The past three years have taken a heavy toll globally. Since COVID-19 was declared as a public health emergency of international concern on 20 January 2020, nearly 7 million deaths have been officially attributed to COVID-19. According to the Director-General of the World Health Organization Tedros Adhanom Ghebreyesus, however, the actual lives lost to the pandemic are many more — closer to 20 million.

COVID-19 was not only a public health emergency; it was also responsible for upending lives and livelihoods globally. The pandemic brought about an economic crisis that paralleled the Great Depression. Economic impacts during 2020 wiped out years of progress towards eliminating extreme poverty and although economic recovery started in 2021, this has been unequally distributed. Unemployment rose sharply, and young people and women have been hardest hit. School closures affected education worldwide and students lost on average approximately 35% of a normal school year’s worth of learning1. Again, effects on education were unequally experienced and children from lower socioeconomic backgrounds were much more affected. Although lockdowns reduced urban crime2, they increased domestic violence3 — with persisting impact. Chinese nationals and people of Chinese origin experienced discrimination that affected their livelihoods4.

Vaccines for the SARS-CoV-2 virus were developed in less than a year, an entirely unprecedented scientific feat (Fig. 1). Yet vaccines have not been equally distributed, as high-income countries hoarded vaccines, especially in the early stages, despite the fact that equitable distribution would benefit everybody5. Even for those countries where vaccines became quickly available, misinformation and disinformation affected intentions to vaccinate6. A new term — ‘infodemic’7 — entered our collective vocabulary to describe the onslaught of unreliable or misleading information widely circulating on social media that interfered with the effectiveness of public health measures. However, it has not been all bad news on the vaccines front. Although much debated, vaccine mandates appear to have been effective in increasing vaccination rates in the general population8 and 70% of the world population has received at least one shot.

Fig. 1: Vaccination innovation from 1880 to 2020.
figure 1

Adapted with permission from ref. 9, Springer Nature Ltd, an adaptation of the original https://ourworldindata.org/vaccination#vaccine-innovation by Max Roser, CC-BY 4.0.

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Throughout the pandemic, as a journal we have prioritized COVID-19 research, review and opinion content with direct relevance to the pandemic response for publication. Similar to many other journals, we expedited the peer review of time-sensitive research and made it freely available for the duration of the pandemic. An early collection of review and opinion content highlighted the role of the social and behavioural sciences at a time when no pharmacological interventions were available. A follow-up collection focused on vaccine inequity. We have now created a new collection with a selection of key COVID-19 research published in our pages over the past three years. Although we are no longer handling COVID-19 manuscripts as time-critical, we know that the work of understanding the human behaviour dimensions of the COVID-19 pandemic and its impacts will persist for years to come. We continue to encourage the submission of manuscripts on the experiences and legacies of the pandemic, and on the lessons that can be learned for the next pandemic.

COVID-19 exposed new threats and old fault lines. Although the WHO’s decision to change the emergency status of COVID-19 provides a symbolic end to the period of greatest danger, the pandemic is not over. Thousands of people still lose their lives to the virus every week and the unequal effects of the pandemic will take years to redress.