COVID-19

This article would not be complete if it did not mention the pandemic of COVID-19. The pandemic disrupted the country, and indeed the work since late 2019. The good news is that, as of this writing, COVID-19 deaths are down 95 percent this year, according to the World Health Organization (WHO).¹²⁹ However, the virus is still alive and well. While the pandemic may be behind us, it has become endemic, and some people are dealing with Long COVID. As of June 9, 2026, the CDC estimates that COVID-19 infections are growing or likely growing in 2 states, declining or likely declining in 38 states, and not changing in 10 states.¹³⁰ The CDC recommends COVID-19 vaccination for individuals aged 6 months and older based on individual-based decision-making, with updated vaccines targeting current variants and annual boosters for high-risk adults.¹³¹ As of mid-2026, SARS-CoV-2 activity remains generally low and stable worldwide, though some regions report elevated activity, including parts of Tropical South America, South West Europe, Africa, and Asia (WHO COVID-19 dashboard).¹³² In the 28-day period from 20 April to 17 May 2026, 62 countries reported 11,560 new cases, a decrease from the previous 28-day period, indicating a downward trend overall, though localized increases of over 10% were observed in eleven countries across the Americas, Europe, and South-East Asia. Testing and reporting reductions mean actual infection rates may be higher than reported.¹³²

In late 2019, a disease was becoming prevalent in Wuhan, China. The symptoms were typical of pneumonia but did not respond to conventional treatments. The World Health Organization (WHO) labeled the disease “2019 Novel Coronavirus” or “2019-nCoV” to denote the disease causing the outbreak in Wuhan, China.¹³³ Vaccines were created for the original virus and its subsequent variants, such as alpha, gamma, and omicron. Travel was severely limited, and by February 18, 2021, approximately 2.5 million women and 1.8 million men left the workforce since the initiation of the pandemic in the U.S.¹³³ On March 11, 2020 the WHO declared COVID-19 a pandemic. “Globally, as of 12:37am CEST, 26 April 2023, there have been 764,474,387 confirmed cases of COVID-19, including 6,915,286 deaths, reported to WHO. As of 24 April 2023, a total of 13,325,228,015 vaccine doses have been administered.¹³⁴ The U.S. Department of Health and Human Services (HHS) announced Guidance in June 2020 that specifies the type of data must be reported to HHS by laboratories along with Coronavirus Disease 2019 (COVID-19) test results, such as demographic data on race, ethnicity, age, and sex.¹³⁵ To better understand the effects of the pandemic health on women, we should reflect on the distinctive health risks and outcomes influenced by sex and gender. For example, women have higher rates of obesity in comparison to men in most countries, but the extent of the difference varies greatly.¹³⁶ Global obesity rates have almost tripled since 1990, while overweight has increased by almost 50%.¹³⁶ Women also have more severe obesity than men, which increases their risk of type 2 diabetes. Women have more comorbidities compared to men.¹³⁷ The six possible chronic conditions are arthritis, current asthma, cancer, cardiovascular disease, chronic obstructive pulmonary disease, and diabetes. Risk factors such as diabetes, smoking, and hypertension have differential impacts on men and women, with some factors conferring a greater risk in women. Across each age group, women have a higher probability than men to have one or more chronic conditions. Women live longer with more chronic health conditions.¹³⁷

It is no surprise that the COVID-19 pandemic has had greater negative effects on women versus men in some areas, as women are often caregivers for others. Also, more women than men are jobless owing to the effect of the coronavirus crisis.¹³⁸ An estimate is that women’s job loss rates due to COVID-19 are about 1.8 times higher than male job loss rates globally, at 5.7 percent versus 3.1 percent respectively. In the healthcare arena, we saw women foregoing many preventive and therapeutic medical appointments, such as screenings.¹³⁹ The study reported that the total number of cancer screenings declined by an average of 87% for breast cancer and 84% for cervical cancer during early 2020 due to the COVID-19 pandemic. This can result in late diagnoses and worse health outcomes.

Many women were pregnant or breast feeding during the pandemic. Many were confused as to how the virus or the vaccine might affect themselves of their unborn babies. On August 11, 2021, CDC released a statement stating that the COVID-19 vaccination is safe for pregnant and breastfeeding women. In 2026, that statement is still true.¹⁴⁰ COVID-19 vaccination offers the greatest benefit if you are at higher risk for severe illness, including if you are pregnant. Pregnancy can increase the risk of becoming very sick from COVID-19. If one becomes ill with COVID-19 during pregnancy, they are at increased risk of complications that may affect their own health and the health of the fetus. COVID-19 vaccination during pregnancy has not been linked to increased health risks for pregnant women or babies. It helps reduce the risk for severe illness from COVID-19. The benefits of the vaccine outweigh the risks on contracting the virus during pregnancy, and it has been proven to be safe.

In fact, a woman’s risk for depression during pregnancy doubled during the COVID-19 pandemic.Women who were pregnant during the pandemic were nearly twice as likely to have possible depression than were matched women who were pregnant prior to the pandemic. Individual and community-level factors tied to socioeconomic inequality were associated with underlying factors of COVID-19-related stress and hardship.¹⁴¹

So how does COVID-19 affect cardiovascular and heart health? A study released on April 26, 2023 implies that even mild COVID-19 can have harmful effects on cardiovascular health.¹⁴² The study compared pre and post COVID-infection levels of arterial stiffness, which has been known to be an indicator linked with the aging and function of arteries. This normally took place two to three months after the illness. One of the study authors hypothesized that the COVID-19 infection prompted the auto-immune process that leads to vasculature deterioration. In another study, researchers reported that women with high job strain, high stressful life events and high social strain were considerably linked with a higher risk of having a heart attack for the first time.¹⁴³ This conclusion was made after observing over 80,000 women in the U.S. and found a 21% increase in risk of having a heart attack.¹⁴³ A Canadian study looked at societal connections and found that they are more strongly associated with hypertension in middle and older aged women than men.¹⁴⁴ Women without husbands or partners, or those who have limited social activities, are at risk for having hypertension. We need to take social factors into consideration in addressing risk for hypertension and cardiovascular disease prevention. The pandemic caused isolation and loneliness, and the health risks are as deadly as smoking a dozen cigarettes daily, costing the health industry billions of dollars annually.¹⁴⁵ Social connection is essential to our health and well being. In fact, loneliness and isolation has become epidemic.¹⁴⁶

And lastly, we will review the effect the COVID-19 pandemic had on oral health care workers. As you can imagine, due to the risk of being infected, the additional precautions that need to be followed, and the extra time it took to treat patients, the pandemic “caused fatigue, frustration and emotional exhaustion among healthcare workers”.¹⁴⁷ The report assessed the impact of COVID-19 on considerations such as health, well-being, accessibility and the working environments of oral health care professionals. The authors believe the results will help to prepare for any future healthcare crises, and government and others responses to them.¹⁴⁷

During the emergency phase of the COVID-19 pandemic, WHO coordinated the global response, supporting countries with preparedness, surveillance, diagnostics, clinical care, medical countermeasures, access to oxygen, country readiness and deployment of COVID-19 vaccines, vaccine safety monitoring, and evidence-based guidance.¹⁴⁸ Since the Director-General of WHO removed the Public Health Emergency of International Concern in May 2023 and the emergency phase ended, WHO has continued to lead the global COVID-19 response, working with governments and partners to shift from emergency measures to long-term, integrated management of COVID-19 and other coronavirus threats.¹⁴⁹

As oral health care professionals, we strive to help our patients maintain optimal oral health and general health. We must be aware of the science that affects health, and that it is constantly changing. Resources are available to keep us current with the research that affects our patients, and subsequently our care. Geriatric and sex-specific research is more abundant as the population ages and our body of knowledge regarding sex and gender differences in illness and treatment increases. As clinicians and researchers, it is vital that we reflect on sex and gender in our approach to diagnosis, prevention, and treatment of diseases