The Impact of COVID-19 on American Life
-Through the Lens of a Leading Global Health Expert-
The COVID-19 pandemic has undoubtedly had a major impact on the daily lives of people around the world. At the COSMO Online Seminar held on November 5, Dr. Dairiku Hozumi, Managing Director of ThinkWell Global, a U.S. think tank specializing in healthcare financing, and Independent Director at COSMO Public Relations Corporation (“COSMO”), was invited to share his thoughts on the current situation in the U.S.
Through his lens as a U.S. resident, Dr. Hozumi discussed the impact of the pandemic on the daily lives of citizens as well as countermeasures against COVID-19. He also touched upon challenges facing the COVAX Facility, a framework for supplying vaccines to prevent new coronavirus infections worldwide, and the future of mRNA vaccines.
After graduating from Juntendo University School of Medicine, Dr. Hozumi received his Master’s of Public Health (MPH) from the University of California, Berkeley, and Master’s of Science in Management (MSM) from the Massachusetts Institute of Technology. He has been involved in public health strategy and execution for over twenty years in more than twenty countries, including Pakistan, Zambia, Malawi, Kenya, and Ghana. To learn more about Dr. Hozumi, view his complete bio here.
Below are highlights from the COSMO Online Seminar.
1. How COVID-19 changed people’s lives in the U.S.
• Due to the lockdown, jobs previously carried out in offices had to be performed remotely, changing the way people think about work, including where they work and what they want out of work. Even after the lockdown was lifted, many did not return to their offices. Under such a climate, there have been changes in the labor market, including a worker shortage.*1
• Additionally, the grocery supply chain serving large supermarket chains has been obstructed due to the pandemic, prompting many consumers to start sourcing produce locally. An increase in food prices has led to a higher cost of living in general, raising concerns over the worsening disparity between the rich and poor.
• Moreover, the federal government’s vaccine mandate has become politicized, with several state governors banning the mandate. To a degree, some opposition to vaccines is not surprising; however, this issue is expected to further polarize society.
• What COVID-19-related trends in the U.S. have we seen play out in Japan?
2. Status of COVAX Facility and challenges
• In order to end the global pandemic, it is crucial that vaccines are distributed fairly to low-income countries and other countries through the COVAX Facility*2 initiative.
• We should also recognize the need to provide support not only for delivery of vaccines to low-income countries, but also support for domestic delivery, storage, and rollout of vaccines.
3. The future of mRNA vaccines
• mRNA vaccine technology is being used to develop general purpose influenza vaccines, therapeutic treatments that target mutated genes that can cause normal cells to become cancerous, and preventive drugs for malaria and HIV.
• It would be wonderful to see these applications materialize, but it could also lead to new societal problems over who would have access to these new drugs.
1. How COVID-19 changed people’s lives in the U.S.
There were three major ways how the spread of COVID-19 affected life in the U.S. First, the way people think about work has drastically changed, and we are now experiencing a phenomenon where there are job openings but no workers. Second, the vulnerability of the grocery supply chain has become evident, and the cost of living has also been affected. Third, issues have emerged in some states over the federal vaccine mandate.
As values shift, more people are reconsidering the way they work
When the lockdown went into effect in March 2020, most, if not all, employees who worked in an office environment were prohibited from working at their offices. Instead, they were made to work from home. Some workers decided to uproot and move to a completely different location. For instance, some relocated from North Carolina to Ohio or Texas, to work where they wanted in a completely new place. Then, even after the rollout of vaccines and the lifting of the lockdown, many refused to return to their offices. The pandemic prompted many to re-imagine their working lives and where to work. From the business owner perspective, how to lure these employees back to their offices after reopening remains a serious issue.*1
Working from home has also changed how people manage family life. When the pandemic hit, one of the first challenges facing families was the issue of childcare. Since daycare centers and similar were also under lockdown, families were at a loss as to how to manage. Many had no choice but to keep children at home. Even though people assumed that remote work would ease certain elements of working life, such as commuting time or the opportunity to work comfortably in their own space, on the contrary, many found themselves in endless Zoom meetings with substantial administrative tasks to deal with. In other words, there was a great burden on workers, which led to even more fatigue and pressure. On the other hand, according to a survey, 40% of people responded that they became more aware of the importance of spending time with family and the value of family.
Increasingly, as the pandemic raged on, people started to quit their jobs to prioritize their own health with little thought of the future. Others left their jobs to figure out what they wanted out of life. Many restaurants had to close indefinitely because employees weren’t returning to work. Some McDonalds franchises have even hiked their hourly wage to $20 to attract workers. With the reopening of offices, people who have been working remotely for the past year and a half will likely be in the office just a few times a week instead of every day. In this way, COVID-19 has changed the way people think about work, including where to work and what they seek in a job. This has led to a major shift in the labor market, such as the phenomenon of abundant job openings with no takers.
Fragile food supply system casting a shadow on the cost of living
Next, I’d like to talk about the food supply system, which is closely connected to peoples’ lives. Before the pandemic, the U.S. relied on major supermarket chains such as Wal-Mart for its food supply. After the pandemic hit, there was a lack of truck drivers, which slowed food distribution. As a result, many were forced to rely on ‘local production for local consumption’ types of business models, such as local farmers’ markets. Under these circumstances, the importance of food sharing systems has been garnering attention.
In addition, food prices have gone up, which has affected living expenses. For example, a 24-pack of 500-milliliter bottles of mineral water used to sell for $11, but it jumped to $14 within a week, which was alarming. Since then, consumer price increases have yet to abate, which has especially impacted low-income people, so the government took measures at an early stage in the pandemic, such as providing $1,200 stimulus checks and implementing a policy of adding welfare payments in addition to unemployment insurance for those who lost their jobs.
Additionally, an eviction moratorium guideline was issued to prevent the eviction of people who fail to pay their rent on time. However, when this guideline expires and renters are left with no option but to leave, disparity due to poverty will increase. Every year in the U.S. at the company level, management discusses cost-of-living adjustments for the following year, and there is growing interest in how much employers will be able to add to paychecks this year.
Will the vaccine mandate further divide society?
The latest hot button pandemic issue is the vaccine mandate. In the U.S., vaccination initially progressed quite rapidly, but the current percentage of people who have been vaccinated has stagnated at around 58% (at the time of this discussion). This rate does not appear to be increasing. In spite of this, few people wear masks. In Houston, Texas, for example, very few people seem to wear masks outside.
In extreme cases, some restaurants even post signs prohibiting customers from entering if masked. Brawls have erupted over the use of facemasks on flights. These are the two extremes in the way people regard vaccines, and this polarity is a major factor contributing to the stagnant vaccination rates in the U.S. Now, with the federal government issuing the vaccine mandate, the issue has become wildly politicized.
People who hold public jobs, such as government contractors and most university related positions, must submit proof of vaccination by January 4 (at the time of this discussion) unless they have religious or health reasons for not complying. States are also moving forward with vaccine mandates, but some individuals are not complying with the mandate.
For example, the head of the sheriff’s department in Los Angeles County, California, declared that he will not require Los Angeles County sheriffs to be vaccinated. He explained that about 10% of sheriffs leave their jobs every year, but increasingly higher numbers are leaving due to the pandemic, and they don’t want that number to increase further due to mandatory vaccination.
According to federal guidelines, companies with more than 100 employees are required to have their employees vaccinated or tested every week, whereas Texas and Florida prohibit such a requirement under the authority of the state governors. As the U.S. administration and the states ramp up their arguments over the vaccine mandate, airplane pilots and those who do business across state lines are left wondering which rules to follow.
Thus, you can see how the vaccine mandate has become a social issue, with tensions rising and society under great strain, further dividing the country. In the future, there will likely be a major divide between those who choose to prevent infection by getting vaccinated and those who refuse to get vaccinated and become infected, acquire immunity, and survive.
Should we expect any similar trends in Japan?
So far, I have talked about the impact of the pandemic on people’s lives in the U.S. Now, let’s have a look at five things observed in the U.S. that could also affect people’s lives in Japan going forward.
First, there is the issue of who will supply the food. In Japan, convenience stores are ubiquitous, and people can easily access them for lunch, entire meals, etc. The situation is of course different from that of the U.S. However, if infectious diseases spread, the question arises as to who is responsible for supplying food in Japan.
Secondly, there is the issue of quarantine measures and behavioral restrictions for people entering Japan from overseas. I believe that increasing numbers of people in Japan are not able to casually venture out on business trips abroad. In the future, the question is how we should deal with this issue in relation to countermeasures against infectious diseases.
What’s more, COVID-19 conspiracy theories, while mostly debunked, have gained traction in the US. I am surprised to see it happening in Japan as well. The key takeaway is how accurate information is managed is extremely important.
To return to the issue of the vaccine mandate mentioned earlier, in the U.S., there has been vocal opposition even among groups of people who are usually supportive of infection prevention, such as nurses, doctors, and pilots. Among the reasons cited for the lack of trust over the new vaccine is the fact that it is developed using a new manufacturing method. There are also concerns about the rushed development and approval process, and that long-term adverse reactions are yet to be confirmed. There is a possibility that Japan will experience similar issues in the future.
Lastly, there is the problem of hate crimes. In the U.S., there was a rise in Asian hate crimes triggered by the COVID-19 pandemic. I think we should be vigilant in Japan to stop racial discrimination before it starts and not allow COVID-19 to be used as an excuse to inflict hatred and racism on others.
2. Status of the COVAX Facility and challenges
Next, let’s examine the current status of the COVAX Facility, an international framework for the joint purchase of vaccines for COVID-19 by multiple countries and their equitable distribution to low-income countries.
In low-income countries, the vaccination rate for COVID-19 is only 3.9%
Currently, the global COVID-19 vaccination rate (of at least one dose) is around 50% (at the time of this discussion), but the figure is only 3.9% in low-income countries. The COVAX Facility’s procurement system for COVID-19 vaccines bears great significance because the global pandemic cannot be contained until people from these countries are vaccinated.
In many countries, support is needed for delivery, storage, and even vaccination
To date, $6.3 billion has been committed to the COVAX Facility by numerous nations and large foundations, and another $3 billion is needed, for a total of $10 billion. With all this money coming in, why are vaccines still not reaching the developing world?
It is said that one of the factors is that the Indian government banned the export of vaccines due to the spread of a new COVID-19 variant in India, which is the largest producer of COVID-19 vaccines. But there are other factors as well. For example, vaccines are transported to the ports and airports of each country, but from there, each country is responsible for domestic delivery.
However, COVID-19 vaccines need to be transported and stored at low temperatures and require a large number of refrigerators for storage. In fact, this has been the bottleneck in support to some areas. While it is important to create an international framework to contain the pandemic, going forward, we also must recognize the need to reach out to the point where vaccination is actually implemented in order to make a difference.
3. The future of mRNA vaccines
The mRNA vaccine to prevent COVID-19 infections involves a new mechanism of action.*3 While it is always advisable to keep up with expert opinions on how the technology works, below are some recent topics of discussion in the U.S. about how this new type of vaccine will be used in the future.
A new hope for multipurpose vaccines
First of all, it is said that the application of mRNA vaccine technology to influenza vaccines could create an all-purpose type of vaccine, instead of the current vaccine that is combined and tailored to each year’s flu-strains based on guesses. There is also talk of cancer treatment using mRNA vaccines to target mutated genes that can cause normal cells to become cancerous. In addition, vaccines based on the mRNA mechanism are being developed for malaria and HIV, for which there are currently no effective vaccines, and are also being considered for use as preventive drugs.
Concerns over new social issues resulting from a rush of new drugs
All of these developments would be wonderful if realized, but they will not be freely available to everyone. We must consider who will have access to these vaccines, under what conditions they will be available, and if they will be covered by insurance. These are some of the questions posed for practical application of this technology as we keep a watchful eye toward emerging issues.
*1: The Great Resignation
“Who is Driving the Great Resignation?” by Ian Cook, Harvard Business Review, September 15, 2021
*2: The Ministry of Health, Labour and Welfare’s announcement to commit to the COVAX Facility (COVID-19 Vaccine Global Access Facility) (in Japanese)
*3: The mechanism of the mRNA vaccine
The Ministry of Health, Labour and Welfare’s Q&A site (in Japanese)