Reckoning With the Pandemic’s Second-Order Impacts

Reckoning With the Pandemic’s Second-Order Impacts
A nurse during a night shift at a field hospital set up to handle a surge of COVID-19 patients, in Cranston, Rhode Island, Feb. 10, 2021 (AP photo by David Goldman).

Can the international community pay attention to multiple health crises at the same time? The coronavirus pandemic is putting this question to the test, and the experience of the past year suggests that the answer is a qualified no. If that is indeed the case, it means that the world will likely be living with the after-effects of COVID-19 for years to come. At the same time, the pandemic has spurred some changes in the world of public health that may create additional chances for improving access to health care in the long term.

COVID-19 itself has already had devastating consequences for the global community. In a little more than a year, this previously unknown disease has infected more than 140 million people in every country in the world. (The North Korean government claims that it has had no cases of the disease, but few give that assertion any credence.) It has killed more than 3 million people, caused widespread economic devastation and stressed health care systems to their limits around the world.

These are only the direct effects of the pandemic. An outbreak of this magnitude also prompts leaders to make far-reaching policy decisions that have significant first-order impacts—the immediate consequences of their actions—as well as second-order impacts, which are the consequences of those consequences. Second-order impacts often play out in both positive and negative ways that are difficult to anticipate, and their outcomes can linger unexpectedly.

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