impact of covid 19 on education essay introduction

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What have we learned about the COVID-19 impact on education so far?

In this report, we present a summary of the findings of what we have learned so far about the impact of the COVID-19 pandemic on education systems.

The impact of COVID on education

The impact of COVID-19 on education across the world has been unprecedented and devastating. By mid-April 2020, almost 1.6 billion learners in 190 countries had been affected by school closures , which were happening on a scale never seen before.

With national governments being forced to make difficult priority decisions regarding public health, the economy and other social impacts, widespread school closures are closely connected to the wider socio-economic effects of the COVID-19 pandemic.

While ad hoc solutions were implemented to address the sudden need for remote and online education, the pandemic highlighted how unprepared international education systems were.

As the WHO Director General remarked on 29th June 2020 , "this is a moment for all of us to reflect on the progress we have made and the lessons we have learned". . Though it is still difficult to know when it will all end, it is vital for governments to consider longer-term implications and actively seek support and collaboration in finding solutions to address wider underlying solutions.

Cambridge and the effect of COVID-19 on education

During the COVID-19 pandemic, Cambridge has been actively monitoring governments’ response to the crisis, researching and engaging with its partners in government, public society organisations and donors from all over the world.

Our aim is to assess the impact of COVID-19 on their education systems, the solutions they are putting in place for the upcoming return to school, as well as their views on the challenges ahead and their aspirations for the future.

Our government partners are located in Sub-Saharan Africa, the Middle East and North Africa (MENA), Central Europe, South Asia, South East Asia, and South America. a

The public society organisations and donors we have been working with include the Department for International Development (DFID), UNICEF, World Bank, British Council, and various NGOs. Our report ‘What have we learned about the COVID-19 impact on education so far?’ presents a summary of our findings from our collaboration with these governments, organisations and donors.

The effect of COVID-19 on education systems

Widespread school closures on a global scale have affected millions of children, teachers, and education support staff. In the UK, for example, normal schooling was suspended for all but vulnerable children and the children of key workers . Teacher Tapp, a daily survey app for teachers in the UK, revealed that on any given day in 2020 only 17% of primary school teachers and 6% of secondary school teachers were going into school .

School closures due to the COVID-19 pandemic have revealed stark inequalities between and across countries and their education systems. The global digital divide serves as a key indicator of this, with half of all learners who could not be in the classroom due to the pandemic (approximately 830 million students) having no access to a computer according to UNESCO data.

While access to digital education is particularly evident in developing countries, this problem exists across the world, even in wealthier countries. Data from BroadbandNow Research reports that, in the USA, an estimated 42 million people have no internet access . With global education systems relying so heavily on online teaching, accessibility issues may widen the existing learning gap .

On a national level, the disparity between wealthier and poorer students has also been highlighted by the pandemic. For example, in the UK, a Teacher Tapp survey shows that teachers at independent schools were three times more likely to have spoken to students using video conferencing than those at state schools.

There were also disparities regarding preparedness, with private schools more likely to have systems in place for online learning prior to the pandemic compared to state schools. Teacher Tapp survey data showed that, before the first school closures, around 30% of private school teachers already had a platform they could use to broadcast lessons , whereas only 10% of state school teachers had access to such a platform.

Despite the lack of strong research evidence of their positive impact on learning, digital technologies will become one of the main conduits used by education systems to build resilience for the future.

We identified demanding challenges ahead, but also the opportunity to rethink and re-design education to meet the needs of future generations of young people in a world that is likely to be quite different post-pandemic.

Post-pandemic education: future challenges

One of the principal challenges raised by this disruption to global education is that it has damaged the progress that had been made towards the UN’s Sustainable Development Goal 4 , which focuses on quality education. The Sustainable Development Goals Report 2021 states that the COVID-19 pandemic has “wiped out 20 years of education gains” across the world.

Potential challenges will also arise regarding how to address the ‘learning loss’ caused by disrupted schooling, which will likely mean that many students have fallen behind the academic expectations set out in national curricula.

While a degree of learning loss was expected, it may have a greater impact than many people would anticipate. A research paper following the 2005 earthquake in Pakistan revealed that just 14 weeks of school closures caused students at all levels to lose between 1.5 and 2 years of schooling . This demonstrates the critical need to plan an effective transition back into normal education as schools reopen.

Technology has become an indispensable part of the education system across much of the world during the pandemic. While research is still ongoing, a few fundamental challenges posed by the increased reliance on technology have been identified, including the need for interactivity, timely feedback for students, and socialising.

Another key challenge that has surfaced during the pandemic so far is the difficulty of collecting data from students when they are not in school, as platforms like Teacher Tapp only survey teachers themselves. Student data would give a clearer idea of what is happening in the home, which would be critical in order to assess the efficacy of current solutions and improve future responses.

Post-pandemic education: opportunities

In spite of all of the challenges that have been caused or exacerbated by the pandemic, the effect of COVID-19 on education systems also provides opportunities to redesign them to be more resilient and equitable in the post-pandemic world.

One of the opportunities we’ve identified is the chance to refine the basic education curriculum by reducing the volume of content and making it more relevant to the current generation of learners. The reduced time and resources available to teachers during the pandemic has forced many to determine which aspects of the curriculum are more important to focus on, which could influence national curricula going forward.

The new post-pandemic world also presents the opportunity for us to rethink the skills and qualities that are prioritised within our education systems. With industries like health and social care experiencing labour shortages, skills including collaboration, empathy and emotional intelligence may be considered more essential by employers , and teaching would need to reflect this shift in attitudes.

Additionally, the increased use of technology across all industries - not just education - means that digital capabilities will become even more vital within the labour market , another change for which schools would need to prepare students.

In addition to reconsidering priorities regarding curricula and skills, post-pandemic education systems also have the opportunity to rethink assessments and examinations. Similarly to many other countries, secondary school exams in the UK were cancelled in 2020 and in 2021 , which meant that alternative methods of awarding grades had to be conceived. This new approach to assessments may influence the format, purpose and mode of delivery of future examinations.

The COVID-19 pandemic and its resultant school closures also present the opportunity to reevaluate the role of teachers within our global post-pandemic education systems. As many parents have had to step in and take on some of the responsibility of educating children, there has been a reappreciation of the importance and complexity of the role of teachers.

Moreover, the adoption of new technologies to assist with teaching highlights many ways that teachers’ jobs could be made easier. Teacher Tapp data showed that 75% of teachers were working less than 7 hours per day in April 2020 compared to just 10% around 18 months earlier. This change can likely be partially credited to teachers having their own childcare responsibilities, with over one-third of teachers having to educate their own children in addition to working . However, their working hours may also be reduced by online applications assisting with tasks including marking and activity setting.

Cambridge report: what have we learned about the COVID-19 impact on education so far?

In this report, we present a summary of what we have learned so far about the effect of the COVID-19 pandemic on education systems; we will continue actively engaging with the wider global education community to support governments in designing effective solutions that address their current and future challenges.

Download Download the full report

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Writing about COVID-19 in a college admission essay

by: Venkates Swaminathan | Updated: September 14, 2020

Print article

For students applying to college using the CommonApp, there are several different places where students and counselors can address the pandemic’s impact. The different sections have differing goals. You must understand how to use each section for its appropriate use.

The CommonApp COVID-19 question

First, the CommonApp this year has an additional question specifically about COVID-19 :

Community disruptions such as COVID-19 and natural disasters can have deep and long-lasting impacts. If you need it, this space is yours to describe those impacts. Colleges care about the effects on your health and well-being, safety, family circumstances, future plans, and education, including access to reliable technology and quiet study spaces. Please use this space to describe how these events have impacted you.

This question seeks to understand the adversity that students may have had to face due to the pandemic, the move to online education, or the shelter-in-place rules. You don’t have to answer this question if the impact on you wasn’t particularly severe. Some examples of things students should discuss include:

• The student or a family member had COVID-19 or suffered other illnesses due to confinement during the pandemic.
• The candidate had to deal with personal or family issues, such as abusive living situations or other safety concerns
• The student suffered from a lack of internet access and other online learning challenges.
• Students who dealt with problems registering for or taking standardized tests and AP exams.

Jeff Schiffman of the Tulane University admissions office has a blog about this section. He recommends students ask themselves several questions as they go about answering this section:

• Are my experiences different from others’?
• Are there noticeable changes on my transcript?
• Am I aware of my privilege?
• Am I specific? Am I explaining rather than complaining?
• Is this information being included elsewhere on my application?

If you do answer this section, be brief and to-the-point.

Counselor recommendations and school profiles

Second, counselors will, in their counselor forms and school profiles on the CommonApp, address how the school handled the pandemic and how it might have affected students, specifically as it relates to:

• Grading scales and policies
• Graduation requirements
• Instructional methods
• Schedules and course offerings
• Testing requirements
• Your academic calendar
• Other extenuating circumstances

Students don’t have to mention these matters in their application unless something unusual happened.

Writing about COVID-19 in your main essay

Write about your experiences during the pandemic in your main college essay if your experience is personal, relevant, and the most important thing to discuss in your college admission essay. That you had to stay home and study online isn’t sufficient, as millions of other students faced the same situation. But sometimes, it can be appropriate and helpful to write about something related to the pandemic in your essay. For example:

• One student developed a website for a local comic book store. The store might not have survived without the ability for people to order comic books online. The student had a long-standing relationship with the store, and it was an institution that created a community for students who otherwise felt left out.
• One student started a YouTube channel to help other students with academic subjects he was very familiar with and began tutoring others.
• Some students used their extra time that was the result of the stay-at-home orders to take online courses pursuing topics they are genuinely interested in or developing new interests, like a foreign language or music.

Experiences like this can be good topics for the CommonApp essay as long as they reflect something genuinely important about the student. For many students whose lives have been shaped by this pandemic, it can be a critical part of their college application.

Want more? Read 6 ways to improve a college essay , What the &%$! should I write about in my college essay , and Just how important is a college admissions essay? .

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The pandemic has had devastating impacts on learning. What will it take to help students catch up?

Subscribe to the brown center on education policy newsletter, megan kuhfeld , megan kuhfeld director of growth modeling and data analytics - nwea jim soland , jim soland assistant professor, school of education and human development - university of virginia, affiliated research fellow - nwea karyn lewis , and karyn lewis vice president of research and policy partnerships - nwea emily morton emily morton research scientist - nwea.

March 3, 2022

As we reach the two-year mark of the initial wave of pandemic-induced school shutdowns, academic normalcy remains out of reach for many students, educators, and parents. In addition to surging COVID-19 cases at the end of 2021, schools have faced severe staff shortages , high rates of absenteeism and quarantines , and rolling school closures . Furthermore, students and educators continue to struggle with mental health challenges , higher rates of violence and misbehavior , and concerns about lost instructional time .

As we outline in our new research study released in January, the cumulative impact of the COVID-19 pandemic on students’ academic achievement has been large. We tracked changes in math and reading test scores across the first two years of the pandemic using data from 5.4 million U.S. students in grades 3-8. We focused on test scores from immediately before the pandemic (fall 2019), following the initial onset (fall 2020), and more than one year into pandemic disruptions (fall 2021).

Average fall 2021 math test scores in grades 3-8 were 0.20-0.27 standard deviations (SDs) lower relative to same-grade peers in fall 2019, while reading test scores were 0.09-0.18 SDs lower. This is a sizable drop. For context, the math drops are significantly larger than estimated impacts from other large-scale school disruptions, such as after Hurricane Katrina—math scores dropped 0.17 SDs in one year for New Orleans evacuees .

Even more concerning, test-score gaps between students in low-poverty and high-poverty elementary schools grew by approximately 20% in math (corresponding to 0.20 SDs) and 15% in reading (0.13 SDs), primarily during the 2020-21 school year. Further, achievement tended to drop more between fall 2020 and 2021 than between fall 2019 and 2020 (both overall and differentially by school poverty), indicating that disruptions to learning have continued to negatively impact students well past the initial hits following the spring 2020 school closures.

These numbers are alarming and potentially demoralizing, especially given the heroic efforts of students to learn and educators to teach in incredibly trying times. From our perspective, these test-score drops in no way indicate that these students represent a “ lost generation ” or that we should give up hope. Most of us have never lived through a pandemic, and there is so much we don’t know about students’ capacity for resiliency in these circumstances and what a timeline for recovery will look like. Nor are we suggesting that teachers are somehow at fault given the achievement drops that occurred between 2020 and 2021; rather, educators had difficult jobs before the pandemic, and now are contending with huge new challenges, many outside their control.

Clearly, however, there’s work to do. School districts and states are currently making important decisions about which interventions and strategies to implement to mitigate the learning declines during the last two years. Elementary and Secondary School Emergency Relief (ESSER) investments from the American Rescue Plan provided nearly $200 billion to public schools to spend on COVID-19-related needs. Of that sum, $22 billion is dedicated specifically to addressing learning loss using “evidence-based interventions” focused on the “ disproportionate impact of COVID-19 on underrepresented student subgroups. ” Reviews of district and state spending plans (see Future Ed , EduRecoveryHub , and RAND’s American School District Panel for more details) indicate that districts are spending their ESSER dollars designated for academic recovery on a wide variety of strategies, with summer learning, tutoring, after-school programs, and extended school-day and school-year initiatives rising to the top.

Comparing the negative impacts from learning disruptions to the positive impacts from interventions

To help contextualize the magnitude of the impacts of COVID-19, we situate test-score drops during the pandemic relative to the test-score gains associated with common interventions being employed by districts as part of pandemic recovery efforts. If we assume that such interventions will continue to be as successful in a COVID-19 school environment, can we expect that these strategies will be effective enough to help students catch up? To answer this question, we draw from recent reviews of research on high-dosage tutoring , summer learning programs , reductions in class size , and extending the school day (specifically for literacy instruction) . We report effect sizes for each intervention specific to a grade span and subject wherever possible (e.g., tutoring has been found to have larger effects in elementary math than in reading).

Figure 1 shows the standardized drops in math test scores between students testing in fall 2019 and fall 2021 (separately by elementary and middle school grades) relative to the average effect size of various educational interventions. The average effect size for math tutoring matches or exceeds the average COVID-19 score drop in math. Research on tutoring indicates that it often works best in younger grades, and when provided by a teacher rather than, say, a parent. Further, some of the tutoring programs that produce the biggest effects can be quite intensive (and likely expensive), including having full-time tutors supporting all students (not just those needing remediation) in one-on-one settings during the school day. Meanwhile, the average effect of reducing class size is negative but not significant, with high variability in the impact across different studies. Summer programs in math have been found to be effective (average effect size of .10 SDs), though these programs in isolation likely would not eliminate the COVID-19 test-score drops.

Figure 1: Math COVID-19 test-score drops compared to the effect sizes of various educational interventions

Source: COVID-19 score drops are pulled from Kuhfeld et al. (2022) Table 5; reduction-in-class-size results are from pg. 10 of Figles et al. (2018) Table 2; summer program results are pulled from Lynch et al (2021) Table 2; and tutoring estimates are pulled from Nictow et al (2020) Table 3B. Ninety-five percent confidence intervals are shown with vertical lines on each bar.

Notes: Kuhfeld et al. and Nictow et al. reported effect sizes separately by grade span; Figles et al. and Lynch et al. report an overall effect size across elementary and middle grades. We were unable to find a rigorous study that reported effect sizes for extending the school day/year on math performance. Nictow et al. and Kraft & Falken (2021) also note large variations in tutoring effects depending on the type of tutor, with larger effects for teacher and paraprofessional tutoring programs than for nonprofessional and parent tutoring. Class-size reductions included in the Figles meta-analysis ranged from a minimum of one to minimum of eight students per class.

Figure 2 displays a similar comparison using effect sizes from reading interventions. The average effect of tutoring programs on reading achievement is larger than the effects found for the other interventions, though summer reading programs and class size reduction both produced average effect sizes in the ballpark of the COVID-19 reading score drops.

Figure 2: Reading COVID-19 test-score drops compared to the effect sizes of various educational interventions

Source: COVID-19 score drops are pulled from Kuhfeld et al. (2022) Table 5; extended-school-day results are from Figlio et al. (2018) Table 2; reduction-in-class-size results are from pg. 10 of Figles et al. (2018) ; summer program results are pulled from Kim & Quinn (2013) Table 3; and tutoring estimates are pulled from Nictow et al (2020) Table 3B. Ninety-five percent confidence intervals are shown with vertical lines on each bar.

Notes: While Kuhfeld et al. and Nictow et al. reported effect sizes separately by grade span, Figlio et al. and Kim & Quinn report an overall effect size across elementary and middle grades. Class-size reductions included in the Figles meta-analysis ranged from a minimum of one to minimum of eight students per class.

There are some limitations of drawing on research conducted prior to the pandemic to understand our ability to address the COVID-19 test-score drops. First, these studies were conducted under conditions that are very different from what schools currently face, and it is an open question whether the effectiveness of these interventions during the pandemic will be as consistent as they were before the pandemic. Second, we have little evidence and guidance about the efficacy of these interventions at the unprecedented scale that they are now being considered. For example, many school districts are expanding summer learning programs, but school districts have struggled to find staff interested in teaching summer school to meet the increased demand. Finally, given the widening test-score gaps between low- and high-poverty schools, it’s uncertain whether these interventions can actually combat the range of new challenges educators are facing in order to narrow these gaps. That is, students could catch up overall, yet the pandemic might still have lasting, negative effects on educational equality in this country.

Given that the current initiatives are unlikely to be implemented consistently across (and sometimes within) districts, timely feedback on the effects of initiatives and any needed adjustments will be crucial to districts’ success. The Road to COVID Recovery project and the National Student Support Accelerator are two such large-scale evaluation studies that aim to produce this type of evidence while providing resources for districts to track and evaluate their own programming. Additionally, a growing number of resources have been produced with recommendations on how to best implement recovery programs, including scaling up tutoring , summer learning programs , and expanded learning time .

Ultimately, there is much work to be done, and the challenges for students, educators, and parents are considerable. But this may be a moment when decades of educational reform, intervention, and research pay off. Relying on what we have learned could show the way forward.

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How COVID-19 caused a global learning crisis

Executive summary.

In our latest report on unfinished learning, we examine the impact of the COVID-19 pandemic on student learning and well-being, and identify potential considerations for school systems as they support students in recovery and beyond. Our key findings include the following:

• The length of school closures varied widely across the world. School buildings in middle-income Latin America and South Asia were fully or partially closed the longest—for 75 weeks or more. Those in high-income Europe and Central Asia were fully or partially closed for less time (30 weeks on average), as were those in low-income sub-Saharan Africa (34 weeks on average).

About the authors

This article is a collaborative effort by Jake Bryant , Felipe Child , Emma Dorn , Jose Espinosa, Stephen Hall , Topsy Kola-Oyeneyin , Cheryl Lim, Frédéric Panier, Jimmy Sarakatsannis , Dirk Schmautzer , Seckin Ungur , and Bart Woord, representing views from McKinsey’s Education Practice.

• Access to quality remote and hybrid learning also varied both across and within countries. In Tanzania, while school buildings were closed, children in just 6 percent of households listened to radio lessons, 5 percent accessed TV lessons, and fewer than 1 percent participated in online learning. 1 Jacobus Cilliers and Shardul Oza, “What did children do during school closures? Insights from a parent survey in Tanzania,” Research on Improving Systems of Education (RISE), May 19, 2021.
• Furthermore, pandemic-related learning delays stack up on top of historical learning inequities. The World Bank estimates that while students in high-income countries gained an average of 50 harmonized learning outcomes (HLO) points a year prepandemic, students in low-income countries were gaining just 20, leaving those students several years behind. 2 Noam Angrist et al., “Measuring human capital using global learning data,” Nature , March 2021, Volume 592.
• High-performing systems, with relatively high levels of pre-COVID-19 performance, where students may be about one to five months behind due to the pandemic (for example, North America and Europe, where students are, on average, four months behind).
• Low-income prepandemic-challenged systems, with very low levels of pre-COVID-19 learning, where students may be about three to eight months behind due to the pandemic (for example, sub-Saharan Africa, where students are on average six months behind).
• Pandemic-affected middle-income systems, with moderate levels of pre-COVID-19 learning, where students may be nine to 15 months behind (for example, Latin America and South Asia, where students are, on average, 12 months behind).
• The pandemic also increased inequalities within systems. For example, it widened gaps between majority Black and majority White schools in the United States and increased preexisting urban-rural divides in Ethiopia.
• Beyond learning, the pandemic has had broader social and emotional impacts on students globally—with rising mental-health concerns, reports of violence against children, rising obesity, increases in teenage pregnancy, and rising levels of chronic absenteeism and dropouts.
• Lower levels of learning translate into lower future earnings potential for students and lower economic productivity for nations. By 2040, the economic impact of pandemic-related learning delays could lead to annual losses of $1.6 trillion worldwide, or 0.9 percent of total global GDP.
• Resilience: Safely reopen schools for in-person learning while ensuring resilience for future disruptions.
• Reenrollment: Encourage students, families, and teachers to reengage with learning in effective learning environments.
• Recovery: Support students as they recover from the academic and social-emotional impacts of the pandemic, starting with an understanding of each student’s needs.
• Reimagining: Recommit to quality education for every child, doubling down on the fundamentals of educational excellence and innovating to adapt.

In some parts of the world, students, parents, and teachers may be experiencing a novel feeling: cautious optimism. After two years of disruptions from COVID-19, the overnight shift to online and hybrid learning, and efforts to safeguard teachers, administrators, and students, cities and countries are seeing the first signs of the next normal. Masks are coming off. Events are being held in person. Extracurricular activities are back in full swing.

These signs of hope are counterbalanced by the lingering, widespread impact of the pandemic. While it’s too early to catalog all of the ways students have been affected, we are starting to see initial indications of the toll COVID-19 has taken on learning around the world. Our analysis of available data found no country was untouched, but the impact varied across regions and within countries. Even in places with effective school systems and near-universal connectivity and device access, learning delays were significant, especially for historically vulnerable populations. 3 Emma Dorn, Bryan Hancock, Jimmy Sarakatsannis, and Ellen Viruleg, “ COVID-19 and education: An emerging K-shaped recovery ,” McKinsey, December 14, 2021. In many countries that had poor education outcomes before the pandemic, the setbacks were even greater. In those countries, an even more ambitious, coordinated effort will likely be required to address the disruption students have experienced.

Our analysis highlights the extent of the challenge and demonstrates how the impact of the pandemic on learning extends across students, families, and entire communities. Beyond the direct effect on students, learning delays have the potential to affect economic growth: by 2040, according to McKinsey analysis, COVID-19-related unfinished learning could translate into $1.6 trillion in annual losses to the global economy.

Acting decisively in the near term could help to address learning delays as well as the broader social, emotional, and mental-health impact on students. In mobilizing to respond to the pandemic’s effect on student learning and thriving, countries also may need to reassess their education systems—what has been working well and what may need to be reimagined in light of the past two years. Our hope is that this article’s analysis provides a potential starting point for dialogue as nations seek to reinvigorate their education systems.

Gauging the pandemic’s widespread impact on education

One of the challenges in assessing the global effect of the pandemic on learning is the lack of data. Comparative international assessments mostly cover middle- to high-income countries and have not been carried out since the beginning of the pandemic. The next Program for International Student Assessment (PISA), for example, was delayed until 2022. 4 “PISA,” OECD, accessed March 30, 2022. Similarly, many countries had to cancel or defer national assessments. As a result, few nations have a complete data set, and many have no assessment data to indicate relative learning before and since school closures. Accordingly, our methodology used available data augmented by informed assumptions to get a directional picture of the pandemic’s effects on the scholastic achievement and well-being of students.

The pandemic’s impact on student learning

We evaluated the potential effect of the pandemic on student learning by multiplying the amount of time school was disrupted in each country by the estimated effectiveness of the schooling students received during disruptions.

The duration of school closures ran the gamut. During the 102-week period we studied (from the onset of COVID-19 to January 2022), school buildings in Latin America, including the Caribbean, and South Asia were fully or partially closed for 75 weeks or more, while those in Europe and Central Asia were fully or partially closed for an average of 30 weeks (Exhibit 1). Schools in some regions began reopening a few months into the pandemic, but as of January 2022, more than a quarter of the world’s student population resided in school systems where schools were not yet fully open.

Remote and hybrid learning similarly varied widely across and within countries. Some students were supported by internet access, devices, learning management systems, adaptive learning software, live videoconferencing with teachers and peers, and home environments with parents or hired professionals to support remote learning. Others had access to radio or television programs, paper packages, and text messaging. Some students may not have had access to any learning options. 5 What’s next? Lessons on education recovery: Findings from a survey of ministries of education amid the COVID-19 pandemic , UNESCO, UNICEF, the World Bank, and OECD, June 2021. We used the World Bank’s estimates on “mitigation effectiveness” by country income level to account for different levels of access to learning tools and quality through the pandemic (see the forthcoming methodological appendix for more details).

Our model suggests that in the first 23 months since the start of the pandemic, students around the world may have lost about eight months of learning, on average, with meaningful disparities across and within regions and countries. For example, students in South Asia, Latin America, and the Caribbean may be more than a year behind where they would have been absent the pandemic. In North America and Europe, students might be an average of four months behind (Exhibit 2).

The regional numbers only begin to tell the full story. The greater the range of school system performance and resources across regions, the greater the variation in student experiences. Students in Japan and Australia may be less than two months behind, while students in the Philippines and Indonesia may be more than a year behind where they would have been (Exhibit 3).

Within countries, the impact of COVID-19 has also affected individual students differently. Wherever assessments have taken place since the onset of the pandemic, they suggest widening gaps in both opportunity and achievement. Historically vulnerable and marginalized students are at an increased risk of falling further behind.

In the United States, students in majority Black schools were half a year behind in mathematics and reading by fall 2021, while students in majority White schools were just two months behind. 6 “ COVID-19 and education: An emerging K-shaped recovery ,” December 14, 2021. In Ethiopia, students in rural areas achieved under one-third of the expected learning from March to October 2020, while those in urban areas learned less than half of the expected amount. 7 Research on Improving Systems of Education (RISE) , “Learning inequalities widen following COVID-19 school closures in Ethiopia,” blog entry by Janice Kim, Pauline Rose, Ricardo Sabates, Dawit Tibebu Tiruneh, and Tassew Woldehanna, May 4, 2021. Assessments in New South Wales, Australia, detected minimal impact on learning overall, but third-grade students in the most disadvantaged schools experienced two months less growth in mathematics. 8 Leanne Fray et al., “The impact of COVID-19 on student learning in New South Wales primary schools: An empirical study,” The Australian Educational Researcher , 2021, Volume 48.

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Covid-19-related losses on top of historical inequalities.

The learning crisis is not new. In the years before COVID-19, many school systems faced challenges in providing learning opportunities for many of their students. The World Bank estimates that before the pandemic, more than half of students in low- and middle-income countries were living in “learning poverty”—unable to read and understand a simple text by age ten. That number may rise as high as 70 percent due to pandemic-related school disruptions. 9 Joao Azevedo et al., “The state of the global education crisis: A path to recovery,” World Bank Group, December 3, 2021.

The World Bank’s harmonized learning outcomes (HLOs) compare learning achievement and growth across countries. This measure combines multiple global student assessments into one metric, with a range of 625 for advanced attainment and 300 for minimum attainment. According to the World Bank’s 2018 HLO database, students from some countries in the Middle East, North Africa, and South Asia were several years behind their counterparts in North America and Europe before the pandemic (Exhibit 4). 10 Data Blog , “Harmonized learning outcomes: transforming learning assessment data into national education policy reforms,” blog entry by Harry A. Patrinos and Noam Angrist, August 12, 2019.

Students in these countries were also progressing more slowly each year in school. While students in high-income countries may have been gaining 50 HLO points in a year, students in low-income countries were gaining just 20. In other words, not much learning was happening in some countries even before the pandemic.

Prepandemic learning levels and pandemic-related learning delays interacted in different ways in different countries and regions. Although each country is unique, three archetypes emerge based on the performance of education systems (Exhibit 5).

High-performing systems. Countries in this archetype generally had higher pre-COVID-19 learning levels. Systems had more capacity for remote learning, and school buildings remained closed for shorter time periods. 11 “Education: From disruption to recovery,” UNESCO, accessed March 11, 2022. Data suggest that after the initial shock of the pandemic in 2020, learning delays increased only moderately with subsequent school closures in the 2021–22 school year. Some high-income countries seem to show little evidence of decreased learning overall. According to the Australian National Assessment Program–Literacy and Numeracy (NAPLAN), the COVID-19 pandemic did not have a statistically significant impact on average student literacy and numeracy levels, even in Victoria, where learning was remote for more than 120 days. 12 “Highlights from Victorian preliminary results in NAPLAN 2021,” Victoria state government, August 26, 2021; Adam Carey, Melissa Cunningham, and Anna Prytz, “‘Children have suffered enormously’: School closures leave experts divided,” The Age , Melbourne, July 25, 2021. However, in many high-income countries, the impact of the pandemic on learning remained significant. Assessments of student learning in the United States in fall 2021 suggested students had fallen four months behind in mathematics and three months behind in reading. 13 “ COVID-19 and education: An emerging K-shaped recovery ,” December 14, 2021. Inequalities in learning also increased within many of these countries, with historically marginalized students most affected.

Lower-income, prepandemic-challenged systems. This archetype consists of mostly low-income and lower-middle-income countries with very low levels of pre-COVID-19 learning. When the pandemic struck, school buildings closed for varying periods of time, 14 “Education: From disruption to recovery,” UNESCO, accessed March 11, 2022. with limited options for remote learning. In Tanzania, for example, schools were closed for 15 weeks, and during this period, just 6 percent of households reported that their children listened to radio lessons, 5 percent watched TV lessons, and fewer than 1 percent accessed educational programs on the internet. 15 Jacobus Cilliers and Shardul Oza, “What did children do during school closures? Insights from a parent survey in Tanzania,” Research on Improving Systems of Education (RISE), May 19, 2021. Across the analyzed time period, schools in sub-Saharan Africa were fully open for more weeks, on average, than schools in any other region. As a result, the pandemic’s impact on learning was relatively muted, even though many of these systems faced challenges with effective remote learning. 16 A report of six countries in Africa, for example, found limited impact of the pandemic on already-low student outcomes. For more information, see “MILO: Monitoring impacts on learning outcomes,” UNESCO, accessed March 11, 2022.

These relatively smaller pandemic learning delays are likely due in part to the limited progress students were making in schools before COVID-19. 17 World Bank blogs , “Harmonized learning outcomes: Transforming learning assessment data into national education policy reforms,” blog entry by Harry A. Patrinos and Noam Angrist, August 12, 2019. If students weren’t progressing scholastically when schools were open, closures were likely to have less impact. In Tanzania before the pandemic, three-quarters of students in grade three could not read a basic sentence. 18 “What did children do during school closures?,” May 19, 2021.

Pandemic-affected middle-income systems. School systems in Latin American and South Asian countries had low to moderate performance before COVID-19. Many middle-income countries in this group did have some capacity to plan and roll out remote-learning options, especially in urban areas. 19 “Responses to Educational Disruption Survey (REDS),” UNESCO, accessed March 11, 2022. However, pandemic-related disruptions caused widespread school closures for extended periods of time—more than 50 weeks in some countries. 20 “Education: From disruption to recovery,” UNESCO, accessed March 11, 2022. The resulting learning delays may represent a true crisis for major economies such as India, Indonesia, and Mexico, where students are more than a year behind, on average.

While some students may have just learned more slowly than they would have absent the pandemic, others in this archetype may have actually slipped backward. A study by the Azim Premji Foundation suggests that as early as January 2021, more than 90 percent of students assessed in India have lost at least one language ability (such as reading words or writing simple sentences), while more than 80 percent lost a math ability (for example, identifying single- and double-digit numbers or naming shapes). 21 Loss of learning during the pandemic , Azim Premji Foundation, February 2021. This pattern could be particularly challenging, since higher-order skills are increasingly important in middle-income countries with rising levels of workplace automation. McKinsey’s “ Jobs lost, jobs gained ” report 22 For more information, see “ Jobs lost, jobs gained: What the future of work will mean for jobs, skills, and wages ,” McKinsey Global Institute, November 28, 2017. suggests India may need 34 million to 100 million more high school graduates by 2030 to fill workplace demands. The pandemic has put existing high school graduation rates at risk, let alone the vast expansion required to meet future demand for workers.

The pandemic’s effects beyond learning

Much of the dialogue around school systems focuses on educational achievement, but schools offer more than academic instruction. A school system’s contributions may include social interaction; an opportunity for students to build relationships with caring adults; a base for extracurricular activities, from the arts to athletics; an access point for physical- and mental-health services; and a guarantee of balanced meals on a regular basis. The school year may also enable students to track their progress and celebrate milestones. When schools had to close for extended periods of time or move to hybrid learning, students were deprived of many of these benefits.

The pandemic’s impact on the social-emotional and mental and physical health of students has been measured even less than its impact on academic achievement, but early indications are concerning. Save the Children reports that 83 percent of children and 89 percent of parents globally have reported an increase in negative feelings since the pandemic began. 23 The hidden impact of COVID-19 on child protection and wellbeing , Save the Children International, September 2020. In the United States, one in three parents said they were very or extremely worried about their child’s mental health in spring 2021, with rising reported levels of student anxiety, depression, social withdrawal, and lethargy. 24 Emma Dorn, Bryan Hancock, Jimmy Sarakatsannis, and Ellen Viruleg, “ COVID-19 and education: The lingering effects of unfinished learning ,” McKinsey, July 27, 2021. Parents of Black and Hispanic students, the segments most affected by academic unfinished learning, also reported higher rates of concern about their student’s mental health and engagement with school. A UK survey found 53 percent of girls and 44 percent of boys aged 13 to 18 had experienced symptoms or trauma related to COVID-19. 25 Report1: Impact of COVID-19 on young people aged 13-24 in the UK- preliminary findings , PsyArXiv, January 20, 2021. In Bangladesh, a cross-sectional study revealed that 19.3 percent of children suffered moderate mental-health impacts, while 7.2 percent suffered from extreme mental-health effects. 26 Rajon Banik et al., “Impact of COVID-19 pandemic on the mental health of children in Bangladesh: A cross-sectional study,” Children and Youth Services Review , October 2020, Volume 117. Reports of violence against children rose in many countries. 27 “Publications,” Young Lives, accessed March 22, 2022. The pandemic affected physical health as well. Studies from the United States 28 Roger Riddell, “CDC: Child obesity jumped during COVID-19 pandemic,” K-12 Dive , September 24, 2021. and the United Kingdom 29 The annual report of Her Majesty’s chief inspector of education, children’s services and skills 2020/21 , Ofsted, December 7, 2021. show rising rates of childhood obesity. In Latin America and the Caribbean, more than 80 million children stopped receiving hot meals. 30 “We can move to online learning, but not online eating,” United Nations World Food Program, March 26, 2020. In Uganda, a record number of monthly teenage pregnancies—more than 32,000—were recorded from March 2020 to September 2021. 31 “Uganda overwhelmed by 32,000 monthly teen pregnancies,” Yeni Şafak , December 12, 2021.

Some students may never return to formal schooling at all. Even in high-income systems, levels of chronic absenteeism are rising, and some students have not reengaged in school. In the United States, 1.7 million to 3.3 million eighth to 12th graders may drop out of school because of the pandemic. In low- and middle-income countries, the situation could be far worse. Up to one-third of Ugandan students may not return to the classroom. This pattern is in line with past historical crises involving school closures. After the Ebola pandemic, 13 percent of students in Sierra Leone and 25 percent of students in Liberia dropped out of school, with girls and low-income students most affected. 32 The socio-economic impacts of Ebola in Liberia , World Bank, April 15, 2015; The socio-economic impacts of Ebola in Sierra Leone , World Bank, June 15, 2015. Among the poorest primary-school students in Sierra Leone, dropout rates increased by more than 60 percent. 33 William C. Smith, “Consequences of school closure on access to education: Lessons from the 2013-2016 Ebola pandemic,” International Review of Education , April 2021, Volume 67. This may result in reduced employment opportunities and lifelong earnings potential for many of these students.

The potential of long-term economic damage

Education can affect not just an individual’s future earnings and well-being but also a country’s economic growth and vitality. Research suggests higher levels of education lead to increased labor productivity and enhance an economy’s capacity for innovation. Unless the pandemic’s impact on student learning can be mitigated and students can be supported to catch up on missed learning, the global economy could experience lower GDP growth over the lifetime of this generation.

We estimate by 2040, unfinished learning related to COVID-19 could translate to annual losses of $1.6 trillion to the global economy, or 0.9 percent of predicted total GDP (Exhibit 6).

Although the total dollar amount of forgone GDP is highest in the largest economies of the world (encompassing East Asia, Europe, and North America), the relative impact is highest in regions with the greatest learning delays. In Latin America and the Caribbean, pandemic-related school closures could result in losses of more than 2 percent of GDP annually by 2040 and in subsequent years.

Economic impact could be affected further if students don’t return to school and cease learning altogether.

Identifying potential solutions

The response to the learning crisis will likely vary from country to country, based upon preexisting educational performance, the depth and breadth of learning delays, and system resources and capacity to respond. That said, all school systems will likely need to plan across multiple horizons:

As 2022 began, more than 95 percent of school systems around the world were at least partially open for traditional in-person learning. 34 “Responses to Educational Disruption Survey (REDS),” UNESCO, 2022, accessed March 11, 2022. That progress is encouraging but tenuous. Many systems reopened only to close down again when another wave of COVID-19 caused additional disruptions. Even within partially open systems, not all students have access to in-person learning, and many are still attending partial days or weeks. Building resilience could mean ensuring protocols are in place for safe and supportive in-person learning, and ensuring plans are in place to provide remote options that support the whole child at the system, school, and student levels in response to future crises. School systems can also benefit by creating the flexibility to change policies and procedures as new data and circumstances arise.

COVID-19 and education: The lingering effects of unfinished learning

Reenrollment.

Opening buildings and embedding effective safety precautions have been challenging for many systems, but ensuring students and teachers actually turn up and reengage with learning is perhaps even more difficult. Even where in-person learning has resumed, many students have not returned or remain chronically absent. 35 Indira Dammu, Hailly T.N. Korman, and Bonnie O’Keefe, Missing in the margins 2021: Revisiting the COVID-19 attendance crisis , Bellwether Education Partners, October 21, 2021. Families may still have safety worries about in-person learning. Some students may have found jobs and now rely on that income. 36 Elias Biryabarema, “Student joy, dropout heartache as Uganda reopens schools after long COVID-19 shutdown,” Reuters, January 10, 2022. Others may have become pregnant or now act as caregivers at home. 37 Brookings Education Plus Development , “What do we know about the effects of COVID-19 on girls’ return to school?,” blog entry by Erin Ganju, Christina Kwauk, and Dana Schmidt, September 22, 2021. Still others may feel so far behind academically or so disconnected from the school environment at a social level that a return feels impossible. A multipronged approach could be helpful to understand the barriers students may face, how those could differ across student segments, and ways to support all students in continuing their educational journeys.

Systems could consider a tiered approach to support reengagement. Tier-one interventions could be rolled out for all students and include both improving school offerings for families and students and communicating about enhanced services. This might involve back-to-school awareness campaigns at the national and community levels featuring respected community members, clear communication of safety protocols, access to free food and other basic needs on campuses, and the promotion of a positive school climate with deep family engagement.

Tier-two interventions, which could be directed at students who are at heightened risk of not returning to school, may involve more targeted support. These efforts might include community events and canvassing to bring school buses or mobile libraries to historically marginalized neighborhoods, phone- or text-banking aimed at students who have not returned to school, or summer opportunities (including fun reorientation activities) to convince students to return to the school campus. At the student level, it could include providing some groups of students with deeper learning or social-emotional recovery services to help them reintegrate into school.

Tier-three interventions encompass more intensive and specialized support. These efforts may include visits to the homes of individual students or new educational environments tailored to student needs—for example, night schools for students who need to complete high school while working.

Once students are back in school, many may need support to recover from the academic and social-emotional effects of the pandemic. Indeed, while academic recovery seems daunting, supporting the mental-health and social-emotional needs of students may end up being the bigger challenge. 38 Protecting youth mental health: The U.S. surgeon general’s advisory , U.S. Department of Health and Human Services, 2021. This process starts with a recognition that each child is unique and that the pandemic has affected different students in different ways. Understanding each student’s situation, in terms of both learning and well-being, is important at the classroom level, with teachers and administrators trained to interpret cues from students and refer them to more intensive support when necessary. Assessments will likely also be needed at the school and system levels to plan the response.

With an understanding of both the depth and breadth of student needs, systems and schools could consider three levers of academic acceleration: more time, more dedicated attention, and more focused content. Implementation of these levers will likely vary by context, but the overall goals are the same: to overcome both historical gaps and new COVID-19-related losses, and to do so across academic and whole-child indicators.

In high-income countries, digital formative assessments could help determine in real time what students know, where they may have gaps, and what the next step could be for each child. More relational tactics can be incorporated alongside digital assessments, such as teachers taking the time to connect with each child around a simple reading assessment, which may rebuild relationships and connectivity while assessing student capabilities. Schools could also consider universal mental-health diagnostics and screeners, and train teachers and staff to recognize the signs of trauma in students.

Once schools have identified students who need academic support, proven, evidence-based solutions could support acceleration in high-income school systems. High-dosage tutoring, for example, could enable students to learn one to two additional years of mathematics in a single year. Delivered three to five times a week by trained college graduates during the school day on top of regular math instruction, this type of tutoring is labor and capital intensive but has a high return on investment. Acceleration academies, which provide 25 hours of targeted instruction in reading to small groups of eight to 12 students during vacations, have helped students gain three months of reading in just one week. Exposing students to grade-level content and providing them with targeted supports and scaffolds to access this content has improved course completion rates by two to four times over traditional “re-teaching” remediation approaches.

With an understanding of both the depth and breadth of student needs, systems and schools could consider three levers of academic acceleration: more time, more dedicated attention, and more focused content.

In low- and middle-income countries, where learning delays may have been much greater and where the financial and human-capital resources for education can be more limited, different implementation approaches may be required. Simple, fast, inexpensive, and low-stakes evaluations of student learning could be carried out at the classroom level using pen and paper, oral assessments, and mobile data collection, for example.

Solutions for supporting the acceleration of student learning in these contexts could start with ensuring foundational literacy and numeracy (FLN), prioritizing essential standards and content. Evidence-based teaching methods could speed up learning; for example, Pratham’s Teaching at the Right Level (TaRL) approach—which groups children by learning needs, rather than by age or grade, and dedicates time to basic skills with continual reassessment—has led to improvements of more than a year of learning in classrooms and summer camps. 39 Improvements of 0.2 to 0.7 standard deviations; assuming that one year of learning ranges from 0.2 of a standard deviation in low income countries and 0.5 of a standard deviation in high income countries, in accordance with World Bank assumptions:; João Pedro Azevedo et al., Simulating the potential impacts of COVID-19 school closures on schooling and learning outcomes , World Bank working paper 9284, June 2020; David K. Evans and Fei Yuan, Equivalent years of schooling , World Bank working paper 8752, February 2019. Even with the application of existing approaches, more time in class may be required—with options to extend the school year or school day to support students. Widespread tutoring may not be realistic in some countries, but peer-to-peer tutoring and cross-grade mentoring and coaching could supplement in-class efforts. 40 COVID-19 response–remediation: Helping students catch up on lost learning, with a focus on closing equity gaps , UNESCO, July 2020.

Reimagining

In addition to accelerating learning in the short term, systems can also use this moment to consider how to build better systems for the future. This may involve both recommitting to the core fundamentals of educational excellence and reimagining elements of instruction, teaching, and leadership for a post-COVID-19 world. 41 Jake Bryant, Emma Dorn, Stephen Hall, and Frédéric Panier, “ Reimagining a more equitable and resilient K-12 education system ,” McKinsey, September 8, 2020. A lot of ground could be covered by rolling out existing evidence-based interventions at scale—recommitting to core literacy and numeracy skills, high-quality instructional materials, job-embedded teacher coaching, and effective performance management. Recommitting to these basics, however, may not be enough. Systems can also innovate across multiple dimensions: providing whole-child supports, using technology to improve access and quality, moving toward competency-based learning, and rethinking teacher preparation and roles, school structures, and resource allocation.

For example, many systems are reemphasizing the importance of caring for the whole child. Integrating social-emotional learning for all students, providing trauma-informed training for teachers and staff, 42 “Welcome to the trauma-informed educator training series,” Mayerson Center for Safe and Healthy Children, accessed March 22, 2022. and providing counseling and more intensive support on and off campus for some students could provide supportive schooling environments beyond immediate crisis support. 43 “District student wellbeing services reflection tool,” Chiefs for Change, January 2022. A UNESCO survey suggests that 78 percent of countries offered psychosocial and emotional support to teachers as a response to the pandemic. 44 What’s next? Lessons on education recovery , June 2021. Looking forward, the State of California is launching a $3 billion multiyear transition to community schools, taking an integrated approach to students’ academic, health, and social-emotional needs in the context of the broader community in which those students live. 45 John Fensterwald, “California ready to launch $3 billion, multiyear transition to community schools,” EdSource, January 31, 2022.

The role of education technology in instruction is another much-debated element of reimagining. Proponents believe education technology holds promise to overcome human-capital challenges to improved access and quality, especially given the acceleration of digital adoption during the pandemic. Others point out that historical efforts to harness technology in education have not yielded results at scale. 46 Jake Bryant, Felipe Child, Emma Dorn, and Stephen Hall, “ New global data reveal education technology’s impact on learning ,” McKinsey, June 12, 2020.

Numerous experiments are under way in low- and middle-income countries where human capital  challenges are the greatest. Robust solar-powered tablets loaded with the evidence-based literacy and numeracy app one billion led to learning gains of more than four months 47 “Helping children achieve their full potential,” Imagine Worldwide, accessed March 22, 2022. in Malawi, with plans to roll out the program across the country’s 5,300 primary schools. 48 “Partners and projects,” onebillion.org, accessed March 22, 2022. NewGlobe’s digital teacher guides provide scripted lesson plans on devices designed for low-infrastructure environments. In Nigeria, students using these tools progressed twice as fast in numeracy and three times as fast in literacy as their peers. 49 “The EKOEXCEL effect,” NewGlobe Schools, accessed March 22, 2022. As new solutions are rolled out, it will likely be important to continually evaluate their impact compared with existing evidence-based approaches to retain what is working and discard that which is not.

Charting a potential path forward

There is no precedent for global learning delays at this scale, and the increasing automation of the workforce advances the urgency of supporting students to catch up to—and possibly exceed—prepandemic education levels to thrive in the global economy. Systems will likely need resources, knowledge, and organizational capacity to make progress across these priorities.

Even before COVID-19, UNESCO estimated that low- and middle-income countries faced a funding gap of $148 billion a year to reach universal preprimary, primary, and secondary education by 2030 as required by UN Sustainable Development Goal 4. As a result of the pandemic, that gap has widened to $180 billion to $195 billion a year. 50 Act now: Reduce the impact of COVID-19 on the cost of achieving SDG 4 , UNESCO, September 2020. Even if that funding gap were closed, the result would be increased enrollment, not improvements in learning. UNESCO estimates that just 3 percent of global stimulus funds related to COVID-19 have been directed to education , 97 percent of which is concentrated in high-income countries. 51 “Uneven global education stimulus risks widening learning disparities,” UNESCO, October 19, 2021.

In many countries, shortages of teachers and administrators are just as pressing as the lack of funding. Many teachers in Uganda weren’t paid during the pandemic and have found new careers. 52 Alon Mwesigwa, “’I’ll never go back’: Uganda’s schools at risk as teachers find new work during Covid,” Guardian , September 30, 2021. Even high-income countries are grappling with teacher shortages. In the United States, 40 percent of district leaders and principals describe their current staff shortages as “severe” or “very severe.” 53 Mark Lieberman, “How bad are school staffing shortages? What we learned by asking administrators,” EducationWeek , October 12, 2021. Fully addressing pandemic-related learning losses will require a full accounting of the cost and a long-term commitment, recognizing the critical importance of investments in education for future economic growth and stability.

Countries do not need to reinvent the wheel or go it alone. Many existing resources catalog evidence-based practices relevant to different contexts, both historical approaches and those specific to COVID-19 recovery. For high-income countries, the Education Endowment Foundation, Annenberg’s EdResearch for Recovery platform, and the Collaborative for Student Success resources for states and districts in the United States provide research-based guidance on solutions.

In many countries, shortages of teachers and administrators are just as pressing as the lack of funding.

For low- and middle-income countries, materials developed in partnership with UNESCO, UNICEF, and the World Bank include tools to support FLN, Continuous and Accelerated Learning, and teacher capacity (Teach and Coach). UNESCO’s COVID-19 Response Toolkit provides guidance across income levels. Collaboration across schools, regions, and countries could also promote knowledge sharing at a time of evolving needs and practices—from webinars to active communities of practice and shared-learning collaboratives.

Organizing for the response across these multiple levels is a challenge even for the most well-resourced and sophisticated systems. Our recent research found 80 percent of government efforts to transform performance don’t fully meet their objectives. 54 “ Delivering for citizens: How to triple the success rate of government transformations ,” McKinsey, May 31, 2018. Success will likely require a relentless focus on implementation and execution, with multiple feedback loops to achieve continuous learning and improvement.

The COVID-19 pandemic was indisputably a global health and economic crisis. Our research suggests it also caused an education crisis on a scale never seen before.

The pandemic also showed, however, that innovation and collaboration can arise out of hardship. The global education community has an opportunity to come together to respond, bringing evidence-based practices at scale to every classroom. Working together, donors and investors, school systems and districts, principals and teachers, and parents and families can ensure that the students who endured the pandemic are not a lost generation but are instead defined by their resilience.

Jacob Bryant is a partner in McKinsey’s Seattle office; Felipe Child is a partner in the Bogotá office, where Jose Espinosa is an associate partner; Emma Dorn is a senior expert in the Silicon Valley office; Stephen Hall is a partner in the Dubai office, where Dirk Schmautzer is a partner; Topsy Kola-Oyeneyin is a partner in the Lagos office; Cheryl Lim is a partner in the Singapore office; Frédéric Panier is a partner in the Brussels office; Jimmy Sarakatsannis is a senior partner in the Washington, DC, office; and Seckin Ungur is a partner in the Sydney office, where Bart Woord is an associate partner.

The authors wish to thank Annie Chen, Kunal Kamath, An Lanh Le, Sadie Pate, and Ellen Viruleg for their contributions to this article.

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The changes we need: Education post COVID-19

1 Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia

2 School of Education, University of Kansas, 419 JRP, Lawrence, KS 66049 USA

Jim Watterston

The COVID-19 pandemic has caused both unprecendented disruptions and massive changes to education. However, as schools return, these changes may disappear. Moreover, not all of the changes are necessarily the changes we want in education. In this paper, we argue that the pandemic has created a unique opportunity for educational changes that have been proposed before COVID-19 but were never fully realized. We identify three big changes that education should make post COVID: curriculum that is developmental, personalized, and evolving; pedagogy that is student-centered, inquiry-based, authentic, and purposeful; and delivery of instruction that capitalizes on the strengths of both synchronous and asynchronous learning.

Introduction

The impact of the COVID-19 pandemic on education is both unprecedented and widespread in education history, impacting nearly every student in the world (UNICEF 2020 ; United Nations 2020 ). The unexpected arrival of the pandemic and subsequent school closures saw massive effort to adapt and innovate by educators and education systems around the world. These changes were made very quickly as the prevailing circumstances demanded. Almost overnight, many schools and education systems began to offer education remotely (Kamanetz 2020 ; Sun et al. 2020 ). Through television and radio, the Internet, or traditional postal offices, schools shifted to teach students in very different ways. Regardless of the outcomes, remote learning became the de facto method of education provision for varying periods. Educators proactively responded and showed great support for the shifts in lesson delivery. Thus, it is clear and generally accepted that “this crisis has stimulated innovation within the education sector” (United Nations 2020 , p. 2).

However, the changes or innovations that occurred in the immediate days and weeks when COVID-19 struck are not necessarily the changes education needs to make in the face of massive societal changes in a post-COVID-19 world. By and large, the changes were more about addressing the immediate and urgent need of continuing schooling, teaching online, and finding creative ways to reach students at home rather than using this opportunity to rethink education. While understandable in the short term, these changes will very likely be considered insubstantial for the long term.

The COVID-19 pandemic has the potential to be a once in a generation opportunity for real change a number of reasons. First, the pandemic was global and affected virtually all schools. As such, it provides the opportunity for educators and children to come together to rethink the education we actually need as opposed to the inflexible and outdated model that we are likely to feverishly cling to. Second, educators across the world demonstrated that they could collectively change en masse. The pandemic forced closure of schools, leaving teachers, children and adults to carry out education in entirely different situations. Governments, education systems, and schools offered remote learning and teaching without much preparation, planning, and in some cases, digital experience (Kamanetz 2020 ; Sun et al. 2020 ). Third, when schools were closed, most of the traditional regulations and exams that govern schools were also lifted or minimally implemented. Traditional accountability examinations and many other high stakes tests were cancelled. Education was given the room to rapidly adapt to the prevailing circumstances.

It is our hope that as we transition out of the COVID-19 pandemic and into an uncertain future that we can truly reimagine education. In light of this rare opportunity, we wish to urge scholars, policy makers, and educators to have the courage to make bold changes beyond simply changing instructional delivery. The changes that we advocate in this paper are not new but they never managed to gain traction in the pre-COVID-19 educational landscape. Our most recent experience, however, has exacerbated the need for us to rethink what is necessary, desirable, and even possible for future generations.

Changes we need

It is incumbant upon all educators to use this crisis-driven opportunity to push for significant shifts in almost every aspect of education: what, how, where, who, and when. In other words, education, from curriculum to pedagogy, from teacher to learner, from learning to assessment, and from location to time, can and should radically transform. We draw on our own research and that of our colleagues to suggest what this transformation could look like.

Curriculum: What to teach

It has been widely acknowledged that to thrive in a future globalized world, traditionally valued skills and knowledge will become less important and a new set of capabilities will become more dominant and essential (Barber et al. 2012 ; Florida 2012 ; Pink 2006 ; Wagner 2008 ; Wagner and Dintersmith 2016 ). While the specifics vary, the general agreement is that repetition, pattern-prediction and recognition, memorization, or any skills connected to collecting, storing, and retrieving information are in decline because of AI and related technologies (Muro et al. 2019 ). On the rise is a set of contemporary skills which includes creativity, curiosity, critical thinking, entrepreneurship, collaboration, communication, growth mindset, global competence, and a host of skills with different names (Duckworth and Yeager, 2015 ; Zhao et al. 2019 ).

For humans to thrive in the age of smart machines, it is essential that they do not compete with machines. Instead, they need to be more human. Being unique and equipped with social-emotional intelligence are distinct human qualities (Zhao 2018b , 2018c ) that machines do not have (yet). In an AI world individual creativity, artistry and humanity will be important commodities that distinguish us from each other.

Moreover, given the rapidity of changes we are already experiencing, it is clear that lifelong careers and traditional employment pathways will not exist in the way that they have for past generations. Jobs and the way we do business will change and the change will be fast. Thus there are almost no knowledge or skills that can be guaranteed to meet the needs of the unknown, uncertain, and constantly changing future. For this reason, schools can no longer preimpose all that is needed for the future before students graduate and enter the world.

While helping students develop basic practical skills is still needed, education should also be about development of humanity in citizens of local, national, and global societies. Education must be seen as a pathway to attaining lifelong learning, satisfaction, happiness, wellbeing, opportunity and contribution to humanity. Schools therefore need to provide comprehensive access and deep exposure to all learning areas across all years in order to enable all students to make informed choices and develop their passions and unique talents.

A new curriculum that responds to these needs must do a number of things. First, it needs to help students develop the new competencies for the new age (Barber et al. 2012 ; Wagner 2008 , 2012 ; Wagner and Dintersmith 2016 ). To help students thrive in the age of smart machines and a globalized world, education must teach students to be creative, entrepreneurial, and globally competent (Zhao 2012a , 2012b ). The curriculum needs to focus more on developing students’ capabilities instead of focusing only on ‘template’ content and knowledge. It needs to be concerned with students’ social and emotional wellbeing as well. Moreover, it needs to make sure that students have an education experience that is globally connected and environmentally connected. As important is the gradual disappearance of school subjects such as history and physics for all students. The content is still important, but it should be incorporated into competency-based curriculum.

Second, the new curriculum should allow personalization by students (Basham et al. 2016 ; Zhao 2012b , 2018c ; Zhao and Tavangar 2016 ). Although personalized learning has been used quite elusively in the literature, the predominant model of personalized learning has been computer-based programs that aim to adapt to students’ needs (Pane et al. 2015 ). This model has shown promising results but true personalization comes from students’ ability to develop their unique learning pathways (Zhao 2018c ; Zhao and Tavangar 2016 ). That is, students can follow their passions and strengths. This not only requires the curriculum to be flexible so that students can choose what they wish to learn, but also requires students to come up with their own learning pathway without being overly constrained by the pre-determined curriculum. Thus national curriculum or curriculum for all students should be a minimal suite of essential knowledge and skills, sufficient for all students to develop the most basic competences and learn the most common norms, expectations, and the societal organizations of a jurisdiction.

Enabling students to co-develop part of the curriculum is not only necessary for them to become unique but also gives them the opportunity to exercise their right to self-determination, which is inalienable to all humans (Wehmeyer and Zhao 2020 ). It provides the opportunities for students to make choices, propose new learning content, and learn about consequences of their actions. Furthermore, it helps students to become owners of their learning and also develop life-long learning habits and skills. It is to help them go meta about their learning—above what they learn and understand why they learn.

Third, it is important to consider the curriculum as evolving. Although system-level curriculum frameworks have to be developed, they must accommodate changes with time and contexts. Any system-level curriculum should enable the capacity for schools to contextualize and make changes to it as deemed necessary. Such changes must be justifiable of course but a system-level curriculum framework should not use national or state level accountability assessments to constrain the changes.

Pedagogy: How to teach

There is increasing call for learners to be more actively engaged in their own learning. The reasons for students to take a more significant role in their own learning are multiple. First, students are diverse and have different levels of abilities and interests that may not align well with the content they are collectively supposed to learn in the classroom. Teachers have been encouraged to pursue classroom differentiation (Tomlinson 2014 ) and students have been encouraged to play a more active role in defining their learning and learning environments in collaboration with teachers (Zhao 2018c ). Second, the recent movement toward personalized learning (Kallick and Zmuda 2017 ; Kallio and Halverson 2020 ) needs students to become more active in understanding and charting their learning pathways.

To promote student self-determination as both a self-evident, naturally born right and an effective strategy for enhanced learning (Wehmeyer and Zhao 2020 ), we need to consider enabling students to make informed decisions regarding their own learning pathway. This generation of learners are much more active and tech-savvy. They access information instantly and have been doing so throughout their daily life. They have different strengths and weaknesses. They also have different passions. Thus, schools should use discretion to start relaxing the intense requirements of curriculum. Schools could start by allowing students to negotiate part of their curriculum instead of requiring all students learn the same content, as discussed earlier. Students should be enabled to have certain levels of autonomy over what they want to learn, how they learn, where they learn and how they want to be assessed (Zhao 2018c ). When students have such autonomy, they are more likely to be less constrained by the local contexts they are born into. The impact of their home background and local schools may be less powerful.

Students should exercise self-determination as members of the school community (Zhao 2018c ). The entire school is composed of adults and students, but students are the reason of existence for schools. Thus, schools and everything in the school environment should incorporate and serve the students, yet most schools do not have policies and processes that enable students to participate in making decisions about the school—the environment, the rules and regulations, the curriculum, the assessment, and the adults in the school. Schools need to create these conditions through empowering students to have a genuine voice in part of how they operate, if not in its entirety. Students’ right to self-determination implies that they have the right to determine under what conditions they wish to learn. Thus, it is not unreasonable for schools to treat students as partners of learning and of change (Zhao 2011 , 2018c ).

It should not be unique to see school practices co-developed with students (Zhao 2018c ). Students not only will be co-owners (with parents and teachers) of their own learning enterprise, but also co-owners of the school community. It is likely to see students having their own personal learning programs and also acting as fully functioning members of the entire school community, contributing to fundamental decisions regarding the curriculum for all, the staff, the students, and the entire environment.

Moreover, with ubiquitous access to online resources and experts, students do not necessarily need teachers to continually and directly teach them. When students are enabled to own their learning and have access to resources and experts, the role of the teacher changes (Zhao 2018a ). Teachers no longer need to serve as the instructor, the sole commander of information to teach the students content and skills. Instead, the teacher serves other more important roles such as organizer of learning, curator of learning resources, counselor to students, community organizer, motivator and project managers of students’ learning. The teacher’s primary responsibility is no longer simply just instruction, which requires teacher education to change as well. Teacher education needs to focus more on preparing teachers to be human educators who care more about the individual students and serve as consultants and resource curators instead of teaching machines (Zhao 2018a ).

Pedagogy should change as well. Direct instruction should be cast away for its “unproductive successes” or short-term successes but long term damages (Bonawitza et al. 2011 ; Buchsbauma et al. 2011 ; Kapur 2014 , 2016 ; Zhao 2018d ). In its place should be new models of teaching and learning. The new models can have different formats and names but they should be student-centered, inquiry-based, authentic, and purposeful. New forms of pedagogy should focus on student-initiated explorations of solutions to authentic and significant problems. They should help students develop abilities to handle the unknown and uncertain instead of requiring memorization of known solutions to known problems.

Organization: Where and when to teach

Technology has made it possible for schools to offer online education for quite some time and the number of students taking online courses has been on the rise, but not until the arrival of COVID-19 has the majority of education been offered through this mode. While there are many good reasons for schools to return to what was refrred to as “normal,” the normalcy may not be easily achieved because of the uncertainty of the virus, and as discussed above, may not even be desirable.

Moving teaching online is significant. It ultimately changed one of the most important unwritten school rules: all students must be in one location for education to take place. The typical place of learning has been the classroom in a school and the learning time has been typically confined to classes. This massive online movement changed the typical. It has forced teachers to experience remote teaching without proximity to the students. It has also given many teachers the opportunity to rethink the purpose of teaching and connecting with students.

When students are not learning in classes inside a school, they are distributed in the community. They can interact with others through technologies. This can have significant impact on learning activities. If allowed or enabled by a teacher, students could be learning from online resources and experts anywhere in the world. Thus, the where of learning changes from the classroom to the world.

Furthermore, the time of learning also changes. When learning goes online and students are not or do not need to be in schools, their learning time vastly expands beyond the traditional school time. They can learn asynchronously at anytime. Equally important is that their learning time does not need to be synchronous with each other or with that of the teacher.

There are many possible ways for schools to deliver remote learning (Zhao 2020 ). The simplest is to simulate that schools are open with traditional timetables with the default model being that all students attend lessons on screen at the same time as they do in schools. In this case, nothing changes except for the fact that students are not in the same location as their classmates and the teacher. While it has been perhaps the most common approach that has been taken by many schools, this approach has not been very effective and successful, resulting in distress, disengagement, and much less personal interaction and learning than traditional face-to-face situations (Darby 2020 ; Dorn et al. 2020 ).

As schools continue to explore online learning, new and more effective models are being explored, innovatively developed, and practiced. The more effective models of online learning have a well-balanced combination of both synchronous and asynchronous sessions that enable more desirable ways of learning. Instead of teaching online all the time, it is possible, for example, to conduct inquiry-based learning. Students receive instructions from online resources or synchronous meetings, conduct inquiry, create products individually or within small groups, and make presentations in large class synchronous meetings. Instead of lecturing to all students, teachers could create videos of lectures or find videos made by others and share them with students. They would also be meeting with small groups of individuals for specific advice and support. The fundamental pursuit is that there is minimal benefit or student engagement for teachers to lecture all the time when more interesting and challenging instructional models can be developed.

Today, being disconnected physically can result in being more broadly connected virtually. Students have been traditionally associated with their schools and schools have typically served local communities. Thus, students typically are connected and socialize with their peers from restricted catchment areas. Despite the possibility to connect globally with people from other lands, most schools’ activities are local. Today, when local connections become less reliable and students are encouraged to have social distancing, it is possible to encourage more global connections virtually. Students could join different learning communities that involve members from different locations, not necessarily from their own schools. Students could also participate in learning opportunities provided by other providers in remote locations. Furthermore, students could create their own learning opportunities by inviting peers and teachers from other locations.

The ideal model of organizing students, based on the COVID-19 experiences, is perhaps a combination of both online and face-to-face learning opportunities. Many schools have already reopened, but when schools reopen it is unnecessary to undo the online aspect of learning developed during COVID-19. Online learning can be effective (Means et al. 2013 ; Rudestam and Schoenholtz-Read 2010 ; Zhao et al. 2005 ), but a well-designed mixed mode delivery of online and face-to-face education should be more effective for learning in general but especially so should there be future instances of virtual learning (Tucker 2020 ). The idea of blended learning or flipped classrooms (Bishop and Verleger 2013 ) has been promoted and researched in recent years as very effective models of teaching. COVID-19 should have made the convincing much easier since many teachers have been forced to move online.

When learning is both online and face-to-face, students are liberated from having to attend classes at specific times. They are also no longer required to be in the same place to receive instruction from teachers. They could work on their own projects and reach out to their teachers or peers when necessary. When students are no longer required to attend class at the same time in the same place, they can have much more autonomy over their own learning. Their learning time expands beyond school time and their learning places can be global.

Education will undoubtedly go through major changes in the next decade as the combined result of multiple major forces. These changes include curricular changes that determine what is to be learned by learners. It is likely that more students will be moving toward competency-based learning that has an emphasis on developing unique skills and abilities. Learning has to become more based on strengths and passions and become personalized. In response, education providers will need to make student autonomy and student agency key to transforming pedagogy and school organizations. Students will prosper by having more say in their own learning and their learning communities. Moreover, schools will have a unique opportunity to positively and proactively change as a result of COVID-19 and the need for global connections. It is possible to see schools rearrange their schedules and places of teaching so that students can at the same time take part in different and more challenging learning opportunities regardless of their physical locations. Relevant online learning will be on the rise and perhaps becomes a regular part of the daily routine for many students.

Of course, we cannot forget that not all students have equal access to technology, both in terms of hardware and digital competency. The issue of digital divide remains a significant issue around the globe. It is important for us to reimagine a better education with technology and find creative ways to make education more equitable, including wiping out the digital divide.

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Contributor Information

Yong Zhao, Email: ude.uk@oahzgnoy .

Jim Watterston, Email: [email protected] .

• Barber, M., Donnelly, K., & Rizvi, S. (2012). Oceans of Innovation: The Atlantic, The Pacific, Global Leadership and the Future of Education . Retrieved from London: https://www.ippr.org/publications/oceans-of-innovation-the-atlantic-the-pacific-global-leadership-and-the-future-of-education
• Basham JD, Hall TE, Carter RA, Jr, Stahl WM. An operationalized understanding of personalized learning. Journal of Special Education Technology. 2016; 31 (3):126–136. doi: 10.1177/0162643416660835. [ CrossRef ] [ Google Scholar ]
• Bishop JL, Verleger MA. The flipped classroom: A survey of the research. Atlanta, GA: Paper presented at the ASEE national conference proceedings; 2013. [ Google Scholar ]
• Bonawitza E, Shaftob P, Gweonc H, Goodmand ND, Spelkee E, Schulzc L. The double-edged sword of pedagogy: Instruction limits spontaneous exploration and discovery. Cognition. 2011; 120 (3):322–330. doi: 10.1016/j.cognition.2010.10.001. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Buchsbauma D, Gopnika A, Griffithsa TL, Shaftob P. Children’s imitation of causal action sequences is influenced by statistical and pedagogical evidence. Cognition. 2011; 120 (3):331–340. doi: 10.1016/j.cognition.2010.12.001. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Darby, F. (2020, April 14). 5 Low-Tech, Time-Saving Ways to Teach Online During Covid-19. Chronicle of Higher Education. Retrieved from https://www.chronicle.com/article/5-Low-Tech-Time-Saving-Ways/248519
• Dorn, E., Hancock, B., Sarakatsannis, J., & Viruleg, E. (2020, June 1, 2020). COVID-19 and student learning in the United States: The hurt could last a lifetime. McKinsey. Retrieved from https://www.mckinsey.com/industries/public-and-social-sector/our-insights/covid-19-and-student-learning-in-the-united-states-the-hurt-could-last-a-lifetime
• Duckworth AL, Yeager DS. Measurement Matters: Assessing personal qualities other than cognitive ability for educational purposes. Educational Researcher. 2015; 44 (4):237–251. doi: 10.3102/0013189X15584327. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Florida R. The Rise of the Creative Class: Revisited. 2. New York: Basic Books; 2012. [ Google Scholar ]
• Kallick B, Zmuda A. Students at the center: Personalized learning with habits of mind. Alexandria, VA: ASCD; 2017. [ Google Scholar ]
• Kallio JM, Halverson R. Distributed leadership for personalized learning. Journal of Research on Technology in Education. 2020; 52 (3):371–390. doi: 10.1080/15391523.2020.1734508. [ CrossRef ] [ Google Scholar ]
• Kamanetz, A. (2020, March 19). 'Panic-gogy': Teaching Online Classes During The Coronavirus Pandemic. NPR. Retrieved from https://www.npr.org/2020/03/19/817885991/panic-gogy-teaching-online-classes-during-the-coronavirus-pandemic
• Kapur M. Productive failure in learning math. Cognitive Science. 2014; 38 (5):1008–1022. doi: 10.1111/cogs.12107. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kapur M. Examining productive failure, productive success, unproductive failure, and unproductive success in learning. Educational Psychologist. 2016; 51 (2):289–299. doi: 10.1080/00461520.2016.1155457. [ CrossRef ] [ Google Scholar ]
• Means B, Toyama Y, Murphy R, Baki M. The effectiveness of online and blended learning: A meta-analysis of the empirical literature. Teachers College Record. 2013; 115 (3):1–47. [ Google Scholar ]
• Muro, M., Whiton, J., & Maxim, R. (2019). What jobs are affected by AI? Better-paid, better-educated workers face the most exposure . Retrieved from Washington DC: https://www.brookings.edu/research/what-jobs-are-affected-by-ai-better-paid-better-educated-workers-face-the-most-exposure/
• Pane JF, Steiner ED, Baird MD, Hamilton LS. Continued Progress: Promising Evidence on Personalized Learning. Santa Monica, CA: Rand Corporation; 2015. [ Google Scholar ]
• Pink DH. A Whole New Mind: Why Right-brainers Will Rule the Future. New York: Riverhead; 2006. [ Google Scholar ]
• Rudestam KE, Schoenholtz-Read J. Handbook of online learning. 2. Thousand Oaks, Calif: SAGE Publications; 2010. [ Google Scholar ]
• Sun L, Tang Y, Zuo W. Coronavirus pushes education online. Nature Materials. 2020; 19 (6):687–687. doi: 10.1038/s41563-020-0678-8. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Tomlinson CA. Differentiated classroom: Responding to the needs of all learners. Alexandria, VA: ASCD; 2014. [ Google Scholar ]
• Tucker CR. Balance With Blended Learning: Partner With Your Students to Reimagine Learning and Reclaim Your Life. Thousand Oaks, CA: Corwin; 2020. [ Google Scholar ]
• UNICEF. (2020, August 24). ‘What will a return to school during the COVID-19 pandemic look like?’. UNICEF. Retrieved from https://www.unicef.org/coronavirus/what-will-return-school-during-covid-19-pandemic-look
• United Nations. (2020, August). Policy Brief: Education during COVID-19 and beyond. United Nations. Retrieved from https://www.un.org/development/desa/dspd/wp-content/uploads/sites/22/2020/08/sg_policy_brief_covid-19_and_education_august_2020.pdf
• Wagner T. The Global Achievement Gap: Why Even Our Best Schools Don't Teach the New Survival Skills Our Children Need-And What We Can Do About It. New York: Basic Books; 2008. [ Google Scholar ]
• Wagner T. Creating Innovators: The Making of Young People Who Will Change the World. New York: Scribner; 2012. [ Google Scholar ]
• Wagner T, Dintersmith T. Most Likely to Succeed: Preparing Our Kids for the Innovation Era. New York: Scribner; 2016. [ Google Scholar ]
• Wehmeyer M, Zhao Y. Teaching Students to Become Self-Determined Learners. Alexandria, VA: ASCD; 2020. [ Google Scholar ]
• Zhao Y. Students as change partners: A proposal for educational change in the age of globalization. Journal of Educational Change. 2011; 12 (2):267–279. doi: 10.1007/s10833-011-9159-9. [ CrossRef ] [ Google Scholar ]
• Zhao Y. 2012 Flunking innovation and creativity. Phi Delta Kappan. 2012; 94 (1):56–61. doi: 10.1177/003172171209400111. [ CrossRef ] [ Google Scholar ]
• Zhao Y. World Class Learners: Educating Creative and Entrepreneurial Students. Thousand Oaks, CA: Corwin; 2012. [ Google Scholar ]
• Zhao Y. The Changing Context of Teaching and Implications for Teacher Education. Peabody Journal of Education. 2018; 93 :295–308. doi: 10.1080/0161956X.2018.1449896. [ CrossRef ] [ Google Scholar ]
• Zhao Y. Personalizable Education for Greatness. Kappa Delta Pi Record. 2018; 54 (3):109–115. doi: 10.1080/00228958.2018.1481645. [ CrossRef ] [ Google Scholar ]
• Zhao Y. Reach for Greatness: Personalizable Education for All Children. Thousand Oaks, CA: Corwin; 2018. [ Google Scholar ]
• Zhao Y. What Works May Hurt: Side Effects in Education. New York: Teachers College Press; 2018. [ Google Scholar ]
• Zhao Y. Tofu Is Not Cheese: Rethinking Education Amid the COVID-19 Pandemic. ECNU Review of Education. 2020; 3 (2):189–203. doi: 10.1177/2096531120928082. [ CrossRef ] [ Google Scholar ]
• Zhao Y, Lei J, Yan B, Lai C, Tan S. What Makes the Difference: A practical analysis of research on the effectiveness of distance education. Teachers College Record. 2005; 107 (8):1836–1884. doi: 10.1111/j.1467-9620.2005.00544.x. [ CrossRef ] [ Google Scholar ]
• Zhao Y, Tavangar HS. World class learners : personalized education for autonomous learning and student-driven curriculum. Thousand Oaks, California: Corwin; 2016. [ Google Scholar ]
• Zhao Y, Wehmeyer M, Basham J, Hansen D. Tackling the wicked problem of measuring what matters: framing the questions. ECNU Review Education. 2019; 2 (3):262–278. doi: 10.1177/2096531119878965. [ CrossRef ] [ Google Scholar ]

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Open Access

Peer-reviewed

Research Article

Examination of factors that impact mask or respirator purchase and usage during the COVID-19 pandemic

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Software, Validation, Visualization, Writing – original draft, Writing – review & editing

Affiliation Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing

Affiliation School of Communication, East Carolina University, Greenville, North Carolina, United States of America

Affiliation Department of Health Education and Promotion, Environmental Health Sciences Program, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, United States of America

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America, North Carolina Agromedicine Institute, Greenville, North Carolina, United States of America, Center for Human Health and the Environment, NC State University, Raleigh, North Carolina, United States of America

• Nicole Bertges, 
• Sachiyo Shearman, 
• Satomi Imai, 
• Jo Anne G. Balanay, 
• Sinan Sousan

• Published: September 25, 2024
• https://doi.org/10.1371/journal.pone.0308841
• Peer Review
• Reader Comments

Understanding the motivations and barriers populations face in respiratory protection during a pandemic is key to effective primary prevention. The goal of this study was to identify the impact of various motivational factors on individual choice of masks or respirators during the COVID-19 pandemic. The survey study included a sample of 619 participants between the ages of 18 to 75 years old and English speaking, who were asked about factors that affected their choice of masks or respirators between the months of April 2020 and May 2021. Participants showed a positive association between choice of respirator and being male, perceived comfort and trust in respirators, importance of personalization, and trust in information from family or friends. In addition, positive associations were found between income, education, and the amount of trust in CDC, WHO, and local/state health departments. Results indicate the need for increased education on attributes of each mask or respirator, review of respirator fit, research into specific areas of discomfort, and outreach efforts to vulnerable populations.

Citation: Bertges N, Shearman S, Imai S, Balanay JAG, Sousan S (2024) Examination of factors that impact mask or respirator purchase and usage during the COVID-19 pandemic. PLoS ONE 19(9): e0308841. https://doi.org/10.1371/journal.pone.0308841

Editor: Sadia Ilyas, Hanyang University - Seoul Campus: Hanyang University, REPUBLIC OF KOREA

Received: May 7, 2024; Accepted: August 1, 2024; Published: September 25, 2024

Copyright: © 2024 Bertges et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data supporting the findings of this study are available from the Open Science Framework (OSF) at the following link: https://osf.io/c8je9/ .

Funding: This research was supported by the Department of Public Health, School of Communication, and Department of Health Education and Promotion at East Carolina University; the North Carolina Agromedicine Institute; and the National Institute of Environmental Health Sciences of the National Institutes of Health under Award Number P30ES025128. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Competing interests: The authors have declared that no competing interests exist.

Introduction

In January 2020, COVID-19 disease, emerging most probably from in Wuhan, China, affected the world within months. By March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic and global emergency [ 1 ]. Masking is a universally effective prevention method that helps prevent the transmission of respiratory diseases such as COVID-19 [ 2 – 6 ]. The need for masking created an unprecedented mask shortage, and in an effort to aid in supply shortages in the United States, the Centers for Disease Control and Prevention (CDC) developed guidelines that included the reuse of respirators and recommended alternate types of protective wear, such as cloth masks [ 7 ]. Public health communication during the pandemic became a challenge due to the influence of social media and political agendas. Mask or respirator use subsequently ignited a polarizing public debate concerning their benefits, personal disbeliefs, and masking behavior during the COVID-19 pandemic.

At the height of the COVID-19 pandemic, there were many options for masks or respirator choices, each offering differing protection levels and comfort. The choice of respirators, such as the N95 or the KN95, and masks, such as surgical masks or cloth masks, determines the amount of protection offered to the wearer and the individual’s comfort level. Multiple studies have shown that N95 respirators provide superior protection [ 2 – 4 , 6 , 8 , 9 ]. The alternative respirator from China, the KN95, can provide protection against respiratory disease, but it is not certified by the National Institute for Occupational Safety and Health (NIOSH) [ 10 ]. While respirators offer superior protection, alternatives such as surgical and cloth masks have been shown to offer some degrees of protection based on material, wearer behavior, reuse, or fit [ 4 – 6 , 11 ].

While the quality of the product should be the deciding factor in choosing a mask respirator, the choice is often much more complex. Demographic factors such as age, race, and sex have been shown to be associated with masking behavior. In a study conducted by Haischer et al. (2020), masking adherence increased with age and was higher in females [ 12 ]. Race has also been shown to be associated with masking behavior, where a study conducted by Pecoraro et al. (2022) reported that masking was less prevalent in white populations [ 13 ]. An individual’s perceptions about masks or respirators have been shown to be associated with masking behavior [ 14 ]. Cooks et al. (2022) showed that the source of information on masks or respirators and COVID-19 played a role in making decisions, and that race, income, and education influenced which sources were perceived to be more trustworthy [ 15 ].

In many individuals, comfort, such as the breathability and the amount of heat or moisture retained in the mask are cited as a key factors in a mask or respirator choice [ 16 – 20 ]. Cost, convenience, and availability of mask or respirator supplies have been cited as factors in mask choice [ 21 – 26 ]. Additionally, the risk of infection a person faced during the COVID-19 pandemic can affect their masking behaviors. Wismans et al. (2022) reported a positive association between an individual’s belief of their risk of COVID-19 and masking behavior [ 27 ]. Race, education, and income are factors that could influence the amount of trust some populations have in important sources of information, such as the CDC, WHO, and their local or state health departments. Issues of digital access, the perception of mixed messages, and potential xenophobia can create a feeling of mistrust in many, especially in vulnerable populations, on critical issues, such as which masks to choose [ 15 ].

This study examines the behavioral motivations behind individual mask/respirator choices, building on the work of Chaaban et al. (2023), who compared best-selling alternative masks and respirators to the N95 respirator in terms of cost, breathability, and the amount of protection against viral particles in the event of future shortages [ 17 ]. This study aims to identify the factors that influenced participants to choose the higher protection offered through the N95 and KN95 respirator or the lower protection offered through the cloth and surgical masks. The authors identified six factors that could influence the choice of high-protection respirators or low-protection masks.

The study investigated the role of 1) demographics; 2) an individual’s perceptions and attitudes on factors relating to masks and respirators; 3) an individual’s perceived level of trust toward the source of information; 4) an individual’s belief in the protective ability of masks or respirators against the COVID-19 virus; 5) an individual’s perceived risk and protective practices (such as vaccination, handwashing, and social distancing); and 6) an individual’s perceived comfort on the choice of mask or respirator type (high or low protection). In addition, the role of demographic factors such as race, income, and education on the amount of trust in official information sources (CDC, WHO, or local and state health departments) is investigated. The goal of this research is to provide information on respirator and mask usage to the public that addresses an individual’s personal motivations and can provide guidance that considers the limitations and barriers they may encounter in choosing their respiratory protection.

Research design

The study was a cross-sectional study design, and consisted of a survey administered through the Qualtrics Research Platform. The survey questions, written to examine factors present during the peak of the pandemic from April 2020 to May 2021, consisted of multiple-choice questions or Likert scale responses. The sample size was determined through a combination of survey sample best practices, financial considerations, and calculation of recommended sample size based on ±5% Margin of Error and the large study population size [ 28 ].

Procedures/Measures

The data collection protocol was approved as an exempt study (UMCIRB#22–002104) by the East Carolina University Medical Center Institutional Review Board on March 22, 2023. The participants were given written informed consent before participating in the study. The consent form included a full explanation of the study’s purpose, how the information gathered would be used, and their ability to terminate their participation at any time. Then, participants provided online consent by clicking “agree to participate” in the online survey. Only de-identified information was gathered from participants, and the survey responses were protected using the security settings provided by the Qualtrics Research Platform. Data collection was between March 22 nd , 2023, and March 27 th , 2023. An initial pretesting on a smaller population was conducted, which allowed the authors to identify possible wording bias in the survey questionnaire. The sample inclusion criteria was set as individuals above the age of 18 and English speakers. The survey asked the demographic questions such as age, sex, race/ethnicity, and annual household income. In addition, the survey asked the participants’ preferences of respirator and mask usage, various factors in selecting masks and respirators, perceived comfort,perceived protection, perceived risks and protective practices, and perceived level of trusts toward the sources of information on masks and respirators. Included basic demographic questions such as age, sex, race, annual household income A convenience sample was gathered through the Qualtrics Research Platform. Individuals were previously recruited to a survey panel and sent an email/link asking them to complete the survey. Survey participants were compensated for serving on survey panels by Qualtrics Research Platform. The participants did not receive any compensation by the authors in this study.

Participants

A total of 619 participants participated in the survey, with the selection criteria set to ensure that the participants would be balanced based on age and gender. Males made up 50.7% (n = 314), 49.9% (n = 303) were female, and two individuals identified their gender as others, but were removed from the analysis due to the small sample size. The age distribution showed that 19.5% were between 18 and 30, 45.7% were between 31 and 50, and 34.7% were between 51 and 75. The majority of current study’s participants identified themselves as non-Hispanic white (69.2%). Only 3.2% of the participants had less than a high school diploma, compared to 21.5% with a high school diploma or equivalent, 6.3% associate degree, 30.5% bachelor’s degree, 16.3% master’s degree, and 2.3% with a doctoral degree. Annual income of the sample population reflected that 33.4% made less than $35,000, 28.9% between $35,000 and $75,000, and 37.6% made more than $75,000.

Statistical analysis

Statistical analysis was performed using IBM SPSS Statistics (Version 28). The analysis investigated the factors that influenced the participants’ choice of mask (surgical or cloth) or respirator (N95 or KN95), as well as the amount of trust disadvantaged populations (Black/African American, Hispanic, low-income, and low-education) had in the major sources of information on masks, respirators, and the COVID-19 virus during the pandemic. The variables analyzed are shown in Table 1 and were divided into the categories of style, comfort, convenience, choices, individual perceptions, the source of trusted information on masks and respirators or COVID-19, education, income, race, vaccination status, and sex. The independent variables were assessed using a combination of dichotomous, 5-point Likert scale, and multiple-choice questions. Income was dichotomized into “Under $35,000” and “Over $35,00” based on income limits reported by the U.S. Department of Housing and Urban Development’s Office of Policy Development and Research [ 29 ]. Descriptive analysis was used to identify missing or inconsistent data. Variables with inconsistent scaled responses were recoded to ensure they were consistently scaled. A correlation matrix was constructed to identify multicollinearity. Prior to combining the variables, such as the N95 and KN95 into high protection and cloth and surgical masks into low protection, both a dimensional reduction and reliability analysis was run. The variables were then entered into a binary logistic regression analysis to identify the impact each had on the choice of mask or respirator.

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https://doi.org/10.1371/journal.pone.0308841.t001

Table 2 shows the characteristics of the participants. Participant responses indicated that 13.0% preferred the N95, 18.6% preferred the KN95, 28.8% preferred surgical masks, and 39.5% preferred cloth masks. In the sampled population, 16.5% considered themselves having a high risk of contracting COVID-19, 57% reported having family members who were at high risk of COVID-19, and 24.7% of the participants were not vaccinated.

https://doi.org/10.1371/journal.pone.0308841.t002

The results of the binary logistic regressions can be found in Fig 1 . The results show that males had twice the odds of choosing respirators over masks (OR = 1.978, 95% CI [1.331, 2.939], p = 0.001). Individuals who felt that personalization was slightly important had over a two time increase in odds of choosing respirators over masks (OR = 2.619, 95% CI [1.573, 4.359] p = <0.001), but individuals who felt that convenience was very important had a decrease in odds of choosing a respirator compared to masks (OR = 0.424, 95% 136 CI [.183, 0.978], p = 0.044). Individuals who reported above-average trust in media sources of information on COVID-19 or respiratory protection had a decrease in odds of choosing a respirator compared to a mask (OR = 0.400, 95% CI [0.173, 0.926], p = 0.032). Individuals who had an average amount of trust in information on COVID-19 or face protection from family or friends had an almost two-time increase in the odds of choosing respirators over masks (OR = 1.762, 95% CI [1.062, 2.926], p = 0.028). Individuals that reported having high trust in either the N95 or KN95 respirator had an over three time increase in the odds of choosing respirators over masks (OR = 3.425, 95% CI [1.894, 6.193], p = <0.001), while individuals who reported having high trust in both the N95 and the KN95 had more than two times increase in the odds of choosing respirators over masks (OR = 2.688, 95% CI [1.685, 4.289], p = <0.001). Individuals who believed that respirators are comfortable had two times the odds of choosing a respirator over masks (OR = 1.873, 95% CI [1.176, 2.983], p = 0.008).

The error bars represent the 95% confidence intervals.

https://doi.org/10.1371/journal.pone.0308841.g001

An analysis of the association of education, income, and race to the amount of trust in prominent sources of information on masking or COVID-19 during the pandemic was then carried out and is shown in Fig 2 . Individuals with a four-year degree or higher had more than two times increase in the odds of trusting the information from the CDC (OR = 2.273, 95% CI [1.647–3.138], p = <0.001), the WHO (OR = 2.464, 95% CI [1.782–3.407], p = <0.001), and their local or state health department (OR = 2.046, 95% CI [1.481–2.827], p = <0.001) compared to individuals without a four-year degree. Marginalized populations have been previously reported to have lower trust in medical institutions and government agencies [ 30 ]. Therefore, the data was analyzed to see if there was a significant difference in the amount of trust in the information from the CDC, WHO, and local/state health departments in participants who identified as Black/African American or Hispanic. The results show that there was no statistically significant association found in this sample between race/ethnicity and the amount of trust in the CDC, WHO, or the local/state health department. However, when the data was analyzed to see if income would impact the amount of trust participants had in the CDC, WHO, and the local/state health department, the authors found that individuals who made over $35,000 were more likely to trust the CDC (Adjusted OR 1.794, 95% CI [1.277–2.520], p = <0.001), WHO (Adjusted OR 1.610, 95% CI [1.147–2.260], p = 0.006), and local/state health department (Adjusted OR 1.802, 95% CI [1.275–2.548], p = <0.001) than individuals making less than $35,000 a year.

https://doi.org/10.1371/journal.pone.0308841.g002

The goal of this study was to identify factors leading to the choice of respirators, KN95 or N95, and masks (cloth or surgical). The authors’ aim was to provide information that could be used to develop guidance to the public in choosing the highest respiratory protection possible. Although previous studies already established that respirators, such as the N95, provide superior protection, the current study examined several factors impacting the choice of distinct types of masks and respirators. Prevention measures, such as vaccination and the interruption of modes of transmission, are vital in outbreak management. Efforts to increase community awareness of the benefits of wearing a respirator would aid in slowing the transmission of viruses and potentially minimize the number of lives lost in future pandemics. This study identified associations between the motivations of comfort, perceived protection, and trust in information sources with the individuals’ choice of mask or respirator.

The study revealed that males had increased odds of choosing the higher protection provided by respirators. These results are interesting because females have been previously associated with a higher frequency of mask-wearing behavior [ 33 ]. The increased odds in males of choosing a respirator could be related to the fit of the respirators. Previous studies noted that respirators fit the faces of males better than females, due to manufacturing specifications based on a male face size or shape, which could affect comfort [ 31 – 33 ].

Trust in the mask or respirator’s protective ability is the most crucial factor in choosing facial protection and was found to be positively associated with the choice of respirator over masks. These results could indicate that the participants choosing cloth or surgical masks are not fully aware of the amount of protection offered by each type of mask or respirator. Additionally, a positive association was found between comfort in the N95 or KN95 respirator and odds of choosing the respirator. Previous studies have associated headaches, itching, increased facial temperatures, and humidity with the 195 N95 and could be contributing to some choosing looser fitting masks over respirators [ 34 ]. The results showing that comfort is a significant motivational factor is an important finding, as it begins to address the questions of comfort posed by Chaaban et al. [ 17 ]. Further investigations into the specific areas of discomfort, role of fit, facial accessories, and environmental conditions of various demographic groups are needed to understand the motivation for comfort. Identifying specific areas of discomfort could aid in creating communications that could address this barrier and attempt to suggest ways to mitigate the discomfort without sacrificing the protection offered by respirators.

In groups with above-average trust in media sources of information on COVID-19 or face protection, there was a decrease in odds of choosing a respirator compared to a mask. This is interesting as Cooks et al. [ 15 ] associated the decrease in trust with doubts related to the efficacy of masking in general and the age of the individual. The authors’ conclusion agrees with the previous findings that further research is needed on the association between masking behavior and trust in media, as the challenge of using the media will be overcoming the doubt created by the political polarizations during the COVID-19 pandemic, and mistrust in masking to address the knowledge gap in facial protection options. Interestingly, this study found a lack of significance in the association between the belief that the participant was at risk of COVID-19 and the amount of protection chosen. These results contrast with those reported by Huaman et al. [ 35 ], who reported that individuals who believed they were more likely to be at risk were positively associated with the choice of wearing an N95.

One of the most interesting findings in this study was the level of trust vulnerable population felt towards sources of information during a pandemic, such as the CDC, WHO, and their local or state health departments. The results showed no statically significant association between those identified as Black African American or Hispanic and the amount of trust in these agencies, but there was an association with education and income. Individuals of lower income and education were less likely to trust the CDC, WHO, or local and state health departments. Previous studies into the association of education and income with trust in medical agencies have revealed mixed results [ 36 , 37 ]. The lack of trust in these agencies reported in this study could be due to the perception that mixed messages, due to changing guidelines, were being sent about COVID-19 and masking guidance [ 38 ]. In addition, the messages could have been communicated using scientific language that was difficult for individuals with lower education to understand. These results, and the gap in knowledge to compare it to, indicate a need to fully understand the role of income and education in the amount of trust placed in agencies, such as the CDC, WHO, and in the government during the time of a national emergency. The development of communication on masking guidance and other messages on preventive measures must be based on the ability of the target population to understand it and the likelihood of its acceptance.

Limitations

The limitations of this study were the sample size and possible introduction of bias. The study used a convenience sample consisting of 619 participants, which limits the generalizability of the current study. When the population was identified, a filter was used to ensure that the age and sex characteristics were balanced. During this part of the study, race was not identified as a selection criterion, which might have resulted in the sample size in minority groups being too small to show statistical significance. In addition to this, the questionnaire did not include questions related to specific brands or questions dealing with the fit of the mask or respirator. As fit can affect comfort, this information could have helped to identify additional factors that led to discomfort with the mask or respirator. Future work is needed to investigate how these factors affect discomfort with masks or respirators. Brand identification could have helped to explain if the role was based on the perception of quality or merely loyalty to a specific brand name. By asking participants to identify motivations, feelings, and factors that affected their choice of mask or respirator during the peak of the pandemic, recall bias and social desirability bias could have been introduced into the study.

Understanding why masks that offer lower protection are chosen is important in the development of effective exposure prevention measures during a pandemic. The authors illustrated that factors such as sex, comfort, trust, and perceived effectiveness of the mask or respirator can significantly impact the choice of high protection offered by respirators or the lower protection of masks. The knowledge gained will aid in creating targeted communications and outreach aimed at building trust in vulnerable populations, to increase the effectiveness of exposure control measures, such as the choice of higher protection offered by respirators.

• 1. Covid-19 response. Centers for Disease Control and Prevention. March 29, 2023. Accessed March 30, 2023. https://www.cdc.gov/orr/timeline/events/covid.html .
• View Article
• PubMed/NCBI
• Google Scholar
• 7. Centers for Disease Control and Prevention. (2020). Strategies for optimizing the supply of N95 respirators. https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html . Published 2020. Accessed May 29, 2023.
• 29. FY 2023 State Income Limits. U.S. Department of Housing and Urban Development’s Office of Policy Development and Research. 2023. Accessed July 6, 2024. https://www.huduser.gov/portal/datasets/il/il23/State-Incomelimits-Report-FY23.pdf .