Some reflections on the fifth anniversary of the COVID-19 pandemic
March 19, 2025
This week marks the fifth anniversary of the COVID-19 pandemic. The days of bleaching groceries and wearing masks outdoors seem in the far-off past, but the impact of the pandemic continues to loom large. COVID-19 caused 1.2 million deaths in the U.S. and over 7 million deaths globally and led to real and continuing tragedy for many. Caregivers and essential workers risked their lives to treat those with COVID and keep our society running. Some were sickened or died, and many remain traumatized by the experience.
The New York Times (gift link) offers a series of charts that highlight the impact the pandemic had on topics, including the amount of alcohol we purchase, the way we eat, and how many hours we spend in our homes. The pandemic restrictions led to an entire year with no influenza outbreak but also led to dramatic loss of childhood education and substantial foregone economic growth. Unfortunately, the pandemic was also associated with deepening vaccine skepticism. Decreasing early childhood vaccination is implicated in the current measles outbreak in Texas and New Mexico, which has caused at least two deaths and 23 hospitalizations, and is currently at about 200 reported cases.
The pandemic was associated with some rapid advances in clinical care:
mRNA vaccinations were available just a year after the publication of the genome of SARS CoV2, the COVID virus. This technology could help protect us from avian influenza and even help treat cancer.
Telemedicine blossomed, proving that many conditions could be treated without an office visit. This has been especially beneficial in increasing access to mental health services.
Self-administered tests became more prominent. Today, self-administered tests for influenza and various sexually transmitted diseases are available.
Monoclonal antibodies helped protect many from COVID, including those with underlying diseases that placed them at higher risk for complications, hospitalization, or death.
Local pharmacies proved to be an excellent way to distribute vaccinations.
Most of us were surprised that medical costs were lower during the first year of the pandemic, the first such decrease in my professional lifetime. The decline in elective care more than offset the extra costs of providing intensive care for those with severe cases of COVID and paying for testing and vaccination. The steep increase in medical costs in 2022 and following was not a surprise, as the medical community “caught up” on elective procedures, and labor shortages and supply chain disruptions led to an increase in general and health care inflation.
Employers played a critical role in the pandemic response. One of the earliest outbreaks in Boston was associated with a pharmaceutical convention. Most employers sharply curtailed travel and meetings, preventing the spread of disease and demonstrating that employees could accomplish a lot without boarding a plane. Rapid improvements in video conferencing tools allowed many people to protect themselves by working from home during the pandemic. Many, like me, continue to work from home, decreasing the commuting carbon footprint and saving time. Still, employers are determining how to allow flexibility without losing creative team building, and many workers are in jobs that are not amenable to remote work. The pandemic also led many employers to evaluate the air handling and filtration in workplaces. Improvements in indoor air quality can lead to increased productivity and prevent spread of many respiratory diseases.
The pandemic also showed the importance of humility in the face of imperfect information. The public health community initially suggested masking was unimportant and later promoted cloth masks that were likely of little use. Many treatments that showed efficacy in small studies turned out not to work when studied rigorously in large, randomized trials. Children missed more school than necessary, and many people resented vaccination mandates. The pandemic increased polarization and provided an opportunity for those opposed to evidence-based science to gain national prominence.
Implications for employers:
Some activities which began as a response to the pandemic, including remote meeting technology and better indoor air quality, will continue to add value to companies.
Companies benefited from advance planning, and from their ability to show they were decreasing employee risk.
Agility is most important when dealing with the unexpected.
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Tomorrow: Breast and colorectal cancer screening rates have rebounded