The COVID-19 pandemic is a public health crisis of unprecedented scale and complexity. It has resulted in profound loss of life as well as immense social and economic disruption. The disruption continues to have a significant impact on the US economy and threatens to destabilize the world’s interdependent economy in unprecedented ways. Unemployment in the United States has risen to levels not seen in nearly 100 years, with older workers losing their jobs faster than others.

The full impact of the crisis on the economy and population health is not yet known, but most experts agree that the crisis will change society significantly.

The direct health effects of the coronavirus have been greatest for people with pre-existing conditions, people of color, and older adults – especially those living in nursing homes. The impact on the residents and staff of the nursing home is devastating. While nursing home residents make up less than 1 percent of the population, they accounted for over 40 percent of deaths in 2020.

Racial and ethnic differences in infections, hospital admissions, and deaths from COVID-19 are not random; they are the result of long-term inequality due to a lack of social, economic and political opportunity. While these differences contribute to chronic health conditions, structural factors – where people live and work, their access to health care and healthy eating, lack of information, and racial discrimination – also play a major role.

Given these challenges and dynamics, the following steps should be taken.

  • Long-term care facilities must take steps to ensure the health, safety and quality of life of residents and should be held accountable for failure to do so. Facilities must help minimize disease transmission through the use of personal protective equipment, physical distancing requirements, and regular testing of residents, staff and visitors. They need to provide families with more transparency about COVID-19 cases within the facility, as well as treatment and discharge decisions. Given the importance of social connections in maintaining good health and quality of life, they must actively combat social isolation by complying with federal guidelines so that personal visits are safe whenever possible and that all residents are given regular opportunities for virtual visits with loved ones . especially if personal visits are not permitted. Long-term care facilities must be adequately staffed and held accountable when residents are injured, neglected or abused.
  • Policy makers need to ensure access to affordable, quality health care for all and take meaningful steps to address health inequalities. It is important that everyone has easy and safe access to testing and that financial barriers to treatment and care are removed, especially during a public health crisis. Individuals without health insurance and those in financial distress may have difficulty paying for COVID-19 tests, treatments, or vaccines and may be reluctant to obtain necessary services. Since so many families have lost health insurance in addition to their jobs, it is important to provide access through other means.

In addition, the pandemic has emphasized the need for immediate and meaningful action to address the racial and ethnic health inequalities in this country. Black and Latino people are more likely to experience serious illness and death from COVID-19 than others. And they face additional barriers when receiving testing, treatment, and quality care. It is imperative to address the lack of health care and service providers in underserved communities, including a concerted effort to reduce bias in the nature and quality of care for people in these communities.

  • Policy makers and employers need to better support workers who need flexible and safe work environments and strong support when they lose their jobs. The public health measures needed to slow the spread of COVID-19 (i.e. closures and stay-at-home orders) have contributed to widespread unemployment, with older workers particularly hard hit by job losses. Displaced workers need a stronger unemployment insurance system that both pays solid benefits and provides access to effective training and career guidance programs. Paid sick leave and family leave as well as flexible working hours are more important than ever. Workers need equipment and protocols to keep them safe from infection.
  • Politics must support access to high-speed internet. Even before the pandemic, many experts saw digital access as a universal necessity in order to be able to get involved effectively in almost all areas of life, including employers, the government, educational institutions and social circles. The importance of digital access has only increased as people try to minimize their exposure to possible infections. And what is crucial during a pandemic, high-speed connections enable individuals, especially the elderly, to continue to receive the health services they need and see their doctors from the safety of their homes through the use of telemedicine.
  • Both the public and private sectors need to act now to meet current needs and prepare for future public health crises. The health system needs to increase capacity to better cope with the large influx of seriously ill patients. An adequate supply of personal protective equipment must be available for healthcare professionals and other important workers, as well as for the general public. Contact tracing protocols, including those supported by technology, should be developed, reviewed, and operational, with standards designed to protect the privacy of individuals.