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Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

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Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

"COVID-19 vaccination mandates are necessary for public health and safety."

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

COVID-19 vaccination effectiveness data
Information on vaccine mandates in different countries
Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

Introduction
Background Information
Body Paragraphs (with supporting evidence)
Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

The COVID-19 pandemic has presented an unprecedented global challenge, and in the face of this crisis, many countries have debated the implementation of vaccination mandates. This essay argues that such mandates are essential for safeguarding public health and preventing further devastation caused by the virus.

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

COVID-19, caused by the novel coronavirus SARS-CoV-2, emerged in late 2019 and quickly spread worldwide, leading to millions of infections and deaths. Vaccination has proven to be an effective tool in curbing the virus's spread and severity.

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences , evidence, and analysis. Here's an example:

One compelling reason for implementing COVID-19 vaccination mandates is the overwhelming evidence of vaccine effectiveness. According to a study published in the New England Journal of Medicine, the Pfizer-BioNTech and Moderna vaccines demonstrated an efficacy of over 90% in preventing symptomatic COVID-19 cases. This level of protection not only reduces the risk of infection but also minimizes the virus's impact on healthcare systems.

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Some argue that vaccination mandates infringe on personal freedoms and autonomy. While individual freedom is a crucial aspect of democratic societies, public health measures have long been implemented to protect the collective well-being. Seatbelt laws, for example, are in place to save lives, even though they restrict personal choice.

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

In conclusion, COVID-19 vaccination mandates are a crucial step toward controlling the pandemic, protecting public health, and preventing further loss of life. The evidence overwhelmingly supports their effectiveness, and while concerns about personal freedoms are valid, they must be weighed against the greater good of society. It is our responsibility to take collective action to combat this global crisis and move toward a safer, healthier future.

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About COVID-19

When writing a persuasive essay about the COVID-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Here is another example explaining How COVID-19 has changed our lives essay:

The COVID-19 pandemic, which began in late 2019, has drastically altered the way we live. From work and education to social interactions and healthcare, every aspect of our daily routines has been impacted. Reflecting on these changes helps us understand their long-term implications.

COVID-19, caused by the novel coronavirus SARS-CoV-2, is an infectious disease first identified in December 2019 in Wuhan, China. It spreads through respiratory droplets and can range from mild symptoms like fever and cough to severe cases causing pneumonia and death. The rapid spread and severe health impacts have led to significant public health measures worldwide.

The pandemic shifted many to remote work and online education. While some enjoy the flexibility, others face challenges like limited access to technology and blurred boundaries between work and home.

Social distancing and lockdowns have led to increased isolation and mental health issues. However, the pandemic has also fostered community resilience, with people finding new ways to connect and support each other virtually.

Healthcare systems have faced significant challenges, leading to innovations in telemedicine and a focus on public health infrastructure. Heightened awareness of hygiene practices, like handwashing and mask-wearing, has helped reduce the spread of infectious diseases.

COVID-19 has caused severe economic repercussions, including business closures and job losses. While governments have implemented relief measures, the long-term effects are still uncertain. The pandemic has also accelerated trends like e-commerce and contactless payments.

The reduction in travel and industrial activities during lockdowns led to a temporary decrease in pollution and greenhouse gas emissions. This has sparked discussions about sustainable practices and the potential for a green recovery.

COVID-19 has reshaped our lives in numerous ways, affecting work, education, social interactions, healthcare, the economy, and the environment. As we adapt to this new normal, it is crucial to learn from these experiences and work towards a more resilient and equitable future.

Let’s look at another sample essay:

The COVID-19 pandemic has been a transformative event, reshaping every aspect of our lives. In my opinion, while the pandemic has brought immense challenges, it has also offered valuable lessons and opportunities for growth.

One of the most striking impacts has been on our healthcare systems. The pandemic exposed weaknesses and gaps, prompting a much-needed emphasis on public health infrastructure and the importance of preparedness. Innovations in telemedicine and vaccine development have been accelerated, showing the incredible potential of scientific collaboration.

Socially, the pandemic has highlighted the importance of community and human connection. While lockdowns and social distancing measures increased feelings of isolation, they also fostered a sense of solidarity. People found creative ways to stay connected and support each other, from virtual gatherings to community aid initiatives.

The shift to remote work and online education has been another significant change. This transition, though challenging, demonstrated the flexibility and adaptability of both individuals and organizations. It also underscored the importance of digital literacy and access to technology.

Economically, the pandemic has caused widespread disruption. Many businesses closed, and millions lost their jobs. However, it also prompted a reevaluation of business models and work practices. The accelerated adoption of e-commerce and remote work could lead to more sustainable and efficient ways of operating in the future.

In conclusion, the COVID-19 pandemic has been a profound and complex event. While it brought about considerable hardship, it also revealed the strength and resilience of individuals and communities. Moving forward, it is crucial to build on the lessons learned to create a more resilient and equitable world.

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

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Examples of Persuasive Essay About COVID-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of COVID-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the COVID-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

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Examples of Persuasive Essay About COVID-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get an idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

Searching for the topic of Online Education? Our persuasive essay about online education is a must-read.

Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

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Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively.

Here are some tips to help you craft a compelling persuasive essay on this topic:

Choose a Specific Angle: Narrow your focus to a specific aspect of COVID-19, like vaccination or public health measures.
Provide Credible Sources: Support your arguments with reliable sources like scientific studies and government reports.
Use Persuasive Language: Employ ethos, pathos, and logos , and use vivid examples to make your points relatable.
Organize Your Essay: Create a solid persuasive essay outline and ensure a logical flow, with each paragraph focusing on a single point.
Emphasize Benefits: Highlight how your suggestions can improve public health, safety, or well-being.
Use Visuals: Incorporate graphs, charts, and statistics to reinforce your arguments.
Call to Action: End your essay conclusion with a strong call to action, encouraging readers to take a specific step.
Revise and Edit: Proofread for grammar, spelling, and clarity, ensuring smooth writing flow.
Seek Feedback: Have someone else review your essay for valuable insights and improvements.

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Common Topics for a Persuasive Essay on COVID-19

Here are some persuasive essay topics on COVID-19:

The Importance of Vaccination Mandates for COVID-19 Control
Balancing Public Health and Personal Freedom During a Pandemic
The Economic Impact of Lockdowns vs. Public Health Benefits
The Role of Misinformation in Fueling Vaccine Hesitancy
Remote Learning vs. In-Person Education: What's Best for Students?
The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
The Mental Health Crisis Amidst the COVID-19 Pandemic
The Long-Term Effects of COVID-19 on Healthcare Systems
Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

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Frequently Asked Questions

What is a good title for a covid-19 essay.

A good title for a COVID-19 essay should be clear, engaging, and reflective of the essay's content. Examples include:

"The Impact of COVID-19 on Global Health"
"How COVID-19 Has Transformed Our Daily Lives"
"COVID-19: Lessons Learned and Future Implications"

How do I write an informative essay about COVID-19?

To write an informative essay about COVID-19, follow these steps:

Choose a specific focus: Select a particular aspect of COVID-19, such as its transmission, symptoms, or vaccines.
Research thoroughly: Gather information from credible sources like scientific journals and official health organizations.
Organize your content: Structure your essay with an introduction, body paragraphs, and a conclusion.
Present facts clearly: Use clear, concise language to convey information accurately.
Include visuals: Use charts or graphs to illustrate data and make your essay more engaging.

How do I write an expository essay about COVID-19?

To write an expository essay about COVID-19, follow these steps:

Select a clear topic: Focus on a specific question or issue related to COVID-19.
Conduct thorough research: Use reliable sources to gather information.
Create an outline: Organize your essay with an introduction, body paragraphs, and a conclusion.
Explain the topic: Use facts and examples to explain the chosen aspect of COVID-19 in detail.
Maintain objectivity: Present information in a neutral and unbiased manner.
Edit and revise: Proofread your essay for clarity, coherence, and accuracy.

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Keep reading

Read these 12 moving essays about life during coronavirus

Artists, novelists, critics, and essayists are writing the first draft of history.

by Alissa Wilkinson

The world is grappling with an invisible, deadly enemy, trying to understand how to live with the threat posed by a virus . For some writers, the only way forward is to put pen to paper, trying to conceptualize and document what it feels like to continue living as countries are under lockdown and regular life seems to have ground to a halt.

So as the coronavirus pandemic has stretched around the world, it’s sparked a crop of diary entries and essays that describe how life has changed. Novelists, critics, artists, and journalists have put words to the feelings many are experiencing. The result is a first draft of how we’ll someday remember this time, filled with uncertainty and pain and fear as well as small moments of hope and humanity.

The Vox guide to navigating the coronavirus crisis

At the New York Review of Books, Ali Bhutto writes that in Karachi, Pakistan, the government-imposed curfew due to the virus is “eerily reminiscent of past military clampdowns”:

Beneath the quiet calm lies a sense that society has been unhinged and that the usual rules no longer apply. Small groups of pedestrians look on from the shadows, like an audience watching a spectacle slowly unfolding. People pause on street corners and in the shade of trees, under the watchful gaze of the paramilitary forces and the police.

His essay concludes with the sobering note that “in the minds of many, Covid-19 is just another life-threatening hazard in a city that stumbles from one crisis to another.”

Writing from Chattanooga, novelist Jamie Quatro documents the mixed ways her neighbors have been responding to the threat, and the frustration of conflicting direction, or no direction at all, from local, state, and federal leaders:

Whiplash, trying to keep up with who’s ordering what. We’re already experiencing enough chaos without this back-and-forth. Why didn’t the federal government issue a nationwide shelter-in-place at the get-go, the way other countries did? What happens when one state’s shelter-in-place ends, while others continue? Do states still under quarantine close their borders? We are still one nation, not fifty individual countries. Right?

A syllabus for the end of the world

Award-winning photojournalist Alessio Mamo, quarantined with his partner Marta in Sicily after she tested positive for the virus, accompanies his photographs in the Guardian of their confinement with a reflection on being confined :

The doctors asked me to take a second test, but again I tested negative. Perhaps I’m immune? The days dragged on in my apartment, in black and white, like my photos. Sometimes we tried to smile, imagining that I was asymptomatic, because I was the virus. Our smiles seemed to bring good news. My mother left hospital, but I won’t be able to see her for weeks. Marta started breathing well again, and so did I. I would have liked to photograph my country in the midst of this emergency, the battles that the doctors wage on the frontline, the hospitals pushed to their limits, Italy on its knees fighting an invisible enemy. That enemy, a day in March, knocked on my door instead.

In the New York Times Magazine, deputy editor Jessica Lustig writes with devastating clarity about her family’s life in Brooklyn while her husband battled the virus, weeks before most people began taking the threat seriously:

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

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

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

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

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

What day is it today?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Essay On Covid-19: 100, 200 and 300 Words

Updated on
Apr 30, 2024

COVID-19, also known as the Coronavirus, is a global pandemic that has affected people all around the world. It first emerged in a lab in Wuhan, China, in late 2019 and quickly spread to countries around the world. This virus was reportedly caused by SARS-CoV-2. Since then, it has spread rapidly to many countries, causing widespread illness and impacting our lives in numerous ways. This blog talks about the details of this virus and also drafts an essay on COVID-19 in 100, 200 and 300 words for students and professionals.

Table of Contents

1 Essay On COVID-19 in English 100 Words
2 Essay On COVID-19 in 200 Words
3 Essay On COVID-19 in 300 Words
4 Short Essay on Covid-19

Essay On COVID-19 in English 100 Words

COVID-19, also known as the coronavirus, is a global pandemic. It started in late 2019 and has affected people all around the world. The virus spreads very quickly through someone’s sneeze and respiratory issues.

COVID-19 has had a significant impact on our lives, with lockdowns, travel restrictions, and changes in daily routines. To prevent the spread of COVID-19, we should wear masks, practice social distancing, and wash our hands frequently.

People should follow social distancing and other safety guidelines and also learn the tricks to be safe stay healthy and work the whole challenging time.

Also Read: National Safe Motherhood Day 2023

Essay On COVID-19 in 200 Words

COVID-19 also known as coronavirus, became a global health crisis in early 2020 and impacted mankind around the world. This virus is said to have originated in Wuhan, China in late 2019. It belongs to the coronavirus family and causes flu-like symptoms. It impacted the healthcare systems, economies and the daily lives of people all over the world.

The most crucial aspect of COVID-19 is its highly spreadable nature. It is a communicable disease that spreads through various means such as coughs from infected persons, sneezes and communication. Due to its easy transmission leading to its outbreaks, there were many measures taken by the government from all over the world such as Lockdowns, Social Distancing, and wearing masks.

There are many changes throughout the economic systems, and also in daily routines. Other measures such as schools opting for Online schooling, Remote work options available and restrictions on travel throughout the country and internationally. Subsequently, to cure and top its outbreak, the government started its vaccine campaigns, and other preventive measures.

In conclusion, COVID-19 tested the patience and resilience of the mankind. This pandemic has taught people the importance of patience, effort and humbleness.

Essay On COVID-19 in 300 Words

COVID-19, also known as the coronavirus, is a serious and contagious disease that has affected people worldwide. It was first discovered in late 2019 in Cina and then got spread in the whole world. It had a major impact on people’s life, their school, work and daily lives.

COVID-19 is primarily transmitted from person to person through respiratory droplets produced and through sneezes, and coughs of an infected person. It can spread to thousands of people because of its highly contagious nature. To cure the widespread of this virus, there are thousands of steps taken by the people and the government.

Wearing masks is one of the essential precautions to prevent the virus from spreading. Social distancing is another vital practice, which involves maintaining a safe distance from others to minimize close contact.

Very frequent handwashing is also very important to stop the spread of this virus. Proper hand hygiene can help remove any potential virus particles from our hands, reducing the risk of infection.

In conclusion, the Coronavirus has changed people’s perspective on living. It has also changed people’s way of interacting and how to live. To deal with this virus, it is very important to follow the important guidelines such as masks, social distancing and techniques to wash your hands. Getting vaccinated is also very important to go back to normal life and cure this virus completely.

Also Read: Essay on Abortion in English in 650 Words

Short Essay on Covid-19

Please find below a sample of a short essay on Covid-19 for school students:

Also Read: Essay on Women’s Day in 200 and 500 words

to write an essay on COVID-19, understand your word limit and make sure to cover all the stages and symptoms of this disease. You need to highlight all the challenges and impacts of COVID-19. Do not forget to conclude your essay with positive precautionary measures.

Writing an essay on COVID-19 in 200 words requires you to cover all the challenges, impacts and precautions of this disease. You don’t need to describe all of these factors in brief, but make sure to add as many options as your word limit allows.

The full form for COVID-19 is Corona Virus Disease of 2019.

Simran Popli

An avid writer and a creative person. With an experience of 1.5 years content writing, Simran has worked with different areas. From medical to working in a marketing agency with different clients to Ed-tech company, the journey has been diverse. Creative, vivacious and patient are the words that describe her personality.

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

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

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

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

More from TIME

Read More: The Family Time the Pandemic Stole

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The Reintroduction of Kamala Harris
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Coronavirus: The world has come together to flatten the curve. Can we stay united to tackle other crises?

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Coronavirus Pandemic

Writing about COVID-19 in a college admission essay

by: Venkates Swaminathan | Updated: September 14, 2020

Print article

Writing about COVID-19 in your college admission essay

For students applying to college using the CommonApp, there are several different places where students and counselors can address the pandemic’s impact. The different sections have differing goals. You must understand how to use each section for its appropriate use.

The CommonApp COVID-19 question

First, the CommonApp this year has an additional question specifically about COVID-19 :

Community disruptions such as COVID-19 and natural disasters can have deep and long-lasting impacts. If you need it, this space is yours to describe those impacts. Colleges care about the effects on your health and well-being, safety, family circumstances, future plans, and education, including access to reliable technology and quiet study spaces. Please use this space to describe how these events have impacted you.

This question seeks to understand the adversity that students may have had to face due to the pandemic, the move to online education, or the shelter-in-place rules. You don’t have to answer this question if the impact on you wasn’t particularly severe. Some examples of things students should discuss include:

The student or a family member had COVID-19 or suffered other illnesses due to confinement during the pandemic.
The candidate had to deal with personal or family issues, such as abusive living situations or other safety concerns
The student suffered from a lack of internet access and other online learning challenges.
Students who dealt with problems registering for or taking standardized tests and AP exams.

Jeff Schiffman of the Tulane University admissions office has a blog about this section. He recommends students ask themselves several questions as they go about answering this section:

Are my experiences different from others’?
Are there noticeable changes on my transcript?
Am I aware of my privilege?
Am I specific? Am I explaining rather than complaining?
Is this information being included elsewhere on my application?

If you do answer this section, be brief and to-the-point.

Counselor recommendations and school profiles

Second, counselors will, in their counselor forms and school profiles on the CommonApp, address how the school handled the pandemic and how it might have affected students, specifically as it relates to:

Grading scales and policies
Graduation requirements
Instructional methods
Schedules and course offerings
Testing requirements
Your academic calendar
Other extenuating circumstances

Students don’t have to mention these matters in their application unless something unusual happened.

Writing about COVID-19 in your main essay

Write about your experiences during the pandemic in your main college essay if your experience is personal, relevant, and the most important thing to discuss in your college admission essay. That you had to stay home and study online isn’t sufficient, as millions of other students faced the same situation. But sometimes, it can be appropriate and helpful to write about something related to the pandemic in your essay. For example:

One student developed a website for a local comic book store. The store might not have survived without the ability for people to order comic books online. The student had a long-standing relationship with the store, and it was an institution that created a community for students who otherwise felt left out.
One student started a YouTube channel to help other students with academic subjects he was very familiar with and began tutoring others.
Some students used their extra time that was the result of the stay-at-home orders to take online courses pursuing topics they are genuinely interested in or developing new interests, like a foreign language or music.

Experiences like this can be good topics for the CommonApp essay as long as they reflect something genuinely important about the student. For many students whose lives have been shaped by this pandemic, it can be a critical part of their college application.

Want more? Read 6 ways to improve a college essay , What the &%$! should I write about in my college essay , and Just how important is a college admissions essay? .

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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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Essay on COVID-19 Pandemic

As a result of the COVID-19 (Coronavirus) outbreak, daily life has been negatively affected, impacting the worldwide economy. Thousands of individuals have been sickened or died as a result of the outbreak of this disease. When you have the flu or a viral infection, the most common symptoms include fever, cold, coughing up bone fragments, and difficulty breathing, which may progress to pneumonia. It’s important to take major steps like keeping a strict cleaning routine, keeping social distance, and wearing masks, among other things. This virus’s geographic spread is accelerating (Daniel Pg 93). Governments restricted public meetings during the start of the pandemic to prevent the disease from spreading and breaking the exponential distribution curve. In order to avoid the damage caused by this extremely contagious disease, several countries quarantined their citizens. However, this scenario had drastically altered with the discovery of the vaccinations. The research aims to investigate the effect of the Covid-19 epidemic and its impact on the population’s well-being.

There is growing interest in the relationship between social determinants of health and health outcomes. Still, many health care providers and academics have been hesitant to recognize racism as a contributing factor to racial health disparities. Only a few research have examined the health effects of institutional racism, with the majority focusing on interpersonal racial and ethnic prejudice Ciotti et al., Pg 370. The latter comprises historically and culturally connected institutions that are interconnected. Prejudice is being practiced in a variety of contexts as a result of the COVID-19 outbreak. In some ways, the outbreak has exposed pre-existing bias and inequity.

Thousands of businesses are in danger of failure. Around 2.3 billion of the world’s 3.3 billion employees are out of work. These workers are especially susceptible since they lack access to social security and adequate health care, and they’ve also given up ownership of productive assets, which makes them highly vulnerable. Many individuals lose their employment as a result of lockdowns, leaving them unable to support their families. People strapped for cash are often forced to reduce their caloric intake while also eating less nutritiously (Fraser et al, Pg 3). The epidemic has had an impact on the whole food chain, revealing vulnerabilities that were previously hidden. Border closures, trade restrictions, and confinement measures have limited farmer access to markets, while agricultural workers have not gathered crops. As a result, the local and global food supply chain has been disrupted, and people now have less access to healthy foods. As a consequence of the epidemic, many individuals have lost their employment, and millions more are now in danger. When breadwinners lose their jobs, become sick, or die, the food and nutrition of millions of people are endangered. Particularly severely hit are the world’s poorest small farmers and indigenous peoples.

Infectious illness outbreaks and epidemics have become worldwide threats due to globalization, urbanization, and environmental change. In developed countries like Europe and North America, surveillance and health systems monitor and manage the spread of infectious illnesses in real-time. Both low- and high-income countries need to improve their public health capacities (Omer et al., Pg 1767). These improvements should be financed using a mix of national and foreign donor money. In order to speed up research and reaction for new illnesses with pandemic potential, a global collaborative effort including governments and commercial companies has been proposed. When working on a vaccine-like COVID-19, cooperation is critical.

The epidemic has had an impact on the whole food chain, revealing vulnerabilities that were previously hidden. Border closures, trade restrictions, and confinement measures have limited farmer access to markets, while agricultural workers have been unable to gather crops. As a result, the local and global food supply chain has been disrupted, and people now have less access to healthy foods (Daniel et al.,Pg 95) . As a consequence of the epidemic, many individuals have lost their employment, and millions more are now in danger. When breadwinners lose their jobs, the food and nutrition of millions of people are endangered. Particularly severely hit are the world’s poorest small farmers and indigenous peoples.

While helping to feed the world’s population, millions of paid and unpaid agricultural laborers suffer from high levels of poverty, hunger, and bad health, as well as a lack of safety and labor safeguards, as well as other kinds of abuse at work. Poor people, who have no recourse to social assistance, must work longer and harder, sometimes in hazardous occupations, endangering their families in the process (Daniel Pg 96). When faced with a lack of income, people may turn to hazardous financial activities, including asset liquidation, predatory lending, or child labor, to make ends meet. Because of the dangers they encounter while traveling, working, and living abroad; migrant agricultural laborers are especially vulnerable. They also have a difficult time taking advantage of government assistance programs.

The pandemic also has a significant impact on education. Although many educational institutions across the globe have already made the switch to online learning, the extent to which technology is utilized to improve the quality of distance or online learning varies. This level is dependent on several variables, including the different parties engaged in the execution of this learning format and the incorporation of technology into educational institutions before the time of school closure caused by the COVID-19 pandemic. For many years, researchers from all around the globe have worked to determine what variables contribute to effective technology integration in the classroom Ciotti et al., Pg 371. The amount of technology usage and the quality of learning when moving from a classroom to a distant or online format are presumed to be influenced by the same set of variables. Findings from previous research, which sought to determine what affects educational systems ability to integrate technology into teaching, suggest understanding how teachers, students, and technology interact positively in order to achieve positive results in the integration of teaching technology (Honey et al., 2000). Teachers’ views on teaching may affect the chances of successfully incorporating technology into the classroom and making it a part of the learning process.

In conclusion, indeed, Covid 19 pandemic have affected the well being of the people in a significant manner. The economy operation across the globe have been destabilized as most of the people have been rendered jobless while the job operation has been stopped. As most of the people have been rendered jobless the living conditions of the people have also been significantly affected. Besides, the education sector has also been affected as most of the learning institutions prefer the use of online learning which is not effective as compared to the traditional method. With the invention of the vaccines, most of the developed countries have been noted to stabilize slowly, while the developing countries have not been able to vaccinate most of its citizens. However, despite the challenge caused by the pandemic, organizations have been able to adapt the new mode of online trading to be promoted.

Ciotti, Marco, et al. “The COVID-19 pandemic.” Critical reviews in clinical laboratory sciences 57.6 (2020): 365-388.

Daniel, John. “Education and the COVID-19 pandemic.” Prospects 49.1 (2020): 91-96.

Fraser, Nicholas, et al. “Preprinting the COVID-19 pandemic.” BioRxiv (2021): 2020-05.

Omer, Saad B., Preeti Malani, and Carlos Del Rio. “The COVID-19 pandemic in the US: a clinical update.” Jama 323.18 (2020): 1767-1768.

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Iran J Med Sci
v.45(4); 2020 Jul

A Narrative Review of COVID-19: The New Pandemic Disease

Kiana shirani, md.

1 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Erfan Sheikhbahaei, MD

2 Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Zahra Torkpour, MD

Mazyar ghadiri nejad, phd.

3 Industrial Engineering Department, Girne American University, Kyrenia, TRNC, Turkey

Bahareh Kamyab Moghadas, PhD

4 Department of Chemical Engineering, Shiraz Branch, Islamic Azad University, Shiraz, Iran

Matina Ghasemi, PhD

5 Faculty of Business and Economics, Business Department, Girne American University, Kyrenia, TRNC, Turkey

Hossein Akbari Aghdam, MD

6 Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Athena Ehsani, PhD

7 Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran

Saeed Saber-Samandari, PhD

8 New Technologies Research Center, Amirkabir University of Technology, Tehran, Iran

Amirsalar Khandan, PhD

9 Department of Electrical Engineering, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

10 0Technology Incubator Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Nearly every 100 years, humans collectively face a pandemic crisis. After the Spanish flu, now the world is in the grip of coronavirus disease 2019 (COVID-19). First detected in 2019 in the Chinese city of Wuhan, COVID-19 causes severe acute respiratory distress syndrome. Despite the initial evidence indicating a zoonotic origin, the contagion is now known to primarily spread from person to person through respiratory droplets. The precautionary measures recommended by the scientific community to halt the fast transmission of the disease failed to prevent this contagious disease from becoming a pandemic for a whole host of reasons. After an incubation period of about two days to two weeks, a spectrum of clinical manifestations can be seen in individuals afflicted by COVID-19: from an asymptomatic condition that can spread the virus in the environment, to a mild/moderate disease with cold/flu-like symptoms, to deteriorated conditions that need hospitalization and intensive care unit management, and then a fatal respiratory distress syndrome that becomes refractory to oxygenation. Several diagnostic modalities have been advocated and evaluated; however, in some cases, diagnosis is made on the clinical picture in order not to lose time. A consensus on what constitutes special treatment for COVID-19 has yet to emerge. Alongside conservative and supportive care, some potential drugs have been recommended and a considerable number of investigations are ongoing in this regard

What’s Known

Substantial numbers of articles on COVID-19 have been published, yet there is controversy among clinicians and confusion among the general population in this regard. Furthermore, it is unreasonable to expect physicians to read all the available literature on this subject.

What’s New

This article reviews high-quality articles on COVID-19 and effectively summarizes them for healthcare providers and the general population.

Introduction

A pathogen from a human-animal virus family, the coronavirus (CoV), which was identified as the main cause of respiratory tract infections, evolved to a novel and wild kind in Wuhan, a city in Hubei Province of China, and spread throughout the world, such that it created a pandemic crisis according to the World Health Organization (WHO). CoV is a large family of viruses that were first discovered in 1960. These viruses cause such diseases as common colds in humans and animals. Sometimes they attack the respiratory system, and sometimes their signs appear in the gastrointestinal tract. There have been different types of human CoV including CoV-229E, CoV-OC43, CoV-NL63, and CoV-HKU1, with the latter two having been discovered in 2004 and 2005, respectively. These types of CoV regularly cause respiratory infections in children and adults. 1 There are also other types of these viruses that are associated with more severe symptoms. The new CoV, scientifically known as “SARS-CoV-2”, causes severe acute respiratory syndrome (SARS). 2 A newer type of the virus was discovered in September 2012 in a 60-year-old man in Saudi Arabia who died of the disease; the man had traveled to Dubai a few days earlier. The second case was a 49-year-old man in Qatar who also passed away. The discovery was first confirmed at the Health Protection Agency’s Laboratory in Colindale, London. The outbreak of this CoV is known as the Middle East Respiratory Syndrome (MERS), commonly referred to as “MERS-CoV”. The virus has infected 2260 people and has killed 912, most of them in the Middle East. 3 - 5 Finally, in December 2019, for the first time in Wuhan, in Hubei Province of China, a new type of CoV was identified that caused pneumonia in humans. 6 SARS-CoV-2 has affected 5404512 people and killed more than 343514 around the world according to the WHO situation report-127 (May 26, 2020). 3 , 7 - 10 The WHO has officially termed the disease “COVID-19”, which refers to corona, the virus, the disease, the year 2019, and its etiology (SARS-CoV-2). This type of CoV had never been seen in humans before. The initial estimates showed a mortality rate ranging from between 1% and 3% in most countries to 5% in the worst-hit areas ( Figure 1 ). 9 Some Chinese researchers succeeded in determining how SARS-CoV-2 affects human cells, which could help to develop techniques of viral detection and had antiviral therapy potential. Via a process termed “cryogenic electron microscopy (cryo-EM)”, these scientists discovered that CoV enters human cells utilizing a kind of cell membrane glycoprotein: angiotensin-converting enzyme 2 (ACE2). Then, the S protein is split into two sub-units: S1 and S2. S1 keeps a receptor-binding domain (RBD); accordingly, SARS-CoV-2 can bind to the peptidase domain of ACE2 directly. It appears that S2 subsequently plays a role in cellular fusion. Chinese researchers used the cryo-EM technique to provide ACE2 when it is linked to an amino acid transporter called “B0AT1”. They also discovered how to connect SARS-CoV-2 to ACE2-B0AT1, which is another complex structure. Given that none of these molecular structures was previously known, the researchers hoped that these studies would lead to the development of an antiviral or vaccine that would help to prevent CoV. Along the way, scientists found that ACE2 has to undergo a molecular process in which it binds to another molecule to be activated. The resulting molecule can bind two SARS-CoV-2 protein molecules simultaneously. The scientists also studied different SARS-CoV-2 RBD binding methods compared with other SARS-CoV-RBDs, which showed how subtle changes in the molecular binding sequence make the coronal structure of the virus stronger.

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Most cases with SARS-CoV-2 are asymptomatic or have mild clinical pictures such as influenza and colds. This group of patients should be detected and isolated in their homes to break the transmission chain of the disease and adhere to the precautionary recommendations in order not to infect other people. The screening process will help this group and suppress the outbreak in the community. Patients with the confirmed disease who are admitted to hospitals can contaminate this environment, which should be borne in mind by healthcare providers and policymakers.

Transmission

While the first mode of the transmission of COVID-19 to humans is still unknown, a seafood market where live animals were sold was identified as a potential source at the beginning of the outbreak in the epidemiologic investigations that found some infected patients who had visited or worked in that place. The other viruses in this family, namely MERS and SARS, were both confirmed to be zoonotic viruses. Afterward, the person-to-person spread was established as the main mode of transmission and the reason for the progression of the outbreak. 11 Similar to the influenza virus, SARS-CoV-2 spreads through the population via respiratory droplets. When an infected person coughs, sneezes, or talks, the respiratory secretions, which contain the virus, enter the environment as droplets. These droplets can reach the mucous membranes of individuals directly or indirectly when they touch an infected surface or any other source; the virus, thereafter, finds its ways to the eyes, nose, or mouth as the first incubation places. 11 - 15 It has been reported that droplets cannot travel more than two meters in the air, nor can they remain in the air owing to their high density. Nonetheless, given the other hitherto unknown modes of transmission, routine airborne transmission precautions should be considered in high-risk countries and during high-risk procedures such as manual ventilation with bags and masks, endotracheal intubation, open endotracheal suctioning, bronchoscopy, cardiopulmonary resuscitation, sputum induction, lung surgery, nebulizer therapy, noninvasive positive pressure ventilation (eg, bilevel positive airway pressure and continuous positive airway pressure ), and lung autopsy. In the early stages of the disease, the chances of the spread of the virus to other persons are high because the viral load in the body may be high despite the absence of any symptoms ( Figure 2 ). 11 - 13 The person-to-person transmission rates can be different depending on the location and the infection control intervention; still, according to the latest reports, the secondary COVID-19 infection rate ranges from 1% to 5%. 13 - 23 Although the RNA of the virus has been detected in blood and stool, fecal-oral and blood-borne transmissions are not regarded as significant modes of transmission yet. 19 - 26 There have been no reports of mother-to-fetus transmission in pregnant women. 27

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SARS-CoV-2 mode of transmission and clinical manifestations are illustrated in this figure. The potential source of this outbreak was identified to be from animals, similar to MERS and SARS, in epidemiologic studies; nonetheless, person-to-person transmission through droplets is currently the important mode. After reaching mucous membranes by direct or indirect close contact, the virus replicates in the cells and the immune system attacks the body due to its nature. Afterward, the clinical pictures appear, which are much more similar to influenza. However, different patients will have a spectrum of signs and symptoms.

Source Investigation

Recently, the appearance of SARS-CoV-2 in society shocked the healthcare system. 28 - 32 Veterinary corona virologists reported that COVID-19 was isolated from wildlife. Several studies have shown that bats are receptors of the CoV new version in 2019 with variants and changes in the environment featuring various biological characteristics. 33 - 36 The aforementioned mammals are a major source of CoV, which causes mild-to-severe respiratory illness and can even be deadly. In recent years, the virus has killed several thousands of people of all ages. 37 - 39 The mutated alternative of the virus can be transmitted to humans and cause acute respiratory distress. 40 , 41 One of the main causes of the spread of the virus is the exotic and unusual Chinese food in Wuhan: CoV is a direct result of the Chinese food cycle. The virus is found in the body of animals such as bats, 42 and snake or bat soup is a favorite Chinese food. Therefore, this sequence is replicated continuously. Almost everyone who was infected for the first time was directly in the local Wuhan market or had indirectly tried snake or bat soup in a Chinese restaurant. An investigation stated that the Malayan pangolin (Manis javanica) was a possible host for SARS-CoV-2 and recommended that it be removed from the wet market to prevent zoonotic transmissions in the future. 43 , 44

Pathogenesis

The important mechanisms of the severe pathogenesis of SARS-CoV-2 are not fully understood. Extensive lung injury in SARS-CoV-2 has been related to increased virus titers; monocyte, macrophage, and neutrophil infiltrations into the lungs; and elevated levels of pro-inflammatory cytokines and chemokines. Thus, the clinical exacerbation of SARS-CoV-2 infection may be in consequence of a combination of direct virus-induced cytopathic and immunopathological effects due to excessive cytokinesis. Changes in the cytokine/chemokine profile during SARS infection showed increased levels of circulating cytokines such as tumor necrosis factor-α (TNF-α), C–X–C motif chemokine 10 (CXCL10), interleukin (IL)-6, and IL-8 levels, in conjunction with elevated levels of serum pro-inflammatory cytokines such as IL-1, IL-6, IL-12, interferon-gamma (IFN-γ), and transforming growth factor-β (TGF-β). Nevertheless, constant stimulation by the virus creates a cytokine storm that has been related to acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndromes (MODS) in patients with COVID-19, which may ultimately lead to diminished immunity by lowering the number of CD4+ and CD8+ T cells and natural killer cells (crucial in antiviral immunity) and decreasing cytokine production and functional ability (exhaustion). It has been shown that IL-10, an inhibitory cytokine, is a major player and a potential target for therapeutic aims. 45 - 51 Severe cases of COVID-19 have respiratory distress and failure, which has been linked to the altered metabolism of heme by SARS-CoV-2. Some virus proteins can dissociate iron from porphyrins by attacking the 1-β chain of hemoglobin, which decreases the oxygen-transferring ability of hemoglobin. Research has also indicated that chloroquine and favipiravir might inhibit this process. 52

Clinical Manifestations

SARS-CoV-2, which attacks the respiratory system, has a spectrum of manifestations; nonetheless, it has three main primary symptoms after an incubation period of about two days to two weeks: fever and its associated symptoms such as malaise/fatigue/weakness; cough, which is nonproductive in most of the cases but can be productive indeed; and shortness of breath (dyspnea) due to low blood oxygenation. Although these symptoms appear in the body of the affected person over two to 14 days, patients may refer to the clinic with gastrointestinal symptoms (nausea/vomiting-diarrhea) or decreased sense of smell and/or taste. More devastatingly, however, patients may refer to the emergency room with such coagulopathies as pulmonary thromboembolism, cerebral venous thrombosis, and other related manifestations. The WHO has stated that dry throat and dry cough are other symptoms detected in the early stages of the infection. 53 , 54 The estimations of the severity of the disease are as follows: mild (no or mild pneumonia) in 81%, severe (eg, with dyspnea, hypoxia, or >50% lung involvement on imaging within 24 to 48 hours) in 14%, and critical (eg, with respiratory failure, shock, or multiorgan dysfunction) in 5%. In the early stages, the overall mortality rate was 2.3% and no deaths were observed in non-severe patients. Patients with advanced age or underlying medical comorbidities have more mortality and morbidity. 55 Although adults of middle age and older are most commonly affected by SARS-CoV-2, individuals at any age can be infected. A few studies have reported symptomatic infection in children; still, when it occurs, it has mild symptoms. The vast majority of cases have the infection with no signs and symptoms or mild clinical pictures; they are called “the asymptomatic group”. These patients do not seek medical care and if they come into close contact with others, they can spread the virus. Therefore, quarantine in their home is the best option for the population to break the transmission of the virus. It should be considered that some of these asymptomatic patients have clinical signs such as chest computed tomography scan (CT-Scan) infiltrations. Similar to bacterial pneumonia, lower respiratory signs and symptoms are the most frequent manifestations in serious cases of COVID-19, characterized by fever, cough, dyspnea, and bilateral infiltrates on chest imaging. In a study describing pneumonia in Wuhan, the most common clinical signs and symptoms at the onset of the illness were fever in 99% (although fever might not be a universal finding), fatigue in 70%, dry cough in 59%, anorexia in 40%, myalgia in 35%, dyspnea in 31%, and sputum production in 27%. Headache, sore throat, and rhinorrhea are less common, and gastrointestinal symptoms (eg, nausea and diarrhea) are relatively rare. 7 , 42 , 43 , 45 - 48 , 56 , 57 According to our clinical experience in Iran, anosmia, atypical chest pain, diarrhea, nausea/vomiting, and hemoptysis are other presenting symptoms in the clinic. It should be noted that COVID-19 has some unexplained potential complications such as secondary bacterial infections, myocarditis, central nervous system injury, cerebral edema, MODS, acute demyelinating encephalomyelitis (ADEM), kidney injury, liver injury, new-onset seizure, coagulopathy, and arrhythmias.

Laboratory data : Complete blood counts, which constitute a routine laboratory test, have shown different results in terms of the white blood cell count: from leukopenia and lymphopenia to leukocytosis, although lymphopenia appears to be the most common. Fatal cases have exhibited severe lymphopenia accompanied by an increased level of D-dimer. Liver function enzymes can be increased; however, it is not sufficient to diagnose a disease. The serum procalcitonin level is a marker of infection, especially in bacterial diseases. Patients with COVID-19 who require intensive care unit (ICU) management may have elevated procalcitonin. Increased urea and creatinine, creatinine-phosphokinase, lactate dehydrogenase, and C-reactive protein are other findings in some cases. 7 , 56 , 57

Imaging studies : Routine chest X-ray (CXR) is widely deemed the first-step management to evaluate any respiratory involvement. Although negative findings in CXR do not rule out the viral disease, patients without common findings do not have severe disease and can, consequently, be managed in the outpatient setting. 58 , 59 Another modality is chest CT-Scan. It can be ordered in suspected cases with typical symptoms at the first step, or it can be performed after the detection of any abnormalities in CXR. The most common demonstrations in CT-Scan images are ground-glass opacification, round opacities, and crazy paving with or without bilateral consolidative abnormalities (multilobar involvement) in contrast to most cases of bacterial pneumonia, which have locally limited involvement. Pleural thickening, pleural effusion, and lymphadenopathy are less common. 58 - 61 Tree-in-bud, peribronchial distribution, nodules, and cavity are not in favor of common COVID-19 findings. Although reverse transcriptase-polymerase chain reaction (RT-PCR) is used to confirm the diagnosis, it is a time-consuming procedure and has high false-negative/false-positive findings; hence, in the emergency clinical setting, CT-Scan findings can be a good approach to make the diagnosis. It is deserving of note, however, that false-positive/false-negative cases were reported by one study to be high and other differential diagnoses should be in mind in order not to miss any other cases such as acute pulmonary edema in patients with heart disease.

Suspected cases should be diagnosed as soon as possible to isolate and control the infection immediately. COVID-19 should be considered in any patient with fever and/or lower respiratory tract symptoms with any of the following risk factors in the previous 2 weeks: close contact with confirmed or suspected cases in any environment, especially at work in healthcare places without sufficient protective equipment or long-time standing in those places, and living in or traveling from well-known places where the disease is an epidemic. 61 - 66 Patients with severe lower respiratory tract disease without alternative etiologies and a clear history of exposure should be considered having COVID-19 unless confirmed otherwise. According to the Centers for Disease Control and Prevention (CDC), sending tests to check SARS-CoV-2 in suspected cases is based on physicians’ clinical judgment. Although there are some positive cases without clinical manifestations (ie, fever and/or symptoms of acute respiratory illness such as cough and dyspnea), infectious disease and control centers should take action in society to limit the exposure of such patients to other healthy individuals. The CDC prioritizes the use of the specific test for hospitalized patients, symptomatic patients who are at risk of fatal conditions (eg, age ≥65 y, chronic medical conditions, and immunocompromising conditions) and those who have exposure risks (recent travel, contact with patients with COVID-19, and healthcare workers). 61 - 66 Although treatment should be started after the confirmation of the disease, RT-PCR for highly suspected cases is a time-consuming test; accordingly, a considerable number of clinicians favor the use of a combination of clinical manifestations with imaging modalities (eg, CT-Scan findings) and their clinical judgment regarding the probability of the disease in order not to lose more time. 61 - 66

Treatment of COVID-19

There is no confirmed recommended treatment or vaccine for SARS-CoV-2; prevention is, therefore, better than treatment. Nevertheless, the high contagiousness of COVID-19, combined with the fact that some individuals fail to adhere to precautionary measures or they have significant risk factors, means that this infectious disease is inevitable in some people. Beside supportive treatments, many types of medications have been introduced. These medications come from previous experimental studies on SARS, MERS, influenza, or human immunodeficiency virus (HIV); hence, their efficacy needs further experimental and clinical approval. Patients with mild symptoms who do not have significant risk factors should be managed in their home like a self-made quarantine (in an isolated room); still, prompt hospital admission is required if patients exhibit signs of disease deterioration. 25 , 67 , 68 Isolation from other family members is an important prevention tip. Patients should wear face masks, eat healthy and warm foods similar to when struggling with influenza or colds, do the handwashing process, dispose of the contaminated materials cautiously, and disinfect suspicious surfaces with standard disinfectants. 69 Patients with severe symptoms or admission criteria should be hospitalized with other patients who have the same disease in an isolated department. When the disease is progressed, ICU care is mandatory. 25 , 67 , 68 SARS-CoV-2 attacks the respiratory system, diminishing the oxygenation process and forcing patients with low blood oxygen saturation to take extra oxygen from different modalities. Nasal cannulae, face masks with or without a reservoir, intubation in severe cases, and then extracorporeal membrane oxygenation in refractory hypoxia have been used; however, the safety and efficacy of these measures should be evaluated. As was mentioned above, impaired coagulation is one of the major complications of the disease; consequently, alongside all recommended supportive care and drugs, anticoagulants such as heparin should be administered prophylactically ( Table 1 ). Although it is said that all the clinical signs and symptoms of COVID-19 are induced by the immune system, as other research on influenza and MERS has revealed, glucocorticoids are not recommended in COVID-19 pneumonia unless other indications are present (eg, exacerbation of chronic obstructive pulmonary disease and refractory septic shock) due to the high risk of mortality and delayed viral clearance. Earlier in the national and international guidelines, nonsteroidal anti-inflammatory drugs such as naproxen were recommended on the strength of their antipyretic and anti-inflammatory components; however, the guideline has been revised recently and acetaminophen with or without codeine is currently the favored drug in patients with COVID-19. 25 , 67 , 68 According to the pathogenesis of the disease, whereby cytokine storm and immune-cell exhaustion can be seen in severe cases, selective antibodies against harmful interleukins such as IL-6 and IL-10 or other possible agents can be therapeutic for fatal complications. Tocilizumab, an IL-6 inhibitor, albeit with limited clinical efficacy, has been introduced in China’s National Health Commission treatment guideline for severe infection with profound pulmonary involvement (ie, white lung). 70 , 87

Summary of possible anti-COVID-19 drugs

Drug Name	Mechanism of Action	Regimen	References
Hydroxychloroquine sulfate	Antigen-presenting cell lysosomal pH modulator; toll-like receptor family inhibitor; hemozoin biocrystalization inhibitor; altering the ACE2 glycosylation, which inhibits S-protein binding and phagocytosis	First day, 400 mg BD and then, 200 mg BD	, -
Chloroquine phosphate	Late endosomal and lysosomal pH enhancer, zinc ionophore (RdRP inhibitor)	First day 500 mg BD and then, 250 mg BD	, -
Lopinavir/Ritonavir	Combined protease inhibitor	400 mg/100 mg BD	, , , - , ,
Atazanavir/Ritonavir	Combined protease inhibitor	300 mg/100 mg once daily	,
Atazanavir	Protease inhibitor	400 mg once daily	,
Favipiravir	RdRP inhibitor	Loading dose, 1600 mg and then, 600 mg TDS	, ,
Remdesivir	RdRP inhibitor	First day, 200 mg IV daily and then, 100 mg IV daily	, , - ,
Ribavirin	RdRP inhibitor	1200 mg BD	-
Oseltamivir	Neuraminidase inhibitors	75 mg BD	,
Interferon-β-1a	Antiviral cytokine	22 or 44 μg 3 times/week	, , ,

mg, Milligrams; BD, Every 12 hours; RdRP, RNA-dependent RNA polymerase; TDS, Every 8 hours; IV, Intravenous; IL, Interleukin; μg, Micrograms

RNA synthesis inhibitors (eg, tenofovir disoproxil fumarate and 2’-deoxy-3’-thiacytidine [3TC]), neuraminidase inhibitors (NAIs), nucleoside analogs, lopinavir/ritonavir, atazanavir, remdesivir, favipiravir, INF-β, and Chinese traditional medicine (eg, Shufeng Jiedu and Lianhuaqingwen capsules) are the major candidates for COVID-19. 26 , 70 , 85 , 88 - 96 Antiviral drugs have been investigated for various diseases, but their efficacy in the treatment of COVID-19 is under investigation and several randomized clinical trials are ongoing to release a consensus result on the treatment of this infectious disease. Moderate-to-severe SARS-CoV-2 disease needs drug therapy. Favipiravir, a previously validated drug for influenza, is a drug that has shown promising results for COVID-19 in experimental and clinical studies, but it is under further evaluation. 70 , 79 , 80 Remdesivir, which was developed for Ebola, is an antiviral drug that is under evaluation for moderate-to-severe COVID-19 owing to its promising results in in vitro investigations. 70 , 73 - 75 , 81 Remdesivir was shown to have reduced the virus titer in infected mice with MERS-CoV and improved lung tissue damage with more efficiency compared with a group treated with lopinavir/ritonavir/INF-β. 67 , 70 Another investigation studied the potential efficacy of INF-β-1 in the early stages of COVID-19 as a potential antiviral drug. 86 Although there is some hope, an evidence-based consensus requires further clinical trials. 70 , 77 A combined protease inhibitor, lopinavir/ritonavir, is used for HIV infection and has shown interesting results for SARS and MERS in in vitro studies. 73 - 75 The clinical effectiveness of lopinavir/ritonavir for SARS-CoV-2 was also reported in a case report. 70 , 71 , 74 , 76 Atazanavir, another protease inhibitor, with or without ritonavir is another possible anti-COVID-19 treatment. 77 , 78 NAIs, including oseltamivir, zanamivir, and peramivir, are recommended as antiviral treatment in influenza. 68 Oral oseltamivir was tried for COVID-19 in China and was first recommended in the Iranian guideline for COVID-19 treatment; nevertheless, because of the absence of strong evidence indicating its efficacy for SARS-CoV-2, it was eliminated from the subsequent updates of the guideline. 85 RNA-dependent RNA polymerase inhibitors with anti-hepatitis C effects such as ribavirin have shown satisfactory results against SARS-CoV-2 RNA polymerase; however, they have limited clinical approval. 82 - 84 The well-known drugs for rheumatoid arthritis, systemic lupus erythematosus, and an antimalarial drug, chloroquine 71 and hydroxychloroquine 21 are other potential drugs for moderate-to-severe COVID-19 but with limited or no clinical appraisal. Hydroxychloroquine has exhibited better safety and fewer side effects than chloroquine, which makes it the preferred choice. 70 Furthermore, the immunomodulatory effects of hydroxychloroquine can be used to control the cytokine precipitation in the late phases of SARS-CoV-2 infections. There are numerous mechanisms for the antiviral activity of hydroxychloroquine. A weak base drug, hydroxychloroquine concentrates on such intracellular sections as endosomes and lysosomes, thereby halting viral replication in the phase of fusion and uncoating. Additionally, this immunosuppressive and antiparasitic drug is capable of altering the glycosylation of ACE2 and inhibiting both S-protein binding and phagocytosis. 72 A recent multicenter study showed that regarding the risks of cardiovascular adverse effects and mortality rates, hydroxychloroquine or chloroquine with or without a macrolide (eg, azithromycin) was not beneficial for hospitalized patients, although further research is needed to end such controversies. 97

Disease Duration

It is not easy to quarantine the patients who have fully recovered because there is evidence that they are highly infectious. 81 The recovery time for confirmed cases based on the National Health Commission reports of China’s government was estimated to range between 18 and 22 days. 73 As indicated by the WHO, the healing time seems to be around two weeks for moderate infections and 3 to 6 weeks for the severe/ serious disease. 75 Pan Feng and others studied 21 confirmed cases with COVID-19 pneumonia with about 82 CT-Scan images with a mean interval of four days. Lung abnormalities on chest CT showed the highest severity approximately 10 days after the initial onset of symptoms. All patients became clear after 11 to 26 days of hospitalization. From day zero to day 26, four stages of lung CT were defined as follows: Stage 1 (first 4 days): ground-glass opacities; Stage 2 (second 4 days): crazy-paving patterns; Stage 3 (days 9–13): maximum total CT scores in the consolidations; and Stage 4 (≥14 d): steady improvements in the consolidations with a reduction in the total CT score without any crazy-paving pattern. 74 Nevertheless, there are also rare cases reported from some studies that show the recurrence of COVID-19 after negative preliminary RT-PCR results. For example, Lan and othersstudied one hospitalized and three home-quarantined patients with COVID-19 and evaluated them with RT-PCR tests of the nucleic acid. All the patients with positive RT-PCR test results had CT imaging with ground-glass opacification or mixed ground-glass opacification and consolidation with mild-to-moderate disease. After antiviral treatments, all four patients had two consecutive negative RT-PCR test results within 12 to 32 days. Five to 13 days after hospital discharge or the discontinuation of the quarantine, RT-PCR tests were repeated, and all were positive. An additional RT-PCR test was performed using a kit from a different manufacturer, and the results were also positive. Their findings propose that a minimum percentage of recovered patients may still be infection carriers. 76

Supplements for COVID-19

Since the appearance of SARS-CoV-2 in Wuhan, China, there have been reports of the unreliable and unpredictable use of mysterious therapies. Some recommendations such as the use of certain herbs and extracts including oregano oil, mulberry leaf, garlic, and black sesame may be safe as long as people do not utilize their hands for instance. 98 According to data released by the CDC, vitamin C (VitC) supplements can decrease the risk of colds in people besides preventing CoV from spreading. The aforementioned organization states that frequent consumption of VitC supplements can also decrease the duration of the cold; however, if used only after the cold has risen, its consumption does not influence the disease course. VitC also plays an important role in the body. One of the main reasons for taking VitC is to strengthen the immune system because this vitamin plays a significant part in the immune system. Firstly, VitC can increase the production of white blood cells (lymphocytes and phagocytes) in the bone marrow, which can support and protect the body against infections. Secondly, VitC helps immune cells to function better while preserving white blood cells from damaging molecules such as free oxidative radicals and ions. Thirdly, VitC is an essential part of the skin’s immune system. This vitamin is actively transported to the skin surface, where it serves as an antioxidant and helps to strengthen the skin barrier by optimizing the collagen synthesis process. Patients with pneumonia have lower levels of VitC and have been revealed to have a longer recovery time. 69 , 99 In a randomized investigation, 200 mg/d of VitC was applied to older patients and resulted in improvements in the respiratory symptoms. Another investigation reported 80% fewer mortalities in a controlled group of VitC takers. 73 However, for effective immune system improvement, VitC should be consumed alongside adequate doses of several other supplements. Although VitC plays an important role in the body, often a balanced diet and the consumption of fresh fruits and vegetables can quickly fill the blanks. While taking high amounts of VitC is less risky because it is water-soluble and its waste is eliminated in the urine, it can induce diarrhea, nausea, and abdominal spasms at higher concentrations. Too much VitC may cause calcium-oxalate kidney stones. People with genetic hemochromatosis, an iron deficiency disorder, should consult a physician before taking any VitC supplements as high levels of VitC can lead to tissue damage. Some studies have evaluated the different doses of oral or intravenous VitC for patients admitted to the hospital for COVID-19. Although they used different regimens, all of them demonstrated satisfactory results regarding the resolution of the compilations of the disease, decreased mortality, and shortened lengths of stay in the ICU and/or the hospital. 100 , 101 Immunologists have also recommended 6 000 units of vitamin A (VitA) per day for two weeks, more than twice the recommended limit for VitA, which can create a poisoning environment over time. According to the guidance of the National Institutes of Health (NIH), middle-aged men and women should take 1 and 2 mg of VitA every day, respectively. The safe upper limit of this vitamin is 6000 mg or 5000 units, and overdose can have serious outcomes such as dizziness, nausea, headache, coma, and even death. Extreme consumption of VitA throughout pregnancy can lead to birth anomalies.

Similar to VitC, vitamin D (VitD) has antioxidant, anti-inflammatory, and immune-modulatory effects in our body such as reducing pro-inflammatory cytokines and inhibiting viral replication according to experimental studies. 83 The VitD state of our body is checked through 25 (OH) VitD in the serum. VitD deficiency is pandemic around the world due to multifactorial reasons. It has been shown that VitD deficient patients are prone to SARS-CoV-2 and, accordingly, treating VitD deficiency is not without benefits. Grant and others recommended 10 000 units per day for two weeks and then 5 000 units per day as the maintenance dose to keep the level between 40 and 100 ng/mL. 102 VitD toxicity causes gastrointestinal discomfort (dyspepsia), congestion, hypercalcemia, confusion, positional disorders, dysrhythmia, and kidney dysfunction.

James Robb, 103 a researcher who detected CoV for the first time as a consultant pathologist with the National Cancer Institute of America, suggested the influence of zinc consumption. Oral zinc supplements can be dissolved in the nback of the throat. Short-term therapy with oral zinc can decrease the duration of viral colds in adults. Zinc intake is also associated with the faster resolution of nasal congestion, nasal drainage, sore throats, and coughs. Researchers 104 , 105 have warned that the consumption of more than 1 mg of zinc a day can lead to zinc poisoning and have side effects such as lowered immune function. Children and old people with zinc insufficiency in developing nations are extremely vulnerable to pneumonia and other viral infections. It has also been determined that zinc has a major role in the production and activation of T-cell lymphocytes. 106 , 107

And finally, for high-risk people or those who work in high-risk places such as healthcare providers, hydroxychloroquine has been mentioned to be effective as a prophylactic regimen ( Table 2 ). Although different doses have been investigated so far, Pourdowlat and others recommended 200 mg daily before exposure, and for the post-exposure scenario, a loading dose of 600-800 mg followed by a maintenance dose of 200 mg daily. 74

Possible prophylactic regimens against SARS-CoV-2 infection

Agent	Mechanism of Action	Regimen	Reference
VitA	Antioxidant, anti-inflammatory, immune-regulatory agent	6 000 IU/d for 2 weeks	-
VitC		1)intravenous 200 mg/kg body weight/d, divided into 4 doses for ICU-care patients 2)oral 6 g/d 3)one 10–20 g IV (max: 1.5 g/kg)	-
VitD		10 000 IU/d for 2 weeks until the 25(OH)Vit D level reaches 40–60 ng/mL and then 5 000 IU/d
Zinc	Antioxidant, anti-inflammatory, immune-regulatory agent, intracellular signal molecule in immune cells, RdRP inhibitor	Max: 1 mg/d	-
Hydroxychloroquine sulfate	Antigen-presenting cell lysosomal pH modulator; toll-like receptor family inhibitor; hemozoin biocrystalization inhibitor; altering the ACE2 glycosylation, which inhibits S-protein binding and phagocytosis	200 mg/d

IU, International unit; mg, Milligrams; kg, Kilograms; ICU, Intensive care unit; g, Grams; IV, Intravenous; Vit, Vitamin; ng, Nanograms; mL, Milliliter

COVID-19 Kits and Deep Learning

COVID-19 has threatened public health, and its fast global spread has caught the scientific community by surprise. 108 Hence, developing a technique capable of swiftly and reliably detecting the virus in patients is vital to prevent the spreading of the virus. 109 , 110 One of the ways to diagnose this new virus is through RT-PCR, a test that has previously demonstrated its efficacy in detecting such CoV infections as MERS-CoV and SARS-CoV. Consequently, increasing the availability of RT-PCR kits is a worldwide concern. The timing of the RT-PCR test and the type of strain collected are of vital importance in the diagnosis of COVID-19. One of the characteristics of this new virus is that the serum is negative in the early stage, while respiratory specimens are positive. The level of the virus at the early stage of the illness is also high, even though the infected individual experiences mild symptoms. 111 For the management of the emerging situation of COVID-19 in Wuhan, various effective diagnostic kits were urgently made available to markets. While a few different diagnostics kits are used merely for research endeavors, only a single kit developed by the Beijing Genome Institute (BGI) called “Real-Time Fluorescent PCR” has been authenticated for clinical diagnostics. Fluorescent RT-PCR is reliable and able to offer fast results probably within a few hours (usually within two hours). Besides RT-PCR, China has successfully developed a metagenomic-sequencing kit based on combinatorial probe-anchor synthesis that can identify virus-related bacteria, allowing observation and evaluation during the transmission of the virus. Furthermore, the metagenomic-sequencing kit based on combinatorial probe-anchor synthesis is far faster than the abovementioned fluorescent RT-PCR kit. Apart from China, a Singapore-based laboratory, Veredus, developed a virus detection kit (Vere-CoV) in late January. It is a portable Lab-On-Chip used to detect MERS-CoV, SARS-CoV, and SARS-CoV-2, in a single examination. This kit works based on the VereChip™ technology, the lines of code (LOC) program incorporating two different influential molecular biological functions (microarray and PCR) precisely. Several studies have focused on SARS-CoV diagnostic testing. These papers have presented investigative approaches to the identification of the virus using molecular testing (ie, RT-PCR). Researchers probed into the use of a nested PCR technique that contains a pre-amplification step or integrating the N gene as an extra subtle molecular marker to improve on the sensitivity. 112 - 115 CT-Scan is very useful for diagnosing, evaluating, and screening infections caused by COVID-19. One recommendation for scanning the disease is to take a scan every three to five days. According to researchers, most CT-Scan images from patients with COVID-19 are bilateral or peripheral ground-glass opacification, with or without stabilization. Nowadays, because of a paucity of computerized quantification tools, only qualitative reports and sometimes inaccurate analyses of contaminated areas are drawn upon in radiology reports. A categorization system based on the deep learning approach was proposed by a study to automatically measure infected parts and their volumetric ratios in the lung. The functionality of this system was evaluated by making some comparisons between the infected portions and the manually-delineated ones on the CT-Scan images of 300 patients with COVID-19. To increase the manual drawing of training samples and the non-interference in the automated results, researchers adopted a human-based approach in collaboration with radiologists so as to segment the infected region. This approach shortens the time to about four minutes after 3-time updating. The mean Dice similarity coefficient illustrated that the automatically detected infected parts were 91.6% similar to the manually detected ones, and the average of the percentage estimated error was 0.3% for the whole lung. 116 , 117

Prevention Considerations

In the healthcare setting, any individual with the manifestations of COVID-19 (eg, fever, cough, and dyspnea) should wear a face mask, have a separate waiting area, and keep the distance of at least two meters. Symptomatic patients should be asked about recent travel or close contact with a patient in the preceding two weeks to find other possible infected patients. The CDC and WHO have announced special precautions for healthcare providers in the hospital and during different procedures. Wearing tight-fitting face masks with special filters and impermeable face shields is necessary for all of them. 11 , 18 , 65 , 66 , 76 , 118 - 124 Other people should pay attention to the CDC and WHO preventive strategies, which recommend that individuals not touch their eyes, mouth, and nose before washing or disinfecting their hands; wash their hands regularly according to the standard protocol; use effective disinfection solutions (ie, containing at least 60% ethylic alcohol) for contaminated surfaces; cover their mouth when coughing and sneezing; avoid waiting or walking in crowded areas, and observe isolation protocols in their home. Postponing elective work and decreasing non-urgent visits and traveling to areas in the grip of COVID-19 may be useful to lessen the risk of exposure. If suspected individuals with mild symptoms are managed in outpatient settings, an isolated room with minimal exposure to others should be designed. Patients and their caregivers should wear tight-fitting face masks. 11 , 18 , 65 , 66 , 76 , 118 - 124 Substantial numbers of individuals with COVID-19 are asymptomatic with potential exposure; accordingly, a screening tool should be employed to evaluate these cases. In addition to passport checks, corona checks have been incorporated into the protocols in airports and other crowded places. The use of a remote thermometer to measure body temperature leads to an increase in the number of false-negative cases. It is, thus, essential that everyone pay sufficient heed to the WHO and CDC recommendations in their daily life. Traveling is not prohibited, but it should be restricted and passengers from any country should be monitored. 11 , 18 , 65 , 66 , 76 , 118 - 124

SARS-CoV-2 is the new highly contagious CoV, which was first reported in China. While it had a zoonotic origin in the beginning, it subsequently spread throughout the world by human contact. COVID-19 has a spectrum of manifestations, which is not lethal most of the time. To diagnose this condition, physicians can avail themselves of laboratory and imaging findings besides signs and symptoms. RT-PCR is the gold standard, but it lacks sufficient sensitivity and specificity. Although there are some potential drugs for COVID-19 and some vitamins or minerals for prophylaxis, the best preventive strategies are quarantine (staying at home) and the use of personal protective equipment and disinfectants.

Acknowledgement

The authors express their gratitude toward the Supporting Organizations for Foreign Iranian Students, Islamic Azad University Isfahan (Khorasgan) Branch, and Isfahan University of Medical Sciences.

Conflict of Interest: None declared.

How COVID-19 pandemic changed my life



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Table of Contents

Introduction

The COVID-19 pandemic is one of the biggest challenges that our world has ever faced. People around the globe were affected in some way by this terrible disease, whether personally or not. Amid the COVID-19 pandemic, many people felt isolated and in a state of panic. They often found themselves lacking a sense of community, confidence, and trust. The health systems in many countries were able to successfully prevent and treat people with COVID-19-related diseases while providing early intervention services to those who may not be fully aware that they are infected (Rume & Islam, 2020). Personally, this pandemic has brought numerous changes and challenges to my life. The COVID-19 pandemic affected my social, academic, and economic lifestyle positively and negatively.

Social and Academic Changes

One of the changes brought by the pandemic was economic changes that occurred very drastically (Haleem, Javaid, & Vaishya, 2020). During the pandemic, food prices started to rise, affecting the amount of money my parents could spend on goods and services. We had to reduce the food we bought as our budgets were stretched. My family also had to eliminate unhealthy food bought in bulk, such as crisps and chocolate bars. Furthermore, the pandemic made us more aware of the importance of keeping our homes clean, especially regarding cooking food. Lastly, it also made us more aware of how we talked to other people when they were ill and stayed home with them rather than being out and getting on with other things.

Furthermore, COVID-19 had a significant effect on my academic life. Immediately, measures to curb the pandemic were announced, such as closing all learning institutions in the country; my school life changed. The change began when our school implemented the online education system to ensure that we continued with our education during the lockdown period. At first, this affected me negatively because when learning was not happening in a formal environment, I struggled academically since I was not getting the face-to-face interaction with the teachers I needed. Furthermore, forcing us to attend online caused my classmates and me to feel disconnected from the knowledge being taught because we were unable to have peer participation in class. However, as the pandemic subsided, we grew accustomed to this learning mode. We realized the effects on our performance and learning satisfaction were positive, as it seemed to promote emotional and behavioral changes necessary to function in a virtual world. Students who participated in e-learning during the pandemic developed more ownership of the course requirement, increased their emotional intelligence and self-awareness, improved their communication skills, and learned to work together as a community.

If there is an area that the pandemic affected was the mental health of my family and myself. The COVID-19 pandemic caused increased anxiety, depression, and other mental health concerns that were difficult for my family and me to manage alone. Our ability to learn social resilience skills, such as self-management, was tested numerous times. One of the most visible challenges we faced was social isolation and loneliness. The multiple lockdowns made it difficult to interact with my friends and family, leading to loneliness. The changes in communication exacerbated the problem as interactions moved from face-to-face to online communication using social media and text messages. Furthermore, having family members and loved ones separated from us due to distance, unavailability of phones, and the internet created a situation of fear among us, as we did not know whether they were all right. Moreover, some people within my circle found it more challenging to communicate with friends, family, and co-workers due to poor communication skills. This was mainly attributed to anxiety or a higher risk of spreading the disease. It was also related to a poor understanding of creating and maintaining relationships during this period.

Positive Changes

In addition, this pandemic has brought some positive changes with it. First, it had been a significant catalyst for strengthening relationships and neighborhood ties. It has encouraged a sense of community because family members, neighbors, friends, and community members within my area were all working together to help each other out. Before the pandemic, everybody focused on their business, the children going to school while the older people went to work. There was not enough time to bond with each other. Well, the pandemic changed that, something that has continued until now that everything is returning to normal. In our home, it strengthened the relationship between myself and my siblings and parents. This is because we started spending more time together as a family, which enhanced our sense of understanding of ourselves.

The pandemic has been a challenging time for many people. I can confidently state that it was a significant and potentially unprecedented change in our daily life. By changing how we do things and relate with our family and friends, the pandemic has shaped our future life experiences and shown that during crises, we can come together and make a difference in each other’s lives. Therefore, I embrace wholesomely the changes brought by the COVID-19 pandemic in my life.

Haleem, A., Javaid, M., & Vaishya, R. (2020). Effects of COVID-19 pandemic in daily life. Current medicine research and practice , 10 (2), 78.
Rume, T., & Islam, S. D. U. (2020). Environmental effects of COVID-19 pandemic and potential strategies of sustainability. Heliyon , 6 (9), e04965.
☠️ Assisted Suicide
Affordable Care Act
Breast Cancer
Genetic Engineering

8 Lessons We Can Learn From the COVID-19 Pandemic

BY KATHY KATELLA May 14, 2021

Rear view of a family standing on a hill in autumn day, symbolizing hope for the end of the COVID-19 pandemic

Note: Information in this article was accurate at the time of original publication. Because information about COVID-19 changes rapidly, we encourage you to visit the websites of the Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), and your state and local government for the latest information.

The COVID-19 pandemic changed life as we know it—and it may have changed us individually as well, from our morning routines to our life goals and priorities. Many say the world has changed forever. But this coming year, if the vaccines drive down infections and variants are kept at bay, life could return to some form of normal. At that point, what will we glean from the past year? Are there silver linings or lessons learned?

“Humanity's memory is short, and what is not ever-present fades quickly,” says Manisha Juthani, MD , a Yale Medicine infectious diseases specialist. The bubonic plague, for example, ravaged Europe in the Middle Ages—resurfacing again and again—but once it was under control, people started to forget about it, she says. “So, I would say one major lesson from a public health or infectious disease perspective is that it’s important to remember and recognize our history. This is a period we must remember.”

We asked our Yale Medicine experts to weigh in on what they think are lessons worth remembering, including those that might help us survive a future virus or nurture a resilience that could help with life in general.

Lesson 1: Masks are useful tools

What happened: The Centers for Disease Control and Prevention (CDC) relaxed its masking guidance for those who have been fully vaccinated. But when the pandemic began, it necessitated a global effort to ensure that everyone practiced behaviors to keep themselves healthy and safe—and keep others healthy as well. This included the widespread wearing of masks indoors and outside.

What we’ve learned: Not everyone practiced preventive measures such as mask wearing, maintaining a 6-foot distance, and washing hands frequently. But, Dr. Juthani says, “I do think many people have learned a whole lot about respiratory pathogens and viruses, and how they spread from one person to another, and that sort of old-school common sense—you know, if you don’t feel well—whether it’s COVID-19 or not—you don’t go to the party. You stay home.”

Masks are a case in point. They are a key COVID-19 prevention strategy because they provide a barrier that can keep respiratory droplets from spreading. Mask-wearing became more common across East Asia after the 2003 SARS outbreak in that part of the world. “There are many East Asian cultures where the practice is still that if you have a cold or a runny nose, you put on a mask,” Dr. Juthani says.

She hopes attitudes in the U.S. will shift in that direction after COVID-19. “I have heard from a number of people who are amazed that we've had no flu this year—and they know masks are one of the reasons,” she says. “They’ve told me, ‘When the winter comes around, if I'm going out to the grocery store, I may just put on a mask.’”

Lesson 2: Telehealth might become the new normal

What happened: Doctors and patients who have used telehealth (technology that allows them to conduct medical care remotely), found it can work well for certain appointments, ranging from cardiology check-ups to therapy for a mental health condition. Many patients who needed a medical test have also discovered it may be possible to substitute a home version.

What we’ve learned: While there are still problems for which you need to see a doctor in person, the pandemic introduced a new urgency to what had been a gradual switchover to platforms like Zoom for remote patient visits.

More doctors also encouraged patients to track their blood pressure at home , and to use at-home equipment for such purposes as diagnosing sleep apnea and even testing for colon cancer . Doctors also can fine-tune cochlear implants remotely .

“It happened very quickly,” says Sharon Stoll, DO, a neurologist. One group that has benefitted is patients who live far away, sometimes in other parts of the country—or even the world, she says. “I always like to see my patients at least twice a year. Now, we can see each other in person once a year, and if issues come up, we can schedule a telehealth visit in-between,” Dr. Stoll says. “This way I may hear about an issue before it becomes a problem, because my patients have easier access to me, and I have easier access to them.”

Meanwhile, insurers are becoming more likely to cover telehealth, Dr. Stoll adds. “That is a silver lining that will hopefully continue.”

Lesson 3: Vaccines are powerful tools

What happened: Given the recent positive results from vaccine trials, once again vaccines are proving to be powerful for preventing disease.

What we’ve learned: Vaccines really are worth getting, says Dr. Stoll, who had COVID-19 and experienced lingering symptoms, including chronic headaches . “I have lots of conversations—and sometimes arguments—with people about vaccines,” she says. Some don’t like the idea of side effects. “I had vaccine side effects and I’ve had COVID-19 side effects, and I say nothing compares to the actual illness. Unfortunately, I speak from experience.”

Dr. Juthani hopes the COVID-19 vaccine spotlight will motivate people to keep up with all of their vaccines, including childhood and adult vaccines for such diseases as measles , chicken pox, shingles , and other viruses. She says people have told her they got the flu vaccine this year after skipping it in previous years. (The CDC has reported distributing an exceptionally high number of doses this past season.)

But, she cautions that a vaccine is not a magic bullet—and points out that scientists can’t always produce one that works. “As advanced as science is, there have been multiple failed efforts to develop a vaccine against the HIV virus,” she says. “This time, we were lucky that we were able build on the strengths that we've learned from many other vaccine development strategies to develop multiple vaccines for COVID-19 .”

Lesson 4: Everyone is not treated equally, especially in a pandemic

What happened: COVID-19 magnified disparities that have long been an issue for a variety of people.

What we’ve learned: Racial and ethnic minority groups especially have had disproportionately higher rates of hospitalization for COVID-19 than non-Hispanic white people in every age group, and many other groups faced higher levels of risk or stress. These groups ranged from working mothers who also have primary responsibility for children, to people who have essential jobs, to those who live in rural areas where there is less access to health care.

“One thing that has been recognized is that when people were told to work from home, you needed to have a job that you could do in your house on a computer,” says Dr. Juthani. “Many people who were well off were able do that, but they still needed to have food, which requires grocery store workers and truck drivers. Nursing home residents still needed certified nursing assistants coming to work every day to care for them and to bathe them.”

As far as racial inequities, Dr. Juthani cites President Biden’s appointment of Yale Medicine’s Marcella Nunez-Smith, MD, MHS , as inaugural chair of a federal COVID-19 Health Equity Task Force. “Hopefully the new focus is a first step,” Dr. Juthani says.

Lesson 5: We need to take mental health seriously

What happened: There was a rise in reported mental health problems that have been described as “a second pandemic,” highlighting mental health as an issue that needs to be addressed.

What we’ve learned: Arman Fesharaki-Zadeh, MD, PhD , a behavioral neurologist and neuropsychiatrist, believes the number of mental health disorders that were on the rise before the pandemic is surging as people grapple with such matters as juggling work and childcare, job loss, isolation, and losing a loved one to COVID-19.

The CDC reports that the percentage of adults who reported symptoms of anxiety of depression in the past 7 days increased from 36.4 to 41.5 % from August 2020 to February 2021. Other reports show that having COVID-19 may contribute, too, with its lingering or long COVID symptoms, which can include “foggy mind,” anxiety , depression, and post-traumatic stress disorder .

“We’re seeing these problems in our clinical setting very, very often,” Dr. Fesharaki-Zadeh says. “By virtue of necessity, we can no longer ignore this. We're seeing these folks, and we have to take them seriously.”

Lesson 6: We have the capacity for resilience

What happened: While everyone’s situation is different (and some people have experienced tremendous difficulties), many have seen that it’s possible to be resilient in a crisis.

What we’ve learned: People have practiced self-care in a multitude of ways during the pandemic as they were forced to adjust to new work schedules, change their gym routines, and cut back on socializing. Many started seeking out new strategies to counter the stress.

“I absolutely believe in the concept of resilience, because we have this effective reservoir inherent in all of us—be it the product of evolution, or our ancestors going through catastrophes, including wars, famines, and plagues,” Dr. Fesharaki-Zadeh says. “I think inherently, we have the means to deal with crisis. The fact that you and I are speaking right now is the result of our ancestors surviving hardship. I think resilience is part of our psyche. It's part of our DNA, essentially.”

Dr. Fesharaki-Zadeh believes that even small changes are highly effective tools for creating resilience. The changes he suggests may sound like the same old advice: exercise more, eat healthy food, cut back on alcohol, start a meditation practice, keep up with friends and family. “But this is evidence-based advice—there has been research behind every one of these measures,” he says.

But we have to also be practical, he notes. “If you feel overwhelmed by doing too many things, you can set a modest goal with one new habit—it could be getting organized around your sleep. Once you’ve succeeded, move on to another one. Then you’re building momentum.”

Lesson 7: Community is essential—and technology is too

What happened: People who were part of a community during the pandemic realized the importance of human connection, and those who didn’t have that kind of support realized they need it.

What we’ve learned: Many of us have become aware of how much we need other people—many have managed to maintain their social connections, even if they had to use technology to keep in touch, Dr. Juthani says. “There's no doubt that it's not enough, but even that type of community has helped people.”

Even people who aren’t necessarily friends or family are important. Dr. Juthani recalled how she encouraged her mail carrier to sign up for the vaccine, soon learning that the woman’s mother and husband hadn’t gotten it either. “They are all vaccinated now,” Dr. Juthani says. “So, even by word of mouth, community is a way to make things happen.”

It’s important to note that some people are naturally introverted and may have enjoyed having more solitude when they were forced to stay at home—and they should feel comfortable with that, Dr. Fesharaki-Zadeh says. “I think one has to keep temperamental tendencies like this in mind.”

But loneliness has been found to suppress the immune system and be a precursor to some diseases, he adds. “Even for introverted folks, the smallest circle is preferable to no circle at all,” he says.

Lesson 8: Sometimes you need a dose of humility

What happened: Scientists and nonscientists alike learned that a virus can be more powerful than they are. This was evident in the way knowledge about the virus changed over time in the past year as scientific investigation of it evolved.

What we’ve learned: “As infectious disease doctors, we were resident experts at the beginning of the pandemic because we understand pathogens in general, and based on what we’ve seen in the past, we might say there are certain things that are likely to be true,” Dr. Juthani says. “But we’ve seen that we have to take these pathogens seriously. We know that COVID-19 is not the flu. All these strokes and clots, and the loss of smell and taste that have gone on for months are things that we could have never known or predicted. So, you have to have respect for the unknown and respect science, but also try to give scientists the benefit of the doubt,” she says.

“We have been doing the best we can with the knowledge we have, in the time that we have it,” Dr. Juthani says. “I think most of us have had to have the humility to sometimes say, ‘I don't know. We're learning as we go.’"

Information provided in Yale Medicine articles is for general informational purposes only. No content in the articles should ever be used as a substitute for medical advice from your doctor or other qualified clinician. Always seek the individual advice of your health care provider with any questions you have regarding a medical condition.

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

Joint statement by ilo, fao, ifad and who.

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

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

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

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

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

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

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

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

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

Media Contacts

Kimberly Chriscaden

Communications Officer World Health Organization

Nutrition and Food Safety (NFS) and COVID-19

Open access
Published: 26 August 2024

Paramedics’ experiences and observations: work-related emotions and well-being resources during the initial months of the COVID-19 pandemic—a qualitative study

Henna Myrskykari 1 , 2 &
Hilla Nordquist 3

BMC Emergency Medicine volume 24 , Article number: 152 ( 2024 ) Cite this article

Metrics details

As first responders, paramedics are an extremely important part of the care chain. COVID-19 significantly impacted their working circumstances. We examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic.

This qualitative study utilized reflective essay material written by experienced, advanced-level Finnish paramedics ( n = 30). The essays used in this study were written during the fall of 2020 and reflected the period when Finland had declared a state of emergency (on 17.3.2020) and the Emergency Powers Act was implemented. The data was analyzed using an inductive thematic analysis.

The emotions experienced by the EMS personnel in their new working circumstances formed three themes: (1) New concerns arose that were constantly present; (2) Surviving without proper guidance; and (3) Rapidly approaching breaking point. Three themes were formed from work-related factors that were identified as resources for the well-being of the EMS personnel. These were: (1) A high level of organizational efficiency was achieved; (2) Adaptable EMS operations; and (3) Encouraging atmosphere.

Conclusions

Crisis management practices should be more attentive to personnel needs, ensuring that managerial and psychological support is readily available in crisis situations. Preparedness that ensures effective organizational adaptation also supports personnel well-being during sudden changes in working circumstances.

Peer Review reports

At the onset of the COVID-19 pandemic, healthcare personnel across the globe faced unprecedented challenges. As initial responders in emergency healthcare, paramedics were quickly placed at the front lines of the pandemic, dealing with a range of emergencies in unpredictable conditions [ 1 ]. The pandemic greatly changed the everyday nature of work [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Those working on the front line were suddenly forced to adjust to personal protective equipment (PPE) requirements [ 9 , 10 ] and rapidly changing instructions that caused significant adjustments to their job description [ 11 , 12 ]. For instance, it has been reported that during the initial stages of the COVID-19 pandemic, Emergency Medical Services (EMS) personnel, including paramedics working in prehospital emergency care, experienced a significant increase in stress [ 10 , 13 ] due to several reasons, such as the lack of protection and support, increased demands, lack of personnel, fear of exposure to COVID-19 during missions, concerns of spreading the virus to family members, and frustration over quickly changing work policies [ 11 , 14 , 15 ].

With the unprecedented challenges posed by the COVID-19 pandemic, some research has been directed toward identifying available resources that help in coping with such situations. For example, Sangal et al. [ 15 ] underscored the association between effective communication and reduced work stress and burnout, and emphasized the critical need for two-way communication, consistent messaging, and the strategic consolidation of information prior to its dissemination. In parallel, Dickson et al. [ 16 ] highlight the pivotal role of leadership strategies in fostering a healthful work environment. These strategies include being relationally engaging, visibly present, open, and caring for oneself and others, while embodying core values such as compassion, empathy, courage, and authenticity. Moreover, Awais et al. [ 14 ] identify essential measures to reduce mental distress and support EMS personnel’s overall well-being in pandemic conditions, such as by providing accessible mental health and peer support, ensuring a transparent information flow, and the implementation of clear, best-practice protocols and guidelines. As a lesson learned from COVID-19, Kihlström et al. (2022) add that crisis communication, flexible working conditions, compensation, and allowing for mistakes should be part of crisis management. They also emphasize the importance of psychological support for employees. [ 12 ]

Overall, the COVID-19 pandemic had a multifaceted impact on EMS personnel, highlighting the necessity for comprehensive support and resilience strategies to safeguard their well-being [ 11 , 17 , 18 ] alongside organizational functions [ 12 , 19 ]. For example, in Finland, it has been noted in the aftermath of COVID-19 that the availability and well-being of healthcare workers are key vulnerabilities of the resilience of the Finnish health system [ 12 ]. Effective preparedness planning and organizational resilience benefit from learning from past events and gaining a deeper understanding of observations across different organizational levels [ 12 , 19 , 20 ]. For these reasons, it is important to study how the personnel experienced the changing working circumstances and to recognize the resources, even unexpected ones, that supported their well-being during the initial phase of the COVID-19 pandemic [ 12 , 19 ].

The aim of this study was to examine the emotions experienced and the resources identified as supportive of work well-being during the initial months of the COVID-19 pandemic, from the perspective of the paramedics. Our research questions were: According to the experiences and observations of paramedics, (1) what kinds of emotions did the EMS personnel experience in the new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic? In this study, emotions are understood as complex responses involving psychological, physiological, and behavioral components, triggered by significant events or situations [ 21 ]. Resources are understood as physical, psychological, social, or organizational aspects of the work that help achieve work goals, reduce demands and associated costs [ 22 ].

Materials and methods

This qualitative study utilized reflective essay material written in the fall of 2020 by experienced, advanced-level paramedics who worked in the Finnish EMS during the early phase of the pandemic, when Finland had declared (March 17, 2020 onward) a state of emergency and implemented the Emergency Powers Act. This allowed for new rules and guidelines from the government to ensure the security of healthcare resources. Some work rules for healthcare personnel changed, and non-urgent services were limited.

Data collection procedures

This study is part of a broader, non-project-based research initiative investigating the work well-being of paramedics from various perspectives, and the data was collected for research purposes from this standpoint. The data collection for this study was conducted at the South-Eastern Finland University of Applied Sciences as part of the Current Issues in EMS Management course. The course participants were experienced, advanced-level Finnish paramedics who were students of the master’s degree program in Development and Management of Emergency Medical Services. A similar data collection method has been utilized in other qualitative studies [for example, 23 , 24 ].

The South-Eastern Finland University of Applied Sciences granted research permission for the data collection on August 20, 2020. The learning platform “Learn” (an adapted version of Moodle [ 25 ]) was used to gather the data. A research notice, privacy statement, and essay writing instructions were published on the platform on August 21, 2020. The paramedics were asked to write about their own experiences and observations regarding how the state of emergency impacted the work well-being of EMS personnel. They were instructed not to use references but only their own reflections. Three guiding questions were asked: “What kind of workloads did EMS personnel experience during the state of emergency?” “How has this workload differed from normal conditions?” and “What effects did this workload have on the well-being of the EMS personnel?”. The assignment did not refer solely to paramedics because the EMS field community may also include individuals with other titles (such as EMS field supervisors or firefighters performing prehospital emergency care); hence the term “EMS personnel” was used.

The essay was part of the mandatory course assignments, but submitting it for research purposes was voluntary. The paramedics were informed that their participation in the study would not affect their course evaluations. They had the freedom to decline, remove parts of, or withdraw the essay before analysis. None of the paramedics exercised these options. They were also informed that the last author removes any identifying details (such as names, places, and organizational descriptions that could reveal their workplace) before sharing the data with other, at the time unnamed, researchers. The last author (female) is a senior researcher specializing in EMS and work well-being topics, a principal lecturer of the respective course, and the head of the respective master’s program, and familiar to all of them through their studies. The paramedics were aware that the essays were graded by the last author on a pass/fail scale as part of the course assessment. However, comprehensive and well-reasoned reflections positively influenced the course grade. The evaluation was not part of this study. The paramedics had the opportunity to ask further questions about the study directly from the last author during and after the essay writing process and the course.

The paramedics wrote the essays between August 23, 2020, and November 30, 2020. Thirty-two paramedics (out of 39) returned their essays using the Learn platform during this timeframe. Thus, seven of the course completions were delayed, and the essays written later were no longer appropriate to include in the data due to the time elapsed since the initial months of the COVID-19 pandemic.

All 32 gave their informed consent for their essays to be included in the study. Essays written by paramedics who had not actively participated in EMS field work during exceptional circumstances were excluded from the material ( n = 2), because they wrote the essay from a different perspective, as they could not reflect on their own experiences and observations. Thus, a total of 30 essays were included in the study. The total material was 106 pages long and comprised 32,621 words in Finnish.

Study participants

Thirty advanced-level paramedics from Finland participated in this study. They all had a bachelor’s degree in emergency care or nursing with additional emergency care specialization. At the time of the study, they were pursuing their master’s studies. Thirteen of them were women, and seventeen were men. The average age of the participants was 33.5 years among women and 35.9 years among men. Women had an average of 8.7 years of work experience, and men had 8.8 years. All the participating paramedics worked in EMS in different areas across Finland (except northern Finland) during their studies and the early phase of the pandemic.

Data analysis

The data was analyzed with a thematic analysis following the process detailed by Braun & Clarke [ 26 ]. First, the two researchers thoroughly familiarized themselves with the data, and the refined aim and research questions of the study were formulated inductively in collaboration based on the content of the data (see [ 26 ], page 84). After this, a thorough coding process was mainly carried out by the first author (female), who holds a master’s degree, is an advanced-level paramedic who worked in EMS during the pandemic, and at the time of the analysis was pursuing her doctoral studies in a different subject area related to EMS. Generating the initial codes involved making notes of interesting features of anything that stood out or seemed relevant to the research question systematically across the entire dataset. During this process, the original paragraphs and sentences were copied from the essay material into a table in Microsoft Word, with each research question in separate documents and each paragraph or sentence in its own row. The content of these data extracts was then coded in the adjacent column, carefully preserving the original content but in a more concise form. Then, the content was analyzed, and codes were combined to identify themes. After that, the authors reviewed the themes together by moving back and forth between the original material, the data in the Word documents, and the potential themes. During this process, the authors worked closely and refined the themes, allowing them to be separated and combined into new themes. For example, emotions depicting frustration and a shift to indifference formed their own theme in this kind of process. Finally, the themes were defined into main, major and minor themes and named. In the results, the main themes form the core in response to the research questions and include the most descriptions from the data. The major themes are significant but not as central as the main themes. Major themes provide additional depth and context to the results. One minor theme was formed as the analysis process progressed, and it provided valuable insights and details that deepened the response to the research question. All the coded data was utilized in the formed themes. The full content of the themes is reported in the Results section.

The emotions experienced by the EMS personnel in their new working circumstances formed three themes: New concerns arose that were constantly present (main theme); Surviving without proper guidance (major theme); and Rapidly approaching breaking point (major theme) (Fig. 1 ). Work-related factors identified as resources for the well-being of EMS personnel formed three themes: A high level of organizational efficiency was achieved (main theme); Adaptable EMS operations (major theme); and Encouraging atmosphere (minor theme) (Fig. 2 ).

Emotions experienced by the EMS personnel in their new working circumstances

Main theme: New concerns arose that were constantly present

The main theme included several kinds of new concerns. In the beginning, the uncertainty about the virus raised concerns about work safety and the means to prevent the spread of the disease. The initial lack of training and routines led to uncertainty. In addition, the decrease in the number of EMS missions raised fears of units being reduced and unilateral decisions by the management to change the EMS personnel’s work responsibilities. The future was also a source of uncertainty in the early stages. For example, the transition to exceptional circumstances, concerns about management and the supervisors’ familiarity with national guidelines and lack of information related to sickness absence procedures, leave, personal career progression, and even the progress of vaccine development, all contributed to this feeling of uncertainty. The initial uncertainty was described as the most challenging phase, but the uncertainty was also described as long-lasting.

Being on the front line with an unknown, potentially dangerous, and easily transmissible virus caused daily concerns about the personnel’s own health, especially when some patients hid their symptoms. The thought of working without proper PPE was frightening. On the other hand, waiting for a patient’s test result was stressful, as it often resulted in many colleagues being quarantined. A constant concern for the health of loved ones and the fear of contracting the virus and unknowingly bringing it home or transmitting it to colleagues led the EMS personnel to change their behavior by limiting contact.

Being part of a high-risk group , I often wondered , in the case of coronavirus , who would protect me and other paramedics from human vanity and selfishness [of those refusing to follow the public health guidelines]? (Participant 25)

The EMS personnel felt a weight of responsibility to act correctly, especially from the perspective of keeping their skills up to date. The proper selection of PPE and aseptic procedures were significant sources of concern, as making mistakes was feared to lead to quarantine and increase their colleagues’ workloads. At the same time, concerns about the adequacy of PPE weighed on the personnel, and they felt pressure on this matter to avoid wastage of PPEs. The variability in the quality of PPE also caused concerns.

Concerns about acting correctly were also tied to ethical considerations and feelings of inadequacy when the personnel were unable to explain to patients why COVID-19 caused restrictions on healthcare services. The presence of students also provoked such ethical concerns. Recognizing patients’ symptoms correctly also felt distressing due to the immense responsibility. This concern was also closely tied to fear and even made some question their career choices. The EMS personnel were also worried about adequate treatment for the patients and sometimes felt that the patients were left alone at home to cope. A reduction in patient numbers in the early stages of the pandemic raised concerns about whether acutely ill individuals were seeking help. At the same time, the time taken to put on PPE stressed the personnel because it increased delays in providing care. In the early phase of the pandemic, the EMS personnel were stressed that patients were not protected from them.

I’m vexed in the workplace. I felt it was immediately necessary to protect patients from us paramedics as well. It wasn’t specifically called for , mostly it felt like everyone had a strong need to protect themselves. (Participant 30)

All these concerns caused a particularly heavy psychological burden on some personnel. They described feeling more fatigued and irritable than usual. They had to familiarize themselves with new guidelines even during their free time, which was exhausting. The situation felt unjust, and there was a looming fear of the entire healthcare system collapsing. COVID-19 was omnipresent. Even at the base station of the EMS services, movement was restricted and social distancing was mandated. Such segregation, even within the professional community, added to the strain and reduced opportunities for peer support. The EMS personnel felt isolated, and thoughts about changing professions increased.

It was inevitable that the segregation of the work community would affect the community spirit , and a less able work community has a significant impact on the individual level. (Participant 8)

Major theme: Surviving without proper guidance

At the onset of the pandemic, the job description of the EMS personnel underwent changes, and employers could suddenly relocate them to other work. There was not always adequate support for familiarizing oneself with the new roles, leading to a feeling of loss of control. The management was described as commanding and restricting the personnel’s actions. As opportunities to influence one’s work diminished, the sense of job satisfaction and motivation decreased.

Some felt that leadership was inadequate and neglectful, especially when the leaders switched to remote work. The management did not take the situation seriously enough, leaving the EMS personnel feeling abandoned. The lack of consistent leadership and failure to listen to the personnel caused dissatisfaction and reduced occupational endurance. In addition, the reduced contact with colleagues and close ones reduced the amount of peer support. The existing models for psychological support were found to be inadequate.

Particularly in the early stages, guidelines were seen as ambiguous and deficient, causing frustration, irritation, and fear. The guidelines also changed constantly, even daily, and it was felt that the information did not flow properly from the management to the personnel. Changes in protection recommendations also led to skepticism about the correctness of the national guidance, and the lack of consistent guidelines perplexed the personnel. Internalizing the guidelines was not supported adequately, but the necessity to grasp new information was described as immense and cognitively demanding.

At times , it felt like the work was a kind of survival in a jungle of changing instructions , one mission at a time. (Participant 11)

Major theme: Rapidly approaching breaking point

Risking one’s own health at work caused contentious feelings while concurrently feeling angry that management could work remotely. The arrogant behavior of people toward COVID-19 left them frustrated, while the EMS personnel had to limit their contacts and lost their annual leave. There were fears about forced labor.

Incomplete and constantly changing guidelines caused irritation and indifference, as the same tasks had to be performed with different levels of PPE within a short time. Some guidelines were difficult to comply with in practice, which was vexing.

Using a protective mask was described as distressing, especially on long and demanding missions. Communication and operation became more difficult. Some described frustration with cleaning PPE meant for single use.

Ensuring the proper implementation of a work pair’s aseptic and equipment maintenance was burdensome, and explaining and repeating guidelines was exhausting. A feeling of indifference was emphasized toward the end of a long shift.

After the initial stage, many began to slip with the PPE guidelines and found the instructions excessive. COVID-19 information transmitted by the emergency center lost its meaning, and instructions were left unheeded, as there was no energy to believe that the patient would have COVID-19, especially if only a few disease cases had been reported in their area.

It was disheartening to hear personnel being labeled as selfish for demanding higher pay during exceptional circumstances. This lack of recognition eroded professionalism and increased thoughts of changing professions.

However , being a doormat and a human toilet , as well as a lack of appreciation , undermines my professionalism and the prolonged situation has led me to seriously consider a different job , where values other than dedication and constant flexibility carry weight. I have heard similar thoughts from other colleagues. None of us do this for money. (Participant 9)

Work-related factors identified as resources for the well-being of EMS personnel

Main theme: A high level of organizational efficiency was achieved

The main theme held several different efficient functions. In the early stages of the pandemic, some felt that the information flow was active. Organizations informed the EMS personnel about the disease, its spread, and its impact on the workplace and emergency care activities.

Some felt that managers were easily accessible during the pandemic, at least remotely. Some managers worked long days to be able to support their personnel.

The response to hate and uncertainty was that one of the supervisors was always present in the morning and evening meetings. Supervisors worked long hours so as to be accessible via remote access. (Participant 26)

The organizations took effective steps to control infections. Quick access to COVID-19 tests, clear guidelines for taking sick leave, and permission to take sick leave with a low threshold were seen as positive things. The consideration of personnel belonging to risk groups by moving them to other work tasks was also perceived as positive. In addition, efforts were made to prevent the emergence of infection chains by isolating EMS personnel in their own social facilities.

Established guidelines, especially on the correct use of protective measures, made it easier to work. Some mentioned that the guidelines were available in ambulances and on phones, allowing the protection guidelines to be checked before going on a mission.

The employers took into account the need for psychological support in a diverse manner. Some organizations provided psychological support such as peer debriefing activities, talking therapy with mental health professionals, actively inquiring about their personnel’s feelings, and training them as support workers. The pandemic situation also caused organizations to create their own standard operating models to decrease mental load.

Fortunately , the problem has now been addressed actively , as a peer-to-peer defusing model was built up at our workplace during the crisis , and group defusing has started , the purpose of which is to lighten the work-related mental load. (Participant 3)

Major theme: Adaptable EMS operations

There were several different resources that clarified mission activities. The amount of protective and cleaning equipment was ramped up, and the treatment equipment was quickly updated to meet the demands brought about by the pandemic and to enable safety distances for the EMS personnel. In addition, various guidelines were amended to reduce exposure. For example, personnel on the dedicated COVID-19 ambulances were separated to work without physical contact with others, and field supervisors joined the EMS missions less often than before. Moreover, people at the scene were contacted by phone in advance to ensure that there would be no exposure risk, which also allowed other occupational safety risks to be identified. New practices resulted from the pandemic, such as cleaning communication equipment during shift changes and regularly using PPE with infected patients. All of these were seen as positive resources for efficient work.

At the end of each shift , all keys , telephones , etc., were cleaned and handed over to the next shift. This practice was not previously established in our area , but this will become a permanent practice in the future and is perceived by everyone in our work community as a positive thing. (Participant 10)

Some stated that access to PPE was sufficient, especially in areas where the number of COVID-19 infections was low. PPE was upgraded to make it easier to wear. Further, organizations acquired a variety of cleaning equipment to speed up the disinfection of ambulances.

Organizations hired more employees to enable leave and the operation of dedicated COVID-19 ambulances. The overall number of ambulances was also increased. Non-urgent missions were handled through enhanced phone services, reducing the unnecessary exposure of EMS personnel to COVID-19.

Five extra holiday substitutes were hired for EMS so that the employer could guarantee the success of agreed leave , even if the Emergency Preparedness Act had given them opportunities to cancel or postpone it. (Participant 12)

Minor theme: Encouraging atmosphere

Peer support from colleagues, a positive, comfortable, pleasant work environment, and open discussion, as well as smooth cooperation with other healthcare employees were felt to be resources for work well-being by reducing the heavy workload experienced. Due to the pandemic, the appreciation of healthcare was felt to increase slightly, which was identified as a resource.

One factor affecting resilience in the healthcare sector is certainly that in exceptional circumstances , visibility and appreciation have somewhat increased. (Participant 23)

This study examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic. Each research question was answered with three themes.

Previous studies have shown that the pandemic increased the workload of paramedics, prompting changes in their operating models and the function of EMS to align with new pandemic-related requirements [ 9 , 27 ]. Initially, the paramedics in the current study described facing unclear and deficient guidelines and feeling obligated to follow instructions without adequate support to internalize them. Constantly changing instructions were linked to negative emotions in various ways. Moreover, the overwhelming flood of information was heavily connected to this, although the information flow was also perceived as a resource, especially when it was timely and well-structured. The study by Sangal et al. [ 15 ] has raised similar observations and points out the importance of paying special attention to the personnel working in the frontline, as in EMS, who might be more heavily impacted by too much information and anxiety about it. They also discovered that three factors are crucial for addressing the challenges of information overload and anxiety: consolidating information before distributing it, maintaining consistent communication, and ensuring communication is two-way. McAlearney et al. [ 11 ] found that first responders, including EMS personnel, reported frustration regarding COVID-19 information because of inconsistencies between sources, misinformation on social media, and the impact of politics. A Finnish study also recognized that health systems were not sufficiently prepared for the flood of information in the current media environment [ 12 ]. Based on these previous results and our findings, it can be concluded that proper implementation of crisis communication should be an integral part of organizations’ preparedness in the future, ensuring that communication effectively supports employee actions in real-life situations. Secondly, this topic highlights the need for precise guidelines and their implementation. With better preparedness, similar chaos could be avoided in the future [ 17 ].

Many other factors also caused changes in work. The EMS mission profile changed [ 3 , 4 , 5 , 6 ], where paramedics in this study saw concerns. To prevent infection risk, the number of pre-arrival calls increased [ 7 ], the duration of EMS missions increased [ 8 , 9 ], and the continuous use of PPE and enhanced hygiene standards imposed additional burdens [ 9 , 10 ]. In Finland, there was no preparedness for the levels of PPE usage required in the early stages of the pandemic [ 12 ]. In this study, paramedics described that working with potentially inadequate PPE caused fear and frustration, which was increased by a lack of training, causing them to feel a great deal of responsibility for acting aseptically and caring for patients correctly. Conversely, providing adequate PPE, information and training has been found to increase the willingness to work [ 28 ] and the sense of safety in working in a pandemic situation [ 29 ], meaning that the role of precise training, operating instructions and leadership in the use of PPE is emphasized [ 30 ].

The paramedics in this study described many additional new concerns in their work, affecting their lives comprehensively. It has been similarly described that the pandemic adversely affected the overall well-being of healthcare personnel [ 31 ]. The restrictions implemented also impacted their leisure time [ 32 ], and the virus caused concerns for their own and their families’ health [ 11 , 28 ]. In line with this, the pandemic increased stress, burnout [ 10 , 33 ], and anxiety among EMS personnel and other healthcare personnel working on the frontline [ 11 , 14 , 34 , 35 ]. These kinds of results underscore the need for adequate guidance and support, a lack of which paramedics reported experiencing in the current study.

Personnel play a crucial role in the efficient operation of an organization and comprise the main identified resource in this study. Previous studies and summaries have highlighted that EMS personnel did not receive sufficient support during the COVID-19 pandemic [ 11 , 14 , 17 , 18 ]. Research has also brought to light elements of adequate support related to the pandemic, such as a review by Dickson et al. [ 16 ] that presents six tentative theories for healthful leadership, all of which are intertwined with genuine encounter, preparedness, and information use. In this current study, the results showed numerous factors related to these contexts that were identified as resources, specifically underlined by elements of caring, effective operational change, knowledge-based actions, and present leadership, similarly described in a study by Eaton-Williams & Williams [ 18 ]. Moreover, the paramedics in our study highlighted the importance of encouragement and identified peer support from colleagues as a resource, which is in line with studies in the UK and Finland [ 12 , 23 , 37 ].

In the early stages of the pandemic, it was noted that the EMS personnel lacked adequate training to manage their mental health, and there was a significant shortage of psychosocial support measures [ 14 ], although easy access to support would have been significant [ 18 ]. In the current study, some paramedics felt that mental health support was inadequate and delayed, while others observed an increase in mental health support during the pandemic, seeing it as an incentive for organizations to develop standard operating models for mental support, for example. This awakening was identified as a resource. This is consistent, as providing psychological support to personnel has been highlighted as a core aspect of crisis management in a Finnish study assessing health system resilience related to COVID-19 [ 12 ]. In a comprehensive recommendation commentary, Isakov et al. [ 17 ] suggest developing a national strategy to improve resilience by addressing the mental health consequences of COVID-19 and other occupational stressors for EMS personnel. This concept, applicable beyond the US, supports the view that EMS organizations are becoming increasingly aware of the need to prepare for and invest in this area.

A fundamental factor likely underlying all the described emotions was that changes in the job descriptions of the EMS personnel due to the pandemic were significant and, in part, mandated from above. In this study, paramedics described feelings of concern and frustration related to these many changes and uncertainties. According to Zamoum and Gorpe (2018), efficient crisis management emphasizes the importance of respecting emotions, recognizing rights, and making appropriate decisions. Restoring trust is a significant challenge in a crisis situation, one that cannot be resolved without complete transparency and open communication [ 38 ]. This perspective is crucial to consider in planning for future preparedness. Overall, the perspective of employee rights and obligations in exceptional circumstances has been relatively under-researched, but in Australia, grounding research on this perspective has been conducted with paramedics using various approaches [ 39 , 40 , 41 ]. The researchers conclude that there is a lack of clarity about the concept of professional obligation, specifically regarding its boundaries, and the issue urgently needs to be addressed by developing clear guidelines that outline the obligation to respond, both in normal day-to-day operations and during exceptional circumstances [ 39 ].

Complex adaptive systems (CAS) theory recognizes that in a resilient organization, different levels adapt to changing environments [ 19 , 20 ]. Barasa et al. (2018) note that planned resilience and adaptive resilience are both important [ 19 ]. Kihlström et al. (2022) note that the health system’s resilience was strengthened by a certain expectation of crisis, and they also recognized further study needs on how effectively management is responding to weak signals [ 12 ]. This could be directly related to how personnel can prepare for future changes. The results of this study revealed many negative emotions related to sudden changes, but at the same time, effective organizational adaptation was identified as a resource for the well-being of EMS personnel. Dissecting different elements of system adaptation in a crisis has been recognized as a highly necessary area for further research [ 20 ]. Kihlström et al. (2022) emphasize the importance of ensuring a healthy workforce across the entire health system. These frameworks suggest numerous potential areas for future research, which would also enhance effective preparedness [ 12 ].

Limitations of the study

In this study, we utilized essay material written in the fall of 2020, in which experienced paramedics reflected on the early stages of the COVID-19 pandemic from a work-oriented perspective. The essays were approached inductively, meaning that they were not directly written to answer our research questions, but the aim and the research questions were shaped based on the content [ 26 ]. The essays included extensive descriptions that aligned well with the aim of this study. However, it is important to remember when interpreting the results that asking specifically about this topic, for instance, in an interview, might have yielded different descriptions. It can be assessed that the study achieved a tentative descriptive level, as the detailed examination of complex phenomena such as emotions and resources would require various methods and observations.

Although the essays were mostly profound, well-thought-out, and clearly written, their credibility [ 42 ] may be affected by the fact that several months had passed between the time the essays were written and the events described. Memories may have altered, potentially influencing the content of the writings. Diary-like material from the very onset of the pandemic might have yielded more precise data, and such a data collection method could be considered in future research on exceptional circumstances.

The credibility [ 42 ] could also have been enhanced if the paramedics who wrote the essays had commented on the results and provided additional perspectives on the material and analysis through a multi-phase data collection process. This was not deemed feasible in this study, mainly because there was a 2.5-year gap between data collection and the start of the analysis. However, this also strengthened the overall trustworthiness of the study, as it allowed the first author, who had worked in prehospital emergency care during the initial phase of the pandemic, to maintain a distance from the subject, and enabled a comparison of our own findings with previously published research that investigated the same period in different contexts. The comparison was made when writing the discussion, with the analysis itself being inductive and following the thematic analysis process described by Braun & Clarke [ 26 ].

When evaluating credibility [ 42 ], it should also be noted that the participants who wrote the essays, i.e., the data for the study, were experienced paramedics but also students and one of the researchers was their principal lecturer. This could potentially limit credibility if the students, for some reason, did not want to produce truthful content for their lecturer to read. However, this risk can be considered small because the essays’ topics did not concern the students’ academic progress, the essays’ content was quite consistent, and the results aligned with other studies. As a strength, it can be considered that the students shared their experiences without holding back, as the thoughts were not for workplace use, and they could trust the data privacy statement.

To enhance transferability [ 42 ], the context of the study was described in detail, highlighting the conditions prevailing in Finnish prehospital emergency care during the early stages of the pandemic. Moreover, including a diverse range of perspectives from paramedics working in different regions of Finland (except Northern Finland) contributes to the transferability of the study, indicating that the results may be applicable and relevant to a wider context beyond a single specific region.

Dependability [ 42 ] was reinforced by the close involvement of two researchers from different backgrounds in the analysis of the material, but a limitation is that no separate analyses were conducted. However, the original data was repeatedly revisited during the analysis, which strengthened the dependability. Moreover, the first author kept detailed notes throughout the analysis process, and the last author supervised the progress while also contributing to the analysis and reporting. The research process is also reported in detail.

This study highlighted numerous, mainly negative emotions experienced by EMS personnel during the initial months of the COVID-19 pandemic due to new working circumstances. At the same time, several work-related factors were identified as resources for their well-being. The findings suggest that crisis management practices should be more attentive to personnel needs, ensuring that personnel have the necessary support, both managerial and psychological, readily available in crisis situations. Effective organizational adaptation in a crisis situation also supports personnel well-being, emphasizing the importance of effective preparedness. Future research should particularly focus on considering personnel well-being as part of organizational adaptation during exceptional circumstances and utilize these findings to enhance preparedness.

Data availability

The datasets generated and analyzed during the current study are not publicly available due to the inclusion of sensitive information and the extent of the informed consent provided by the participants.

Abbreviations

Complex Adaptive Systems (theory)

Coronavirus Disease 2019

Emergency Medical Services

Personal Protective Equipment

United Kingdom

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We want to sincerely thank all the paramedics who participated in this study.

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Study design (HM, HN). Data collection (HN). Methodology (HN). Analysis (HM, HN). Writing (HM, HN). Review and editing (HM, HN). Supervision (HN). Both authors read and approved the final manuscript.

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The study followed the good scientific practice defined by the Finnish National Board on Research Integrity TENK [ 43 ]. The study was conducted in accordance with the Helsinki Declaration and applicable national guidelines. Adhering to the Finnish National Board on Research Integrity (TENK) guidelines on ethical principles of research with human participants and ethical review in the human sciences in Finland, an ethical review statement from a human sciences ethics committee was not required for this type of study. The participants consisted of adult students engaged in regular employment. Their involvement in the research was grounded on informed consent. The study did not involve concerns regarding the participants’ physical integrity, nor were they subjected to exceptionally strong stimuli. The potential for causing mental harm was not beyond what is typically encountered in everyday life, and their participation did not pose any safety risks [ 44 ].

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Myrskykari, H., Nordquist, H. Paramedics’ experiences and observations: work-related emotions and well-being resources during the initial months of the COVID-19 pandemic—a qualitative study. BMC Emerg Med 24 , 152 (2024). https://doi.org/10.1186/s12873-024-01072-0

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How to Write a Persuasive Essay About Covid19 | Examples & Tips

Steps to Write a Persuasive Essay About Covid-19

Step 1: Choose a Specific Thesis Statement

Step 2: Research and Gather Information

Step 3: Outline Your Essay

Step 4: Write the Introduction

Step 5: Provide Background Information

Step 6: Develop Body Paragraphs

Step 7: Address Counterarguments

Step 8: Write the Conclusion

Step 9: Revise and Proofread

Step 10: Cite Your Sources

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Introduction

Social networks

Social support

Social and interactional norms

Recommendations and conclusions

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

Recommendation 2: intelligently balance online and offline ways of relating

Recommendation 3: build stronger and sustainable localised communities

Ethics statements

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Essay on COVID-19 Pandemic

Cite this page

A Narrative Review of COVID-19: The New Pandemic Disease

Erfan Sheikhbahaei, MD

Zahra Torkpour, MD

Bahareh Kamyab Moghadas, PhD

Matina Ghasemi, PhD