was underway, but the impact of surging infections in the fourth quarter remains to be measured: many countries were registering more daily cases than they had in the second quarter, when the G20 economies contracted at an annualized rate (see Table 1.1 for data on the seven largest economies).2 The economic contraction is expected to increase inequality in many countries;3 but an Structural fissures exacerbated by the crisis threaten to make the recovery deeply uneven The Global Risks Report 2021 17 uneven economic rebound can exacerbate the inequities. At the time of writing, key capital markets had surged above prepandemic levels,4 yielding gains that will mostly benefit wealthy stockholders. The impact of the pandemic on livelihoods has been catastrophic, especially on those who have no savings, have lost their jobs or faced pay cuts. Working hours equivalent to 495 million jobs were lost in the second quarter of 20205 —14% of the world’s entire workforce.6 At the time of writing, only half were expected to have been recovered by the end of the year.7 Youth, unskilled workers, working parents—especially mothers—and already-disadvantaged minorities have been especially hard hit: 70% of working women across nine of the world’s largest economies believe their careers will be slowed by the pandemic’s disruption,8 while 51% of youth from 112 countries believe their educational progress has been delayed.9 The economic impact varies across regions. The Euro area and Latin America are expected to have contracted the most in 2020.10 Only 28 economies are expected to have grown in 2020, with China the only G-20 country among them.11 In low- and lower-middle-income countries, severe FIGURE 1.1 IMF World Output Projections Forecasts for 2020 Jan 0% Apr Jun Oct Jan Apr Jun 2020 Date of forecast 2019 Oct % and long-lasting humanitarian impacts could be exacerbated by lower levels of financial support and fewer aid workers.12 Poor working conditions and lack of social protections are likely to aggravate the impact on the world’s 2 billion informal workers.13 Source: IMF. 2019 and 2020. World Economic Outlooks and quarterly updates. REUTERS/MOON The Global Risks Report 2021 18 Health fallout At the time of writing, nearly 100 million people worldwide had contracted COVID-19 and more than 2 million had died,14 making SARS-CoV-2 one of the deadliest viruses in history.15 Global infections were rising, with upwards of 600,000 new cases and more than 10,000 deaths every day.16 Long-term health impacts remain unknown: in South Korea, a survey found that 90% of recovered COVID-19 patients were still suffering from physical and psychological side effects such as ageusia (loss of taste), anosmia (loss of smell), attention disorder and fatigue.17 Collateral health impacts—physical and mental—will continue to have devastating consequences worldwide: in the United States, for example, delayed treatment of emergencies, chronic diseases and psychological distress have already caused a death rate of 6% over what would normally be expected.18 The pandemic has strained healthcare systems, exposing their lack of capacity. Hospitals worldwide were quickly overwhelmed, and at the time of writing many were again at risk—from several countries in Europe19 to India,20 Mexico,21 South Africa22 and the United States.23 Some countries have reported new shortages of medical supplies.24 Healthcare professionals have struggled with anxiety, depression, fear, isolation and even social stigma.25 In countries such as Australia,26 Colombia,27 Ecuador,28 India,29 the United Kingdom,30 and the United States,31 financial, physical and mental stress have caused many to plan to stop working or leave the professionDecember 2020. Note: Change in Business Confidence between December 2019 and May 2020, when the indicator registered its lowest data point for OECD countries in aggregate. The Global Risks Report 2021 19 Underlying disparities The damage from COVID-19 has been worsened by long-standing gender, race, age and income inequalities. Disadvantaged groups went into the crisis with lower resilience as a result of disparities in well-being; financial stability and security; and access to healthcare, education and technology. Previous editions of the Global Risks Report have highlighted that income inequality, despite declining on a global scale, had reached historical highs in many countries (see, for example, The Fraying Fundamentals chapter in the 2020 edition of the report).32 million people into extreme poverty every year.34 This has amplified the pandemic’s impact on the physical well-being of people in low-income households,35 women,36 and the elderly. Sixty percent of adults lacked basic digital knowledge and skills when workplaces and schools across the world suddenly closed to curb the spread of COVID-19, forcing a rapid leap to online operations.37 Many students lacked access to a computer for schoolwork: percentages of students affected ranged from 25% in China to 45% in Mexico and 65% in Indonesia.38 Digital divides were already worrisome before the pandemic: in 2018, reporting that half the world’s population were connected to the internet, the International Telecommunication Union called to “redouble our collective efforts to leave no one