transmission of SARS-CoV-2 as a result of mortality and morbidity within the working-age population?
• How does sustained covid-19 infection impact different labour markets?
• How do labour market disruptions as a result of covid-19 feed into broader economic impacts (for example, economic output and gross domestic product—GDP)?
• What factors influence the magnitude of covid-19 at a country level?

Through an evidence review, model and series of in-depth interviews, this study explores the estimated economic impact of covid-19 in a future where the virus persists globally. It focuses on the impact of covid-induced mortality or morbidity to the working-age population. Recognising that the virus has varying effects on countries driven by a series of country-specific factors, Economist Impact has identified four distinct country archetypes to assess the potential impacts across a range of countries. The model forecasts impacts for each archetype under three hypothetical scenarios: a baseline scenario which assumes that 2022 infection rates will continue through 2025, and optimistic and pessimistic scenarios where 2022 covid-19 infection rates decrease or increase, respectively, by 10% in 2023 and remain at that level through 2025.* 

The research gives rise to several key findings:

• Countries characterised by both high infection rates and high productivity levels are likely to experience the greatest economic losses. For a reference country characterised by high infection rates and high productivity levels, this analysis forecasts potential GDP losses in 2025 between 0.76% in the base case scenario and almost 1% in a pessimistic scenario. In a country the size of the UK, this could imply a loss of up to US$ 25bn. Comparatively, a reference country with low infection rates and productivity levels might lose between 0.019% to 0.023% of its GDP (around US$ 1bn for an economy the size of the UK).
• Without measures in place to suppress infection rates, SARS-CoV-2 infection could continue to have substantial impacts on economies. Even in an optimistic scenario, some groups of countries (those with high infection rates and high productivity rates) could see GDP loss of over 0.75% in 2025, suppressing economic growth and development. This analysis sheds light on these potential impacts highlighting the need for continued action and efforts by governments and policymakers. In addition, country-specific factors, such as productivity rate, adherence to control measures, extent of mitigation efforts and the implementation of fiscal support programmes, strongly influence the economic impact of sustained covid-19 infection rates.
• Measures to reduce the severity of illness caused by the infection can play an important role in minimising the economic consequences across all countries, but particularly those with higher infection rates. The model forecasts the loss to GDP based on the productive hours of work that are lost due to covid-19 infection. The findings from the literature review suggest that the majority of work hours lost to covid-19 are associated with acute symptomatic covid-19 infection and the post-acute sequelae of SARS-CoV-2 infection (long covid) rather than covid-related deaths and exit from the workforce. Therefore, global and national measures to reduce the severity of illness from levels that force people infected by covid-19 temporarily out of work can help to mitigate against some of the potential economic impacts of persistent infection.

This study seeks to quantify how the virus may continue to impact global economies, and explores how actions to mitigate economic impact, control infection alter the overall economic impact of sustained infection rates. The report offers considerations for governments and policymakers to reduce the economic and societal impact of future health emergencies by considering actions to boost resilience and reduce the vulnerabilities of economic systems, all critical components for stronger responses to future global emergencies.

* 2022 Infection rates were sourced from covid-19 estimates modelled by the Institute for Health Metrics and Evaluation (IHME). IHME forecasts country infection rates, among other indicators, using a hybrid model that is “grounded in real-time data.”

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[1]  World Health Organization. More than half a billion people pushed or pushed further into extreme poverty due to health care costs. Available from: https://www.who.int/news/item/12-12-2021-more-than-half-a-billion-people-pushed-or-pushed-further-into-extreme-poverty-due-to-health-care-costs [2]  Mathieu E, Ritchie H, Rodés-Guirao L, et al. Coronavirus pandemic (covid-19). Available from: https://ourworldindata.org/coronavirus [3]  USASpending. The federal response to covid-19. Available from: https://www.usaspending.gov/disaster/covid-19?publicLaw=all [4]  Appleby J. The public finance cost of covid-19. BMJ 2022; 376 :o490. [5]  World Bank. Covid-19 to plunge global economy into worst recession since World War II. Press release. 2020 Jun 8. Available from: https://www.worldbank.org/en/news/press-release/2020/06/08/covid-19-to-plunge-global-economy-into-worst-recession-since-world-war-ii

Related content

Championing Inclusivity: progress towards good health for all

In the UK for example, black women are four times more likely than white women to die in childbirth. Furthermore, babies that are black or black-British, Asian or Asian-British have a more than 50% higher risk of perinatal mortality, compared to white-British babies.

Typically, people with the highest incomes from dominant or majority groups enjoy the best health and the most years of their lives in good health—while people with lower incomes from marginalised groups are most vulnerable to morbidity and mortality. There is a need to think dynamically about the role of structural barriers and sociocultural influences and how they impact holistic health:this is where inclusivity in health comes in. It’s about challenging us to think differently about health: exploring new partnerships, better understanding of what good health means to the different communities within our societies, engaging with the public and thinking outside the box to bring new stakeholder groups into action.

In October we launched the Health Inclusivity Index, developed by Economist Impact and supported by Haleon. The first edition of a three-year research program assessing the state of health inclusivity in an initial 40 countries, based on three domains: health in society,  inclusive health systems, and community and individual empowerment. I had the pleasure of sharing a stage with influential opinion leaders during the launch event–organised by Haleon at the Wellcome Collection—where we discussed how inclusivity is essential to better health for all. We explored the role of policy in facilitating collaboration to improve health and removing structural barriers to accessing care, and  the critical need to match policy with structured implementation mechanisms.

The majority (93%) of countries in our index recognise health as a human right; only Jordan, the UAE, and the US fail to do so. All but seven countries also recognise that health (as a human right) means more than access to healthcare and includes access to safe drinking water, sanitation, food, housing and other requirements for a health-promoting environment. Despite this one in five countries have exclusionary policies or practices that explicitly restrict access to healthcare for certain groups or individuals. Six of these eight countries are also countries who claim to  recognise health as a human right. Professor David Napier, professor of medical anthropology at University College London, introduced the concept of defining “who we, (the population) are”. He highlighted that governments must define “we” and this is often  narrowly focused   on the majority, leaving those who fall outside of this definition of ‘we’ without access to social services.

According to our findings there is a clear role for inclusivity in improving health and plugging the inequitable gap in outcomes for the most vulnerable. While life expectancy has improved globally, healthy life expectancy has not, meaning we are living more of our life in poor health. Countries with a higher inclusivity index have populations that live for longer in better health.

We know that inclusivity goes beyond the provision of services. Barriers to health prevent individuals within a population from accessing services, even when they are readily available. Services that are free at the point of use are not inclusive if they are under-resourced, low in quality,  have limited hours of service, do not cater to language differences and require long-distance  travel. Baroness Tanni Grey-Thompson, a member of House of Lords, detailed how under-resourced they are and therefore lack the capacity to effectively respond to the overwhelming number of public requests.

People need the capacity to engage with and influence their health, recognising that many barriers are outside of their control. Examples include being time poor - lacking  the time to exercise or prepare healthy food and having a job that does not pay for time off to seek healthcare. Language barriers and limited literacy skills,—particularly health literacy and the ability to understand health information. Domain 3 of our index, “Community, and Individual Empowerment”, emerged as the strongest driver of inclusivity. Countries that prioritised empowering local communities—removing these socio-cultural barriers—and placing individuals at the centre of service delivery, were among the highest-scoring for health inclusivity.  Eight of the top ten scoring countries achieve their highest score in this domain. Beyond this, Domain 3 has the strongest correlation with overall inclusivity score, indicating that it is the best predictor of a country’s overall score in the index.

What should be done?

Don’t stop campaigning for universal health coverage and the social determinants of wellbeing —they are critical to expanding access to healthcare particularly for the most vulnerable

Empower communities and enable self-agency:an effective approach to expanding access to whole health. During our discussions, Katy Jon Went, head of methodology at the Human Library, reminded us at the event of the “need to humanise the data” recognising that there are individuals, communities and societies behind the numbers

Work from the outside in. By deliberately supporting vulnerable groups, you will help improve health for all and remove structural barriers that mostly impact the minority

Pull in the same direction: elevate the importance of coordination to achieve common goals

Advocate for high-quality data collection, and “real-world evidence” for inclusivity

Nations must tackle all three domains of the Health Inclusivity Index to achieve an inclusive system that promotes universal wellbeing . The Health Inclusivity Index provides the first ever quantitative measure of inclusivity, but also provides a framework for countries to pull levers that drive inclusivity and improve health for all.  For more information, explore the Health Inclusivity Index Hub and white paper.

Personalised healthcare for billions: Communication challenges in the post...

Personalised healthcare for billions: Communication challenges in the post covid-19 age is a report written by Economist Impact and commissioned by WhatsApp. 

Understanding the healthcare communications methods that worked during the covid-19 pandemic, and the new and innovative approaches and digital tools that facilitated this, can help guide the development of an improved approach to healthcare communications in the future. The experience of governments in managing complex healthcare challenges, such as mass vaccinations, while combating misinformation and ensuring data privacy, also provide key insights to guide the development of further digitalisation of healthcare communications and services.

Key findings from this project include:

Economist Impact would like to thank the interviewees who generously offered their time and insights, including:

The findings and views expressed in this report are those of Economist Impact and do not necessarily reflect the views of survey respondents, interviewees or the project sponsor.

Five important questions for health in a post-pandemic world

How will digital health evolve? Will cost containment come back? Are we prepared for the next pandemic? Will mental health remain as a priority? These are common questions Economist Impact gets from stakeholders in health, nearly two-and-a-half years since covid-19 first dominated the world’s agenda. While it’s challenging to separate passing fads from long-term drivers, there are clear themes that will rightly shape the future of health. However, the path each takes is not predetermined—at least not yet. 

Here are five important trends we are tracking in a post-pandemic world of health:

Is covid-19 really over?

In most of the world, the pendulum has already swung from one end to the other and back again with responses to covid-19. Long periods of strict mask adherence, widespread testing and restrictions on social interaction have given way to activities that are nearing pre-pandemic levels. A reason for this shift is due to human nature, where the combination of exhaustion and desire for normalcy drive current behaviors. However, another factor stems from changing perceptions about the virus, levels of risk posed and the anticipated movement to endemic status. 

There are positive signs,  such as the ratio of cases to hospitalisations and the effectiveness of vaccines, indicating a different stage in the covid-19 evolution, but it’s also clear the path forward will be both uneven and unpredictable. Countries employed varying tactics during the pandemic, from “zero-covid” strategies in China and New Zealand to a mixed-policy approach in America and the UK, but all have experienced similar or worse metrics this month, than a year before. Also, with mounting evidence about long-term health concerns for those with prior infections, we are likely to see more—not fewer— risks in the near future.

In this sense, there is a need for a balanced approach moving forward. Instead of “learning to live”with the virus, affected stakeholders—health, economic, societal—can seek out nuanced policies and integrated actions to mitigate future threats. The scars of the recent past should also spur proactive monitoring and preparation as frantic, reactive efforts across the world have already proven too costly. As covid-19 maintains an active presence, these actions allow for a greater chance of success and will  also foster an environment better placed to deal with future pandemics. 

What to do with the silent pandemic? 

Many health experts argue that another major crisis had been prevalent before covid-19, but its slow-building nature ensured it did not attract nearly as much attention. The “silent pandemic”of non-communicable diseases (NCDs)—diabetes, cancer, respiratory and cardiovascular conditions—had plagued advanced and emerging economies for decades. This stems from a combination of underlying lifestyle choices and ageing populations. While progress had been made, countries were still falling behind targets such as Sustainable Development Goal (SDG) 3.4 and the reduction of premature deaths from NCDs.

The pandemic not only halted progress but led to regression: postponement of public health screenings, disruptions in quality treatments, lower patient engagement, worsening healthy behaviors and overstretched healthcare workforce. In the past year, as much of the world has attempted to return to past care dynamics, these factors have led to a “double burden” with NCDs, where the backlog of cases weighing down fragile health systems is putting the “silent pandemic” on an even more precarious path.    

Tackling this will be an ongoing effort for years to come. However, positive ramifications from the pandemic—new tools in health, better understanding of wellbeing, active support from outside of health systems—can lead to improved interventions and outcomes. A pertinent example is the current dialogue and action around mental health—in the workplace, in communities and the mainstream media— raising awareness and promoting openness to combat a critical issue. Sustaining that trend across different NCDs could lead to lasting change.

What will technology’s role be in the future health ecosystem?

Technology has long offered great potential for health; the challenge has not been generating innovative ideas, but translating them into real-world solutions. The pandemic experience—either through necessity or real progress—has in part bridged the existing gap, providing a clear roadmap for the application of tools such as “augmented intelligence” in proactive decision-making. This type of problem-solving goes beyond health, intersecting with societal challenges such as ensuring the important principle of medical neutrality in conflict zones. 

The question of who will lead the way in generating impactful solutions remains. For years, expectations have been high for technology firms increasing their health presence, yet measured impact has been inconsistent at best. However, the pandemic has accelerated this movement with Alphabet’s growing investment in health and Amazon’s recent acquisition of a US primary care entity.. This trend is expected to continue, especially as the technology industry applies lessons from its role in the pandemic response towards more mainstream healthcare needs.

Where is health’s voice in the sustainability movement?

Health is intertwined with one of the world’s most important movements: the urgent need for global action towards a more sustainable planet. The recent heatwave across many parts of the world is another reminder of the importance of sustainability efforts and its relationship with health. As Natalia Kanem from the United Nations Population Fund (UNFPA) aptly stated at last year’s World Health Summit, “climate change affects poverty, affects hunger, certainly affects health”.

Acting upon that clear and logical connection will be a critical area of focus for health. From more eco-friendly healthcare supply chains, to access to sustainable food systems for balanced diets, a multitude of opportunities exist for stakeholders to assume greater leadership. Not only will health further strengthen the need for increased investment and attention on this issue, a “health in all policies” approach will also ensure a holistic, societal view around sustainability goals. 

Will the pandemic foster a new age or will we revert to past norms?

One of the most critical lessons from the pandemic is found throughout history—the power of collective action and singular focus on a shared goal. In the case of covid-19, this was manifested through numerous collaborations: vaccine development and distribution, research and public health communication and societal interventions to slow the spread of a dangerous new virus. Actors that embraced a dedication to the “common good” instead of individual objectives, generated clear results: findings from an Economist Impact study on pandemic response is one example of many that identified stakeholder collaboration as a vital element of success.

The opportunity exists to employ the same tactic for the biggest issues that rose in importance following the pandemic: health equity, sustainable innovation and holistic wellness. Underpinning this window for seismic change is a greater recognition from actors in health and society that known problems in health require new approaches. That recognition, along with existing models of success, such as a cross-sectoral group of actors working together for healthy ageing, offer a roadmap to replicate in the future. 

Tackling these issues requires the same collaborative spirit and long-run view; two dynamics that are difficult to maintain beyond moments of crisis. Indeed, a return to short-term focused, incentive-driven and siloed activity in health is likely. To ensure the window is not lost, it is vital to reframe the benefits of wellness in a way that aligns shared goals between a wider group of actors. The vision laid out by business leaders, who increasingly see health as a strategic imperative, is a signal of a larger paradigm shift in how we can collectively work towards a world of better health for all. 

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Health, Economic and Social Development Challenges of the COVID-19 Pandemic: Strategies for Multiple and Interconnected Issues

Sigamani panneer.

1 Department of Social Work, School of Social Sciences and Humanities, Central University of Tamil Nadu, Thiruvarur 610005, Tamil Nadu, India; ni.ca.ntuc@ramukayahdup (U.P.); moc.liamg@dtahbahkel (L.B.); ni.ca.ntuc.stneduts@91brtrebor (R.R.B.P.)

Komali Kantamaneni

2 Faculty of Science and Technology, University of Central Lancashire, Preston PR1 2HE, UK

Udhayakumar Palaniswamy

Robert ramesh babu pushparaj, kesavan rajasekharan nayar.

3 Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram 695024, Kerala, India; moc.liamg@rayanrk

Hilaria Soundari Manuel

4 Centre for Applied Research, The Gandhigram Rural Institute, Deemed to be University, Gandhigram, Dindigul 624302, Tamil Nadu, India; [email protected]

F. X. Lovelina Little Flower

5 Department of Social Work, Bharathiar University, Coimbatore 641046, Tamil Nadu, India; ni.ude.cub@anilevol

6 Centre for Architecture and Built Environment Research, University of the West of England, Bristol BS16 1QY, UK; [email protected]

Associated Data

Not applicable.

The COVID-19-pandemic-related economic and social crises are leading to huge challenges for all spheres of human life across the globe. Various challenges highlighted by this pandemic include, but are not limited to, the need for global health cooperation and security, better crisis management, coordinated funding in public health emergencies, and access to measures related to prevention, treatment and control. This systematic review explores health, economic and social development issues in a COVID-19 pandemic context and aftermath. Accordingly, a methodology that focuses on identifying relevant literature with a focus on meta-analysis is used. A protocol with inclusion and exclusion criteria was developed, with articles from 15 December 2019 to 15 March 2022 included in the study. This was followed by a review and data analysis. The research results reveal that non-pharmaceutical measures like social distancing, lockdown and quarantine have created long-term impacts on issues such as changes in production and consumption patterns, market crashes resulting in the closure of business operations, and the slowing down of the economy. COVID-19 has exposed huge health inequalities across most countries due to social stratification and unequal distribution of wealth and/or resources. People from lower socio-economic backgrounds lack access to essential healthcare services during this critical time for both COVID-19 and other non-COVID ailments. The review shows that there is minimal literature available with evidence and empirical backup; similarly, data/studies from all countries/regions are not available. We propose that there is a need to conduct empirical research employing a trans-disciplinary approach to develop the most effective and efficient strategies to combat the pandemic and its aftermath. There is a need to explore the social and ecological determinants of this contagious infection and develop strategies for the prevention and control of COVID-19 or similar infections in future.

1. Introduction

This paper explores the challenges of the COVID-19 pandemic and the significance of non-pharmaceutical measures for global health and socio-economic development. The COVID-19 pandemic introduced economic and social crises that are posing huge challenges across the globe. The most serious challenges related to the COVID-19 pandemic and post-COVID future are related to the employment and incomes of millions of people, social security, income support schemes, the burden on women, the plight of migrants and informal sector workers, mental health issues, and restrictions on economic activity, including halted production, with firms unable to sell their goods and services [ 1 ]. The pandemic has also sparked fear and anxiety due to economic shocks and recession [ 2 ]. In an attempt to “flatten the curve”, various countries’ governments have imposed international border shutdowns [ 3 , 4 ], internal travel constraints [ 5 ] and longer periods of quarantine [ 6 , 7 ]. Economists have predicted that the COVID-19 pandemic will slow down Gross Domestic Product (GDP) growth by one-half a percentage point for 2020, and this applies to all countries (from 2.9% to 2.4%) [ 8 ]. Social distancing, lockdown and quarantine have high economic and social costs associated with them because they introduce changes in production and consumption patterns, which caused financial markets to crash, resulting in the closure of business operations [ 9 ]. Furthermore, this pandemic also introduced the international community to various challenges relating to global health cooperation and security, crisis management (investment in emergency preparedness) and coordinated funding during public health emergencies. The global economy has been very badly affected, especially the agro-livestock industry, hitting their lowest growth rates across various countries [ 10 ]. A decrease in inputs availability and a decrease in agricultural production during the pandemic affected food security as well [ 11 ].

Globally 3.3 billion people, which constitutes 81% of the world’s workforce, were affected by the lockdown. Of this lockdown-affected workforce, 61% were workers from the informal sector, and of this 90% were from low- and middle-income countries [ 12 , 13 ]. The nationwide lockdowns during the COVID-19 pandemic disunited and isolated much of the migrant populations. Due to the lack of job opportunities, millions of migrant workers were forced to return to their countries/counties/villages in a time when public transportation was closed or severely restricted. Migrants faced humanitarian and health security challenges and unusual logistical nightmares from the states where they migrated [ 14 ]. Furthermore, in many developing and underdeveloped countries, the available social security measures are weak, with a lack of access to health care and economic security [ 15 ]. As many state borders were closed, inter-country travel and trade were shut and more than 30 million people fell into poverty in the absence of active policies to protect or substitute income flows to vulnerable populations. These policies, decisions and actions severely impacted the health and wellbeing of a large section of the population [ 16 ]. With chronic low funding in rural healthcare and the economy, the pandemic has revealed the weaknesses of rural infrastructure in almost all countries [ 17 ].

2. Review Protocol

A systematic review has been selected for this study with exclusion and inclusion criteria applied to narrow down the literature search. A large number of academic literature and policy documents related to COVID-19 have been considered for this study. Google, Google Scholar, PubMed, Science Direct, Web of Science and Scopus were used to identify the relevant literature. Google has been used to search various policy reports and other associated documents that are not available in scientific search engines such as Science Direct, Web of Science and Scopus. This review attempted to find solutions to health, economic and social development challenges of the COVID-19 pandemic. The major objectives of the review were to understand the inter-linkages between health, economy and society, to assess the pandemic crisis, to explore health and development implications of COVID-19, to compile possible and easily workable strategies for solving problems of COVID-19, to understand the role of multi-stakeholders in time of crisis and to document innovative collaborative strategic directions to control the pandemic. Based on these objectives, the search was made to look through each database that contained the terms: COVID-19, health and development challenges, pandemics, multiple and interconnected issues, economic impact and strategies, prevention and recommendations. During the search, results from diverse sources identified some duplicate articles, especially those associated with COVID-19. Due to this, a unique combination of words was used to explore the relevant literature as follows:

• COVID-19 and low- and middle-income countries
• COVID-19 and developed countries
• Stages of lockdown and health impacts
• Lockdown and economic impact
• COVID-19 and health impacts
• COVID-19—disaster management
• Post-pandemic context

Appropriate literature was identified from the diverse sources, based on data quality, focus area, rigourous methods, and removal of replicas; the subsequent works were scrutinised according to the exclusion and inclusion criteria listed in Table 1 . This process was undertaken in different phases, with the date of publication, abstract and title considered for exclusion and inclusion. If the title and abstract did not fully reveal the scope of the study, the full article was examined to fully assess the entire information for that specific particular. Furthermore, some grey literature was considered for this study. Google and organization websites such as United Nations Development Programme (UNDP), World Health Organization (WHO), United Nations (UN), and United Nations Office for Outer Space Affairs (UNOOSA) were used to get the most up-to-date information. PICO was used as the strategy to undertake the systematic review.

Criteria for the inclusion and exclusion.

Based on Google, Google Scholar, PubMed, Science Direct, Web of Science and Scopus, a total of 1825 relevant articles were identified. However, more than 600 (628) duplicates were identified and these were deleted. Moreover, literature that was not closely related to the search words led to the deletion of a further 426 articles. At this stage, 771 articles had been considered for assessment. After careful consideration of the titles and abstracts, a further 424 articles were removed. At this stage, 347 articles had been considered for the analysis. After reading these 347 papers, a further 202 articles were deleted, as they had either highly technical or overly sensitive issues. Finally, 145 papers were considered for the study. Of these 145 papers, Table 2 presents the top 10 papers, which are the most relevant and highly cited articles. Figure 1 provides information on the inclusion and exclusion criteria of the literature.

Systematic review—PRISMA model flow diagram (inclusion and exclusion criteria).

Systematic analysis results—top 10 articles and their information.

3. Review Results

3.1. pandemics and their impact on various population groups.

Pandemics/disasters often leave a significant impact on human health and development. This includes, but is not limited to, loss of human lives, livelihood issues, and psycho-social problems. Pandemics can create long-term imbalances in societies and communities. The challenges confronted by the general public due to the pandemic have revealed inadequacies in the areas of managing health risks, injuries, diseases, disabilities, psychological problems and deaths [ 18 ]. The COVID-19 pandemic has affected all aspects of human life and the global economy [ 19 ]. The World Trade Organization (WTO) and Organization for Economic Cooperation and Development (OECD) marked the COVID-19 pandemic as the greatest peril to the world economy since the financial emergency of 2008–2009 [ 20 ]. Emerging issues related to jobs and income of millions of people, social safety net, future of income support schemes, the burden on women, and the plight of migrants and informal sector workers are some of the main challenges that the world is confronting [ 21 ]. Oxfam predicts that the economic crisis due to COVID-19 could push half a billion people into poverty [ 22 ]. Due to the lockdown, economic activities and livelihoods were affected in many ways, especially in the fields such as production and distribution, consumption, restriction on trade and business, large-scale uncertainties in the market, lack of access to the resources and sudden disappearance of the more informal sectors of employment/sector [ 23 ]. The global outbreak has resulted in developmental impacts on health, education, gender, economy, politics and the environment. The COVID-19 pandemic has exposed huge health inequalities across countries and within countries due to existing social stratification and resource sharing. People from lower socio-economic strata lack access to essential healthcare services during the pandemic time [ 24 ]. The economic decline during the pandemic has significantly affected people from the lower socio-economic stratum [ 23 ]. This pandemic has marked a significant impact on the lives of many vulnerable sections of society, including women and children. Across countries, the number of cases related to domestic violence has increased [ 25 ]. The pandemic has had an extensive impact on the education sector [ 26 , 27 , 28 ], and all educational institutions have been closed for several months, especially in countries where vaccination proceeded at a slower pace. The pandemic has forced a worldwide lockdown, with a huge number of citizens confined to their homes [ 29 ], often resulting in social isolation. Social isolation has led to chronic loneliness and boredom, which has affected mental health, human happiness and wellbeing [ 25 ].

The pandemic affected political systems across the globe, causing ideological differences, lack of need-based initiatives, geopolitical cooperation/dysfunctions, misinformation and misleading/false claims. The COVID-19 pandemic has affected religion in many ways, including cutting short pilgrimages and journeys related to religious practices and festivities [ 30 ]. People working in the informal sector, including migrant workers, are at a high risk of poverty as their income and livelihood options are limited [ 31 , 32 ]. Vulnerable populations have struggled to cope with the magnitude of problems and the incidence of suicide has increased due to loss of income, livelihood and other factors [ 33 ]. Challenges of immunization, nutrition, poverty, hunger, acute undernourishment, and health inequalities, especially amongst vulnerable groups, have posed severe health and economic challenges [ 31 ].

The pandemic’s impact on social life, the economy and the financial sector has led millions of people to face an unprecedented situation related to poverty, wherein an average of 3.3 billion of the global workforce are at risk of losing their livelihoods [ 12 , 34 ]. Breadwinners working in the informal economy, particularly marginalized populations in low-income countries, which includes small-scale farmers and indigenous peoples, have been drastically affected [ 35 ]. According to a WHO survey, in May 2020, it was found that in 155 countries, the pandemic had severely curtailed people’s ability to avail treatment services for Non-Communicable Diseases (NCDs). This situation is of significant concern because people living with non-communicable diseases tend to be at higher risk of severe COVID-19-related illness and death [ 36 ]. While the health systems of various countries are being challenged by the increasing demand for care of COVID-19 patients, it is imperative to maintain preventive and curative health care services, especially for the most vulnerable populations, such as children, women, older persons, people living with chronic conditions, minorities and people living with disabilities [ 37 ]. The pandemic has deepened pre-existing inequalities in social, political and economic systems, including access to health services and social protection. Women with care responsibilities, informal workers, low-income families and young people have been most adversely affected by the pandemic. There has also been a significant rise in domestic violence [ 38 ]. An increase in violence against women has resulted in a threat to public health and women’s health across the globe. The health impacts of violence, particularly intimate partner or domestic violence, on women and children have significantly increased in various societies. Women who have been displaced, are refugees, and are living in conflict-affected areas are the most vulnerable [ 39 ]. Lack of education and economic insecurity has also increased the risk of gender-based violence. Without sufficient economic resources, women cannot escape from abusive partners and hence face a greater threat of sexual exploitation and trafficking [ 40 ]. Pandemic-induced poverty has also widened the gender poverty gap, pushing women into extreme poverty, as they earn less and hold less secure jobs than men [ 22 , 41 ]. The economic fallout for women has increased due to more unpaid care work, thereby compelling them to go back to traditional gender roles of more household and care workers [ 42 ].

Children are affected due to the pandemic and this is most visible in their health and education in various ways [ 43 ]. Children from marginalized sections have been the victims as inequalities in the teaching-learning system widened. Data show that 463 million children did not have access to the internet or digital devices for remote learning during the closure of schools [ 44 ]. Closures of schools have severely affected those children who rely on school-based nutrition programmes for their food and survival. Children suffering violence at home, refugee children, migrant children and children affected by conflict face appalling human rights violations and threats to their safety and well-being [ 45 ]. The additional stress and stigma that befall families struggling to cope have also impacted their children [ 45 ]. In the last two decades, there has been significant progress in the fight against child labour; however, the pandemic could significantly reverse this otherwise positive trend [ 46 ]. This reversal is because the crisis has enormously disrupted global education, and the lack of distance-learning solutions in many of the developing and underdeveloped countries has excluded children from online education for a very long duration. Furthermore, this trend has the potential to push millions of children into child labour [ 47 ]. Whilst the adverse socio-economic and financial impacts have fallen on the majority of households globally, there is significant inequality with some children impacted more severely, for example marginalized minority groups, disabled, street-connected and homeless populations, single or child-headed households, migrants, refugees, internally displaced persons, or people from conflict or disaster-affected areas, will be more vulnerable to child labour [ 48 ].

Beyond poverty and informality, the most explicit references to other vulnerable people and groups include older persons and people living with disabilities [ 49 ]. As the world struggles with an incomparable health crisis, older persons have become the topmost victims. The pandemic affected persons of all ages, yet older persons and those with underlying medical conditions tend to be at a higher risk of serious illness and death due to COVID-19 [ 50 ]. In the face of a life-threatening pandemic, especially during the first wave, many of the older persons faced challenges in accessing medical treatments and health care services for non-COVID ailments and chronic diseases. In developing countries, the prolonged lockdowns, weak health systems and healthcare facilities requiring out-of-pocket expenditure left millions of older people, especially those in the poorest groups, without access to basic health care, which ultimately increased their vulnerability to COVID-19 as well [ 51 ]. While older people often have been invisible in humanitarian action, the pandemic uncovered their exclusion. Older persons usually had to rely on multiple income sources, including paid work, savings, financial support from families and pensions. Additionally, for those older people living alone, isolation combined with other factors such as limited mobility creates greater risks [ 52 ]. Individuals living with disabilities represent 15% of the population [ 53 ], and their barriers related to accessing mobility, access to health services and appropriate communication have increased tremendously, which further increases their vulnerability [ 54 ]. The physical, social, economic and health impacts of COVID 19 on people with disabilities require empirical studies so that severity can be assessed and appropriate policies can be developed [ 55 ].

3.2. Governance Issues

The pandemic also put to test the efficiency and quality of governance and the political will of the leadership in each country. During a public health crisis, people naturally depend on their governments for security and support [ 56 ]. COVID-19 brought in a unique set of challenges to governments across the globe, such as a lack of post-crisis reconstruction and recovery, weak legal and institutional mechanisms, weak infrastructural facilities, including communication networks, a lack of systematic, periodic assessment and accounting of potential losses, and poorly managed financial, technical and human resources [ 57 ]. Spontaneous behavioural reactions such as generalized panic and rumours regarding the spread of COVID-19 were reported from across the countries and each country dealt with it using different levels of efficiency and effectiveness [ 58 ]. For example, in India, the most troubling aspect was the shortage of proper provision of safety nets (e.g., food safety) during the lockdown for the weakest and vulnerable sections of the population, which was tackled by providing free food grains and cash transfer support for three months [ 59 ]. The unprecedented pandemic situation has shown the inadequacies in the global governance structure [ 31 ]. Moreover, the spread of fake news and misinformation was a major unresolved challenge for many of the democratic governments [ 60 ].

3.3. Strategies for Solving Multiple, Interconnected Problems of COVID-19

The WHO report on global surveillance for human infection with novel coronavirus highlights the importance of research studies to understand the viral transmission from animals and animal handlers, which will serve as evidence to prevent outbreaks similar to COVID 19 in the future [ 61 ]. To effectively respond to a public health emergency, the health system of the country must engage and step up preparedness activities with active involvement and leadership of the health department/ministry. Public health systems play a crucial role in planning health responses to respond and recover from the threats and emergencies introduced by pandemics. In various countries, fragmentation of health services has led to limited timely interventions and responses to health crises, which shows the need to have a strong coordination mechanism in place [ 62 ]. Public health emergency preparedness requires planning and intervention activities to prevent the spread of the virus, protect against other diseases and environmental hazards, promote and encourage health-seeking behaviours, respond to the crisis, assist communities in recovery, ensure quality and accessibility of the essential health services. Highly active surveillance is needed in all countries using the WHO-recommended surveillance case definition [ 63 ]. Furthermore, epidemiologic and surveillance activities would enable the public health systems to choose the most efficient ways to control the pandemic [ 64 ]. Non-pharmaceutical interventions based on supported physical distancing have a strong potential to lower the epidemic peak [ 65 ]. Priority should be accorded to certain areas, including assessment of the global health landscape; to accepting and recognizing epidemiological, environmental and economic crisis; to ensuring health regulations, such as tobacco control; to upgrading healthcare service delivery systems; and to ensuring innovative infection control, global research collaboration, universal health coverage, and public health surveillance. To support contact tracing, governments must consider expanding the use of information technology and digital initiatives to find high-risk areas [ 66 ].

The role of effective public health surveillance is crucial both in the short term and long term because the disease may remain in isolated pockets and regions even if it ceases to be a pandemic anymore. Surveillance informs about reality on the ground and provides insights for policymakers, which is essential [ 67 ]. Exploring and using web-based open tools to modernize data reporting can help provide newer, faster insights about COVID-19 controls [ 68 ]. COVID-19 surveillance in low/middle-income countries for a longer period is a real challenge due to a lack of resources, expertise, skills, people’s attitude to tackling these issues technology transfer, financial assistance and capacity-building support is to be ensured [ 69 ].

The disease load of the pandemic is inequitably distributed among vulnerable populations [ 70 ]. People living in low- and middle-income countries have reduced capacity for self-protection (due to poor housing, sanitation and living conditions) [ 71 ] a high risk of food insecurity [ 72 ], a widened gap in health care access [ 73 ], loss of livelihoods, and a decrease in dietary intake and health care consumption [ 74 ]. Public policy needs to reorient federal, state and local governments to handle health equity issues sensibly [ 75 ]. The relevance of integrating public health efforts with broader public policy and acknowledging the role of social determinants of health is important [ 76 ]. Developing universal schemes for food assurance, minimum incomes, reforming unemployment insurance, and investment in community development will help to address health-inequity-related issues in the post-pandemic era [ 77 ].

COVID-19 is unlikely to be controlled or eliminated until there is global coverage of the population with effective vaccination. Vaccine development itself is not adequate; its mass production, affordability, global availability and acceptability in local communities are also important [ 78 ]. Strategies are needed to ensure affordability by handling Intellectual Property Rights issues and increasing production [ 79 ]. Long-term massive investment in the vaccination is needed; however, if the regular health budget is diverted for this, it will lead to long-term adverse consequences for general health indicators and development [ 80 ]. Increasing government revenue and getting grants and aid from donors and international loan providers are important [ 81 ]. Uneven distribution of vaccination is always a major challenge [ 82 ]; hence, vaccines should be distributed in stages, giving priority to older persons, high-risk individuals and people with co-morbidities [ 83 ]. The distribution must adhere to the WHO framework for allocating COVID-19 vaccines internationally based on need [ 84 ]. Vaccine hesitancy is prevalent in low-income and high-income countries alike, with sceptics found in all socioeconomic, religious and ethnic groups [ 85 ]. Culturally tailored health communication measures [ 86 ], community engagement [ 87 ] and a robust pharmacovigilance system [ 88 ] are important strategies for addressing vaccine hesitancy.

3.4. Role of Multi-Stakeholders in Controlling the Pandemic and Promoting the Development

COVID-19 presents a set of significant challenges to health care providers worldwide [ 89 ]. Given the complexity of the problem and the requirement of inter-sectoral collaboration, formal multidisciplinary working groups are recommended to offer relevant, effective and pragmatic solutions [ 90 ]. The pandemic is a complex phenomenon, with multiple determinants and impacts across all spheres of life. The pandemic experience serves as evidence for the need to adopt a comprehensive trans-disciplinary approach, including several experts, not only from medical sciences but also from engineering, political science, economics, humanities, psycho-social and demographic disciplines [ 91 ], as well as media that raises public awareness about health promotion and prevention [ 92 ]. The care of patients with COVID-19 can be optimized by collaborating with various multi-stakeholders to meet the demands that are required to combat the deadly disease. Multiple stakeholder engagement is critical to address the public health crises resulting from the pandemic, including but not limited to: aid donors [ 93 , 94 ], international aid networks, legislative and regulatory arms of the state, logistics organizations, private health care sectors [ 95 , 96 ], direct suppliers, media, social media [ 97 , 98 , 99 ], local aid networks, private insurance companies [ 100 ], military and para-military forces [ 101 ], government and inter-government organizations. Inputs of experts from the field of management, economics, environmental health, disaster management and other specialized disciplines to be incorporated in policy formulation based on inter-sectoral collaboration, which in turn can create programs and policies that are more efficient and feasible [ 90 ]. The support of patients, healthcare professionals and the wider community in addition to the government is equally important to address this health crisis [ 60 ].

3.5. COVID-19 and Social Development

The innovative, collaborative and strategic directions proposed to control the pandemic by slowing down transmission and reducing mortality associated with the pandemic are presented in Table 3 .

Strategies for COVID-19 and beyond.

4. Future Research: Moving beyond the Transdisciplinary Framework and Study Limitations

Trans-disciplinary health science research must be the prime approach to develop a universal response to COVID-19. Long-term research priorities must serve towards an evidence base for the public health system to plan or respond to future pandemics and to develop effective systems to reach out to the public [ 143 ]. The COVID-19 pandemic has been developed as a public health and developmental crisis for all countries, and this has revealed new challenges to the research community across the globe. Extensive research is needed to understand the COVID-19 crisis life cycle and its causes and consequences (Recovery, Mitigation, Response and Preparation). Revisiting datasets, redefining relevant methodologies, facilitating access to online resources and exploring culturally relevant approaches is critical at this juncture. The search for relevant information sources and trying to compile proper data of active as well as closed COVID-19 cases is an important task for health researchers. Research studies are needed to explore the interconnection of climate change to the development of the virus and to understand the possible environmental factors that could influence virus diffusion [ 144 ]. Comprehensive scientific studies needed to be initiated to explore COVID-19′s impact on human development, human happiness, the well-being of helping professionals, their families and others in the community. Synthesizing evidence more rapidly will help contribute towards provision of broad-ranging intervention guidelines and longer-term strategies for human happiness and well-being and social and economic recovery. Ensuring adequate quality research work, communicating thereof with multi-stakeholders and developing policy briefs for appropriate government action is a priority area. There is also a need to strengthen community-based crisis risk management, learn from the field with empirical evidence and replicate best practices. Transdisciplinary research is best suited to explore the new parameters that could be appropriate to explain COVID-19′s initial diffusion and its development as a pandemic [ 144 ].

5. Recommendations

The widespread prevalence of the infection and high causalities has made pandemic policies a high priority. As a response to control the pandemic, the WHO has recommended countries to develop preparatory policies to fight against the pandemic as well as address pandemic-induced developmental problems [ 145 ]. Developing appropriate COVID-19 control policies is a huge public health concern for all countries, and this requires combined inter-sectoral collaboration and government agreements through various coalitions [ 90 ]. The policy response should be two-fold: address present critical health and livelihood issues and suggest an approach to deal with the long-term issues the pandemic has introduced. The public health sector must take the lead for the whole of society, with a welfare approach to minimize the negative impacts of COVID-19 and help people restore the balance in their lives and livelihoods. This includes responding with appropriate public health emergency actions, identifying economic impacts, identifying and dealing effectively with misinformation spread about the disease [ 146 ]. Governments need to focus on providing authoritative information via multiple sources to ensure accurate data and appropriate social behaviour. Increasing transparency, ensuring proper restrictions, designing suitable prioritization guidelines about how to allocate scarce resources and making use of effective technologies are important [ 146 ]. To recognize the potential of psychological burnout from long hours of work and potential demoralization from persistent stress among health care workers is also an area that needs the urgent attention of policy framers. Vaccine and therapeutic investment, as well as research and development on COVID-19 control/elimination, is another key area. Governments need to strike a balance between protecting health and respecting human rights [ 146 ]. Identifying a new set of priorities and reworking national spending priorities will help to utilise available resources most efficiently and facilitate the return of normality in people’s lives. Governments should address the long-standing challenges of health and nutrition of low-income households, strengthen food supply chains and empower women in food chains [ 147 ]. In response to the COVID-19 crisis, the International Labour Organization (ILO) has structured the four-pillar policy framework based on international labour standards to tackle the socio-economic crisis, stimulate the economy and employment, protect workers in the workplace, and rely on social dialogue for solutions [ 148 ].

6. Conclusions

The world is facing unprecedented challenges due to COVID-19, and hence pragmatic and innovative approaches are needed for pandemic management. To contain the spread of the virus, public health surveillance needs to be strengthened, through research, capacity building and action. Inter-institutional collaborations can help in enhancing the quality of surveillance, preparedness and capacity building during public health emergencies. Working closely with inter-regional and national public health and emergency management plans will help to control virus transmission and other risk factors. Since the pandemic has profound and long-term economic and social impacts, an integrated model for sustainable development, the delivery of training courses, and strengthening institutional mechanisms are essential for sustainable recovery and restoring normality in people’s lives. The complex problems of pandemic threats have to be handled proactively by formulating innovative strategies and protocols to respond to similar outbreaks in the future. Furthermore, it is necessary to implement practical, evidence-based public policy measures and innovative approaches to deal with pandemic management, including developing strong linkages between strategic partners, alternative resource mapping strategies, a robust institutional and legal framework, and promoting health equity across economies.

Author Contributions

Conceptualization, S.P.; methodology, S.P., K.K., R.R.B.P., L.B. and H.S.M.; validation, K.K., L.R. and H.S.M.; data analysis and data synthesis, S.P., R.R.B.P., L.B., H.S.M., F.X.L.L.F. and K.R.N.; writing—original draft preparation, S.P., U.P., L.B. and R.R.B.P.; writing—review and editing, K.R.N., R.R.B.P., L.B., H.S.M., F.X.L.L.F. and L.R.; visualization, S.P.; supervision, S.P., K.K. and U.P. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

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Informed consent statement, data availability statement, conflicts of interest.

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

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

• inequalities

Data availability statement

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

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

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

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Introduction

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

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

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

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

Social networks

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

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

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

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

Social support

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

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

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

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

Social and interactional norms

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

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

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

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

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

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

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

Recommendations and conclusions

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

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

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

Recommendation 2: intelligently balance online and offline ways of relating

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

Recommendation 3: build stronger and sustainable localised communities

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

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

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

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

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

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

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