COVID-19 Updates

Updated November 05, 2021

Over the past year, the Coronavirus Disease 2019 (COVID-19) has emerged as a global pandemic, impacting lives and economies on scales rarely seen. Below, Forte Analytics has highlighted the impact of COVID-19 on the U.S. health care system.

Our thoughts are with the families and loved ones impacted by this crisis, especially the hospitals, physicians, and long-term care providers serving on the front lines.

Data source: USAFacts
Retrieved from
Accessed on November 08, 2021. (Data current as of November 05, 2021.)
Rendered by Forte Analytics

1-Month Change in U.S. Health Care Jobs:
Overall and Three Components Representing Ambulatory Health Care Services, Hospitals, and Nursing and Residential Care Facilities

Data source: Bureau of Labor Statistics, CES6562100001, CES6562200001, CES6562300001, Plus Sum of All Three Components
Updated on November 05, with data through October 2021

For years, the U.S. health care sector has demonstrated remarkable durability with respect to annual and monthly job growth and has weathered significant downturns, such as the Great Recession and other less impactful recessions. In fact, the resistance of this sector to job cuts during these downturns has led some to refer to it as a “recession-resistant” component of the U.S. economy.1 Unexpectedly, a global viral pandemic—a time of urgent need—has exposed vulnerabilities underlying the U.S. health care system. The ongoing challenges in the health care sector first appeared as a crack in March 2020 (–94,700 jobs), followed by the opening of a chasm in April 2020 (–1.5 million jobs).

The monthly jobs report for May 2020 brought some good news. Broadly, the U.S. economy added more than 2.8 million payroll jobs and the unemployment rate dropped significantly. Within the health care sector, more than 300,000 workers returned to jobs in May. While these increases were limited to the ambulatory health care services (AHCS) component, the pace of job losses slowed in the other two health care components, raising hopes of a rebound across all components in June’s report.

Indeed, the good employment news continued in June 2020, with the U.S. economy adding 4.8 million payroll jobs, as the unemployment rate fell to 11.1%. In health care, more than 350,000 jobs were added. By component, AHCS and hospitals both added jobs, while nursing and residential care facilities (NRCF) posted another monthly loss.

As 2020 came to a close, the employment reports showed a slowing labor market, culminating with the loss of more than 300,000 jobs in December 2020. Economists pointed to a surge of COVID-19 cases—which prompted another round of regional shutdowns—and a prolonged period without additional federal economic stimulus as two of the primary reasons for the loss of momentum.

Relief on both fronts is now available. As of early November 2021, there are three COVID-19 vaccines in use in the U.S. (see below), and the federal government has approved another $0.9 trillion and $1.9 trillion in relief through legislation passed in late 2020 and early 2021, respectively. The employment reports through October 2021 reflect the effects of this additional stimulus, as well as progress made with respect to the pandemic. Specifically, the economy has average monthly growth of more than 580,000 jobs in 2021. After a period of slower jobs growth in August and September 2021, the rate of increase picked up in October 2021 as the recent surge in COVID-19 cases tied to the spread of the Delta variant subsided.

In health care, the differences among the three underlying components of employment have grown starker over the past year. Specifically, all three components saw sharp declines from their most recent highs in February 2020 through April 2020: AHCS fell by more than 17%, hospitals fell by 2.5%, and NRCF by 4.1%. However, their paths after April 2020 diverged. Both AHCS and hospitals recovered significantly, with AHCS showing an increase of 0.4% and hospitals having a decrease of just 1.7% through October 2021. In contrast, the NRCF component has eroded throughout nearly all of this entire period, falling by a cumulative 12.0% through September 2021. The sustained decline in the NRCF component reflects both the severe impact of COVID-19 on the nursing home population as well as an accelerating trend away from nursing homes as a site of care. Recently imposed vaccine mandates are also impacting employment levels in the health care sector.

1 M.L. Dolfman, et al. Healthcare jobs and the Great Recession. Monthly Labor Review. Retrieved from Accessed April 2020.

Top 20 Countries for Cumulative COVID-19 Case Counts, by Date

Data source: World Health Organization
Retrieved from
Accessed on November 08, 2021. (Data current as of November 08, 2021.)

As COVID-19 sweeps across the globe, governments at all levels—nation, state, and municipality—are reacting with varying speed and to varying degrees. As the threat of an outbreak increases, governments must make complex decisions, risking criticism for reacting either too aggressively or too slowly. The mathematics of pandemics is unforgiving, with early actions vital in slowing or even halting the spread of the disease.1 As South Korea makes clear, recent experience with an outbreak can make government’s job easier. However, the duration of the current pandemic has stretched the public’s patience, even for those early success stories, as indicated by rising case counts in South Korea.2

As we enter the last quarter of 2021, the world’s efforts to contain COVID-19 remained mixed. The number of cases associated with viral variants across the globe, including those first identified in the United Kingdom (B.1.1.7, Alpha), South Africa (B.1.351, Beta), Brazil (P.1, Gamma), and India (B.1.617.2, Delta) continues to rise. Special attention should be paid as these variants appear more easily transmissible, more deadly, and/or less susceptible to immunity developed through vaccination. The World Health Organization recently reinstated guidance for fully vaccinated individuals to wear masks in certain situations to limit the spread of the Delta variant, which is a variant of concern around the world. At present, the CDC is once again recommending wearing masks indoors, even for those who have been vaccinated, when they are in areas of high community transmission of the Delta variant. Collectively, these issues highlight the challenges of limiting the spread of the disease through non-pharmaceutical interventions—masks, reduced public gatherings, social distancing, etc.—steps that disrupt lives and economies significantly, highlighting the world’s need for and anticipation of safe and effective vaccinations.

Through November 2021, three vaccines have received Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA)—two based on mRNA (Pfizer/BioNTech and Moderna) and one based on DNA (Johnson & Johnson). The former were approved as two-dose regimens, while the latter was approved as a one-dose regimen. The FDA also allowed more flexible storage conditions for the Pfizer/BioNTech vaccine as a way of reducing logistical challenges.3 Vaccine distribution and administration accelerated significantly through early April 2021, leading to an average of more than 3 million doses administered per day in the U.S., providing hope for a return to a social and economic environment closer to that of the pre-pandemic period. However, as of early November 2021, the daily rate of vaccination has remained much lower than earlier in the year, making vaccine hesitancy a prominent concern. A recent emergency use authorization for children aged 5–11 may drive the U.S. daily vaccination rate higher over the coming weeks and months. This is welcome news as public health officials are keeping a watchful eye on the virus’s evolution, including a range of variants arising in distinct parts of the world. The Delta variant now accounts for more than 98% of daily cases in the U.S., and many parts of the country are dealing with elevated case counts, especially among the unvaccinated portions of the population. Daily case counts in the U.S. are once again near 100,000, for the first time since February 2021.

As the U.S. navigates the challenges of yet another surge in COVID-19 cases, the country must remember the tight coupling between the course of the pandemic and the path of the economy. Although advances in vaccines and treatments for COVID-19 offer reason for optimism, we must not forget nature’s bias toward selecting for evolutionary advantage. Each new infection offers the virus the possibility of evolving to a form that diminishes or eliminates our progress to date. For public health officials, this means keeping a careful eye on the rise of variants across the globe with hopes of slowing their spread, while nations race to raise the collective immunity of the population as quickly as possible.

1 Australian Academy of Sciences. The Mathematics of Social Distancing. Retrieved from Accessed April 2020.

2 Kuhn, A. (2020). New Coronavirus Cases Are on the Rise in South Korea. Retrieved from September 2020.

3 FDA. (2021). Coronavirus (COVID-19) Update: FDA Allows More Flexible Storage, Transportation Conditions for Pfizer-BioNTech COVID-19 Vaccine. Retrieved from May 2021.