essay on covid 19 heroes

Meet the COVID-19 frontline heroes

Molly Kinder · May 2020

Part of an ongoing series

The COVID-19 frontline

Despite the hardships and health risks, millions of essential frontline workers continue to do their jobs during the COVID-19 pandemic. These hardworking heroes are keeping Americans fed, picking up their trash, providing them life-saving medicine, delivering their groceries and packages, preparing their food, cleaning their hospitals, caring for those who are most vulnerable, and keeping us safe—often while earning low wages and few benefits.

In this series, I will introduce you to some of these frontline workers: In their own words, they share the risks and challenges they face, the concerns they have, and how they are coping. They will highlight what policymakers, employers, and each of us can do to better protect and support them.

Unsung health heroes

Although doctors and nurses—who earn a median wage of $105 per hour and $34 per hour, respectively—receive the lion’s share of public recognition for their life-saving role in the fight against COVID-19, they represent less than 20% of all essential health workers.

Millions of other health workers earn significantly lower wages while receiving less public recognition for their roles, despite their sacrifices. Nearly 7 million essential workers are employed in low-wage health jobs on the COVID-19 front lines, including:

Health care support workers such as orderlies and phlebotomists
Direct care workers such as home health and personal care aides
Health care service workers such as housekeepers and cooks

Median wages across these occupations were just $13.48 per hour in 2019—well short of a living wage. More than 80% of them are women, and they are also disproportionately workers of color.

Learn more about the essential role they are playing in the pandemic and what policymakers and employers should do to better protect, compensate, support, and respect them.

Source: Data from May 2019 Occupational Employment Statistics and the Census Bureau’s Current Population Survey

Grocery workers

Across the country, more than two million people work in grocery stores. Deemed essential businesses, grocery stores and supermarkets are staying open even in the worst-hit communities.

Due to close proximity and frequent face-to-face interaction with customers and colleagues, grocery workers are highly exposed to COVID-19 , and the virus has already killed several of them . Employers have responded with new safety measures , but more aggressive safeguards and wider access to personal protective equipment (PPE) are needed.

Pay for most grocery workers is low. Grocery cashiers earn a median wage of just $10.93/hour . Employer-provided benefits are rare for non-unionized grocery workers. Prior to the start of the pandemic, Walmart and Kroger, the country’s two largest grocery chains, offered hundreds of thousands of workers no paid sick leave. Most large grocery chains have introduced temporary COVID-19 sick leave as well as one-time bonuses or hazard pay of an additional $2/hour.

Yvette Beatty

Home health aide · Age 60

“I am feeling scared. Saying goodbye to my family, I don’t know if it is going to be the last goodbye.”

“I hope and pray to God I would never get it. I don’t think I would even go home. I would tell my kids: Give me a tent, feed me from the outside.

“We are running around with no protective gear. I would love to see us have hazard masks, instead of putting cloths over our face or going to the Dollar Store and buying dollar masks. We are taking a chance on our life, too. We need equipment.

“You’re telling me, before you pushed out these trillions and millions of dollars, you couldn’t push this out for us? You couldn’t push it out for these people who are on trash trucks, who are mopping floors, who are picking up biowaste, who are home health aides? We right here on the front line, we need you too. Open up. It is time to wake and recognize us.”

Tony Powell

Hospital administrative coordinator · Age 62

“We are like soldiers marching into battle, but you don’t have enough guns.”

“It’s just overwhelming, the amount that you will go through every day having to be on the front lines. A lot of people can work from home. They don’t understand what it means.

“Nobody recognizes those workers that are really on the front line. People are recognizing doctors and nurses. But they’re not recognizing dietary, environmental service, CNAs. These are the people doing all the main grunt work that has to be done. Nobody is telling them, ‘We appreciate what you do. We realize you have a family. We realize you are underpaid. We realize you are understaffed.

“People are not looking at people like us on the lower end of the spectrum. We’re not even getting respect. That is the biggest thing: we are not even getting respect. Nobody is listening to their voices. Maybe they’ll wake up and see: Oh, these are the people that are actually taking care of the people that need to be taken care of. ”

Hospital housekeeper · Age 29

“One minute you are important enough. The next minute, you aren’t that important to get the proper equipment, but you are important enough to clean for the next patient.”

“We had one patient that we thought had the virus. We asked the charge nurse to send us to get fit-tested for the N95 mask that everyone was wearing. Her response was, ‘No, these are for special people.’ And we were just like, ‘We are here to clean the room and make sure no one else gets the virus, and you are telling us that these are for special people?’

“I’ve been on my unit for seven years. We are on the same unit every day, with the same people. I don’t even think my charge nurse knows my name. They just see us as housekeeping. That is what they call us.

“It shouldn’t take such a trying time for us to get recognized, considering we are the heart of the hospital. We are making sure that family members aren’t coming home with new germs and with new illnesses, because we are keeping the hospital clean. I don’t think it should be like: Oh yeah, let’s recognize them now, because we need them. It’s something that I think should have been going on.”

David Saucedo

Nursing home cook · Age 52

“I am having to argue for my supplies. It makes me feel secondary, not equal. You are expendable in a way.”

“I deal with patients who are not capable of taking care of themselves, that have dementia. I accepted that head-on because I have two handicapped brothers. My heart always goes to people who cannot help themselves. I really care for all my patients.

“Whatever infections they have, it all is going to end up in the kitchen. The Alzheimer’s patients don’t know about ‘six feet, keep your distance.’ They just come up to you, grab you, and sit and talk to you. I need to protect them as much as I need to protect myself. The last thing I want to do is get one of my patients sick or one of my loved ones sick.

“When I was in the Navy, when we went to war, I was getting paid hazardous duty pay. Okay, I signed up to work in a hospital, I knew germs were going to be there. But, had everyone knew coronavirus was going to come, how many people would have decided not to work in a hospital? To me, it is a hazardous job right now. We should be getting paid hazardous pay."

Sabrina Hopps

Acute care facility housekeeping aide · Age 46

“Housekeepers are the number-one hero. If housekeeping does not clean the rooms correctly, the pandemic will be worse than what it is.”

“I clean patient rooms in the ICU department. Those are the sickest people. It scares me because I can be cleaning a patient’s room and the patient can have the coronavirus and I would never know. I have asthma, and my son has asthma. My son is a cancer survivor. I am petrified to not know what is going on or what the patients have.

“I feel we should be getting extra compensation. We are supposed to get a 3% bonus. With my pay, at $14.60 an hour, 3% isn't going to do nothing. If pay was better, I would be able to live on my own and so could my children. What I make, it is not enough. So I am forced to share an apartment with my son and daughter and my granddaughter. Going back and forth to work, I am jeopardizing their lives, their safety, especially my son’s. His immune system is shot, just like mine.

“If I didn’t love what I do, I could have walked away and sat at home, like half the world, and got unemployment. But that’s not me. The patients deserve better. It is me and the other housekeepers who sit and talk with the patients to brighten up their day, because they don’t have family members visiting now. As long as God put me on this earth, I am going to continue to go to work.”

Elizabeth Peachy

Home health aide · Age 49

“It’s not really about the money, because it isn’t enough to live on, to be honest.”

“We do not get any benefits. We are not given any PPE. We’re not given any resources other than an online website. In one day, I was in West Virginia, trying to find PPE. I would be in Augusta, I would be in Wardensville, Baker, and in Moorefield. I would be in Winchester, Virginia, Front Royal, in Stephens City. We have people going in homes, and we get no PPE.

“Without home care workers to care for these high-risk patients, they will become sick even without the COVID-19. We bathe them, we feed them, we clean them. We take them to the doctor appointments, we take them to the hospital, we take them to get blood work. We buy their groceries.

“I can guarantee you, if these workers don’t come out to these homes and they do not provide care to these high-risk patients, they will get sick and thousands will be in the hospital. And they will be flooded with these patients.”

Pauline Moffitt

Home health aide · Age 50

“I pray always: Lord, please stretch my pay. Please. It is a struggle.”

“We do a lot. We do more than even nurses and doctors. We go beyond just cleaning, changing diapers. We are their family. We are their eyes and their ears. You keep them company, you make them laugh, you cheer them up. Sometimes mentally, it is a challenge for us, it breaks us down. At the end of the day, you are tired.

“The work is more than the pay. They cut back my pay to $9 an hour. I spend more than I make. It is a struggle. I live in a low-income home. My husband right now because of the virus is out of a job. I have to pay a lot of bills. What am I supposed to do? I just wish they would raise it and give us a little more. Not just for me, but all the other home health aides that are in the same situation.”

Ditanya Rosebud · Age 46

Nursing home cook and hostess

“I am diabetic, I am asthmatic. I don’t want to bring this home to my kids.”

“I understand we signed up to work in a nursing home. But we didn’t sign up for this pandemic. We wanted to make sure that our residents are well taken care of, well fed, the place is clean and sanitized. We didn’t come in to say: Well today might be your last day.

“We—the CNAs, the GNAs, housekeeping, dietary, laundry—we are right there. Still bringing supplies. Still cleaning. Still cooking. Still interacting with the residents. We come to work on days that we aren’t even scheduled for because we have so many other employees out. And all they can say to us is, ‘This is what you signed up for.’ It is frustrating. I am pissed off.

“Our situation will be better if we can get appreciation. That sounds crazy: appreciation. A thank you. ‘I am glad you are here, thank you for coming to work.’ Hazard pay. Anything. Somebody do something! The company shows no compassion. We are just another body. That’s it. No more, no less. But I continue to go because those residents also need somebody there for them. They can’t see their family members, they can’t go out of their rooms. So we try to find little things to do. I just love the work.”

Amber Stevens

Cashier at Shoppers · Age 30

“It is very tiresome on the body, as well as scary on the mind.”

“We are tired. The past 3 to 4 weeks have been consistent, nonstop people. They haven’t really put a limit on how many people can come in at a time. We don’t have restricted hours. It is worrisome.”

“I come home to my little one. I want to go home and see my mom. You don’t want to pick up anything at work and bring it back to your family. It is very scary.”

Courtney Meadows

Cashier at Kroger · Age 37

“We are no longer being seen as bottom feeders. It’s sad that it took this pandemic for people to see how really valuable we are.”

“I live in the coal fields of West Virginia. If you don’t have a medical degree, a law degree, or you’re a coal miner or something of that nature, then you have minimum wage jobs. People just look down on you, thinking, that that is all that you can get.”

“Now they are seeing, ‘these people are really putting their lives on the line. These people are worth more than what they make. These people are out here and they are serving us and being positive.’ The customers are grateful for it. It makes me proud.”

Jeffrey Reid

Meat clerk at Giant · Age 54

“It’s just the sheer enormity of this pandemic. You can see it in people. You can see fear. You can see pandemonium.”

“Someone will come around the aisle, they have the shopping cart, the gloves on, a mask on. You step back and think, ‘Wow, man, this is really happening.’”

“I am a hard worker. I get up every day, I do my 8 hours, it’s like a routine. Now overnight, I am thrust on the frontlines of this. The governors are saying you are essential personnel, the president is thanking grocery workers. I saw in line this little kid yesterday on National Superhero Day, dressed up as a clerk in one of his favorite grocery chains. I am fascinated and excited by it.”

Lisa Harris

Cashier at Kroger · Age 32

“The pay isn't enough. I have coworkers that serve people every day, and then have to go pay for their own groceries with food stamps.”

“I understand that catching the coronavirus is a very good possibility given I see 300 customers a day. I am grateful for my health care that the union fought for. I pray a lot.”

“I am going to attempt to work through this at risk to myself. A lot of my coworkers are in the same boat because they can't afford to do otherwise. The atmosphere is anxiety ridden, hurried, and on edge. The customers are now saying thank you for your hard work. We would like to hear that from our company.”

Matt Milzman

Cashier at Safeway · Age 29

“Realize that we are just as at risk as anyone who has been designated emergency personnel. I don’t have any special degrees to work grocery, but you have to eat.”

“To be honest with you, I am scared. I’m a religious man. Besides my normal prayers I do every day, I never did much special praying before I went to work. Before every shift, I am doing that now.”

“This is a virus, this isn’t just a slip and fall at work. It is going to hurt my kids, my community. I live in an apartment building. We live on top of each other. This thing spreads like crazy.”

Michelle Lee

Cashier at Safeway · Age 51

“Today I rang up an $800 order. My back was hurting, my arm was hurting. My coworkers are saying their bodies are starting to wear down.”

“We aren’t staying six feet away from the customers. When we ring them up, they are like two feet away from us. We check out 200 customers a day. A doctor can wear a mask and protective gear. We don’t have all of that.”

“My concern is not just for me, but for all of my coworkers. I know a lot of my coworkers have little children. Some of my coworkers have some illnesses that they are fighting. A lot of my coworkers can't afford to be off work for a long period of time.”

We are enormously grateful to each of these workers for sharing their stories and to UFCW Local 400 for their collaboration. We thank Amber, Courtney, Jeffrey, Lisa, Matt and Michelle, and each and every worker on the frontline, for the sacrifices they are making on behalf of all of us.

Photos taken by Molly Kinder: Amber Stevens, Jeffrey Reid, Lisa Harris, Matt Milzman, and Michelle Lee. Photo of Courtney Meadows taken by Mark Covey.

These interviews were conducted by Molly Kinder between March 19, 2020 and April 8, 2020. Participants have provided permission to Brookings to use their names, likenesses, transcribed words, and audio for this series.

We are enormously grateful to each of these workers for sharing their stories, Thanks to PHI, SEIU, SEIU Local 1199, Angelina Drake, Tatia Cooper, Yvonne Slosarski, Leslie Frane and LaNoral Thomas for their collaboration with the worker interviews. We thank Tony, Andrea, Yvette, David, Sabrina, Elizabeth, Pauline, Ditanya, and each and every worker on the front line for the sacrifices they are making on behalf of all of us.

These interviews were conducted between April 1, 2020 and April 28, 2020. Participants have provided permission to Brookings to use their names, likenesses, transcribed words, and audio for this series.

UN Philippines 2023 Annual Report

Who are the real-life heroes in the time of COVID-19?

Op-ed by Mr. Gustavo Gonzalez, UN Resident Coordinator and Humanitarian Coordinator in the Philippines, for World Humanitarian Day 2020

On World Humanitarian Day (WHD), 19 August, we celebrate and honor frontline workers, who, despite the risks, continue to provide life-saving support and protection to people most in need. On this day, we also commemorate humanitarians killed, harassed, and injured while performing their duty. This year’s theme is “Real-Life Heroes”.

But, what does it mean to be a hero? What does it take to help those in need, the poor and at-risk communities, those who are most vulnerable when a disaster strike? Why should we hold up as heroic the deeds of those who everyday continue to extend a helping hand?

As I write this, I am mourning the death of a UN colleague. He died last Friday, struck down by COVID-19, at the age of 32. As a team member of the UN’s Migration Agency, he showed exemplary dedication and commitment to the situation of migrants amidst this pandemic.

He was a true frontline hero, and he is not alone.

In these extraordinary times, and despite the very real danger to themselves, Filipino front line workers, like my fallen colleague, everyday put their own safety and well-being aside to provide life-saving support and protection to people most in need.

In the Philippines, every day since the beginning of the year, humanitarian workers have stood on the front lines dealing with the challenges arising from COVID-19 and other disaster events, like the displacement from the Taal Volcano eruption, the damage wrought by Typhoon Ambo, as well as continuing relief efforts in Marawi City and responding to those affected by the Cotabato and Davao Del Sur earthquakes. Despite the many risks, humanitarians continue to do their work, diligently and selflessly providing assistance to those who need it most.

Through years of responding to various emergencies and capitalizing on national expertise and capacity, the humanitarian community in the country has embraced a truly localized approach by recognizing what at-risk communities themselves can do in these challenging times. The private sector in the Philippines has also stepped up in sharing its resources and capabilities, joining with other humanitarian actors to support affected local governments and communities.

As we give recognition to local real-life heroes, we also need to protect and keep them free from harassment, threats, intimidation and violence. Since 2003, some 4,961 humanitarians around the world have been killed, wounded or abducted while carrying out their life-saving duties. In 2019 alone, the World Health Organization reported 1,009 attacks against health-care workers and facilities, resulting in 199 deaths and 628 injuries.

The COVID-19 pandemic has unveiled an important number of vulnerabilities as well as exposed our weaknesses in preventing shocks. It has also shown that the magnitude of the challenge is exceeding the response capacity of any single partner or country. It represents, in fact, one of the most dramatic calls to work together. The success of this battle will greatly rely on our capacity to learn from experience and remain committed to the highest humanitarian values. Our real-life heroes are already giving the example.

On 4 August, a revised version of the largest international humanitarian response plan in the country since Typhoon Yolanda in 2013 was released by the United Nations and humanitarian partners in the Philippines. Some 50 country-based UN and non-governmental partners are contributing to the response, bringing together national and international NGOs, faith-based organizations as well as the private sector.

COVID-19 might be today’s super-villain, but it does not deter our real-life heroes from doing their job and tirelessly working to find ways to combat the threat and eventually beat the invisible nemesis. We mourn the thousands who have lost their lives to the virus across the globe, including my colleague whom I have spoken of.

At the same time, we join Filipinos in upholding—in the midst of great adversity-- the tradition of celebrating the best of human kindness, generosity, social justice, human rights, solidarity and Bayanihan spirit. We celebrate what makes our front liners and humanitarian real-life heroes. We salute them for continuously putting their lives on the line, despite the risks and uncertainties. Their efforts must not be overlooked or forgotten.

Mabuhay ang Real-life Heroes! Happy World Humanitarian Day!

Gustavo Gonzalez is the United Nations Resident Coordinator and Humanitarian Coordinator in the Philippines

UN entities involved in this initiative

Goals we are supporting through this initiative.

The Country Won’t Work Without Them. 12 Stories of People Putting Their Lives on the Line to Help Others During Coronavirus

T he term “ frontline workers ” often conjures images of doctors in Hazmat suits and soldiers in uniform. But during the coronavirus outbreak , workers across a vast array of industries have found themselves essential parts of the machine that keeps the world in motion, required to do their jobs despite great risk—whether hog farm employees or bus drivers , mental health counselors or police officers . Here, as part of TIME’s new issue, frontline workers of all types share their triumphs and fears in their own voices.

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Health Care Heroes of the COVID-19 Pandemic

1 Dr Bauchner is Editor in Chief, JAMA and JAMA Network, and Mr Easley is Publisher, Periodical Publications, JAMA Network
Editorial To JAMA Authors, Reviewers, and Especially Physician Readers—A Profound Thank You Phil B. Fontanarosa, MD, MBA; Howard Bauchner, MD; Robert Golub, MD JAMA
Viewpoint Priorities for the US Health Community Responding to COVID-19 Amesh A. Adalja, MD; Eric Toner, MD; Thomas V. Inglesby, MD JAMA
Viewpoint Supporting the Health Care Workforce During the COVID-19 Global Epidemic James G. Adams, MD; Ron M. Walls, MD JAMA
A Piece of My Mind Personal Risk and Societal Obligation Amidst COVID-19 Cynthia Tsai, MD JAMA
Viewpoint Understanding and Addressing Anxiety Among Healthcare Professionals During the COVID-19 Pandemic Tait Shanafelt, MD; Jonathan Ripp, MD, MPH; Mickey Trockel, MD, PhD JAMA

The COVID-19 pandemic has accounted for tens of thousands of deaths and ultimately will affect millions more people who will survive. There will be time to mourn the victims and care for the survivors. But it is also time to recognize and thank some of the heroes who have emerged so far.

Li Wenliang, MD, Chinese ophthalmologist at Wuhan Central Hospital, who alerted Chinese authorities of a disease that resembled severe acute respiratory syndrome, was initially censored, and died 6 weeks later of COVID-19.

Anthony S. Fauci, MD, director of the US National Institute of Allergy and Infectious Diseases, who has calmly led the US through this pandemic, with experience and intelligence, and who has tried mightily to reassure a worried nation, with science and utmost professionalism.

Maurizio Cecconi, MD, head of the Anaesthesia and Intensive Care Department of Humanitas Research Hospital in Milan, Italy, who looked into a camera, told the story of the early days in Lombardy, Italy, and galvanized the world to prepare for the tsunami of COVID-19 disease to come.

Millions of health care workers—physicians, nurses, technicians, other health care professionals, and hospital support staff, as well as first responders including emergency rescue personnel, law enforcement officers, and others who provide essential services and products—around the world have faced the challenge of providing care for patients with COVID-19, while often ill-equipped and poorly prepared, risking their own lives to save the lives of others. They honor us all with their commitment, dedication, and professionalism.

JAMA and the JAMA Network salute and sincerely thank the countless heroes of this pandemic.

Published Online: April 20, 2020. doi:10.1001/jama.2020.6197

Conflict of Interest Disclosures: None reported.

Sara Cody, MD, Santa Clara County Health Officer and
Nancy Rosenstein Messonnier, MD, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention

1. Bauchner H, Fontanarosa PB, Livingston EH. Conserving Supply of Personal Protective Equipment—A Call for Ideas. JAMA. Published online March 20, 2020. doi:10.1001/jama.2020.4770

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Bauchner H , Easley TJ , on behalf of the entire editorial and publishing staff of JAMA and the JAMA Network. Health Care Heroes of the COVID-19 Pandemic. JAMA. 2020;323(20):2021. doi:10.1001/jama.2020.6197

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Even if you aren’t a big science fiction fan, Project Hail Mary is a terrific story about two friends using science and engineering to save the day.

Inspiring acts

Incredible people caring for those in need during COVID-19.

When I was a kid, my image of a hero was largely inspired by my dad’s collection of early Superman comics. I read them all. A “hero” was somebody who had supernatural powers like flying, laser vision, or the strength to bend steel.

As humans, of course, we’re all pretty limited in our physical powers. We don’t fly. We can’t see through walls. But what’s unbounded in us is our ability to see injustices and to take them on—often at great risk to ourselves.

My work in global health and development has introduced me to many extraordinary heroes with this kind of superpower. And I’ve had the honor of highlighting many of them on this blog : An epidemiologist who helped eradicate smallpox . A doctor working to end sexual violence in Africa. A researcher working to end hunger with improved crops. Just to name a few.

Why do we need heroes?

Because they represent the best of who we can be. Their efforts to solve the world’s challenges demonstrate our values as a society and they serve as powerful examples of how to make a positive difference in the world. And if enough people hear about their actions, they can inspire others to do something heroic too.

If there’s ever been a time that we need heroes, it’s now. The COVID-19 pandemic has created unprecedented health and economic challenges, especially for the most vulnerable among us. The good news is that many people from all walks of life are doing their part to help them. Health care workers. Scientists. Firefighters. Grocery store workers. Aid workers. Vaccine trial participants. And ordinary citizens caring for their neighbors.

Here are portraits of a few individuals from around the world working to alleviate suffering during this pandemic. I hope their stories inspire you just as much as they have me.

To these heroes and heroes everywhere, thank you for the work you do!

1. One million bars of soap and counting

For the last four years, Basira Popul has been a dedicated polio worker in Afghanistan, traveling from home to home to help vaccinate children and bring an end to the crippling disease.

Basira Popul knocks on the door of a house during home visits, distributing soap and educating families about the COVID-19 pandemic.

When the COVID-19 pandemic hit, social distancing restrictions forced the polio workers to pause their vaccination campaigns. But that didn’t stop their efforts to improve the health of the communities they serve. Instead of vaccinating for polio, Basira and thousands of her colleagues are now distributing bars of soap and giving hygiene lessons to curb the spread of the virus.

Basira demonstrates proper handwashing to children in the Surkh-Rōd District, Nangarhar Province, Afghanistan.

Basira speaks with a mother about proper sanitation, hygiene, and handwashing to prevent the spread of COVID-19.

They have raised awareness of the coronavirus throughout the country and given out more than one million bars of soap to help keep families in Afghanistan safe.

2. It’s a hot and uncomfortable job, but she loves it

As a COVID-19 tester in Bangalore, India, Shilpashree A.S. (Like many people in India, she uses initials referring to her hometown and her father’s name as her last name.) dons PPE, including a protective gown, goggles, latex gloves, and a mask. Then, she steps inside a tiny booth with two holes for her arms to reach through to perform nasal swab tests on long lines of patients.

Shilpashree A.S., a COVID-19 tester and lab technician, tests a patient who exhibits COVID-19 symptoms, from within a booth at the Jigani Primary Health Center in Bengaluru, India.

She has a critical job during this pandemic, but it comes with many hardships. “It’s hot and uncomfortable,” Shilpashree said of the hours she spends dressed in layers of protective gear inside the booth.

Shilpashree and other health workers get organized to carry out tests on the side of the road in Bengaluru, India.

Patients line up at the Jigani Primary Health Center for COVID-19 testing in Bengaluru, India.

The challenges continue after work. To prevent the spread of the coronavirus, she is not allowed to have contact with her family. For the last five months she’s only been able to visit with them on video calls. “I haven’t yet seen my children or hugged them,” she said. “It is like seeing a fruit from up-close but not eating it.” Still, there is no other job she would rather be doing right now. “Even though this involves risk, I love this job. It brings me happiness,” she said.

After a long day of testing, Shilpashree inputs the test results into a centralized database.

3. Trial benefits

Scientists around the world are racing to develop a coronavirus vaccine. There are more than 150 vaccine candidates in development and dozens of trials underway. All these trials need volunteers willing to step forward and help test whether the vaccine is effective and safe. One of those volunteers is Thabang Seleke from Soweto, South Africa.

Thabang Seleke plays with his youngest child in front of his home in South Africa after returning from the clinic where he is participating in Africa’s first COVID-19 vaccine trial.

Thabang is participating in the first African trial of the ChAdOx1 nCoV-19 coronavirus vaccine, which was developed by the Jenner Institute at the University of Oxford. It is also undergoing trials in the UK, U.S., and Brazil. The South Africa trial involves 2,000 volunteers within the Soweto area of Johannesburg, and is being run by Shabir Madhi, Professor of Vaccinology at the University of the Witwatersrand in Johannesburg.

Thabang, who lives in Soweto, South Africa, takes a local taxi to visit the clinic where researchers will monitor his symptoms and immune responses during the vaccine trial.

Thabang has blood and swab samples taken during each visit to the clinic to make sure he remains COVID-19 negative and there are no negative side effects from the vaccine.

Thabang double checks his vaccine trial paperwork after finishing his clinic visit.

Professor Shabir Madhi, who is managing the South African vaccine trial, shows Thabang how to fill in his diary card where he will log his symptoms and any side effects he may experience from the vaccine.

In South Africa, more than 600,000 people have been diagnosed with COVID-19 and more than 13,000 people have died from it since March. Thabang heard about the trial from a friend and stepped forward to join to help bring an end to the coronavirus in Africa and beyond. This trial, Thabang said, “will benefit the whole world.”

Thabang poses with his family outside their home in Soweto.

4. The best of humanity at a time of crisis

Sikander Bizenjo, founder of Balochistan Youth Against Corona, smiles with children in an isolated tribal settlement in Naal, Balochistan, Pakistan, after distributing food assistance to the community.

When COVID-19 spread into Pakistan, Sikander Bizenjo knew where the pandemic would have the biggest impact: on the poorest areas of his country, including places like his home province of Balochistan. More than 70 percent of the population in this arid, mountainous region in southwestern Pakistan lives in poverty and struggles to gain access to education and health care.

Balochistan Youth Against Corona volunteers pack ration bags for the food distribution drive.

A young child stands inside their home after receiving a ration bag and soap from Balochistan Youth Against Corona.

Sikander had moved away from Balochistan to Karachi, where he is now a manager at a business school. But he knew he needed to do something to help his home during the pandemic. After reaching out to local government officials and aid organizations, he learned that many families lacked food and that health facilities had shortages of medical equipment. So he founded a group called the Balochistan Youth Against Corona, which raises funds for monthly food rations for 10,000 households in Balochistan as well of personal protective equipment, masks, face shields and hand sanitizers for frontline health workers.

Sikander works on the distribution drive from his grandfather’s home in Naal, Balochistan.

Sikander speaks to villagers about the importance of soap and handwashing to prevent the spread of COVID-19 while distributing soap packets to them.

The support from other volunteers and donors has been overwhelming, he said. “I’ve seen the very best of humanity come out of this pandemic. People have been supporting us. People have been so kind and generous,” he said.

5. Tuning into better health with Sister Banda

If you have a question about COVID-19 in Zambia, you’ll want to tune into FM 99.1 Yatsani Community Radio. You’ll get advice on how to prevent the spread of the coronavirus from Catholic nun and social worker Sister Astridah Banda.

Catholic nun and social worker Sister Astridah Banda prepares to record her COVID-19 Awareness Program on Yatsani Community Radio in Lusaka, Zambia.

Sister Banda is not a doctor, but she is a passionate public health advocate. When the coronavirus arrived in Zambia, she noticed that most of the public health bulletins about social distancing, masks, and handwashing were being written in English. While English is an official language in Zambia, many people speak one of Zambia’s seven local languages and they were missing out on this critical information. Sister Banda wanted everyone to have access. So, in March, she approached Yatsani Community Radio and asked to start broadcasts where she could translate health bulletins into Zambia’s local languages and provide other critical news on the coronavirus. Her show, which airs several times each week, is produced in a talk show format with various guests who discuss specific health topics and answer questions from callers.

When she’s not on the air, Sister Banda gives lessons to community leaders in Lusaka, Zambia on how to prevent the spread of COVID-19, including good hand washing practices.

Sister Banda (right) with Sister Christabel Kazembe preparing face masks for community distribution in Lusaka, Zambia.

It now reaches more than 1.5 million people, creating a community of listeners looking out for one another to get through this pandemic. “The whole pandemic has brought humanity together,” she said. “We realize that our life is actually short and we need to spend most of it building on what is important. And these are relationships. Getting in touch with one another, being there for each other.”

6. “The answers lie within each of us”

When the first cases of COVID-19 were reported in the Navajo and Hopi Reservations, Ethel Branch grew alarmed that her community didn’t have what it needed to deal with the virus.

A building near the highway depicting mask awareness in the time of COVID-19 on the Navajo reservation in Cameron, Arizona.

The Navajo and Hopi Reservations have many elderly people living without electricity or running water who would need support. She decided she should try to do something about it. Ethel, a former attorney general for the Navajo Nation, resigned from her job at a law firm. She created a GoFundMe page and built an organization called Navajo Hopi Solidarity to help bring relief to the elderly, single parents, and struggling families. To date, she has raised over $5 million. Other community members also found ways to help, including Wayne Wilson and his son, Shelvin, who deliver water to dozens of families in need.

Ethel Branch, founder of Navajo Hopi Solidarity, a COVID-19 relief organization, poses with her 6-month old son in Flagstaff, Arizona.

Many parts of the Navajo Nation don’t have access to water. Wayne Wilson and his son Shelvin bring water to vulnerable families throughout the reservation.

Ethel’s organization has assisted 5,000 families across the reservations. She works with young volunteers from the reservations to deliver food to those in need. “It’s been really amazing. The teamwork, people just stepping forward and making things happen,” she said. “The answers lie within each of us. Each of us has the ability to make choices and to take action and have a positive impact on our community.”

Volunteers for the relief organization Navajo Hopi Solidarity deliver food to families in need in Chinle, Arizona.

7. A long journey to better women’s health

Even before COVID-19, Laxmi Rayamajhi’s job providing birth control services in the remotest areas of Nepal was never easy.

Laxmi Rayamajhi hikes to provide family planning services at Bela, Panchkhal Municipality-10, Kavrepalanchok, Nepal.

As a community health worker for Marie Stopes International, she hikes for hours over hazardous terrain, crossing rivers and landslides to reach the villages she services. But the pandemic has created new obstacles. A national lockdown, supply chain disruptions, and overwhelmed health facilities have all made it more difficult to deliver sexual and reproductive health care services to women in Nepal. And many women won’t visit local health facilities to seek care because they fear they will be infected with the coronavirus.

Laxmi talks to local women about family planning and reproductive health.

Laxmi counsels one of her clients at a remote health post in Nepal.

These healthcare challenges are being experienced by women throughout the world. According to one estimate, if these disruptions continue, 49 million additional women in low- and middle-income countries will go without contraceptives over the next year, leading to 15 million additional unplanned pregnancies. Still, Laxmi and thousands of care providers like her are working tirelessly to overcome these obstacles.

Laxmi inserts a long-lasting contraceptive implant in a client visiting a remote health post in Nepal. The implant prevents pregnancy for up to 5 years.

Laxmi continues to make her long journeys through Nepal to remote health posts to provide care to women in need. For those not comfortable seeing her in-person, she now provides phone consultations. “With my efforts, if women’s health gets better, and creates a healthy impact in our communities, I am grateful,” she said.

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Volunteers: real-life heroes in the time of COVID-19

Amédéo Miceli, President Maison Croix-Rouge, La Louvière (Belgium) ©MCR La Louvière

At the heart of the Covid-19 pandemic, volunteers have demonstrated an exceptional display of solidarity across the world. Responding to calls for help from their local communities, they are everyday heroes.

“Volunteers have been assisting vulnerable groups, correcting misinformation, educating children, providing essential services to the elderly, and supporting front-line health workers,” says United Nations Secretary-General António Guterres on the occasion of International Volunteer Day on 5 December.

Wave of solidarity

A wave of solidarity has broken across Europe, including in France, where platform Tous Bénévoles (All Volunteers) witnessed a doubling in those registering in 2020, with 40,000 new volunteers. Stemming from a wide range of backgrounds, volunteers responded to various needs: from helping the elderly, to supporting the disabled, migrants, school children as well as food banks.

“It is one of the few positive effects of Covid-19,” says Isabelle Persoz, President of Tous Bénévoles. More and more young people are signing up and sticking to volunteerism, she adds. A website has even been set up especially for them.

The International Committee of the Red Cross confirms the rise in numbers, with hundreds of thousands of new volunteers across the world, including 48,000 new sign-ups in the Netherlands and 60,000 in Italy.

“We are unable to respond (…) to all the external volunteer offers we receive,” says Natacha Dewitte, Assistant Director in Human Resources at the Red Cross in French speaking Belgium .

Thanks to the influx of volunteers, the Red Cross has been able to maintain its relief and social efforts and support the triage of patients in front of hospitals and test centres. The organisation even received an unprecedented offer from a cinema production and casting company who helped install a food distribution hub.

Unwavering optimism

Valérie Verbelen, field volunteer, Red Cross Belgium ©Valérie Verbelen

Volunteers who have been stepping in to help during the pandemic have been a beacon of selflessness and optimism.

Valérie Verbelen, aged 50, has been a field volunteer for the Red Cross in Belgium since March 2019. Trained in first aid, she did not hesitate for one moment to give a helping hand to hospitals. “I felt it was important to give my time,” she tells UNRIC. Some paradoxes, however, remain difficult to overcome. “Usually, we get close to people, but now we are forced to keep our distance to protect both them and us.”

Belgian medical student Andrea Dehaene, aged 22, volunteers in a test centre for asymptomatic patients at Ghent University Hospital. She has no regrets. “You feel good knowing you are contributing to the fight against the pandemic. I am also learning new things at the same time,” she says.

Such inspiring efforts are to be admired. “Volunteers bring enormous extra value to society at a very low cost,” says Joost van Alkemade, Director and Community Manager of the Association of Dutch Voluntary Organisations (NOV).

A difficult choice between fear and solidarity

The pandemic has nonetheless also had the opposite effect: some senior citizens, who are particularly at risk, have been denied the chance of helping on the field over concerns for their health. Red Cross France subsequently lost 11,000 volunteers aged over 60 in one day. “For these volunteers, it is difficult not to be there in person because volunteering is a way to regain some social contact,” regrets Isabelle Persoz.

This obstacle did not stop Amédéo Miceli, aged 64, and President of the Red Cross centre in La Louvière, Belgium. The centre, which distributes emergency packages and provides urgent food supplies, was overwhelmed at the start of the pandemic.

More and more people needing help

“During the first wave, the number of urgent requests for food aid exploded, increasing by 200-300% in just a few months,” says Miceli, who has not been daunted by fatigue or the virus. “I have been in the field since March. I am not afraid… It is exhausting, but we cannot walk away, we cannot turn our backs.”

With the continuing economic fallout from the crisis, the need for volunteers will not disappear. Food banks, for example, anticipate a huge increase in demand for food aid.

“Everyone can become a volunteer. The first thing you need is goodwill; every act is valuable,” concludes Isabelle Persoz.

Should you wish to become a volunteer, visit the websites of these associations.

International Committee of the Red Cross
Tous Bénévoles
Association of Dutch Organisations Voluntary Effort (NOV)
Médecins du Monde
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Nurses on the front lines: A history of heroism from Florence Nightingale to coronavirus

Dean of the Solomont School of Nursing, UMass Lowell

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Leslie Neal-Boylan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Nurses are heroes of the COVID-19 crisis. May 12 is International Nurses Day, which commemorates the birthday of Florence Nightingale, the first “professional nurse.” The World Health Organization also named this year the “ Year of the Nurse ” in honor of Nightingale’s 200th birthday.

To nurses everywhere, this day and this year have great significance. Nurses, who are being recognized as heroes, have long awaited recognition as health care professionals in their own right and not ancillary to physicians. It’s wonderful to be recognized now in the context of coronavirus, but nurses have always been at the forefront – during war, epidemics and other times of disaster.

I have been a nurse for 40 years and a nurse practitioner for 17 of those years. An active clinician, researcher, scholar and educator, I currently serve as dean of the Solomont School of Nursing at the University of Massachusetts Lowell. Throughout my career, nurses have typically been relegated to a secondary role, and if mentioned at all, we are described as assisting doctors. Nurses today are still asked why they didn’t become doctors instead. Aren’t we smart enough?

Many people don’t realize that nursing and doctoring are entirely different professions with different purposes. We are proud to work alongside doctors and other health professionals, but we have never worked behind them. Not all nurses work at the bedside, but we all touch the lives of patients.

Many nurses have doctoral degrees. They conduct research that advances the quality of patient care. Nurses change health care policy . For example, nurses play a significant role in health care reform and advise Congress on proposed health care rules and regulations. They also guide organizations regarding health care technology and care coordination and sit on executive boards of health care organizations. Nursing is both an art and a science.

The role of the nurse has evolved, but some things haven’t changed. Nurses have always cared for the sick, the well and the dying. We promote health and prevent illness. We interpret what is happening so that patients understand it. We are there for the entire patient experience from birth to old age, from wellness to illness, and throughout age and illness toward a peaceful and dignified death.

Our history provides many examples.

In 1854, Florence Nightingale brought 38 volunteer nurses to care for soldiers during the Crimean War. The cause of the conflict focused on the rights of Christians in the Holy Land and involved Russia, the Ottoman Empire, France, Sardinia and the United Kingdom. Male nurses provided care as far back as the Knights Hospitaller in the 11th century. But prior to Nightingale’s involvement, male and female nurses consisted of untrained family members or soldiers who cared for the ill and infirm.

Nightingale was the first to organize nurses and provide standardized roles and responsibilities for the profession. As such, she is credited with founding modern professional nursing . She was also an expert statistician, collecting data on patients and what did and didn’t work to make them better . Nightingale and her nurses improved sanitation, hygiene and nutrition . They provided care and comfort. Their work had a major impact on the survival of soldiers.

The American Civil War in the 1860s brought thousands of trained nurses to the battlefront, risking their lives to care for soldiers on both sides of the conflict. The most famous were Dorothea Dix , an advocate for indigenous populations and the mentally ill; Clara Barton , founder of the American Red Cross; and Louisa May Alcott , the author of “Little Women.”

Nurses again answered the call with the yellow fever epidemic of 1878 , rushing from all over the country to Tennessee. The epidemic ultimately killed 18,000 people, and many nurses died while caring for the sick.

The U.S. recruited more than 22,000 trained nurses to treat Americans overseas and back at home from 1917 to 1919 during World War I. The war brought death from combat to about 53,000 Americans, while about 40 million civilians and military died worldwide. Time after time, nurses have left the warmth, comfort and safety of their homes to care for others.

Nurses were also among the millions who died from the 1918 influenza pandemic. Fifty million people died worldwide . This pandemic is probably most comparable to what we are experiencing today with COVID-19. But epidemics, such as polio, off and on from 1916 to 1954; the global pandemic of influenza A, 1957-1958; swine flu, 2009-2010; Ebola, 2014-2016; and Zika, 2015-2020, have also required constant nursing care.

I remember the AIDS pandemic, which began in 1981. I was a visiting nurse and saw many patients in their homes, from homeless shelters to penthouse apartments. Everyone suffered not only because of the physical and mental effects of the disease but also because of the stigma. People, even their families, were afraid to touch patients, kiss them or be near them. It was a lonely time for these patients. I watched them deteriorate and die. Nurses were often the only ones to hold the hands of these patients, so they wouldn’t die alone.

Nurses were also there during 9/11. They were among the courageous first responders who risked their lives to save others. Many have chronic diseases because of their exposure to Ground Zero .

Every year, nurses are voted first among the professions the public trusts the most, according to Gallup. We work hard to earn and maintain that trust. You will find us caring for people in their homes, in public health departments, in nursing homes and skilled care facilities, in rehabilitation hospitals, in prisons and correctional institutions, caring for the mentally ill and providing health care advice over phones and computers. Nurses work wherever there are people.

What do we ask in return? It’s simple. We don’t consider ourselves heroes, but we do deserve respect. Public images of the nurse in a sexy uniform or as a handmaiden to a doctor are wrong and insulting. We are professionals. Once the COVID-19 crisis is over, please don’t forget that we are always here for you. Always have been. Always will be.

Florence Nightingale

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Cleaners, the unsung heroes at the covid-19 frontline, "i am at a very high risk of being infected because i am very close to the patients and i touch everywhere”.

hygienist, cleaners, coronavirus, COVID-19, Uganda, handwashing with soap, chlorine, hygiene, cleaning surfaces,

Everywhere in the world, people have repeatedly been told to frequently wash hands with soap and running water as well as sanitize and clean surfaces around them to avoid catching COVID-19, among other infections. In homes, cleaning surfaces has become a routine. In health facilities, the situation is not any different. Cleaning and disinfecting surfaces have been heightened to reduce the risk of infection as well as provide health workers and patients with decent and clean places to work and get medical attention. Behind this enhanced hygiene are the cleaners or hygienists, the unsung heroes in the fight against the COVID-19 pandemic. It’s a few minutes after 7am at Kikuube Health Centre IV, Kikuube District, Western Uganda. The facility is visited on a daily basis by hundreds of patients from all corners of the district. Children, women, men, old and young, stroll in during a light morning drizzle. In a tiny room is 27-year-old Yusto Katahoire, the chief hygienist or cleaner at the health facility. He is in charge of the general cleanliness at the health facility, a job he has done for the last 10 years. Upon arrival, the first thing he does is slot on his protective gear before touching anything. It is COVID-19 times, so he has to protect himself before anything else. One by one, he puts on the different elements of his protective equipment that include his overalls, gum boots, plastic apron, heavy duty gloves (these after surgical gloves), goggles and then finally his mask. With the gear in place, he is ready to start his daily duties.

Life and work before COVID-19

When Yustos first heard of COVID-19, he worried because of the nature of his job and remembered the insufficient protection he had at the time. “I felt unsafe and knew for sure I would be among the first people to catch the disease. I had also heard that many health workers were getting infected and some were dying.”

“My personal protective equipment was very old with holes and many components were missing. I am at a very high risk of being infected because I am very close to the patients and I touch everywhere,” he shares.

The cleaning equipment was not any better. The cleaning team used shrubs from the bush and local booms to clean floors with plain water.

UNICEF support brings relief

The situation is very different today. Thanks to UNICEF support, health facilities, including Kikuube Health Centre IV, Yusto’s duty station, have received sets of complete personal protective equipment (PPE) for use by all frontline workers to enhance their safety during COVID-19. UNICEF has also provided health facilities with water, sanitation and hygiene supplies that include chlorine, hand sanitizers, liquid soap, handwashing stations and cleaning equipment to enhance infection prevention and control. No wonder, today, Yustos is more confident at work, and feels safer and energized to serve. Well clad in his complete protective gear, he goes about his daily tasks.

“My new PPE is modern, and I feel safer when I wear it,” Yustos mutters.

His first stop is at a huge drum at the verandah of the facility, where he mixes chlorine granules with water. He must measure the right quantities for handwashing and cleaning surfaces. Once the chlorinated water is ready, his team of two distributes the water to all handwashing stations placed all over the health centre. The water will be used by patients later as they access the various sections for health services. He then proceeds to use some of the chlorinated water to clean the floors, patients’ benches, and workstations, as well as providing some to other health workers to clean their instruments and equipment. They must reduce the risk of infection at the health centre. In a few minutes, all corners of the facility are clean and disinfected, way before more health workers and patients trickle in. The general cleaning of the facility is done twice a day but Yutos is available any time to clean after patients. Without cleaners like Yustos, health facilities would be unsafe for patients and health workers, especially during pandemics such as COVID-19. With the new PPE, Yustos feels safer and ensures that he always wears his gear properly to avoid getting infected. Yustos is also among the healthy facility personnel that received training on infection prevention and control supported by UNICEF. From the training he learnt how to mix the chlorinated water and how to effectively clean the facility. When asked why he keeps doing what he does despite the risks involved, Yustos mentions that being appreciated for keeping the health facility clean and reducing the risk of infection makes him very proud.

“I consider myself a brave person because I dedicated myself to work in such a public place with high risk of getting sick, especially during such times,” Yustos concludes.

Meet Yusto Katahoire, the chief hygienist or cleaner at Kikuube Health Centre IV who ensures the facility is clean and surfaces sanitised to protect those who seek health services, from infections during COVID-19. Thanks to UNICEF support, health facilities, including Kikuube, have received sets of complete personal protective equipment (PPE) for use by all frontline workers to enhance their safety during COVID-19.

Having access to clean water helps me concentrate in school.

“I'm excited that we can use the new bath shelters to shower, and that we have a place to dispose of our pads”.

UNICEF, Iceland commission water facility in Northern Uganda

Embassy of Iceland, alongside UNICEF and Terego District officials, commissioned the WASH facility at Aria Primary School and Tuku Health Centre II

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COVID-19 Heroes and Memorial Day

Join THA and Texas hospitals in celebrating the inaugural Texas COVID-19 Heroes and Memorial Day on March 4.

Beginning in 2024, every March 4 in Texas will be observed as “COVID-19 Heroes and Memorial Day” under a new state law developed by Rep. R.D. “Bobby” Guerra, D-McAllen, which establishes a uniform statewide date to honor and recognize the contributions and sacrifices of Texans who played crucial roles during the COVID-19 pandemic. This includes health care professionals, first responders, essential workers, and others who worked tirelessly to support their communities during these challenging times.

COVID-19 Heroes and Memorial Day will also be a time to memorialize the almost 95,000 people in Texas who have lost their lives to COVID-19 since March 4, 2020 – the date the disease was first diagnosed in Texas.

How to Get Involved

We at THA would like to see our membership embrace and encourage widespread recognition of this new annual tribute to our best and bravest. We’re asking you to work within your facilities to create custom plans , tailored to your hospitals and communities, to celebrate the day both internally and beyond your facility walls , with media outreach and community efforts. Potential ways to celebrate include:

Planning a staff, community or local press event;
Creating tribute videos for local health care workers and others honored on Heroes Day;
Creating special signage to commemorate the day; and
Social media posts.

Download Press Release Template for COVID-19 Heroes and Memorial Day

Use the template below (MS Word format) to share how your hospital is recognizing COVID-19 Heroes and Memorial Day. Replace all italicized text with specific information about your hospital’s event and share with local news or media outlets.

COVID-19 Heroes Day Resources

The Texas Hospital Association will be honoring the efforts of Texas hospitals on COVID-19 Heroes and Memorial Day and we encourage hospitals, health care workers and community members to participate as well. The resources below can be used to heighten awareness and show appreciation for Texas hospitals and health care workers ahead of and on March 4.

Sample Social Media Copy :

Before March 4:

We invite you to join us on March 4 for the inaugural COVID-19 Heroes and Memorial Day. This day was created to officially recognize the front line workers whose steadfast commitment kept Texans safe during the COVID-19 pandemic, and to honor and remember the 95,000 Texans who lost their lives to the disease.

On March 4:

Today marks the four-year anniversary of the first COVID-19 case in Texas, and today, [Hospital Name] joins other Texas hospitals to solemnly commemorate the inaugural COVID-19 Heroes and Memorial Day. We salute the resilience and dedication of our staff, who worked tirelessly amid the pandemic and honor the nearly 95,000 Texans who lost their lives to the disease.

Right-click to download each of the images below, or click here to download a .zip of all graphics.

Note: Some versions of the Chrome browser will download graphics only in .webp format. If this is an issue, please download the .zip package to access the two .png images and the single animated .gif.

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He was a true frontline hero, and he is not alone.

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Mabuhay ang Real-life Heroes! Happy World Humanitarian Day!

Gustavo Gonzalez is the United Nations Resident Coordinator and Humanitarian Coordinator in the Philippines

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During the COVID-19 pandemic, the media have repeatedly praised healthcare workers for their ‘heroic’ work. Although this gratitude is undoubtedly appreciated by many, we must be cautious about overuse of the term ‘hero’ in such discussions. The challenges currently faced by healthcare workers are substantially greater than those encountered in their normal work, and it is understandable that the language of heroism has been evoked to praise them for their actions. Yet such language can have potentially negative consequences. Here, I examine what heroism is and why it is being applied to the healthcare workers currently, before outlining some of the problems associated with the heroism narrative currently being employed by the media. Healthcare workers have a clear and limited duty to treat during the COVID-19 pandemic, which can be grounded in a broad social contract and is strongly associated with certain reciprocal duties that society has towards healthcare workers. I argue that the heroism narrative can be damaging, as it stifles meaningful discussion about what the limits of this duty to treat are. It fails to acknowledge the importance of reciprocity, and through its implication that all healthcare workers have to be heroic, it can have negative psychological effects on workers themselves. I conclude that rather than invoking the language of heroism to praise healthcare workers, we should examine, as a society, what duties healthcare workers have to work in this pandemic, and how we can support them in fulfilling these.

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COVID-19: Long-term effects

Some people continue to experience health problems long after having COVID-19. Understand the possible symptoms and risk factors for post-COVID-19 syndrome.

Most people who get coronavirus disease 2019 (COVID-19) recover within a few weeks. But some people — even those who had mild versions of the disease — might have symptoms that last a long time afterward. These ongoing health problems are sometimes called post- COVID-19 syndrome, post- COVID conditions, long COVID-19 , long-haul COVID-19 , and post acute sequelae of SARS COV-2 infection (PASC).

What is post-COVID-19 syndrome and how common is it?

Post- COVID-19 syndrome involves a variety of new, returning or ongoing symptoms that people experience more than four weeks after getting COVID-19 . In some people, post- COVID-19 syndrome lasts months or years or causes disability.

Research suggests that between one month and one year after having COVID-19 , 1 in 5 people ages 18 to 64 has at least one medical condition that might be due to COVID-19 . Among people age 65 and older, 1 in 4 has at least one medical condition that might be due to COVID-19 .

What are the symptoms of post-COVID-19 syndrome?

The most commonly reported symptoms of post- COVID-19 syndrome include:

Symptoms that get worse after physical or mental effort
Lung (respiratory) symptoms, including difficulty breathing or shortness of breath and cough

Other possible symptoms include:

Neurological symptoms or mental health conditions, including difficulty thinking or concentrating, headache, sleep problems, dizziness when you stand, pins-and-needles feeling, loss of smell or taste, and depression or anxiety
Joint or muscle pain
Heart symptoms or conditions, including chest pain and fast or pounding heartbeat
Digestive symptoms, including diarrhea and stomach pain
Blood clots and blood vessel (vascular) issues, including a blood clot that travels to the lungs from deep veins in the legs and blocks blood flow to the lungs (pulmonary embolism)
Other symptoms, such as a rash and changes in the menstrual cycle

Keep in mind that it can be hard to tell if you are having symptoms due to COVID-19 or another cause, such as a preexisting medical condition.

It's also not clear if post- COVID-19 syndrome is new and unique to COVID-19 . Some symptoms are similar to those caused by chronic fatigue syndrome and other chronic illnesses that develop after infections. Chronic fatigue syndrome involves extreme fatigue that worsens with physical or mental activity, but doesn't improve with rest.

Why does COVID-19 cause ongoing health problems?

Organ damage could play a role. People who had severe illness with COVID-19 might experience organ damage affecting the heart, kidneys, skin and brain. Inflammation and problems with the immune system can also happen. It isn't clear how long these effects might last. The effects also could lead to the development of new conditions, such as diabetes or a heart or nervous system condition.

The experience of having severe COVID-19 might be another factor. People with severe symptoms of COVID-19 often need to be treated in a hospital intensive care unit. This can result in extreme weakness and post-traumatic stress disorder, a mental health condition triggered by a terrifying event.

What are the risk factors for post-COVID-19 syndrome?

You might be more likely to have post- COVID-19 syndrome if:

You had severe illness with COVID-19 , especially if you were hospitalized or needed intensive care.
You had certain medical conditions before getting the COVID-19 virus.
You had a condition affecting your organs and tissues (multisystem inflammatory syndrome) while sick with COVID-19 or afterward.

Post- COVID-19 syndrome also appears to be more common in adults than in children and teens. However, anyone who gets COVID-19 can have long-term effects, including people with no symptoms or mild illness with COVID-19 .

What should you do if you have post-COVID-19 syndrome symptoms?

If you're having symptoms of post- COVID-19 syndrome, talk to your health care provider. To prepare for your appointment, write down:

When your symptoms started
What makes your symptoms worse
How often you experience symptoms
How your symptoms affect your activities

Your health care provider might do lab tests, such as a complete blood count or liver function test. You might have other tests or procedures, such as chest X-rays, based on your symptoms. The information you provide and any test results will help your health care provider come up with a treatment plan.

In addition, you might benefit from connecting with others in a support group and sharing resources.

Long COVID or post-COVID conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html. Accessed May 6, 2022.
Post-COVID conditions: Overview for healthcare providers. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html. Accessed May 6, 2022.
Mikkelsen ME, et al. COVID-19: Evaluation and management of adults following acute viral illness. https://www.uptodate.com/contents/search. Accessed May 6, 2022.
Saeed S, et al. Coronavirus disease 2019 and cardiovascular complications: Focused clinical review. Journal of Hypertension. 2021; doi:10.1097/HJH.0000000000002819.
AskMayoExpert. Post-COVID-19 syndrome. Mayo Clinic; 2022.
Multisystem inflammatory syndrome (MIS). Centers for Disease Control and Prevention. https://www.cdc.gov/mis/index.html. Accessed May 24, 2022.
Patient tips: Healthcare provider appointments for post-COVID conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/post-covid-appointment/index.html. Accessed May 24, 2022.
Bull-Otterson L, et al. Post-COVID conditions among adult COVID-19 survivors aged 18-64 and ≥ 65 years — United States, March 2020 — November 2021. MMWR Morbidity and Mortality Weekly Report. 2022; doi:10.15585/mmwr.mm7121e1.

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Why the Pandemic Probably Started in a Lab, in 5 Key Points

By Alina Chan

Dr. Chan is a molecular biologist at the Broad Institute of M.I.T. and Harvard, and a co-author of “Viral: The Search for the Origin of Covid-19.”

This article has been updated to reflect news developments.

On Monday, Dr. Anthony Fauci returned to the halls of Congress and testified before the House subcommittee investigating the Covid-19 pandemic. He was questioned about several topics related to the government’s handling of Covid-19, including how the National Institute of Allergy and Infectious Diseases, which he directed until retiring in 2022, supported risky virus work at a Chinese institute whose research may have caused the pandemic.

For more than four years, reflexive partisan politics have derailed the search for the truth about a catastrophe that has touched us all. It has been estimated that at least 25 million people around the world have died because of Covid-19, with over a million of those deaths in the United States.

Although how the pandemic started has been hotly debated, a growing volume of evidence — gleaned from public records released under the Freedom of Information Act, digital sleuthing through online databases, scientific papers analyzing the virus and its spread, and leaks from within the U.S. government — suggests that the pandemic most likely occurred because a virus escaped from a research lab in Wuhan, China. If so, it would be the most costly accident in the history of science.

Here’s what we now know:

1 The SARS-like virus that caused the pandemic emerged in Wuhan, the city where the world’s foremost research lab for SARS-like viruses is located.

At the Wuhan Institute of Virology, a team of scientists had been hunting for SARS-like viruses for over a decade, led by Shi Zhengli.
Their research showed that the viruses most similar to SARS‑CoV‑2, the virus that caused the pandemic, circulate in bats that live r oughly 1,000 miles away from Wuhan. Scientists from Dr. Shi’s team traveled repeatedly to Yunnan province to collect these viruses and had expanded their search to Southeast Asia. Bats in other parts of China have not been found to carry viruses that are as closely related to SARS-CoV-2.

The closest known relatives to SARS-CoV-2 were found in southwestern China and in Laos.

Large cities

Mine in Yunnan province

Cave in Laos

South China Sea

The closest known relatives to SARS-CoV-2

were found in southwestern China and in Laos.

philippines

The closest known relatives to SARS-CoV-2 were found

in southwestern China and Laos.

Sources: Sarah Temmam et al., Nature; SimpleMaps

Note: Cities shown have a population of at least 200,000.

There are hundreds of large cities in China and Southeast Asia.

There are hundreds of large cities in China

and Southeast Asia.

The pandemic started roughly 1,000 miles away, in Wuhan, home to the world’s foremost SARS-like virus research lab.

The pandemic started roughly 1,000 miles away,

in Wuhan, home to the world’s foremost SARS-like virus research lab.

The pandemic started roughly 1,000 miles away, in Wuhan,

home to the world’s foremost SARS-like virus research lab.

Even at hot spots where these viruses exist naturally near the cave bats of southwestern China and Southeast Asia, the scientists argued, as recently as 2019 , that bat coronavirus spillover into humans is rare .
When the Covid-19 outbreak was detected, Dr. Shi initially wondered if the novel coronavirus had come from her laboratory , saying she had never expected such an outbreak to occur in Wuhan.
The SARS‑CoV‑2 virus is exceptionally contagious and can jump from species to species like wildfire . Yet it left no known trace of infection at its source or anywhere along what would have been a thousand-mile journey before emerging in Wuhan.

2 The year before the outbreak, the Wuhan institute, working with U.S. partners, had proposed creating viruses with SARS‑CoV‑2’s defining feature.

Dr. Shi’s group was fascinated by how coronaviruses jump from species to species. To find viruses, they took samples from bats and other animals , as well as from sick people living near animals carrying these viruses or associated with the wildlife trade. Much of this work was conducted in partnership with the EcoHealth Alliance, a U.S.-based scientific organization that, since 2002, has been awarded over $80 million in federal funding to research the risks of emerging infectious diseases.
The laboratory pursued risky research that resulted in viruses becoming more infectious : Coronaviruses were grown from samples from infected animals and genetically reconstructed and recombined to create new viruses unknown in nature. These new viruses were passed through cells from bats, pigs, primates and humans and were used to infect civets and humanized mice (mice modified with human genes). In essence, this process forced these viruses to adapt to new host species, and the viruses with mutations that allowed them to thrive emerged as victors.
By 2019, Dr. Shi’s group had published a database describing more than 22,000 collected wildlife samples. But external access was shut off in the fall of 2019, and the database was not shared with American collaborators even after the pandemic started , when such a rich virus collection would have been most useful in tracking the origin of SARS‑CoV‑2. It remains unclear whether the Wuhan institute possessed a precursor of the pandemic virus.
In 2021, The Intercept published a leaked 2018 grant proposal for a research project named Defuse , which had been written as a collaboration between EcoHealth, the Wuhan institute and Ralph Baric at the University of North Carolina, who had been on the cutting edge of coronavirus research for years. The proposal described plans to create viruses strikingly similar to SARS‑CoV‑2.
Coronaviruses bear their name because their surface is studded with protein spikes, like a spiky crown, which they use to enter animal cells. T he Defuse project proposed to search for and create SARS-like viruses carrying spikes with a unique feature: a furin cleavage site — the same feature that enhances SARS‑CoV‑2’s infectiousness in humans, making it capable of causing a pandemic. Defuse was never funded by the United States . However, in his testimony on Monday, Dr. Fauci explained that the Wuhan institute would not need to rely on U.S. funding to pursue research independently.

The Wuhan lab ran risky experiments to learn about how SARS-like viruses might infect humans.

1. Collect SARS-like viruses from bats and other wild animals, as well as from people exposed to them.

2. Identify high-risk viruses by screening for spike proteins that facilitate infection of human cells.

2. Identify high-risk viruses by screening for spike proteins that facilitate infection of

human cells.

In Defuse, the scientists proposed to add a furin cleavage site to the spike protein.

3. Create new coronaviruses by inserting spike proteins or other features that could make the viruses more infectious in humans.

4. Infect human cells, civets and humanized mice with the new coronaviruses, to determine how dangerous they might be.

While it’s possible that the furin cleavage site could have evolved naturally (as seen in some distantly related coronaviruses), out of the hundreds of SARS-like viruses cataloged by scientists, SARS‑CoV‑2 is the only one known to possess a furin cleavage site in its spike. And the genetic data suggest that the virus had only recently gained the furin cleavage site before it started the pandemic.
Ultimately, a never-before-seen SARS-like virus with a newly introduced furin cleavage site, matching the description in the Wuhan institute’s Defuse proposal, caused an outbreak in Wuhan less than two years after the proposal was drafted.
When the Wuhan scientists published their seminal paper about Covid-19 as the pandemic roared to life in 2020, they did not mention the virus’s furin cleavage site — a feature they should have been on the lookout for, according to their own grant proposal, and a feature quickly recognized by other scientists.
Worse still, as the pandemic raged, their American collaborators failed to publicly reveal the existence of the Defuse proposal. The president of EcoHealth, Peter Daszak, recently admitted to Congress that he doesn’t know about virus samples collected by the Wuhan institute after 2015 and never asked the lab’s scientists if they had started the work described in Defuse. In May, citing failures in EcoHealth’s monitoring of risky experiments conducted at the Wuhan lab, the Biden administration suspended all federal funding for the organization and Dr. Daszak, and initiated proceedings to bar them from receiving future grants. In his testimony on Monday, Dr. Fauci said that he supported the decision to suspend and bar EcoHealth.
Separately, Dr. Baric described the competitive dynamic between his research group and the institute when he told Congress that the Wuhan scientists would probably not have shared their most interesting newly discovered viruses with him . Documents and email correspondence between the institute and Dr. Baric are still being withheld from the public while their release is fiercely contested in litigation.
In the end, American partners very likely knew of only a fraction of the research done in Wuhan. According to U.S. intelligence sources, some of the institute’s virus research was classified or conducted with or on behalf of the Chinese military . In the congressional hearing on Monday, Dr. Fauci repeatedly acknowledged the lack of visibility into experiments conducted at the Wuhan institute, saying, “None of us can know everything that’s going on in China, or in Wuhan, or what have you. And that’s the reason why — I say today, and I’ve said at the T.I.,” referring to his transcribed interview with the subcommittee, “I keep an open mind as to what the origin is.”

3 The Wuhan lab pursued this type of work under low biosafety conditions that could not have contained an airborne virus as infectious as SARS‑CoV‑2.

Labs working with live viruses generally operate at one of four biosafety levels (known in ascending order of stringency as BSL-1, 2, 3 and 4) that describe the work practices that are considered sufficiently safe depending on the characteristics of each pathogen. The Wuhan institute’s scientists worked with SARS-like viruses under inappropriately low biosafety conditions .

In the United States, virologists generally use stricter Biosafety Level 3 protocols when working with SARS-like viruses.

Biosafety cabinets prevent

viral particles from escaping.

Viral particles

Personal respirators provide

a second layer of defense against breathing in the virus.

DIRECT CONTACT

Gloves prevent skin contact.

Disposable wraparound

gowns cover much of the rest of the body.

Personal respirators provide a second layer of defense against breathing in the virus.

Disposable wraparound gowns

cover much of the rest of the body.

Note: Biosafety levels are not internationally standardized, and some countries use more permissive protocols than others.

The Wuhan lab had been regularly working with SARS-like viruses under Biosafety Level 2 conditions, which could not prevent a highly infectious virus like SARS-CoV-2 from escaping.

Some work is done in the open air, and masks are not required.

Less protective equipment provides more opportunities

for contamination.

Some work is done in the open air,

and masks are not required.

Less protective equipment provides more opportunities for contamination.

In one experiment, Dr. Shi’s group genetically engineered an unexpectedly deadly SARS-like virus (not closely related to SARS‑CoV‑2) that exhibited a 10,000-fold increase in the quantity of virus in the lungs and brains of humanized mice . Wuhan institute scientists handled these live viruses at low biosafet y levels , including BSL-2.
Even the much more stringent containment at BSL-3 cannot fully prevent SARS‑CoV‑2 from escaping . Two years into the pandemic, the virus infected a scientist in a BSL-3 laboratory in Taiwan, which was, at the time, a zero-Covid country. The scientist had been vaccinated and was tested only after losing the sense of smell. By then, more than 100 close contacts had been exposed. Human error is a source of exposure even at the highest biosafety levels , and the risks are much greater for scientists working with infectious pathogens at low biosafety.
An early draft of the Defuse proposal stated that the Wuhan lab would do their virus work at BSL-2 to make it “highly cost-effective.” Dr. Baric added a note to the draft highlighting the importance of using BSL-3 to contain SARS-like viruses that could infect human cells, writing that “U.S. researchers will likely freak out.” Years later, after SARS‑CoV‑2 had killed millions, Dr. Baric wrote to Dr. Daszak : “I have no doubt that they followed state determined rules and did the work under BSL-2. Yes China has the right to set their own policy. You believe this was appropriate containment if you want but don’t expect me to believe it. Moreover, don’t insult my intelligence by trying to feed me this load of BS.”
SARS‑CoV‑2 is a stealthy virus that transmits effectively through the air, causes a range of symptoms similar to those of other common respiratory diseases and can be spread by infected people before symptoms even appear. If the virus had escaped from a BSL-2 laboratory in 2019, the leak most likely would have gone undetected until too late.
One alarming detail — leaked to The Wall Street Journal and confirmed by current and former U.S. government officials — is that scientists on Dr. Shi’s team fell ill with Covid-like symptoms in the fall of 2019 . One of the scientists had been named in the Defuse proposal as the person in charge of virus discovery work. The scientists denied having been sick .

4 The hypothesis that Covid-19 came from an animal at the Huanan Seafood Market in Wuhan is not supported by strong evidence.

In December 2019, Chinese investigators assumed the outbreak had started at a centrally located market frequented by thousands of visitors daily. This bias in their search for early cases meant that cases unlinked to or located far away from the market would very likely have been missed. To make things worse, the Chinese authorities blocked the reporting of early cases not linked to the market and, claiming biosafety precautions, ordered the destruction of patient samples on January 3, 2020, making it nearly impossible to see the complete picture of the earliest Covid-19 cases. Information about dozens of early cases from November and December 2019 remains inaccessible.
A pair of papers published in Science in 2022 made the best case for SARS‑CoV‑2 having emerged naturally from human-animal contact at the Wuhan market by focusing on a map of the early cases and asserting that the virus had jumped from animals into humans twice at the market in 2019. More recently, the two papers have been countered by other virologists and scientists who convincingly demonstrate that the available market evidence does not distinguish between a human superspreader event and a natural spillover at the market.
Furthermore, the existing genetic and early case data show that all known Covid-19 cases probably stem from a single introduction of SARS‑CoV‑2 into people, and the outbreak at the Wuhan market probably happened after the virus had already been circulating in humans.

An analysis of SARS-CoV-2’s evolutionary tree shows how the virus evolved as it started to spread through humans.

SARS-COV-2 Viruses closest

to bat coronaviruses

more mutations

Source: Lv et al., Virus Evolution (2024) , as reproduced by Jesse Bloom

The viruses that infected people linked to the market were most likely not the earliest form of the virus that started the pandemic.

Not a single infected animal has ever been confirmed at the market or in its supply chain. Without good evidence that the pandemic started at the Huanan Seafood Market, the fact that the virus emerged in Wuhan points squarely at its unique SARS-like virus laboratory.

5 Key evidence that would be expected if the virus had emerged from the wildlife trade is still missing.

In previous outbreaks of coronaviruses, scientists were able to demonstrate natural origin by collecting multiple pieces of evidence linking infected humans to infected animals.

Infected animals

Earliest known

cases exposed to

live animals

Antibody evidence

of animals and

animal traders having

been infected

Ancestral variants

of the virus found in

Documented trade

of host animals

between the area

where bats carry

closely related viruses

and the outbreak site

Infected animals found

Earliest known cases exposed to live animals

Antibody evidence of animals and animal

traders having been infected

Ancestral variants of the virus found in animals

Documented trade of host animals

between the area where bats carry closely

related viruses and the outbreak site

For SARS-CoV-2, these same key pieces of evidence are still missing , more than four years after the virus emerged.

For SARS-CoV-2, these same key pieces of evidence are still missing ,

more than four years after the virus emerged.

Despite the intense search trained on the animal trade and people linked to the market, investigators have not reported finding any animals infected with SARS‑CoV‑2 that had not been infected by humans. Yet, infected animal sources and other connective pieces of evidence were found for the earlier SARS and MERS outbreaks as quickly as within a few days, despite the less advanced viral forensic technologies of two decades ago.
Even though Wuhan is the home base of virus hunters with world-leading expertise in tracking novel SARS-like viruses, investigators have either failed to collect or report key evidence that would be expected if Covid-19 emerged from the wildlife trade . For example, investigators have not determined that the earliest known cases had exposure to intermediate host animals before falling ill. No antibody evidence shows that animal traders in Wuhan are regularly exposed to SARS-like viruses, as would be expected in such situations.
With today’s technology, scientists can detect how respiratory viruses — including SARS, MERS and the flu — circulate in animals while making repeated attempts to jump across species . Thankfully, these variants usually fail to transmit well after crossing over to a new species and tend to die off after a small number of infections. In contrast, virologists and other scientists agree that SARS‑CoV‑2 required little to no adaptation to spread rapidly in humans and other animals . The virus appears to have succeeded in causing a pandemic upon its only detected jump into humans.

The pandemic could have been caused by any of hundreds of virus species, at any of tens of thousands of wildlife markets, in any of thousands of cities, and in any year. But it was a SARS-like coronavirus with a unique furin cleavage site that emerged in Wuhan, less than two years after scientists, sometimes working under inadequate biosafety conditions, proposed collecting and creating viruses of that same design.

While several natural spillover scenarios remain plausible, and we still don’t know enough about the full extent of virus research conducted at the Wuhan institute by Dr. Shi’s team and other researchers, a laboratory accident is the most parsimonious explanation of how the pandemic began.

Given what we now know, investigators should follow their strongest leads and subpoena all exchanges between the Wuhan scientists and their international partners, including unpublished research proposals, manuscripts, data and commercial orders. In particular, exchanges from 2018 and 2019 — the critical two years before the emergence of Covid-19 — are very likely to be illuminating (and require no cooperation from the Chinese government to acquire), yet they remain beyond the public’s view more than four years after the pandemic began.

Whether the pandemic started on a lab bench or in a market stall, it is undeniable that U.S. federal funding helped to build an unprecedented collection of SARS-like viruses at the Wuhan institute, as well as contributing to research that enhanced them . Advocates and funders of the institute’s research, including Dr. Fauci, should cooperate with the investigation to help identify and close the loopholes that allowed such dangerous work to occur. The world must not continue to bear the intolerable risks of research with the potential to cause pandemics .

A successful investigation of the pandemic’s root cause would have the power to break a decades-long scientific impasse on pathogen research safety, determining how governments will spend billions of dollars to prevent future pandemics. A credible investigation would also deter future acts of negligence and deceit by demonstrating that it is indeed possible to be held accountable for causing a viral pandemic. Last but not least, people of all nations need to see their leaders — and especially, their scientists — heading the charge to find out what caused this world-shaking event. Restoring public trust in science and government leadership requires it.

A thorough investigation by the U.S. government could unearth more evidence while spurring whistleblowers to find their courage and seek their moment of opportunity. It would also show the world that U.S. leaders and scientists are not afraid of what the truth behind the pandemic may be.

More on how the pandemic may have started

Where Did the Coronavirus Come From? What We Already Know Is Troubling.

Even if the coronavirus did not emerge from a lab, the groundwork for a potential disaster had been laid for years, and learning its lessons is essential to preventing others.

By Zeynep Tufekci

Why Does Bad Science on Covid’s Origin Get Hyped?

If the raccoon dog was a smoking gun, it fired blanks.

By David Wallace-Wells

A Plea for Making Virus Research Safer

A way forward for lab safety.

By Jesse Bloom

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

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Alina Chan ( @ayjchan ) is a molecular biologist at the Broad Institute of M.I.T. and Harvard, and a co-author of “ Viral : The Search for the Origin of Covid-19.” She was a member of the Pathogens Project , which the Bulletin of the Atomic Scientists organized to generate new thinking on responsible, high-risk pathogen research.

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Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

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COVID-19 Vaccine: What You Need to Know

The COVID-19 vaccine is very good at preventing serious illness, hospitalization and death. Because the virus that causes COVID-19 continues to change, vaccines are updated to help fight the disease. It is important to check the Centers for Disease Control and Prevention (CDC) COVID-19 vaccine information for the latest details. (Posted 11/22/23)

What is the COVID-19 vaccine?

The COVID-19 vaccine lessens the severity of COVID-19 by teaching the immune system to recognize and fight the virus that causes the disease.

For fall/winter 2023–2024, the updated COVID-19 vaccine is based on the XBB.1.5 variant. The updated vaccine is made by Pfizer-BioNTech, Moderna and Novavax. This season, only one shot of the vaccine is needed for most people, and there are no boosters. (People who are immunocompromised or ages 6 months to 4 years may need more than one 2023–2024 vaccine.)

How is the 2023–2024 COVID-19 vaccine different from previous COVID-19 vaccines?

The 2023–2024 COVID-19 vaccine targets XBB.1.5, a subvariant of Omicron. While none of the variants currently circulating are exact matches to the vaccine, they are all closely related to the XBB.1.5 strain. Studies show that the updated vaccine is effective against the variants currently causing the majority of COVID-19 cases in the U.S.

Who should get a COVID-19 vaccine?

Because the 2023–2024 vaccine is effective for recent strains of COVID-19, it is recommended that everyone stay up to date with this vaccine. Previous vaccines or boosters were not developed to target the more recent strains. For 2023–2024, the CDC recommends:

Everyone age 5 and older receive one shot of the updated vaccine.
Children ages 6 months to 4 years may need more than one shot to be up to date.
People who are moderately or severely immunocompromised may need more than one shot.

You can review the full recommendations on the CDC’s Stay Up to Date with COVID-19 Vaccines webpage . Be sure to talk to your primary care doctor or pediatrician if you are unsure about vaccine recommendations.

What are the side effects of the COVID-19 vaccine?

Side effects vary and may last one to three days. Common side effects are:

Soreness at the injection site

COVID-19 Vaccine and Pregnancy

COVID-19 vaccines approved by the Food and Drug Administration (FDA) are safe and recommended for people who are pregnant or lactating, as well as for those r intending to become pregnant.

People who are pregnant or were recently pregnant are at a greater risk for severe COVID-19. Having a severe case of COVID-19 while pregnant is linked to a higher risk of pre-term birth and stillbirth and might increase the risk of other pregnancy complications.

What should parents know about the COVID-19 vaccine and children?

The CDC recommends the 2023–2024 vaccine for adolescents and teenagers ages 12 and older, and for children ages 6 months through 11 years.

Children age 5 and older need one shot of the updated vaccine.

Children are less likely to become seriously ill from COVID-19 than adults, although serious illness can happen. Speak with your pediatrician if you have questions about having your child vaccinated.

If I recently had COVID-19, do I need a 2023–2024 vaccine?

If you recently had COVID-19, the CDC recommends waiting about three months before getting this updated vaccine. If you encounter the virus again, having the updated vaccine will:

Lessen your risk of severe disease that could require hospitalization
Reduce the chance that you infect someone else with COVID-19
Help keep you protected from currently circulating COVID-19 variants

How long should I wait to get this vaccine if I recently had an earlier version of a COVID-19 vaccine or booster?

People age 5 years and older should wait at least two months after getting the last dose of any COVID-19 vaccine before receiving the 2023–2024 vaccine, according to CDC guidance .

Is natural immunity better than a vaccine?

Natural immunity is the antibody protection your body creates against a germ once you’ve been infected with it. Natural immunity to the virus that causes COVID-19 is no better than vaccine-acquired immunity, and it comes with far greater risks. Studies show that natural immunity to the virus weakens over time and does so faster than immunity provided by COVID-19 vaccination.

Do I need a COVID-19 booster?

The 2023–2024 vaccine is a one-shot vaccine for most people, and there is no booster this season. (People who are immunocompromised or ages 6 months to 4 years may need more than one 2023–2024 vaccine.)

The FDA calls this an updated vaccine (not a “booster” like previous shots) because it builds a new immune response to variants that are currently circulating. This change reflects the current approach of treating COVID-19 similarly to the flu, with preventive measures such as an annual vaccination.

When should I get a COVID-19 vaccine?

Like the flu and other respiratory diseases, COVID-19 tends to be more active in the fall and winter, so getting a vaccine in the fall is recommended.

How quickly does the COVID-19 vaccine become effective?

It usually takes about two weeks for the vaccine to become effective. The CDC website provides more information on how the COVID-19 vaccines work .

How long does the COVID-19 vaccine last?

Studies suggest that COVID-19 vaccines are most effective during the first three months after vaccination.

Is it safe to get a flu and COVID-19 vaccine at the same time?

Yes, it safe to get both shots at the same time. Keep in mind that each has similar side effects and you may experience side effects from both.

Is the COVID-19 vaccine safe?

Yes. COVID-19 vaccines approved by the FDA meet rigorous testing criteria and are safe and effective at preventing serious illness, hospitalization and death. Millions of people have received the vaccines, and the CDC continues to monitor their safety and effectiveness as well as rare adverse events.

Where can I get a COVID-19 vaccine?

The COVID-19 vaccine is available at pharmacies. See vaccines.gov to find a convenient location.

Trauma Team Puts an Athlete Back in the Saddle

Illustrated doctor and patient speaking together

Patient Safety Infographic

Coronavirus: Younger Adults Are at Risk, Too

‘Healthcare Heroes’: problems with media focus on heroism from healthcare workers during the COVID-19 pandemic

Caitríona l cox.

The Healthcare Improvement Studies (THIS) Institute, Cambridge CB2 0AH, UK

Introduction

In recent weeks praise for ‘Healthcare Heroes’ has been plentiful in the media, with The Mirror even launching a campaign for all healthcare workers to receive a medal for their work. 1 2 Although this gratitude is undoubtedly appreciated by many, we must be cautious about overuse of the term ‘hero’ in such discussions.

The challenges faced by healthcare workers in the current pandemic are substantially greater than those encountered in their normal work, and it is understandable that the language of heroism has been evoked to praise them for their actions. Yet such language can have potentially negative consequences.

The question of what is expected of healthcare workers in a pandemic—in particular with regard to what level of personal risk they should shoulder—is a complex one. Hollow dependence on the narrative of healthcare workers as ‘heroes’ oversimplifies the issue, providing a potentially damaging and morally vacuous evaluation of an important topic. Here, I will examine what heroism is and why it is being applied to the healthcare workers in the present situation, before outlining some of the problems associated with the heroism narrative currently being employed by the media.

What is heroism?

The term hero is widely used and has been applied to a range of fictional and real figures, and consequently it is difficult to reach a precise definition that adequately reflects its common usage. A number of elements have been proposed as necessary for actions to be considered heroic. 3

Since Urmson’s 1958 seminal paper, most accounts consider heroic actions to be supererogatory. 4 5 Supererogatory actions are morally excellent actions that go beyond the duty of the agent: they are actions which are good, but not strictly required. 6 Supporters of the concept of supererogation have used a ‘two-tier’ model of ethical guidance for action to differentiate what one must do (the obligatory) and what one can only be encouraged to do (the supererogatory). 5

Although all heroic actions are supererogatory, not all supererogatory actions are necessarily heroic. Other elements are generally required to make an action heroic, which help to set heroism apart from other prosocial activities, such as giving money to charity (which are altruistic, not heroic). 3 Heroism typically involves a voluntary engagement with an acknowledged degree of personal risk to help others. 3 The risk does not have to involve physical peril, but may involve ‘personal sacrifice in other dimensions of life’, such as serious financial consequences or loss of social status. 3 Both having the choice to act in a certain way and recognising the possible risks/costs are important—someone who has been forced into acting, or acts blithely without any awareness of the hazard, does not act heroically.

A full discussion of the moral and ethical status of heroism, and indeed the philosophical debate surrounding supererogation, is beyond the scope of this paper. For now, let us consider heroic actions to be voluntary prosocial actions, associated with an acknowledged degree of personal risk, which transcend the duty of the agent.

Heroism in the current pandemic

Even outside of a pandemic, there are ways in which the normal actions of healthcare workers could fit the above description of heroism. Healthcare workers voluntarily act to help others in the face of recognised personal risk when they are routinely exposed to infectious diseases in a variety of settings. An accident and emergency nurse risks contracting hepatitis through a needlestick injury, while a physician might be exposed to multidrug-resistant tuberculosis as part of their work. These personal risks are an accepted part of working in certain healthcare roles, so are not encountered unknowingly. Healthcare workers doing their everyday jobs have not, however, been widely lauded as heroes in the media in recent years: these risks have largely been viewed as simply ‘part of the job’. What has changed in the current pandemic to prompt a sudden focus on heroism? Is there something substantially different about the act of working in the COVID-19 pandemic which justifies the change in narrative?

Several historical epidemics have given rise to work examining the duty of healthcare workers to treat patients in the face of personal risk. In particular, the HIV/AIDS epidemic in the 1980s resulted in robust debates regarding the grounding and extent of a physician’s duty of care to patients. 7 8 Later, the 2003 severe acute respiratory syndrome (SARS) outbreak further demonstrated the need to explore conflicts between professional and personal obligations. 9–12 Most of these discussions concerning risk and obligation focused on the concept of ‘duty of care’, or ‘duty to treat’, weighing up the risk to individual healthcare workers against their duty to their patients.

In the COVID-19 pandemic, the risks to healthcare workers are appreciably greater than those encountered in normal practice. In addition to risk of contracting the infection, other costs include ‘physical and mental exhaustion, the torment of difficult triage decisions, and the pain of losing patients and colleagues’. 13 The emotional cost of having to live away from vulnerable family members for extended periods of time while working has also been acknowledged. We might thus argue that although some personal risk is inherent in working in healthcare, these risks are so amplified currently that descriptions of heroism are justified. Moreover, the advice for the public to stay at home to protect themselves contrasts sharply with the requirement for healthcare workers to continue attending work to care for patients, which has emphasised the concept of healthcare workers making a significant sacrifice by continuing to work. The widespread use of militaristic language in the coverage of the pandemic has further fostered the image of front-line staff acting heroically in the ‘battle’ against the virus.

It is thus not surprising that many have reached for the superlative ‘heroic’ in describing the actions of healthcare workers. Yet while these descriptions of ‘healthcare heroes’ may be superficially fitting, the continuing dominance of the hero narrative in the media is in several ways unhelpful.

Heroism stifles meaningful discussion about the duty of care and its limits

A significant problem with the dominant heroism narrative is that it stifles meaningful, and much needed, discussion about under what obligations healthcare workers have to work. The question of what can reasonably be expected of healthcare workers in a pandemic is best addressed through an examination of their duty of care, including what grounds it and what its limits are. Media focus on heroism does not afford sufficient examination of these questions.

It is uncontroversial to state that healthcare professionals have a duty of care to their patients. This duty of care is a ‘special’ positive moral duty, which arises from the relationship between the healthcare worker and the patient. 14 Special duties have two key characteristics: (1) typically they are role related, and are signified by an overt acceptance of the duty, and (2) they can obligate people to incur greater risk in performing the duty than we might expect others to. 14 Yet the duty of care is neither limitless nor fixed. 15 Sokol has been particularly critical of the concept of duty of care, noting that ‘in the medical context, is often invoked as a sort of quasi-biblical commandment, akin to “do not lie” or “do not murder”.’ 16 While it is intuitively appealing to rely on duty of care to justify what healthcare workers should be expected to do during pandemics, the phrase alone is too nebulous to be useful: relying on it can be ‘ethically dangerous by giving the illusion of legitimate moral justification’. 16 If we accept that healthcare workers have a special positive duty to treat patients of emerging infectious disease, even at some personal risk—a ‘duty to treat’—we must critically examine both what grounds this duty and what its limits are.

Grounding the duty to treat has proved challenging: ‘a solid ethical basis for the health professional’s duty to treat victims of… infectious disease, even at some level of personal risk, has proved elusive’. 17 A number of different accounts have attempted to describe the basis for the duty to treat, the most compelling of which are social contract models. 14 According to these models, healthcare workers have a duty to treat which is grounded in a social contract, the result of a ‘negotiation between the medical profession and the community at large’. 17 Healthcare workers have access to certain privileges as a result of their position in society (such as financial renumeration, relative self-regulation, trust and admiration from laypeople) and in return they have a duty to treat which may entail accepting a degree of personal risk. 14 17–19 Clark argues that healthcare professionals who enjoy such benefits, but do not fulfil their duty to treat, are essentially ‘free riders’. 18

Narrow social contract models, which focus exclusively on the contract between doctors and society (and thus exclude non-professional but essential health workers), have been criticised for being too limited to adequately address the response required by the healthcare sector as a whole to a pandemic. 12 Reid argues that attempts to ground the duty to treat should address the broader question of what sort of society we want to live in, a question which cannot be viewed as a simple negotiation between any one professional group and a community. 12 In asking, whether we would ‘prefer to live in a society that provides healthcare to people with infectious disease… or in a society that practices a form of quarantining of the ill without treatment, leaving them to die in isolation’, Reid recognises a broader social contract which is applicable to all those involved in healthcare, not just doctors. 12

It is clear that the duty to treat is not limitless. Healthcare workers are not duty bound to do absolutely everything in their power to benefit their patients at any level of personal risk: for example, as Sokol points out, few would argue that doctors are morally obligated to donate their kidney to a patient. 16 The idea that the duty to treat is limited, even in the current pandemic, is evidenced by the fact that healthcare workers with medical conditions which make them higher risk for suffering serious COVID-19-related disease have been advised to avoid patient-facing roles. For these healthcare workers, working with patients would thus represent an unacceptable level of personal risk, and would exceed what is required by the duty to treat.

Defining the limits of the duty to treat is a ‘daunting task, strewn with philosophical and logistical difficulties’. 16 Indeed, one working group concluded that they ‘could not reach consensus on the issue… particularly regarding the extent to which healthcare workers are obligated to risk their lives’. 11 If the duty to treat is most firmly grounded in a broad social contract between healthcare workers and society, consensus on what degree of personal risk should be undertaken in different circumstances must come from robust discussion between different stakeholders in society. A crude narrative which focuses on all healthcare workers as heroes stifles such discussion, as it does not properly recognise that the duty to treat is limited.

The importance of acknowledging reciprocity

Reciprocity is of significant importance to social contract theories: in return for accepting personal risk in fulfilling their duty to treat, healthcare workers expect reciprocal social obligations. Healthcare institutions are obligated to support workers and acknowledge their work in difficult conditions. The need to provide personal protective equipment (PPE) to minimise risk of illness among healthcare workers has been highlighted by a number of authors. 9–11 15 20 Other proposed reciprocal duties that healthcare institutions have to their employees include clear communication regarding expectations and risks involved; adequate support, training and resources to perform their duties; counselling and psychological support; support and compensation for their families if they die; and access to treatment or vaccination if it becomes available. 15 17 20 21 The general public, who must play a role in supporting the healthcare system, ‘both during an epidemic and in times where there is no crisis’, also have reciprocal obligations. 12 Reid notes that the public play a role in supporting a healthcare system when they pay taxes or vote for governments that support the healthcare system. 12 In times of pandemic, the public also fulfil their obligations to healthcare workers by following public health guidance—for example, by adhering to social distancing measures, or by taking actions to minimise the spread of infection such as covering their mouth when coughing.

A public narrative that concentrates on individual heroism fundamentally fails to acknowledge the importance of reciprocity. Individual heroism does not provide a firm basis on which to build a systematic response to a pandemic: there must be recognition of the responsibilities of healthcare institutions and the general public. In the current pandemic, issues have been repeatedly raised regarding the availability of PPE for healthcare workers. 22 The requirement for employers to provide PPE to minimise the risk to healthcare workers is reflected by the attitudes of workers themselves—97.2% of healthcare workers in one study agreed that their employer was responsible for offering PPE. 23 Media coverage which praises heroism among healthcare workers diverts attention away from the critical importance of ensuring that reciprocal social obligations to healthcare workers are fulfilled; as Reid notes, ‘the obligation to noble self-sacrifice seems incompatible with insisting on proper protective equipment.’ 12 It has been noted that during the SARS epidemic, the hero narrative proved a politically convenient tool for deflecting attention away from governmental errors: ‘by calling health professionals “heroes”, policy makers in government wanted to escape from their guilt of policy mistakes.’ 9 Indeed, a response based on individual supererogatory action neglects the responsibility that the government and healthcare institutions have in supporting workers, and in creating and maintaining the systems required to deliver healthcare. The hero narrative fails to remind the public and healthcare institutions of their own moral duties, as in its focus on individual healthcare workers’ selfless sacrifice it does not recognise that their duty to treat is irrevocably tied to reciprocal societal obligations.

Negative impact on healthcare workers

The overuse of the concept of heroism in the media could also have a negative psychological impact on healthcare workers themselves, through the implication that all healthcare workers have to be heroic. We are, by definition, not obliged to perform supererogatory acts; as Singer et al 11 note, it seems ‘unreasonable to demand… heroism as the norm’. 11 There is thus a fundamental problem in describing all healthcare workers as heroic. We cannot ask all healthcare workers who go to work to accept personal risk beyond what is reasonably expected of them, as it is simply too demanding; we cannot, in short, expect heroism.

It is important to acknowledge that some healthcare workers may feel that the level of personal risk that they are currently being expected to accept in working is beyond what they ‘signed up’ to. Empirical data on healthcare workers’ attitudes to personal risk and duty reflect the fact that not every worker feels comfortable with accepting such risk; an American study found that only 55% of physicians agreed that ‘physicians have an obligation to care for patients in epidemics even if doing so endangers the physician’s health’, while a British study reported that 26.0% of healthcare workers disagreed that ‘All HCWs have a duty to work, even if high risks involved’. 23 24 In modern healthcare, the risk of exposure to infectious disease is not ubiquitous, and healthcare workers in certain roles may argue that significant occupational exposure to pathogens is not an integral part of their normal job. 14 23 As ‘the risks of treating infectious diseases are simply not obvious in or central to some fields in the way that the risk of fighting fires is obvious in and central to the field of firefighting’, we cannot assume that all those working in healthcare were prepared for the high levels of personal risk that might be incurred through working in a pandemic. 14 The heroism narrative leaves little room for acknowledgement of emotions such as fear or confliction regarding contradictory duties.

Fear and anxiety among healthcare workers who are facing personal risk must be acknowledged and addressed. This might be facilitated by moving away from labelling all healthcare workers as ‘heroes’—which places pressure on them to act in ways which are beyond reasonable expectation—and towards a discussion about what expectations are reasonable within a social contract model. The fact that healthcare professionals themselves have expressed discomfort with being labelled as ‘heroes’ further emphasises that the media’s use of the term can have a negative impact on those it is being bestowed on. 25

Recognising the difficult and incredibly valuable work performed by healthcare workers during the current COVID-19 pandemic is an important part of society’s response to it. We should, however, strive to do this without invoking the language of heroism, which emphasises ideas about self-sacrifice but does not adequately recognise the importance of reciprocity, or that there are limits to the levels of personal risk that we can expect healthcare workers to shoulder. Although the concept of individual heroism is appealing, its use could also have negative psychological consequences for healthcare workers themselves.

There have undoubtedly been many individual acts of heroism from healthcare workers in recent weeks and months, and I do not wish to devalue these; rather, I argue that we should be cautious about centring the narrative on heroism. Healthcare workers have a clear and limited duty to treat during the COVID-19 pandemic, which can be grounded in a broad social contract and is strongly associated with certain reciprocal duties that society has towards healthcare workers. This model of duties and reciprocal obligations is likely to be helpful in guiding our response to the pandemic. Rather than praising all healthcare workers as heroes and clapping them every Thursday, we need to critically examine, as a society, what duties we think healthcare workers have to work in this pandemic, what the reasonable limits to these duties are and how we can reciprocally support them.

Acknowledgments

CLC thanks Dr Zoe Fritz for providing helpful comments on previous versions of this paper.

Contributors: CLC is the sole contributor to the work.

Funding: The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge is funded by The Health Foundation.

Competing interests: None declared.

Patient consent for publication: Not required.

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

Data availability statement: There are no data in this work

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In the pandemic, we were told to keep 6 feet apart. There’s no science to support that.

In a congressional appearance, infectious-disease expert Anthony S. Fauci characterized the recommendation as “an empiric decision that wasn’t based on data.”

The nation’s top mental health official had spent months asking for evidence behind the Centers for Disease Control and Prevention’s social distancing guidelines, warning that keeping Americans physically apart during the coronavirus pandemic would harm patients, businesses, and overall health and wellness.

Now, Elinore McCance-Katz, the Trump administration’s assistant secretary for mental health and substance use, was urging the CDC to justify its recommendation that Americans stay six feet apart to avoid contracting covid-19 — or get rid of it.

“I very much hope that CDC will revisit this decision or at least tell us that there is more and stronger data to support this rule than what I have been able to find online,” McCance-Katz wrote in a June 2020 memo submitted to the CDC and other health agency leaders and obtained by The Washington Post. “If not, they should pull it back.”

The CDC would keep its six-foot social distance recommendation in place until August 2022, with some modifications as Americans got vaccinated against the virus and officials pushed to reopen schools. Now, congressional investigators are set Monday to press Anthony S. Fauci, the infectious-disease doctor who served as a key coronavirus adviser during the Trump and Biden administrations, on why the CDC’s recommendation was allowed to shape so much of American life for so long, particularly given Fauci and other officials’ recent acknowledgments that there was little science behind the six-foot rule after all.

“It sort of just appeared, that six feet is going to be the distance,” Fauci testified to Congress in a January closed-door hearing, according to a transcribed interview released Friday. Fauci characterized the recommendation as “an empiric decision that wasn’t based on data.”

Francis S. Collins, former director of the National Institutes of Health, also privately testified to Congress in January that he was not aware of evidence behind the social distancing recommendation, according to a transcript released in May.

Four years later, visible reminders of the six-foot rule remain with us, particularly in cities that rushed to adopt the CDC’s guidelines hoping to protect residents and keep businesses open. D.C. is dotted with signs in stores and schools — even on sidewalks or in government buildings — urging people to stand six feet apart.

Experts agree that social distancing saved lives, particularly early in the pandemic when Americans had no protections against a novel virus sickening millions of people. One recent paper published by the Brookings Institution , a nonpartisan think tank, concludes that behavior changes to avoid developing covid-19, followed later by vaccinations, prevented about 800,000 deaths. But that achievement came at enormous cost, the authors added, with inflexible strategies that weren’t driven by evidence.

“We never did the study about what works,” said Andrew Atkeson, a UCLA economist and co-author of the paper, lamenting the lack of evidence around the six-foot rule. He warned that persistent frustrations over social distancing and other measures might lead Americans to ignore public health advice during the next crisis.

The U.S. distancing measure was particularly stringent, as other countries adopted shorter distances; the World Health Organization set a distance of one meter, or slightly more than three feet, which experts concluded was roughly as effective as the six-foot mark at deterring infections, and would have allowed schools to reopen more rapidly.

The six-foot rule was “probably the single most costly intervention the CDC recommended that was consistently applied throughout the pandemic,” Scott Gottlieb, former Food and Drug Administration commissioner, wrote in his book about the pandemic, “Uncontrolled Spread.”

It’s still not clear who at the CDC settled on the six-foot distance; the agency has repeatedly declined to specify the authors of the guidance, which resembled its recommendations on how to avoid contracting the flu. A CDC spokesperson credited a team of experts, who drew from research such as a 1955 study on respiratory droplets . In his book, Gottlieb wrote that the Trump White House pushed back on the CDC’s initial recommendation of 10 feet of social distance, saying it would be too difficult to implement.

Perhaps the rule’s biggest impact was on children, despite ample evidence they were at relatively low risk of covid-related complications. Many schools were unable to accommodate six feet of space between students’ desks and forced to rely on virtual education for more than a year, said Joseph Allen, a Harvard University expert in environmental health, who called in 2020 for schools to adopt three feet of social distance.

“The six-foot rule was really an error that had been propagated for several decades, based on a misunderstanding of how particles traveled through indoor spaces,” Allen said, adding that health experts often wrongly focused on avoiding droplets from infected people rather than improving ventilation and filtration inside buildings.

Social distancing had champions before the pandemic. Bush administration officials, working on plans to fight bioterrorism, concluded that social distancing could save lives in a health crisis and renewed their calls as the coronavirus approached. The idea also took hold when public health experts initially believed that the coronavirus was often transmitted by droplets expelled by infected people, which could land several feet away; the CDC later acknowledged the virus was airborne and people could be exposed just by sharing the same air in a room, even if they were farther than six feet apart.

“There was no magic around six feet,” Robert R. Redfield, who served as CDC director during the Trump administration, told a congressional committee in March 2022. “It’s just historically that’s what was used for other respiratory pathogens. So that really became the first piece” of a strategy to protect Americans in the early days of the virus, he said.

It also became the standard that states and businesses adopted, with swift pressure on holdouts. Lawmakers and workers urged meat processing plants, delivery companies and other essential businesses to adopt the CDC’s social distancing recommendations as their employees continued reporting to work during the pandemic.

Some business leaders weren’t sure the measures made sense. Jeff Bezos, founder of online retail giant Amazon, petitioned the White House in March 2020 to consider revising the six-foot recommendation, said Adam Boehler, then a senior Trump administration official helping with the coronavirus response. At the time, Amazon was facing questions about a rising number of infections in its warehouses, and Democratic senators were urging the company to adopt social distancing.

“Bezos called me and asked, is there any real science behind this rule?” Boehler said, adding that Bezos pushed on whether Amazon could adopt an alternative distance if workers were masked, physically separated by dividers or other precautions were taken. “He said … it’s the backbone of trying to keep America running here, and when you separate somebody five feet versus six feet, it’s a big difference,” Boehler recalled. Bezos owns The Washington Post.

Kelly Nantel, an Amazon spokesperson, confirmed that Bezos called Boehler and said the Amazon founder’s focus was the discrepancy between the U.S. recommendation and the WHO’s shorter distance. The company soon said it would follow the CDC’s six-foot social distancing guidelines in its warehouses and later developed technologies to try to enforce those guidelines. “We did it globally everywhere because it was the right thing to do,” Nantel said.

Boehler said he spoke with Redfield and Fauci about testing alternatives to the six-foot recommendation but that he was not aware of what happened to those tests or what they found. Fauci declined to comment. Redfield did not respond to requests for comment.

But challenging the six-foot recommendation, particularly in the pandemic’s early days, was seen as politically difficult. Rochelle Walensky, then chief of infectious disease at Massachusetts General Hospital, argued in a July 2020 email that “if people are masked it is quite safe and much more practical to be at 3 feet” in many school settings.

Five months later, incoming president Joe Biden would tap Walensky as his CDC director. Walensky swiftly endorsed the six-foot distance before working to loosen it, announcing in March 2021 that elementary school students could sit three feet apart if they were masked. Walensky declined to comment.

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As I write this, I am mourning the death of a UN colleague. He died last Friday, struck down by COVID-19, at the age of 32. As a team member of the UN's Migration Agency, he showed exemplary ...
'Healthcare Heroes': problems with media focus on heroism from
During the COVID-19 pandemic, the media have repeatedly praised healthcare workers for their 'heroic' work. Although this gratitude is undoubtedly appreciated by many, we must be cautious about overuse of the term 'hero' in such discussions. The challenges currently faced by healthcare workers are substantially greater than those encountered in their normal work, and it is ...
COVID-19: Long-term effects
People who had severe illness with COVID-19 might experience organ damage affecting the heart, kidneys, skin and brain. Inflammation and problems with the immune system can also happen. It isn't clear how long these effects might last. The effects also could lead to the development of new conditions, such as diabetes or a heart or nervous ...
Why the Pandemic Probably Started in a Lab, in 5 Key Points
Dr. Chan is a molecular biologist at the Broad Institute of M.I.T. and Harvard, and a co-author of "Viral: The Search for the Origin of Covid-19." This article has been updated to reflect news ...
Full article: Assessing the impact of the COVID-19 pandemic
2. The papers. In 'Higher Inequality in Latin America: A Collateral Effect of the Pandemic', Ivonne Acevedo, Francesca Castellani, María José Cota, Giulia Lotti and Miguel Székely explore the evolution of inequality in Latin America during the COVID-19 pandemic by using primary data from household and employment surveys collected in 2020.
COVID-19 Vaccine: What You Need to Know
The COVID-19 vaccine lessens the severity of COVID-19 by teaching the immune system to recognize and fight the virus that causes the disease. For fall/winter 2023-2024, the updated COVID-19 vaccine is based on the XBB.1.5 variant. The updated vaccine is made by Pfizer-BioNTech, Moderna and Novavax. This season, only one shot of the vaccine is ...
The "nurse as hero" discourse in the COVID-19 pandemic: A
Open in a separate window. The results of our analysis of the media suggest that there are three main elements of the hero discourse in COVID-19 that have unforeseen but potent effects on nurses: 1. Nurses as a "necessary sacrifice;" 2. Nurses as "model citizens;" and 3. Heroism itself as the reward for nurses. 5.1.
'Healthcare Heroes': problems with media focus on heroism from
During the COVID-19 pandemic, the media have repeatedly praised healthcare workers for their 'heroic' work. Although this gratitude is undoubtedly appreciated by many, we must be cautious about overuse of the term 'hero' in such discussions. ... Saints and heroes : Melden AI, Essays in moral philosophy. University of Washington Press, 1958.
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Microsoft Forms is a web-based application that allows you to: Create and share online surveys, quizzes, polls, and forms. Collect feedback, measure satisfaction, test knowledge, and more. Easily design your forms with various question types, themes, and branching logic. Analyze your results with built-in charts and reports, or export them to ...
In the pandemic, we were told to keep 6 feet apart. There's no science
One recent paper published by the Brookings Institution, a nonpartisan think tank, concludes that behavior changes to avoid developing covid-19, followed later by vaccinations, prevented about ...

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COVID-19: Long-term effects

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Why the Pandemic Probably Started in a Lab, in 5 Key Points

1 The SARS-like virus that caused the pandemic emerged in Wuhan, the city where the world’s foremost research lab for SARS-like viruses is located.

2 The year before the outbreak, the Wuhan institute, working with U.S. partners, had proposed creating viruses with SARS‑CoV‑2’s defining feature.

3 The Wuhan lab pursued this type of work under low biosafety conditions that could not have contained an airborne virus as infectious as SARS‑CoV‑2.

4 The hypothesis that Covid-19 came from an animal at the Huanan Seafood Market in Wuhan is not supported by strong evidence.

5 Key evidence that would be expected if the virus had emerged from the wildlife trade is still missing.

More on how the pandemic may have started

Where Did the Coronavirus Come From? What We Already Know Is Troubling.

Why Does Bad Science on Covid’s Origin Get Hyped?

A Plea for Making Virus Research Safer