Large Benefits Research Articles

The health, climate, and equity benefits of freight truck electrification in the United States

Abstract Long-haul freight shipment in the United States relies on diesel trucks and constitutes ∼3% of U.S. greenhouse gas emissions and a significant share of local air pollution. Here, we compare the climate and air pollution-related health damages from electric versus diesel long-haul truck fleets. We use truck commodity flows to estimate tailpipe emissions from diesel trucks and regional grid emissions intensities to estimate charging emissions from electric trucks under various grid scenarios. We use a reduced complexity air quality model combined with valuation of air pollution-related premature deaths (using two hazard ratios (HRs)) and quantify the distributional health impacts in different scenarios. We find that annual health and climate costs of the current diesel fleet are $195–$249/capita compared to $174–$205/capita for a new diesel fleet, and $156–$177/capita for an electric fleet, depending on the HR. We find that freight electrification could avoid $6.2–8.5 billion in health and climate damages annually when compared to a fleet of new diesel vehicles (with even higher benefits when compared to the current diesel fleet). However, the Midwest and parts of the Gulf Coast would experience an increase in health damages due to vehicles charging using electricity from coal power plants. If old coal power plants (operating in 1980 or earlier) are replaced with zero-emission generation, electrification of all U.S. freight would result in $32.3–39.2 billion in avoided damages annually and health benefits throughout the U.S. Electrifying transport of consumer manufacturing goods (including electronics, transport equipment, and precision instruments) and food, beverage, and tobacco products would provide the largest absolute health and climate benefits, whereas mixed freight and manufacturing goods would result in the largest benefits per tonne-km. We find small variations in health damages across race and income. These results will help policymakers prioritize electrification and charging investment strategies for the freight transportation sub-sector.

Distinguishing mutants that resist drugs via different mechanisms by examining fitness tradeoffs

There is growing interest in designing multidrug therapies that leverage tradeoffs to combat resistance. Tradeoffs are common in evolution and occur when, for example, resistance to one drug results in sensitivity to another. Major questions remain about the extent to which tradeoffs are reliable, specifically, whether the mutants that provide resistance to a given drug all suffer similar tradeoffs. This question is difficult because the drug-resistant mutants observed in the clinic, and even those evolved in controlled laboratory settings, are often biased towards those that provide large fitness benefits. Thus, the mutations (and mechanisms) that provide drug resistance may be more diverse than current data suggests. Here, we perform evolution experiments utilizing lineage-tracking to capture a fuller spectrum of mutations that give yeast cells a fitness advantage in fluconazole, a common antifungal drug. We then quantify fitness tradeoffs for each of 774 evolved mutants across 12 environments, finding these mutants group into classes with characteristically different tradeoffs. Their unique tradeoffs may imply that each group of mutants affects fitness through different underlying mechanisms. Some of the groupings we find are surprising. For example, we find some mutants that resist single drugs do not resist their combination, while others do. And some mutants to the same gene have different tradeoffs than others. These findings, on one hand, demonstrate the difficulty in relying on consistent or intuitive tradeoffs when designing multidrug treatments. On the other hand, by demonstrating that hundreds of adaptive mutations can be reduced to a few groups with characteristic tradeoffs, our findings may yet empower multidrug strategies that leverage tradeoffs to combat resistance. More generally speaking, by grouping mutants that likely affect fitness through similar underlying mechanisms, our work guides efforts to map the phenotypic effects of mutation.

Distinguishing mutants that resist drugs via different mechanisms by examining fitness tradeoffs.

There is growing interest in designing multidrug therapies that leverage tradeoffs to combat resistance. Tradeoffs are common in evolution and occur when, for example, resistance to one drug results in sensitivity to another. Major questions remain about the extent to which tradeoffs are reliable, specifically, whether the mutants that provide resistance to a given drug all suffer similar tradeoffs. This question is difficult because the drug-resistant mutants observed in the clinic, and even those evolved in controlled laboratory settings, are often biased towards those that provide large fitness benefits. Thus, the mutations (and mechanisms) that provide drug resistance may be more diverse than current data suggests. Here, we perform evolution experiments utilizing lineage-tracking to capture a fuller spectrum of mutations that give yeast cells a fitness advantage in fluconazole, a common antifungal drug. We then quantify fitness tradeoffs for each of 774 evolved mutants across 12 environments, finding these mutants group into classes with characteristically different tradeoffs. Their unique tradeoffs may imply that each group of mutants affects fitness through different underlying mechanisms. Some of the groupings we find are surprising. For example, we find some mutants that resist single drugs do not resist their combination, while others do. And some mutants to the same gene have different tradeoffs than others. These findings, on one hand, demonstrate the difficulty in relying on consistent or intuitive tradeoffs when designing multidrug treatments. On the other hand, by demonstrating that hundreds of adaptive mutations can be reduced to a few groups with characteristic tradeoffs, our findings may yet empower multidrug strategies that leverage tradeoffs to combat resistance. More generally speaking, by grouping mutants that likely affect fitness through similar underlying mechanisms, our work guides efforts to map the phenotypic effects of mutation.

Health, economic and social burden of tobacco in Latin America and the expected gains of fully implementing taxes, plain packaging, advertising bans and smoke-free environments control measures: a modelling study

ObjectiveTo investigate the tobacco-attributable burden on disease, medical costs, productivity losses and informal caregiving; and to estimate the health and economic gains that can be achieved if the main tobacco...

Active social engagement and health among older adults: assessing differences by cancer survivorship status

IntroductionThe number of older adults who are cancer survivors is rapidly growing. Evidence is needed to inform interventions to support successful aging among older adults (including older adult cancer survivors). Active engagement with life, that is, spending time with family and/or close friends, may be related to health outcomes, but this concept remains understudied.MethodsWe used survey data to assess active engagement among older adults (ages 50 + years) from seven mid-Atlantic US states (n = 2,914), and geocoded their residence to collect collected measures of community availability of social interaction. Outcomes were physical and mental health-related quality of life (HRQoL), assessed with the SF-12. We used multivariable, multilevel linear regression to evaluate relationships between social interactions (i.e., “active engagement with life,” or visiting with family and/or friends at least once per week and having at least three close friends, and community-level availability, measured with census tract-level park land and walkability and with county-level availability of social associations) and HRQoL. Finally, we explored differences in these relationships by recent cancer survivorship.ResultsOverall, 1,518 (52.3%) participants were actively engaged. Active engagement was associated with higher physical HRQoL (estimate = 0.94, standard error [SE] = 0.46, p = .04) and mental HRQoL (estimate = 2.10, SE = 0.46, p < .001). The relationship between active engagement and physical HRQoL was stronger for recent cancer survivors (estimate = 4.95, SE = 1.84, p < .01) than for the general population (estimate = 1.10, SE = 0.43, p = .01). Community-level availability of social interaction was not associated with HRQoL.ConclusionOur analysis demonstrated promising associations between active engagement with life and HRQoL among older adults, with large benefits for older cancer survivors. Additional research is needed on how active engagement is associated with better HRQoL, which can inform future policies and programs to optimize the aging process in the US.

Identifying Key Sources for Air Pollution and CO2 Emission Co-control in China.

China is confronting the dual challenges of air pollution and climate change, mandating the co-control of air pollutants and CO2 emissions from their shared sources. Here we identify key sources for co-control that prioritize the mitigation of PM2.5-related health burdens, given the homogeneous impacts of CO2 emissions from various sources. By applying an integrated analysis framework that consists of a detailed emission inventory, a chemical transport model, a multisource fused dataset, and epidemiological concentration-response functions, we systematically evaluate the contribution of emissions from 390 sources (30 provinces and 13 socioeconomic sectors) to PM2.5-related health impacts and CO2 emissions, as well as the marginal health benefits of CO2 abatement across China. The estimated source-specific contributions exhibit substantial disparities, with the marginal benefits varying by 3 orders of magnitude. The rural residential, transportation, metal, and power and heating sectors emerge as pivotal sources for co-control, with regard to their relatively large marginal benefits or the sectoral total benefits. In addition, populous and heavily industrialized provinces such as Shandong and Henan are identified as the key regions for co-control. Our study highlights the significance of incorporating health benefits into formulating air pollution and carbon co-control strategies for improving the overall social welfare.

Caitlin Clark's surprising economic impact

Increases in attendance for University of Iowa's women's basketball games caused by star player Caitlin Clark have led to claims of large economic benefits for Iowa City. This paper uses daily hotel occupancy data to analyze the visitor inflow arising from Clark's stardom. The findings show a surprising pattern: hotel occupancy did increase substantially during Clark's junior season but showed a much smaller increase during her senior season, even with considerably higher game attendance. Local fans substituting from men's games to women's games, thereby leaving fewer women's basketball seats available for out-of-town visitors, appears to explain at least some of the smaller hotel occupancy effect in Clark's senior season.

Acoustic deterrents for Red Fox Vulpes vulpes and threatened shorebird clutch survival on sandy beaches

Red Foxes Vulpes vulpes are a key driver of low reproductive success in beach-nesting shorebirds such as the Hooded Plover Thinornis cucullatus cucullatus, with lethal fox control curtailed by free-roaming pets and nearby urban dwellings. We tested the efficacy of an ultrasonic deterrent to alter fox behaviour and improve clutch survival. A test of the device on mock clutches demonstrated no apparent negative effect on clutch survival so testing occurred on real clutches. The deterrent evoked responses from foxes. Assemblages of species visiting real clutches differed between treatment and control sites, such that foxes tended to visit control clutches more frequently than those with the acoustic deterrent; rates of fox visitation did not differ yet featured low statistical power. The acoustic device did not confer any large benefit in terms of improved clutch survival, although low statistical power precluded us from assessing whether smaller effects occurred. This study suggests that additional aversive stimuli are likely required to deter fox take of real plover eggs.

Ontogeny of migration destination, route and timing in a partially migratory bird.

In migratory animals, the developmental period from inexperienced juveniles to breeding adults could be a key life stage in shaping population migration patterns. Nevertheless, the development of migration routines in early life remains underexplored. While age-related changes in migration routes and timing have been described in obligate migrants, most investigations into the ontogeny of partial migrants only focused on age-dependency of migration as a binary tactic (migrant or resident), and variations in routes and timing among individuals classified as 'migrants' is rarely considered. To fill this gap, we study the ontogeny of migration destination, route and timing in a partially migratory red kite (Milvus milvus) population. Using an extensive GPS-tracking dataset (292 fledglings and 38 adults, with 1-5 migrations tracked per individual), we studied how nine different migration characteristics changed with age and breeding status in migrant individuals, many of which become resident later in life. Individuals departed later from and arrived earlier at the breeding areas as they aged, resulting in a gradual prolongation of stay in the breeding area by 2 months from the first to the fifth migration. Individuals delayed southward migration in the year prior to territory acquirement, and they further delayed it after occupying a territory. Migration routes became more direct with age. Individuals were highly faithful to their wintering site. Migration distance shortened only slightly with age and was more similar among siblings than among unrelated individuals. The large gradual changes in northward and southward migrations suggest a high degree of plasticity in temporal characteristics during the developmental window. However, the high wintering site fidelity points towards large benefits of site familiarity, prompting spatial migratory plasticity to be expressed through a switch to residency. The contrasting patterns of trajectories of age-related changes between spatial and temporal migration characteristics might reflect different mechanisms underlying the expression of plasticity. Investigating such patterns among species along the entire spectrum of migration tactics would enable further understanding of the plastic responses exhibited by migratory species to rapid environmental changes.

Online, group, low-intensity psychological intervention for adults, children, and parents with food allergy

BackgroundFood allergy (FA) impairs psychological wellbeing because of constant vigilance, planning and preparation, dietary and social restrictions, and fear of accidental ingestion, though psychological interventions are sparse. ObjectiveTo examine online, group, low-intensity psychological interventions for adults, children, young people (CYP), and parents with food allergies. MethodsThe randomized controlled trials assessed the feasibility and signal of the efficacy of a psychological intervention for adults, CYP, and parents with FA. Participants were randomized to receive the psychological intervention or treatment as usual. The intervention consisted of two, 3-hour manualized online sessions spaced 1 week apart. All participants completed relevant Food Allergy Quality of Life Questionnaires (FAQLQ) and worry (Penn State Worry Questionnaires), in addition to exploratory outcomes, at baseline, 1 month, and 3 months. ResultsA total of 129 participants (n = 44 adults, n = 52 CYP, and n = 33 parents) were recruited and randomized; 95 (74%) (n = 36 adults, n = 35 CYP, and n = 24 parents) were retained at 3 months. Owing to baseline differences, mean change was used for parent and CYP outcomes. The psychological intervention demonstrated large FAQLQ benefits across adults (g = −1.12, 95% CI −0.41 to −1.28), CYP (g = 1.23, 95% CI 0.51-1.95), and parents (g = 1.43, 95% CI 0.54-2.30) compared with controls at 3-months. ConclusionThis study provides encouraging findings regarding the feasibility of online, group, low-intensity psychological interventions, in terms of recruitment and retention as well as a signal of efficacy on FAQLQ. A definitive trial including health economic analysis and FA-specific psychological measures with consideration of best routes to implementation, is warranted. Trial RegistrationClinicaltrials.gov Identifiers: NCT04763889 (adults), NCT04770727 (CYP), and NCT04774796 (parents).

Biomimetic Porous MXene Antibacterial Adsorbents with Enhanced Toxins Trapping Ability for Hemoperfusion.

2D transition metal carbides and nitrides, i.e., MXene, are recently attracting wide attentions and presenting competitive performances as adsorbents used in hemoperfusion. Nonetheless, the nonporous texture and easily restacking feature limit the efficient adsorption of toxin molecules inside MXene and between layers. To circumvent this concern, here a plerogyra sinuosa biomimetic porous titanium carbide MXene (P-Ti3C2) is reported. The hollow and hierarchically porous structure with large surface area benefits the maximum access of toxins as well as trapping them inside the spherical cavity. The cambered surface of P-Ti3C2 prevents layers restacking, thus affording better interlaminar adsorption. In addition to enhanced toxin removal ability, the P-Ti3C2 is found to selectively adsorb more middle and large toxin molecules than small toxin molecules. It possibly originates from the rich Ti-deficient vacancies in the P-MXene lattice that increases the affinity with middle/large toxin molecules. Also, the vacancies as active sites facilitate the production of reactive oxygen under NIR irradiation to promote the photodynamic antibacterial performance. Then, the versatility of P-MXene is validated by extension to niobium carbide (P-Nb2C). And the simulated hemoperfusion proves the practicability of the P-MXene as polymeric adhesives-free adsorbents to eliminate the broad-spectrum toxins.

Impact of an instructional team's feedback on an instructor's teaching practices in a Biology of Cancer course.

The effective implementation of evidence-based teaching (EBT) in large college courses benefits from the successful use of instructional teams. An instructional team's feedback allows instructors to act based on evidence of student learning, addressing students' needs. This feedback may be particularly important for novice instructors or experienced instructors teaching a class for the first time. This study sought to characterize the nature of an instructional team's feedback as well as its influence on the decisions and actions of a seasoned instructor teaching a new class. Instructional team members provided feedback in the form of anticipations, noticings, and suggestions. Anticipations and suggestions seemed to have the largest impact on the instructor's decisions and actions, while noticings, despite providing insights into student thinking, had a smaller effect. Our findings indicate that an instructional team can provide valuable feedback to instructors when team members have an opportunity to meaningfully participate in the planning and teaching processes.

Cross-Sectional Analysis of Australian Dental Practitioners’ Perceptions of Teledentistry

INTRODUCTION: There has been an increased use of teledentistry by dental practitioners in Australia as a response to the COVID-19 pandemic. Previous studies conducted analysing the opinions of dental practitioners were performed prior to the pandemic, and therefore it is important to determine if perceptions regarding teledentistry have changed following the outbreak. OBJECTIVES: The aim of this study was to determine the perceptions of oral healthcare professionals regarding teledentistry in a clinical setting. METHODS: The cross-sectional study involved an anonymous electronic questionnaire with a sample of 152 dental practitioners. The questionnaire contained 28 questions utilizing a 5-point Likert-scale to assess the perceptions of general dentists on teledentistry regarding diagnosis, accessibility, patient care, technology and finances. Chi-squared test and analysis of variance (ANOVA) were used to analyse the results and percentages of agreement and disagreement were calculated. RESULTS: The participants of the questionnaire believed that teledentistry was effective for consultations and in the diagnosis of simple cases. They indicated large benefits of teledentistry in improving access, delivering post-operative care, and triaging patients, and found it particularly useful during the COVID-19 pandemic. However, the participants felt that teledentistry was ineffective in diagnosing complex cases such as pathology. Concerns were also raised regarding the interventional capacity of teledentistry, the quality of the technology, data security and medicolegal issues. In general, participants preferred in-person care in comparison with teledentistry. They were neutral regarding finance. CONCLUSION: The study provided an insight into the perceptions of Australian dental practitioners regarding teledentistry post-COVID-19. Opinions have changed slightly, but there are large hurdles still to overcome before teledentistry is more widely accepted. Research should be continued to further improve teledentistry in the future.

Replacement of sedentary behavior with various physical activities and the risk of incident depression: a prospective analysis of accelerator-measured and self-reported UK Biobank data.

To examine the dose‒response relationships of sedentary behavior (SB) and physical activities (PAs) with depression, and to explore the effects of replacing SB with PAs on depression risk. The study used data from UK Biobank aged 37 to 73 years. Light physical activity (LPA), moderate-to-vigorous activity (MVPA), sleep duration, and total sedentary behavior (TSB) were measured by accelerometers. Self-reported SB was also adopted when daily screen-sedentary behavior time (SSB) and leisure-sedentary behavior time (LSB) were the focus. Incident depression was obtained from the part of mental and behavioral disorders in the "first occurrence fields" of UK Biobank. A Cox proportional hazard model and isotemporal substitution model were performed to explore the associations of LPA, MVPA, TSB, LSB, SSB, and sleep on depression and the effects of replacing SB time with equal PA time. Highest levels of MVPA (HR = 0.58, 95%CI: 0.50-0.68) were associated with decreased depression risk compared with the lowest level (Q1). Longer SSB time (HR = 1.18, 95%CI: 1.06-1.32), LSB time (HR = 1.19, 95%CI: 1.07-1.32), and TSB time (HR = 1.17, 95%CI: 1.00-1.38) could increase depression risk significantly. Replacing 1h/day TSB, SSB, and LSB with MVPA brought the greatest risk reductions [31% (HR = 0.69, 95%CI: 0.62-0.77), 30% (HR = 0.70, 95%CI: 0.65-0.77), and 29% (HR = 0.71, 95%CI: 0.65-0.77)]. Under the same conditions, the effects of LPA replacement were also significant, but weaker than those of MVPA. Subgroup analyses showed that replacing 1h/d TSB with LPA could significantly decrease the depression risk for the females, but not for the males. Large benefits for reducing the risk of incident depression could be attained by replacing a period of TSB, SSB, or LSB with equal PA time, especially for MVPA. Regular PA and less SB were recommended for improving mental health.

The economic impacts of the UK's eat out to help out scheme

We evaluate the economic impacts of the UK's Eat Out to Help Out (EOTHO) scheme on the food service sector. EOTHO was introduced during the COVID pandemic to stimulate demand by subsidizing the cost of eating out, with a 50 % discount Mondays to Wednesdays in August 2020. We exploit the spatial variation in participation using a continuous difference-in-differences approach and an instrumental variables strategy. We measure the effect on footfall using mobility data from Google and on employment using job posts from Indeed. Our estimates indicate that a one standard deviation increase in exposure to the EOTHO scheme increased footfall in retail & recreation by 2–5 %, and job posts in the food preparation & service industry by 6–8 %. These effects are transitory, and we do not find evidence of large spillover benefits to non-recreational activities or other sectors.

Trade Wars, Nominal Rigidities, and Monetary Policy

Abstract This paper shows that the outcome of trade wars for tariffs and welfare will be affected by the monetary policy regime. The key message is that trade policy interacts with monetary policy in a way that magnifies the welfare costs of discretionary monetary policy in an international setting. If countries follow monetary policies of flexible inflation targeting, trade wars are relatively mild, with low equilibrium tariffs and small welfare costs. Discretionary monetary policies imply much higher tariffs, high inflation rates, and substantially larger welfare costs. We quantify the effects of a global trade war among major economies using estimates of trade elasticities, economic size, net foreign assets, and trade openness. We find large welfare benefits of an inflation targeting monetary policy for all countries.

Joint impact of polygenic risk score and lifestyles on early- and late-onset cardiovascular diseases.

Understanding the interactions between genetic risk and lifestyles on different types and age onsets of cardiovascular disease (CVD) risk can help identify individuals for whom lifestyle changes would be beneficial. Here we developed three polygenic risk scores, called MetaPRSs, for coronary artery disease, ischaemic stroke and intracerebral haemorrhage by combining PRSs for CVD and CVD-related risk factors in 96,400 participants from the prospective China Kadoorie Biobank. Genetic and lifestyle risks were categorized by the disease-specific MetaPRSs and the number of unfavourable lifestyles. High genetic risk and unfavourable lifestyles were found to be more strongly associated with early than late onset of CVD outcomes in men and women. Change from unfavourable to favourable lifestyles resulted in 14.7-, 2.5- and 2.6-fold greater reductions in incidence rates of early-onset coronary artery disease and ischaemic stroke and late-onset coronary artery disease in high than low genetic risk group. Young adults at high genetic risk may have larger benefits in preventing CVD from lifestyle improvements.

Optimisation of global stem cell donor recruitment based on analysis of unsuccessful donor searches.

Despite over 41 million registered potential volunteer stem cell donors worldwide, many patients in need of a transplant do not find an HLA-matched unrelated donor or cord blood units, with the respective odds differing significantly between various populations. In this study, we analysed data of 2205 unsuccessful real-life donor searches sent to the DKMS Registry to identify populations in which further donor recruitment would be associated with particularly large patient benefits. For that purpose, we estimated haplotype frequencies of 67 donor populations at various sample sizes and entered them into two different mathematical models. These models assessed patient benefits from population-specific donor recruitment, operationalised by the number of originally unsuccessful searches that may become successful due to new donors. Consistently, across the different mathematical models and sample sizes, we obtained several countries from East and Southeast Asia (Thailand, Vietnam, China, and the Philippines) and the population of Asians in the USA as countries/populations where donor recruitment activities would be particularly beneficial for patients. We also identified various countries in Southeast and Central Europe as possible target regions for donor recruitment with above-average patient benefits. The results presented are registry-specific in the sense that they were obtained by optimising unsuccessful searches that had been sent to the DKMS Registry. Therefore, it would be desirable to apply the presented methods to a global data set that includes all unsuccessful stem cell donor searches worldwide and uses population-specific haplotype frequencies based on all donors available in the WMDA Search & Match Service.

Global health costs of ambient PM2·5 from combustion sources: a modelling study supporting air pollution control strategies

Climate actions targeting combustion sources can generate large ancillary health benefits via associated air-quality improvements. Therefore, understanding the health costs associated with ambient fine particulate matter (PM2·5) from combustion sources can guide policy design for both air pollution and climate mitigation efforts. In this modelling study, we estimated the health costs attributable to ambient PM2·5 from six major combustion sources across 204 countries using updated concentration-response models and an age-adjusted valuation method. We defined major combustion sources as the sum of total coal, liquid fuel and natural gas, solid biofuel, agricultural waste burning, other fires, and 50% of the anthropogenic fugitive, combustion, and industrial dust source. Global long-term exposure to ambient PM2·5 from combustion sources imposed US$1·1 (95% uncertainty interval 0·8-1·5) trillion in health costs in 2019, accounting for 56% of the total health costs from all PM2·5 sources. Comparing source contributions to PM2·5 concentrations and health costs, we observed a higher share of health costs from combustion sources compared to their contribution to population-weighted PM2·5 concentration across 134 countries, accounting for more than 87% of the global population. This disparity was primarily attributed to the non-linear relationship between PM2·5 concentration and its associated health costs. Globally, phasing out fossil fuels can generate 23% higher relative health benefits compared to their share of PM2·5 reductions. Specifically, the share of health costs for total coal was 36% higher than the source's contributions to corresponding PM2·5 concentrations and the share of health costs for liquid fuel and natural gas was 12% higher. Other than fossil fuels, South Asia was expected to show 16% greater relative health benefits than the percentage reduction in PM2·5 from the abatement of solid biofuel emissions. In most countries, targeting combustion sources might offer greater health benefits than non-combustion sources. This finding provides additional rationale for climate actions aimed at phasing out combustion sources, especially those related to fossil fuels and solid biofuel. Mitigation efforts designed according to source-specific health costs can more effectively avoid health costs than strategies that depend solely on the source contributions to overall PM2·5 concentration. The Health Effects Institute, the National Natural Science Foundation of China, and NASA.

COVID‐19 and global value chains: A discussion of arguments on value chain organisation and the role of the WTO

AbstractWe conduct an in‐depth analysis of the reasons for changes in global value chains as a result of COVID‐19 both from a positive angle, analysing expected changes in the behaviour of firms, and from a normative angle, assessing the different arguments for policy interventions by governments. The analysis generates three main conclusions. First, the COVID‐19 pandemic could contribute to diversification of sources of supply whose extent will vary by sector depending on the costs of value chain reorganisation. The pandemic, by contrast, is not likely to contribute much to re‐shoring, the return of manufacturing activities to industrialised countries, which is more likely to be driven by pre‐existing trends such as rising factor costs in emerging countries, increasing uncertainty about trade policy, and robotization and automation of production. Second, the pandemic has led to increased attention to the provision of essential goods in situations of crisis. Third, the largest risk for the global economy in the aftermath of the pandemic is a move away from open, non‐discriminatory trade policies, which would jeopardise the large benefits of open trade regimes in the current global economy characterised by scale economies, innovation spillovers, and a global division of labour.