Contributor(s): Professor Christopher Murray | The COVID-19 pandemic has had massive global impacts infecting more than 3.5 billion and causing more than 15 million excess deaths. The virus has directly killed millions and the lockdowns needed to dampen transmission may have contributed in various ways to millions of pandemic related deaths not due to SARS Cov2 infection. The COVID-19 pandemic has not only been a major shock to human health but has had unprecedented economic impacts. The distribution of health and economic effects has not been even around the world. Countries judged prior to the pandemic to be better prepared to manage threats such as the United Kingdom and Unites States have not faired particularly well during 2020 and 2021.