Application For Amendment To The 2010-2030 Comprehensive Plan: Fill & Download for Free

There is not much of a health plan that can become a replacement for the Patient Protection and Affordable Care Act of 2010, AKA Obamacare. It is likely to leave with no health care plan, just a patchwork of some Executive Orders that may still be applicable without the supporting PPACA in place, and lot of directives that have little force of law.The PPACA has provision for adults up to 26 years to be included on a parent’s healthcare plan, there is protection from being refused claims based on pre-existing conditions, there is a lifetime and annual maximum on out-of-pocket expenses, there are some states that have availed themselves to expand access to Medicare, there are tax rebate subsidies to support low-paid workers access to commercial and comprehensive health insurance plans if an employer does not offer anything, and some standards for Health Insurers and Providers. Nothing negative in the package, except that it is complex. There are 906 pages of detailed provisions across a range of Health Care issues. https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdfTrump’s healthcare is a an ‘ask’ for Pharmaceutical Companies to lower drug prices, make available cheap and cut-down Insurance Plans, provide some guarantees for Medicaid recipients with a lowest -price drug option, and removed the individual mandate tax penalty, weakening the participation in health care insurance. What is called a ‘Plan’ is just a list of initiatives that do not all have the weight and validity as a provision in a law, and will have no obligation to be followed - in this 8-page summary: https://www.govinfo.gov/content/pkg/FR-2020-10-01/pdf/2020-21914.pdfAs a plan, it is bankrupt, like its author. It merely summarizes positions, and does not wrap up an approach to Healthcare for all Americans, except for the assumption that if you are poor, you can die, and if you are rich, and might need to have coverage, their are a range of options now for you. If you are old, there is some Federal Support from what you have already paid for in Medicaid contributions, but do not hold out that it would last if you are not already on it now. Better that you read and understand that the emperor has no clothes, hence he stormed out of the 60 minutes meeting with Leslie Stahl as he does not understand what a Political. Government, or Legislative plan should entail.An America-First Healthcare PlanSection 1. Purpose. Since January 20, 2017, my Administration has beencommitted to the goal of bringing great healthcare to the American peopleand putting patients first. To that end, my Administration has taken monumental steps to improve the efficiency and quality of healthcare in theUnited States.(a) My Administration has been committed to restoring choice and controlto the American patient.On December 22, 2017, I signed into law the repeal of the burdensomeindividual-mandate penalty, liberating millions of low-income Americansfrom a tax that penalized them for not purchasing health-insurance coveragethey did not want or could not afford. Through Executive Order 13813of October 12, 2017 (Promoting Healthcare Choice and Competition Acrossthe United States), my Administration has expanded coverage options formillions of Americans in several ways. My Administration increased theavailability of renewable short-term, limited-duration healthcare plans, providing options that are up to 60 percent cheaper than the least expensivealternatives under the Patient Protection and Affordable Care Act (ACA)and are projected to cover 500,000 individuals who would otherwise beuninsured. My Administration expanded health reimbursement arrangements,which have been projected by the Department of the Treasury to reach800,000 businesses and over 11 million employees and to expand coverageto more than 800,000 individuals who would otherwise be uninsured. MyAdministration also issued a rule to increase the availability of associationhealth plans for small businesses, which, upon implementation of the rule,are projected to cover up to 400,000 previously uninsured individuals foron average 30 percent less cost.As set forth in the Economic Report of the President (February 2020), myAdministration’s expansion of health savings accounts will further helpmillions of Americans pay for health expenditures by allowing them tosave more of their own money free from Federal taxation, and will especiallyhelp Americans with chronic conditions who now have more flexibilityto enroll in plans that fit their complicated care needs and can be pairedwith a tax-advantaged account.At the beginning of the current COVID–19 pandemic, my Administrationacted to dramatically increase the accessibility and availability of telehealthservices for Medicare beneficiaries, enabling millions of individuals to usethese services. Pursuant to Executive Order 13941 of August 3, 2020 (Improving Rural Health and Telehealth Access), the Secretary of Health and HumanServices will make permanent many of the new policies that improve theaccessibility and availability of telehealth services. In addition, pursuantto that order, the Secretary of Health and Human Services and the Secretaryof Agriculture will develop and implement a strategy to improve the physicaland communications healthcare infrastructure available to rural Americans.Through our State Relief and Empowerment Waivers, my Administrationhas given States additional health-insurance flexibility, which has expandedhealth-insurance coverage options for consumers and lowered costs for patients. These waivers allow States to move away from the ACA’s rigidVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00003 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62180 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documentsstructure and are estimated to have lowered premiums by approximately11 percent in Wisconsin, 20 percent in Minnesota, and 43 percent in Maryland. Due to actions my Administration took, like the State Relief andEmpowerment Waivers, after years of dwindling choices and escalatingprices, plan options for consumers increased and for 2019, for the firsttime ever, benchmark premiums actually decreased on Get 2020 health coverage. Health Insurance Marketplace. For2020, the average benchmark premium dropped by nearly 4 percent.After the prior Administration spent tens of billions of dollars creatingelectronic health records systems unable to accurately or effectively recordand communicate patient data, my Administration has paved the way fora new wave of innovation to allow patients to safely send their own medicalrecords to care providers of their choosing. My Patients over Paperworkinitiative has cut red tape for doctors and nurses so they can spend moretime with their patients, which the Centers for Medicare and MedicaidServices (CMS) within the Department of Health and Human Services (HHS)has estimated to save over 40 million hours of wasted time for providersand suppliers between 2017 and 2021.(b) My Administration has been ceaseless in its efforts to lower coststo make healthcare more affordable for American patients.Under my tenure, prescription drugs saw their largest annual price decreasein nearly half a century. For three consecutive years, we have approveda record number of generic drugs. The Council of Economic Advisers hasestimated that these approvals saved patients $26 billion in the first 18months of my Administration alone. As part of the Further ConsolidatedAppropriations Act, 2020, I signed into law the Creating and RestoringEqual Access to Equivalent Samples Act, which will pave the way foreven more generic drugs and is projected to save taxpayers $3.3 billionfrom 2019 to 2029.CMS has acted to offer Medicare beneficiaries prescription drug plans withthe option of insulin capped at $35 in out-of-pocket expenses for a 30-day supply. We are also reducing Government payments to overcharginghospitals participating in the 340B Drug Pricing Program by instead payingrates that more accurately reflect the hospitals’ acquisition costs, whichCMS estimated would save Medicare beneficiaries $320 million on copayments for drugs alone.As a result of Executive Order 13937 of July 24, 2020 (Access to AffordableLife-Saving Medications), low-income Americans who receive care from afederally qualified health center will have access to insulin and injectableepinephrine at prices lower than ever before. Under Executive Order 13938of July 24, 2020 (Increasing Drug Importation to Lower Prices for AmericanPatients), my Administration will be the first to complete a rulemakingto authorize the safe importation of certain lower-cost prescription drugsfrom Canada. Pursuant to Executive Order 13939 of July 24, 2020 (LoweringPrices for Patients by Eliminating Kickbacks to Middlemen), my Administration is taking action to eliminate wasteful payments to middlemen by passingdrug discounts through to patients at the pharmacy counter without increasing premiums for beneficiaries or cost to Federal taxpayers. And my Administration is taking action to ensure that Medicare patients receive the lowestprice that drug companies offer comparable foreign nations through ExecutiveOrder 13948 of September 13, 2020 (Lowering Drug Prices by Putting AmericaFirst).As part of the Further Consolidated Appropriations Act, 2020, I also signedinto law the repeal of the medical device tax, the annual fee on healthinsurance providers, and the ‘‘Cadillac’’ tax on certain employer-sponsoredhealth insurance, which threatened to dramatically increase the cost ofhealthcare for working families.My Administration is transforming the black-box hospital and insurancepricing systems to be transparent about price and quality. Regardless ofhealth-insurance coverage, two-thirds of adults in America still worry aboutthe threat of unexpected medical bills. This fear is the result of a systemVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00004 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORDFederal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents 62181under which individuals and employers are unable to see how insurancecompanies, pharmacy benefit managers, insurance brokers, and providersare or will be paid. One major culprit is the practice of ‘‘surprise billing,’’in which a patient receives unexpected bills at highly inflated prices fromproviders who are not part of the patient’s insurance network, even ifthe patient was treated at a hospital that was part of the patient’s network.Patients can receive these bills despite having no opportunity to selectaround an out-of-network provider in advance.On May 9, 2019, I announced four principles to guide congressional effortsto prohibit exorbitant bills resulting from patients’ accidentally or unknowingly receiving services from out-of-network physicians. Unfortunately, theCongress has failed to act, and patients remain vulnerable to surprise billing.In the absence of congressional action, my Administration has already takenstrong and decisive action to make healthcare prices more transparent. OnJune 24, 2019, I signed Executive Order 13877 (Improving Price and QualityTransparency in American Healthcare to Put Patients First), directing certainagencies—for the first time ever—to make sure patients have access to meaningful price and quality information prior to the delivery of care. BeginningJanuary 1, 2021, hospitals will be required to publish their real price forevery service, and publicly display in a consumer-friendly, easy-to-understand format the prices of at least 300 different common services that areable to be shopped for in advance.We have also taken some concrete steps to eliminate surprise out-of-networkbills. For example, on April 10, 2020, my Administration required providersto certify, as a condition of receiving supplemental COVID–19 funding,that they would not seek to collect out-of-pocket expenses from a patientfor treatment related to COVID–19 in an amount greater than what thepatient would have otherwise been required to pay for care by an innetwork provider. These initiatives have made important progress, althoughadditional efforts are necessary.Not all hospitals allow for surprise bills. But many do. Unfortunately, surprisebilling has become sufficiently pervasive that the fear of receiving a surprisebill may dissuade patients from seeking appropriate care. And researchsuggests a correlation between hospitals that frequently allow surprise billingand increases in hospital admissions and imaging procedures, putting patients at risk of receiving unnecessary services, which can lead to physicalharm and threatens the long-term financial sustainability of Medicare.Efforts to limit surprise billing and increase the number of providers participating in the same insurance network as the hospital in which they workwould correspondingly streamline the ability of patients to receive careand reduce time spent on billing disputes.On May 15, 2020, HHS released the Health Quality Roadmap to empowerpatients to make fully informed decisions about their healthcare by facilitating the availability of appropriate and meaningful price and quality information. These transformative actions will arm patients with the tools tobe active and effective shoppers for healthcare services, enabling them toidentify high-value providers and services, and ultimately place downwardpressure on prices.My Administration has cracked down on waste, fraud, and abuse that directvaluable taxpayer resources away from those who need them most. MyAdministration implemented a ‘‘site neutral’’ payment system between hospital outpatient departments and physicians’ offices, to ensure Medicarebeneficiaries are charged the same price for the same service regardlessof where it takes place, which CMS estimates will save them approximately$160 million in co-payments for 2020. We also changed the rules to enableGovernment watchdogs to proactively identify and stop perpetrators of fraudbefore money goes out the door.(c) My Administration has been dedicated to providing better care forall Americans.VerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00005 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62182 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential DocumentsThis includes a steadfast commitment to always protecting individuals withpre-existing conditions and ensuring they have access to the high-qualityhealthcare they deserve. No American should have to risk going withouthealth insurance based on a health history that he or she cannot change.In an attempt to justify the ACA, the previous Administration claimedthat, absent action by the Congress, up to 129 million (later updated to133 million) non-elderly people with what it described as pre-existing conditions were in danger of being denied health-insurance coverage. Accordingto the previous Administration, however, only 2.7 percent of such individualsactually gained access to health insurance through the ACA, given existinglaws and programs already in place to cover them. For example, the HealthInsurance Portability and Accountability Act of 1996 has long protectedindividuals with pre-existing conditions, including individuals covered bygroup health plans and individuals who had such coverage but lost it.The ACA produced multiple other failures. The average insurance premiumin the individual market more than doubled from 2013 to 2017, and thosewho have not received generous Federal subsidies have struggled to maintaincoverage. For those who have managed to maintain coverage, many haveexperienced a substantial rise in deductibles, limited choice of insurers,and limited provider networks that exclude their doctors and the facilitiesbest suited to care for them.Additionally, approximately 30 million Americans remain uninsured, notwithstanding the previous Administration’s promises that the ACA wouldaddress this intractable problem. On top of these disappointing results,Federal taxpayers and, unfortunately, future generations of American workers,have been left with an enormous bill. The ACA’s Medicaid expansion andsubsidies for the individual market are projected by the Congressional BudgetOffice to cost more than $1.8 trillion over the next decade.The ACA is neither the best nor the only way to ensure that Americanswho suffer from pre-existing conditions have access to health-insurancecoverage. I have agreed with the States challenging the ACA, who havewon in the Federal district court and court of appeals, that the ACA, asamended, exceeds the power of the Congress. The ACA was flawed fromits inception and should be struck down. However, access to health insurancedespite underlying health conditions should be maintained, even if theSupreme Court invalidates the unconstitutional, and largely harmful, ACA.My Administration has always been committed to ensuring that patientswith pre-existing conditions can obtain affordable healthcare, to loweringhealthcare costs, to improving quality of care, and to enabling individualsto choose the healthcare that meets their needs. For example, when theCOVID–19 pandemic hit, my Administration implemented a program toprovide any individual without health-insurance coverage access to necessaryCOVID–19-related testing and treatment.My commitment to improving care across our country expands vastly beyondthe rules governing health insurance. On July 10, 2019, I signed ExecutiveOrder 13879 (Advancing American Kidney Health) to improve care for thehundreds of thousands of Americans suffering from end-stage renal disease.Pursuant to that order, my Administration launched a program to encouragehome dialysis and promote transplants for patients, and expects to enrollapproximately 120,000 Medicare beneficiaries with end-stage renal diseasein the program. We also have removed financial barriers to living organdonation by adding additional financial support for living donors, suchas by reimbursing expenses for lost wages, child care, and elder care. HHS,together with the American Society of Nephrology, issued two phases ofawards through KidneyX’s Redesign Dialysis Price Competition to worktoward the creation of an artificial kidney.My Administration has taken unprecedented action to improve the qualityof and access to care for individuals with HIV, as part of our goal ofending the epidemic of HIV in the United States by 2030. HHS has awardedVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00006 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORDFederal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents 62183at least $226 million to expand access to HIV care, treatment, medication,and prevention services, focused on 48 counties, Washington, DC, and SanJuan, Puerto Rico, where more than 50 percent of new HIV diagnoses occurredin 2016 and 2017, as well as seven States with a substantial rural HIVrate. We secured a historic donation of a groundbreaking HIV preventivemedication that is available at no cost to eligible patients.My Administration has started a transformation in healthcare in rural America. This includes a new effort, pursuant to my directive in Executive Order13941, to support small hospitals and health clinics in rural communitiesin transitioning from volume-based Medicare and Medicaid reimbursement,which has failed rural communities that struggle with a lack of patientvolume, and toward value-based payment mechanisms that are tailored tomeet the needs of their communities. We updated Medicare payment policiesto address a problem in the program’s payment calculation that has historically disadvantaged rural hospitals, and released a Rural Action Plan toincorporate recommendations from experts and leaders across the FederalGovernment. We have also dedicated a special focus on improving careoffered through the Indian Health Service (IHS) within HHS, including bycreating the Office of Quality, implementing an increase in annual fundingfor IHS by $243 million from 2019 to 2020, and expanding nationwideIHS’s successful Alaska Community Health Aide Program.My Administration has additionally demonstrated an incredible dedicationto protecting and improving care for those most in need, including seniorcitizens, those with substance use disorders, and those to whom our Nationowes the greatest debt: our veterans.I have protected the viability of the Medicare program. For example, onFebruary 9, 2018, I signed into law the repeal of the Independent PaymentAdvisory Board, which would have been a group of unelected bureaucratscreated by the ACA, designed to be insulated from the will of America’selected leaders for the purpose of cutting the spending of this importantprogram. On October 3, 2019, I signed Executive Order 13890 (Protectingand Improving Medicare for Our Nation’s Seniors), to modernize the Medicareprogram and continue its viability. According to CMS estimates, seniorshave saved $2.65 billion in lower Medicare premiums under my Administration while benefiting from more choices. For example, the average monthlyMedicare Advantage premium has declined an estimated 28 percent since2017, and Medicare Advantage has included about 1,200 more plan optionssince 2018. New Medicare Advantage supplemental benefits have helpedseniors stay safe in their homes, improved respite care for caregivers, andprovided transportation, more in-home support services and assistance, andnon-opioid pain management alternatives like therapeutic massages. MedicarePart D premiums are at their lowest level in their history, with the averagebasic premium declining 13.5 percent since 2016.My Administration has directed unprecedented attention on the substanceuse disorder epidemic, with a focus on reducing overdose deaths fromprescription opioids and the deadly synthetic opioid fentanyl. On October24, 2018, I signed the Substance Use-Disorder Prevention that PromotesOpioid Recovery and Treatment for Patients and Communities Act, enablingthe expenditure of billions of dollars of funding for important programsto support prevention and recovery. My Administration has provided approximately $22.5 billion from 2017 to 2020 to address the opioid crisisand improve access to prevention, treatment, and recovery services. Wesaw a 34 percent decrease in total opioids dispensed monthly by pharmaciesbetween 2017 and 2019, an approximate increase of 64 percent in thenumber of Americans who receive medication-assisted treatment for opioiduse disorder since 2016, and a 484 percent increase in naloxone prescriptionssince 2017. Data show that drug overdose deaths fell nationwide for thefirst time in decades between 2017 and 2018, with many of the hardesthit States leading the way.VerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00007 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62184 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential DocumentsImproving care for our Nation’s veterans has been a priority since the beginning of my Administration. On June 6, 2018, I signed the VA MaintainingInternal Systems and Strengthening Integrated Outside Networks (MISSION)Act of 2018, which authorized billions of dollars to improve options forveterans to receive care outside of Department of Veterans Affairs (VA)healthcare providers. Since taking effect, the VA estimates that more than2.4 million veterans have benefited from more than 6.5 million referralsto the 725,000 private healthcare providers with which the VA is nowworking. On June 23, 2017, I signed the Department of Veterans AffairsAccountability and Whistleblower Protection Act of 2017 to hold our civilservants accountable for maintaining the best quality of care possible forour Nation’s veterans by giving the Secretary of Veterans Affairs more powerto discipline employees and shorten an appeals process that can last years.On March 5, 2019, I signed Executive Order 13861 (National Roadmapto Empower Veterans and End Suicide) to ensure that the Federal Governmentleads a collective effort to prevent suicide among our veterans.I have used scientific research to focus on areas most pressing for thehealth of Americans. On September 19, 2019, I signed Executive Order13887 (Modernizing Influenza Vaccines in the United States to PromoteNational Security and Public Health), recognizing the threat that pandemicinfluenza continues to represent and putting forward a plan to preparefor future influenza pandemics. To modernize influenza vaccines and promote national security and public health, HHS issued a 6-year, $226 millioncontract to retain and increase capacity to produce recombinant influenzavaccine domestically, and the National Institute of Allergy and InfectiousDiseases, part of the National Institutes of Health within HHS, initiatedthe Collaborative Influenza Vaccine Innovation Centers program.Investments my Administration has made in scientific research will helptackle some of our most pressing medical challenges and pay dividendsfor generations to come. This includes working to increase funding forAlzheimer’s disease research by billions of dollars since 2017 and a planto invest more than $500 million over the next decade to improve pediatriccancer research. On December 18, 2018, I signed the Sickle Cell Diseaseand Other Heritable Blood Disorders Research, Surveillance, Prevention,and Treatment Act of 2018 to provide support for research into sicklecell disease, which disproportionately impacts African Americans and Hispanics, and to authorize programs relating to sickle cell disease surveillance,prevention, and treatment.On May 30, 2018, I signed the Trickett Wendler, Frank Mongiello, JordanMcLinn, and Matthew Bellina Right to Try Act of 2017, which gives terminally ill patients the right to access certain treatments without being blockedby onerous Federal regulations.In response to the COVID–19 pandemic, my Administration launched Operation Warp Speed, a groundbreaking effort of the Federal Government toengage with the private sector to quickly develop and deliver safe andeffective vaccines, therapeutics, and diagnostics for COVID–19. On August6, 2020, I signed Executive Order 13944 (Combating Public Health Emergencies and Strengthening National Security by Ensuring Essential Medicines,Medical Countermeasures, and Critical Inputs Are Made in the United States),to protect Americans through reduced dependence on foreign manufacturersfor essential medicines and other items and to strengthen the Nation’s PublicHealth Industrial Base.Taken together, these extraordinary reforms constitute an ongoing effort toimprove American healthcare by putting patients first and delivering continuous innovation. And this effort will continue to succeed because of myAdministration’s commitment to delivering great healthcare with morechoices, better care, and lower costs for all Americans.Sec. 2. Policy. It has been and will continue to be the policy of the UnitedStates to give Americans seeking healthcare more choice, lower costs, andVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00008 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORDFederal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents 62185better care and to ensure that Americans with pre-existing conditions canobtain the insurance of their choice at affordable rates.Sec. 3. Giving Americans More Choice in Healthcare. The Secretary of theTreasury, the Secretary of Labor, and the Secretary of Health and HumanServices shall maintain and build upon existing actions to expand accessto and options for affordable healthcare.Sec. 4. Lowering Healthcare Costs for Americans. (a) The Secretary of Healthand Human Services, in coordination with the Commissioner of Food andDrugs, shall maintain and build upon existing actions to expand accessto affordable medicines, including accelerating the approvals of new genericand biosimilar drugs and facilitating the safe importation of affordable prescription drugs from abroad.(b) The Secretary of the Treasury, the Secretary of Labor, and the Secretaryof Health and Human Services shall maintain and build upon existing actionsto ensure consumers have access to meaningful price and quality informationprior to the delivery of care.(i) Recognizing that both chambers of the Congress have made substantialprogress towards a solution to end surprise billing, the Secretary of Healthand Human Services shall work with the Congress to reach a legislativesolution by December 31, 2020.(ii) In the event a legislative solution is not reached by December 31,2020, the Secretary of Health and Human Services shall take administrativeaction to prevent a patient from receiving a bill for out-of-pocket expensesthat the patient could not have reasonably foreseen.(iii) Within 180 days of the date of this order, the Secretary of Healthand Human Services shall update the Medicare.gov: the official U.S. government site for Medicare Hospital Comparewebsite to inform beneficiaries of hospital billing quality, including:(A) whether the hospital is in compliance with the Hospital Price Transparency Final Rule, as amended (84 Fed. Reg. 65524), effective January1, 2021;(B) whether, upon discharge, the hospital provides patients with a receiptthat includes a list of itemized services received during a hospital stay;and(C) how often the hospital pursues legal action against patients, includingto garnish wages, to place a lien on a patient’s home, or to withdrawmoney from a patient’s income tax refund.(c) The Secretary of Health and Human Services, in coordination withthe Administrator of CMS, shall maintain and build upon existing actionsto reduce waste, fraud, and abuse in the healthcare system.Sec. 5. Providing Better Care to Americans. (a) The Secretary of Healthand Human Services and the Secretary of Veterans Affairs shall maintainand build upon existing actions to improve quality in the delivery of carefor veterans.(b) The Secretary of Health and Human Services shall continue to promotemedical innovations to find novel and improved treatments for COVID–19, Alzheimer’s disease, sickle cell disease, pediatric cancer, and other conditions threatening the well-being of Americans.Sec. 6. General Provisions. (a) Nothing in this order shall be construedto impair or otherwise affect:(i) the authority granted by law to an executive department or agency,or the head thereof; or(ii) the functions of the Director of the Office of Management and Budgetrelating to budgetary, administrative, or legislative proposals.(b) This order shall be implemented consistent with applicable law andsubject to the availability of appropriations.VerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00009 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62186 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents(c) This order is not intended to, and does not, create any right or benefit,substantive or procedural, enforceable at law or in equity by any partyagainst the United States, its departments, agencies, or entities, its officers,employees, or agents, or any other person.

The Coronavirus or COVID-19 is a disease based on an unknown virus. It seems that it started in China and has widely spread in almost all countries in the world. This pandemic situation is one of the widely spread diseases in recent history. However, there was an influenza pandemic in 1918 with the exact number of deaths still unknown. Some believe that the death toll would have been about 50–100 million people. At the time of writing this article, COVID-19 has infected 5,306,928 persons worldwide (when the article was finalised for publication, the number has increased up to 15,947,291). The article is aimed at analysing the positive and negative impacts of COVID-19 in a sociological perspective. It is further focused on possible challenges to the supply chain in South Asia. South Asian countries are highly influenced by the pandemic situation, and the regional representation is about 4% in the later part of May 2020 with an increasing tendency. Also, the article has a proposal for the control of the disease as well as the entire socio-economic, environmental and political atmosphere in a country, whilst particularly giving more weight to South Asia. The proposed actions are analysed in short-term, mid-term and long-term basis, and any expert and social worker who is involved in the pandemic control process can gain an insight into what to do and how to perform their tasks. A sociological analysis on COVID-19 is very important because there is a wing comprising dominant medical experts in the control and management of the disease. The article emphasises the importance of a sociological analysis in a pandemic situation. Naturally, anyone would think of a pandemic situation in very negative terms due to its emotional, socio-economic, environmental, political and cultural factors. However, it is also positive due to certain factors that help to reintegrate and reorganise the social system as a whole.The main objective of this paper is to discuss the positive and negative impacts of COVID-19 in a sociological perspective with special attention to the supply change in South Asian countries. In addition, the paper proposes a future action plan or COVID-19 recovery action plan for Sri Lanka as a South Asian country. The country is in a COVID19 affected stage and is gradually progressing into a non-affected stage, and this action plan is focused on at least a five-year period.There is no argument that the local economic and social spheres as well as global spheres have been challenged and some sectors have been drastically dismantled (Malpass 2020). Therefore, we need to repose our trust mostly on local spheres which facilitate our basic needs and other socio-economic needs structure. As we know very well, we are in possession of a substantial service sector, rather than industrial and agricultural sectors. In contrast to these sectors, we need to maintain sound industrial and agricultural sectors to maintain a good service sector. However, our industrial sector will be severely damaged due to COVID-19. Especially, the apparel and textile industry will be heavily damaged due to COVID-19, since the pandemic has severely affected giant countries such as the USA and European countries. This will lead to lesser and lesser demand for readymade apparels, thus leading to the closure of many apparel industries in the country. The factories would not be able to overcome this situation since their buyers would cut down all possible avenues to recover from the dire situation. The export volumes of the agricultural and fisheries sectors would decrease, creating negative economic and social impacts on Sri Lanka. Though the World Bank issued a statement on March 30, 2020, it does not provide any forecasts on Sri Lanka or South Asian countries. It focuses only on East Asian and Pacific countries whilst highlighting the poverty incident that would increase dramatically (World Bank 2020c). If the economic situation were to deteriorate further and the lower-case scenario prevails, then poverty is estimated to increase by about 11 million people in these regions. In April 2020, the World Bank illustrates the South Asian context of COVID-19 and its impacts. It says that the impact of the pandemic will hit hard low-income people, especially informal workers in the hospitality, retail trade and transport sectors who have limited or no access to healthcare or social safety nets (World Bank 2020a). Furthermore, it focuses that the Sri Lankan economic growth in the first quarter of 2020 is between 3.0 and − 0.5 and it will remain low throughout the year. It may slowly grow until 2022 with a 2.5% growth rate. The forecast analysis shows that Sri Lanka will struggle with the economy. Thus, the country needs a well-integrated plan to avoid economic hardships as well as social and political tensions. Especially, it needs political stability, high level of mass participation in all sectors, attitude change in domestic production and use, and low level of dependency on foreign aids and foreign goods and services. Especially, it will help to refurbish the domestic supply chain as the countries’ primary target.When the Sri Lankan scenario is looked at, the economic growth has translated into shared prosperity with the national poverty headcount ratio declining from 15.3% in 2006/07 to 4.1% in 2016 (World Bank 2020b). Extreme poverty is rare and concentrated within some geographical pockets; however, a relatively large share of the population subsists on slightly more than the poverty line. However, COVID-19 would increase poverty incidents to some extent since many apparel sector workers are unemployed or under-employed. Foreign migrant labourers are affected due to the situations in their respective countries and they are losing their decent income. Simultaneously, the tourism and hotel industry will be severely affected, sometimes temporarily as Sri Lanka is managing the pandemic situation satisfactorily and this could attract future foreign tourists on the lookout for healthy living. If the Government of Sri Lanka (GOSL) plans a well-integrated domestic production, strengthening and improvement activities, it will ensure the flow of the national supply chain without any disturbances, and also such a situation may help to gain significant improvements in local and foreign tourism.Within the socio-economic background highlighted above, Sri Lanka needs to have a very comprehensive future action plan to overcome all negative impacts. Especially, it is important to identify the short-term, medium-term, and long-term negative and positive impacts in terms of developing a future action plan or COVID-19 recovery action plan.When focusing on positive impacts the immediate question that may arise is, what are the positive impacts in a global pandemic situation? Sociologically, there is a theoretical perspective and a method called functionalism or functional perspective and this method could be utilised in analysing the impact of social action (Parsons 1951a, b; Rocher 1972; Luhmann 1995; Knudsen 2010). COVID-19 is a social action, and it can also be considered a great social problem on the basis of Richard Puller’s definition. When looked at generally, COVID-19 is a disease spreading through close human contacts in day-to-day social relationships. It is a virus and certain sections also consider this to be a man-made virus or biological weapon. There is no conclusive evidence on who made it or for what purpose. The majority of those directly affected are the elderly and a considerable number of people are dying. The percentage is changing from country to country, and the USA which is highly affected shows that 2.9% of the deaths are amongst these affected persons. The death toll is very high in Italy which is 13%. In Sri Lanka, it is 3.7% and it is a higher figure when compared to India, which is 2.8% (Coronavirus Update (Live): 108,808,073 Cases and 2,395,911 Deaths from COVID-19 Virus Pandemic, 2020). Thus, it is important to understand what the positive impacts are. They are given in the following:1.People are adapting to a pandemic situation, and they also understand what the ideal social behaviour is in a similar situation. This may include government pandemic management systems and policies.2.They learnt about social distancing and its rules, conditions and procedures. Especially, how painful it is but useful within the family and the community. Also, they adapt themselves to the situation whilst contemplating the difference between a normal situation and a pandemic situation.3.As a result of social integration, families and communities engage in a high level of social cohesion or social conscience to face the difficult situation. Hence, everyone is getting used to a common lifestyle, sharing and caring for others, especially the elderly people.4.The death of an elderly or chronically ill person results in a reorganisation or reunion of the family unit. Though it is not an easy task to bear the psycho-social factors, finally they come to certain common conclusions.5.Similarly, the government and regional organisations in the global context may reunite to face the pandemic situation. For example, the SARRC countries reunited over COVID-19 and set up financial allocations for supporting poorer nations. The recent SAARC video conference on COVID 19 has resulted in the establishment of a fund for regional cooperation to combat the pandemic. The giant country India contributed USD 10 million followed by Sri Lanka which contributed USD 5 to the fund. This fund can be utilised for the improvement of domestic and regional production whilst aiming at an uninterrupted supply chain in the agricultural, industrial and service sectors.6.Medical systems in any country will be improved to sustainable levels to face a pandemic situation. They will understand the existing gaps in these systems. Especially, many South and East Asian countries will focus on their indigenous medical systems and how it should be integrated with the biomedical system which shows poorer results. Their dominant authority may be challenged by indigenous medical practitioners due to the strength of the indigenous medical systems to treat COVID-19 patients.7.The global hegemonic power would change and a new hegemonic power relation is taking its place without any brutal war conditions and much economic and social costs. It seems that the USA may lose the hegemonic power, which would be replaced by China and within such a scenario China could achieve its long-term goals. However, it can be delayed and disturbed by the USA through certain economic restrictions against China. Recently, the USA announced that they are willing to withdraw their investments in China. Under such circumstances South Asian countries, particularly India can offer much better economic policies to attract US investments in India. Similarly, Sri Lanka and Bangladesh can grab some such opportunities in certain industrial fields. This may help in improving supply chain values and efficiency in South Asian countries.8.The new hegemonic power may extend its supporting hands to the developing nations and poorer countries. Thus, there will be a competition amongst China, USA and India to support regional countries in South East Asia. The new world order may be a novel experience to the countries and their people. At the beginning it will be optimistic as per the conflict theory in sociology. If it suits the supply chain system in these countries then the people may accept the new order.9.There will be many discoveries and innovations in all affected sectors or spheres at national, regional and global contexts. Most of these would be medical, environment, industry and socio-cultural related. These discoveries and innovations will help to manage the supply chain in South Asian countries.10.The potentials would be in domestic production and services to maintain local traditional lifestyles rather than adapting to modernity. People may repose their trust in many local-level trades and business firms rather than depending on the supermarket systems. These trends strengthen the supply chain network at national and regional levels. Perhaps, there may be some new trading opportunities too amongst regional countries.11.Domestic production could increase due to family or cottage level agricultural practices including other small-scale handicraft productions in society. This may reduce the market demand to some extent and it may also cause negative effects amongst international trades.12.As mentioned above, the pandemic situation may increase the level of innovations amongst the people. Some creative-minded people may introduce much effective and productive primary and secondary things, efficient ways and means of productions, low-cost productions, technological advancements, etc. These trends too may strengthen the supply chain network at national and regional levels.13.People may be attracted to traditional foods and consumption practices mainly based on the human family. Intergenerational social integrity will strengthen and be consolidated by youths. There will be a lesser demand for restaurants and hotel sector supply chains in each level such as national, regional and global due to the social and physical distancing.14.Decline in defence expenditure at national and global levels and minimising the need or requirements in the arms race, especially in nuclear weaponry systems, at least on a temporary basis. Thus, war fear could be minimised in certain regions. This may in turn influence international terrorism and its supply chain networks.15.New ideological constructions in many critical subject disciplines, such as medicine, economics, political science, sociology, psychology, robotic sciences, religious and humanistic sciences. Hence, research and development activities will expand in every country.16.Developments in sociological tool-kits and social engineering skills to deliver efficient services through supply chain networks and management of patients and general public.17.People getting used to do some optional analysis and adapt to follow optimum use of resources, economising resources, and sustainable approaches to satisfy their need structure. These trends may reorganise the supply chain networks in national and regional levels.18.General public may develop some positive altitudes over the special duties performed by various essential services in society, especially, health workers, social workers, police and armed forces who are involved in quarantine processes, etc. However, there should be very efficient supply chains to maintain these services in optimum operation when necessary to society, particularly, in South Asia.19.Reduction in plastic and polythene use at the domestic level, thus reducing the environmental pollution. As a whole, it may contribute to global environmental protection efforts. Especially, it may temporarily reduce greenhouse gases due to the minimum use of vehicles and industries in the world. Perhaps, there may be some climate changes in the environment.20.Reduction in the environmental pollution in the world, regional and national contexts. Mainly, air, sound, and water pollution will be reduced. There are some studies conducted, and they reveal that the pollution level is reduced drastically in all these three sectors.21.Possible formation of further philanthropic ideas amongst the upper hierarchy segments in society. Thus, the domestic supply chain networks should capture these demands effectively.22.If the government is successful in managing the COVID-19 instead of developing a pandemic situation, it can lead to a stable political order in society. Perhaps, the incumbent government could win another term in power as the pandemic situation has provided a great opportunity to compare each country and its skills in the governance of their political regimes.23.Reduction in crimes such as drug addiction, alcoholism, gambling, prostitution or commercial sex, violence and suicide. Again, the supply chain networks in commercial sex, illicit drugs, etc. may change.24.Some countries may amend or introduce specific legislation based on their experiences in the management of COVID-19 pandemic situations. Particularly, trading pacts amongst regional countries may change whilst new pacts may also be formulated.25.Some countries may review policy gaps and take action for policy updates. Sri Lanka needs a policy on indigenous medicine (traditional medicine) which is not covered by the existing health policy in Sri Lanka. It is the right time to respond to the court decision and request a new pharmacopeia with a list of codes.26.More utilisation of the internet for sharing ideas, new knowledge, filtering knowledge gaps, news messages, etc. This may open up more avenues to reduce the stress level of the people.27.Return migrants who are having strong financial resources may invest in Sri Lanka if the socio-economic and political stability established after complete control and management of COVID-19 in Sri Lanka.28.Returning migrants with less or poor financial resources may seek jobs in the apparel sector or plantation sector. Therefore, there will be a high supply in the labour market in the country. This situation may impact the new formation of production and supply chain networks.29.There will be more research on COVID-19, particularly discovering a vaccine and medical strategies which are more effective in patient management. If any new vaccinations are discovered, there will be a massive demand from each country and new supply chain networks will emerge within the health sector.Therefore, positive impacts are relatively high and some impacts are short term and most others are long term. This situation depends on the early stage of April 2020 and the shape could change due to several global socio-economic and political factors. So far, COVID-19 is in a rapid spread tendency in most countries, and there are no sufficient health and socio-economic facilities, especially supply chain networks to address the need structure of the pandemic situation in these countries. When the Indian scenario is analysed, the COVID-19 impacts will be the most painful here when compared to other countries. The social system prevailing in India is not simple in terms of managing the pandemic situation. It is very clear that any society which has a high social disparity may have to face the most negative impacts.The negative impacts towards the family, communities, nations, regions and the world push them backward in any sector or socio-economic and political spheres. Several elements which cause negative impacts can be identified as illnesses or COVID-19, pandemic situation, deaths, social distancing, curfew and the lock-down of the entire functional mechanism of a single society and the global network in production, trade, supply chain networks, transportation, social networking and political network. Therefore, this paper has given similar attention to the negative impacts of COVID-19 at the local, regional and global contexts based on the situation in early April 2020. They are given in the following:1.The pandemic situation has spread as a global pandemic disease which is creating fear, stress, stigma, minimising social networks, etc.2.Health and medical systems, especially biomedical systems, have taken their maximum effort but the healthcare system itself is affected due to various conditions in nature. Thus, there are many deaths reported though the biomedical system has made an enormous effort.3.High rate of deaths due to various illnesses or complications of diseases occurring amongst the patients, especially the elderly who are affected by COVID-19.4.Impossible tasks and challenges to the medical staff, supporting staff, social workers and health administrators at local, domestic and/or global levels. The World Health Organisation (WHO) is the primary entity followed by other United Nations (UN) agencies which are responsible during a regional and/or global pandemic situation.5.Some countries such as Italy, Spain, USA and China and a few other European countries are facing a much higher disintegration in all subsystems of society. Thus, the social system needs a complete reorganisation and integration to survive.6.Dismantling the family relationship and intimate relationships with relatives, neighbours, various communities, etc. These conditions may lead to interpersonal conflicts and domestic violence in the family.7.Losing the knowledge, experience, and services of the elderly would mean that the next generation would not be able to share them for their betterment.8.Downward trends of family economic conditions and several lower hierarchy social classes facing unbearable economic hardships due to lack of daily or monthly earnings. Though there are market accessibility and supply chain network even under the limitation of social mobility, they do not possess the purchasing power.9.Disruptions of schools, universities and vocational education segments where they have to seek certain optional strategies to cover up their educational goals. Especially, they may face some irreversible gaps in their education. All supply chain networks in the education field have been interrupted.10.Some people may face various kinds of stress, social stigma and depression conditions due to the malfunction of the social system.11.Possible social conflicts or conflicts of interests in the subsystems and this may lead towards the social system. Some institutions and organisations may not possess sufficient capacities to find remedial solutions to fill the gaps and issues.12.Decline in religious belief systems and practices in all religions and people may not believe in superstitious powers, in god and other divine and invisible elements in society.13.If the government and its subordinate authorities face some inadequate workable decisions or binding decisions and poor policy applications, it may lead to political instability in society. These conflicts of interests may cause political changes in society.14.Social unrest, stress and social stigma amongst the family members due to their detachment from family as a result of local and international migration. This may get aggravated further through the suspension of continental air transportation under lock-down situations.15.Disruptions in the productions of primary and secondary items in the society. Especially, issues in the production of primary items may lead to social unrest in society. Less demand and lack of proper supply chain networks may aggravate the existing unrest level.16.There are many people who are losing their jobs and incomes in the formal and informal sectors in the society.17.Service providers’ (supply chain networks) inability to continue the day-to-day supply of commodities and other services due to the lack of profit margins. It may lead to detachments from such entities or services, and some people may find alternative solutions. Thus, there may be some temporal decline in supply chains in society.18.People might depend on rumours and other informal channels of information if there is a chaotic condition in formation channels or the dissemination of information. Especially, if there are some loop halls in supply chain networks, these rumours may work rapidly with different social and economic impacts.19.Certain social classes may display their egoistic ideologies at the time of accumulating primary or essential goods and services. This may cause some negative attitudes amongst other social classes by creating conflict of interests.20.Global economic recession and increase in poverty level in society. This may lead to financial crises such as a decline in monetary values, share market values and businesses, changes in supply chain networks, and purchasing power of the people.21.The country has to take alternative action to maintain a stable economy. The developing countries and poor countries may get more loans and grants for their economy to survive. Thus, there will be more economic and political dependency in these countries. As a result of this condition, countries in the hegemonic circle may directly or indirectly fulfil their hidden agendas in the territories of such dependent countries. Being South Asian countries, there are certain common social and economic characteristics that need to be safeguarded during the pandemic situation.22.The pandemic situation will directly influence the Sustainable Development Goals (SDGs) defined to be achieved by 2030, since some countries may not allocate financial resources to meet the country-specific targets.23.Internal fragmentation may occur in global hegemonic countries, particularly in the USA and they may attempt to regain the hegemonic power through various economic and political strategies. Perhaps, they may go for direct war strategies with other countries or accelerate existing intervention in the Middle-East region.24.Sri Lankans who have been employed in foreign countries may return home and future foreign revenues may reduce. It is one of the major revenue in Sri Lanka, especially the migrant workers in the Middle-East, Europe and East Asian countries made a significant contribution to the Sri Lankan economy. This may cause some effects in supply chain networks in Sri Lanka as well as South Asian countries.25.If the government of Sri Lanka does not engage the returning migrants fruitfully, they may get frustrated and thus cause some vulnerability in the informal sectors of society.When these positive and negative impacts are considered, it is very clear that COVID-19 has caused more positive impacts to the nations, regions and the world, particularly to South Asian countries. However, some countries such as Italy, Spain, the USA, and China and several European countries have suffered a lot. At the time of writing this article, COVID-19 has infected 5,306,928 persons worldwide (when the article was finalised for publication, the number has increased up to 15,947,291). Comparatively, these positive and negative impacts are valid for these countries too, irrespectively of the level of the spread of COVID-19.The proposed future action plan or COVID-19 recovery action plan mainly focuses on the socio-economic, environment and political spheres and not on the medical and technical spheres. Table 1 illustrates this categorically.Download PDFResearch NotePublished: 02 September 2020Positive and negative impacts of COVID-19, an analysis with special reference to challenges on the supply chain in South Asian countriesK. KarunathilakeJournal of Social and Economic Development (2020)Cite this article153k Accesses1 CitationsMetricsdetailsAbstractThe Coronavirus or COVID-19 is a disease based on an unknown virus. It seems that it started in China and has widely spread in almost all countries in the world. This pandemic situation is one of the widely spread diseases in recent history. However, there was an influenza pandemic in 1918 with the exact number of deaths still unknown. Some believe that the death toll would have been about 50–100 million people. At the time of writing this article, COVID-19 has infected 5,306,928 persons worldwide (when the article was finalised for publication, the number has increased up to 15,947,291). The article is aimed at analysing the positive and negative impacts of COVID-19 in a sociological perspective. It is further focused on possible challenges to the supply chain in South Asia. South Asian countries are highly influenced by the pandemic situation, and the regional representation is about 4% in the later part of May 2020 with an increasing tendency. Also, the article has a proposal for the control of the disease as well as the entire socio-economic, environmental and political atmosphere in a country, whilst particularly giving more weight to South Asia. The proposed actions are analysed in short-term, mid-term and long-term basis, and any expert and social worker who is involved in the pandemic control process can gain an insight into what to do and how to perform their tasks. A sociological analysis on COVID-19 is very important because there is a wing comprising dominant medical experts in the control and management of the disease. The article emphasises the importance of a sociological analysis in a pandemic situation. Naturally, anyone would think of a pandemic situation in very negative terms due to its emotional, socio-economic, environmental, political and cultural factors. However, it is also positive due to certain factors that help to reintegrate and reorganise the social system as a whole.The main objective of this paper is to discuss the positive and negative impacts of COVID-19 in a sociological perspective with special attention to the supply change in South Asian countries. In addition, the paper proposes a future action plan or COVID-19 recovery action plan for Sri Lanka as a South Asian country. The country is in a COVID19 affected stage and is gradually progressing into a non-affected stage, and this action plan is focused on at least a five-year period.There is no argument that the local economic and social spheres as well as global spheres have been challenged and some sectors have been drastically dismantled (Malpass 2020). Therefore, we need to repose our trust mostly on local spheres which facilitate our basic needs and other socio-economic needs structure. As we know very well, we are in possession of a substantial service sector, rather than industrial and agricultural sectors. In contrast to these sectors, we need to maintain sound industrial and agricultural sectors to maintain a good service sector. However, our industrial sector will be severely damaged due to COVID-19. Especially, the apparel and textile industry will be heavily damaged due to COVID-19, since the pandemic has severely affected giant countries such as the USA and European countries. This will lead to lesser and lesser demand for readymade apparels, thus leading to the closure of many apparel industries in the country. The factories would not be able to overcome this situation since their buyers would cut down all possible avenues to recover from the dire situation. The export volumes of the agricultural and fisheries sectors would decrease, creating negative economic and social impacts on Sri Lanka. Though the World Bank issued a statement on March 30, 2020, it does not provide any forecasts on Sri Lanka or South Asian countries. It focuses only on East Asian and Pacific countries whilst highlighting the poverty incident that would increase dramatically (World Bank 2020c). If the economic situation were to deteriorate further and the lower-case scenario prevails, then poverty is estimated to increase by about 11 million people in these regions. In April 2020, the World Bank illustrates the South Asian context of COVID-19 and its impacts. It says that the impact of the pandemic will hit hard low-income people, especially informal workers in the hospitality, retail trade and transport sectors who have limited or no access to healthcare or social safety nets (World Bank 2020a). Furthermore, it focuses that the Sri Lankan economic growth in the first quarter of 2020 is between 3.0 and − 0.5 and it will remain low throughout the year. It may slowly grow until 2022 with a 2.5% growth rate. The forecast analysis shows that Sri Lanka will struggle with the economy. Thus, the country needs a well-integrated plan to avoid economic hardships as well as social and political tensions. Especially, it needs political stability, high level of mass participation in all sectors, attitude change in domestic production and use, and low level of dependency on foreign aids and foreign goods and services. Especially, it will help to refurbish the domestic supply chain as the countries’ primary target.When the Sri Lankan scenario is looked at, the economic growth has translated into shared prosperity with the national poverty headcount ratio declining from 15.3% in 2006/07 to 4.1% in 2016 (World Bank 2020b). Extreme poverty is rare and concentrated within some geographical pockets; however, a relatively large share of the population subsists on slightly more than the poverty line. However, COVID-19 would increase poverty incidents to some extent since many apparel sector workers are unemployed or under-employed. Foreign migrant labourers are affected due to the situations in their respective countries and they are losing their decent income. Simultaneously, the tourism and hotel industry will be severely affected, sometimes temporarily as Sri Lanka is managing the pandemic situation satisfactorily and this could attract future foreign tourists on the lookout for healthy living. If the Government of Sri Lanka (GOSL) plans a well-integrated domestic production, strengthening and improvement activities, it will ensure the flow of the national supply chain without any disturbances, and also such a situation may help to gain significant improvements in local and foreign tourism.Within the socio-economic background highlighted above, Sri Lanka needs to have a very comprehensive future action plan to overcome all negative impacts. Especially, it is important to identify the short-term, medium-term, and long-term negative and positive impacts in terms of developing a future action plan or COVID-19 recovery action plan.When focusing on positive impacts the immediate question that may arise is, what are the positive impacts in a global pandemic situation? Sociologically, there is a theoretical perspective and a method called functionalism or functional perspective and this method could be utilised in analysing the impact of social action (Parsons 1951a, b; Rocher 1972; Luhmann 1995; Knudsen 2010). COVID-19 is a social action, and it can also be considered a great social problem on the basis of Richard Puller’s definition. When looked at generally, COVID-19 is a disease spreading through close human contacts in day-to-day social relationships. It is a virus and certain sections also consider this to be a man-made virus or biological weapon. There is no conclusive evidence on who made it or for what purpose. The majority of those directly affected are the elderly and a considerable number of people are dying. The percentage is changing from country to country, and the USA which is highly affected shows that 2.9% of the deaths are amongst these affected persons. The death toll is very high in Italy which is 13%. In Sri Lanka, it is 3.7% and it is a higher figure when compared to India, which is 2.8% (Coronavirus Update (Live): 108,808,073 Cases and 2,395,911 Deaths from COVID-19 Virus Pandemic, 2020). Thus, it is important to understand what the positive impacts are. They are given in the following:1.People are adapting to a pandemic situation, and they also understand what the ideal social behaviour is in a similar situation. This may include government pandemic management systems and policies.2.They learnt about social distancing and its rules, conditions and procedures. Especially, how painful it is but useful within the family and the community. Also, they adapt themselves to the situation whilst contemplating the difference between a normal situation and a pandemic situation.3.As a result of social integration, families and communities engage in a high level of social cohesion or social conscience to face the difficult situation. Hence, everyone is getting used to a common lifestyle, sharing and caring for others, especially the elderly people.4.The death of an elderly or chronically ill person results in a reorganisation or reunion of the family unit. Though it is not an easy task to bear the psycho-social factors, finally they come to certain common conclusions.5.Similarly, the government and regional organisations in the global context may reunite to face the pandemic situation. For example, the SARRC countries reunited over COVID-19 and set up financial allocations for supporting poorer nations. The recent SAARC video conference on COVID 19 has resulted in the establishment of a fund for regional cooperation to combat the pandemic. The giant country India contributed USD 10 million followed by Sri Lanka which contributed USD 5 to the fund. This fund can be utilised for the improvement of domestic and regional production whilst aiming at an uninterrupted supply chain in the agricultural, industrial and service sectors.6.Medical systems in any country will be improved to sustainable levels to face a pandemic situation. They will understand the existing gaps in these systems. Especially, many South and East Asian countries will focus on their indigenous medical systems and how it should be integrated with the biomedical system which shows poorer results. Their dominant authority may be challenged by indigenous medical practitioners due to the strength of the indigenous medical systems to treat COVID-19 patients.7.The global hegemonic power would change and a new hegemonic power relation is taking its place without any brutal war conditions and much economic and social costs. It seems that the USA may lose the hegemonic power, which would be replaced by China and within such a scenario China could achieve its long-term goals. However, it can be delayed and disturbed by the USA through certain economic restrictions against China. Recently, the USA announced that they are willing to withdraw their investments in China. Under such circumstances South Asian countries, particularly India can offer much better economic policies to attract US investments in India. Similarly, Sri Lanka and Bangladesh can grab some such opportunities in certain industrial fields. This may help in improving supply chain values and efficiency in South Asian countries.8.The new hegemonic power may extend its supporting hands to the developing nations and poorer countries. Thus, there will be a competition amongst China, USA and India to support regional countries in South East Asia. The new world order may be a novel experience to the countries and their people. At the beginning it will be optimistic as per the conflict theory in sociology. If it suits the supply chain system in these countries then the people may accept the new order.9.There will be many discoveries and innovations in all affected sectors or spheres at national, regional and global contexts. Most of these would be medical, environment, industry and socio-cultural related. These discoveries and innovations will help to manage the supply chain in South Asian countries.10.The potentials would be in domestic production and services to maintain local traditional lifestyles rather than adapting to modernity. People may repose their trust in many local-level trades and business firms rather than depending on the supermarket systems. These trends strengthen the supply chain network at national and regional levels. Perhaps, there may be some new trading opportunities too amongst regional countries.11.Domestic production could increase due to family or cottage level agricultural practices including other small-scale handicraft productions in society. This may reduce the market demand to some extent and it may also cause negative effects amongst international trades.12.As mentioned above, the pandemic situation may increase the level of innovations amongst the people. Some creative-minded people may introduce much effective and productive primary and secondary things, efficient ways and means of productions, low-cost productions, technological advancements, etc. These trends too may strengthen the supply chain network at national and regional levels.13.People may be attracted to traditional foods and consumption practices mainly based on the human family. Intergenerational social integrity will strengthen and be consolidated by youths. There will be a lesser demand for restaurants and hotel sector supply chains in each level such as national, regional and global due to the social and physical distancing.14.Decline in defence expenditure at national and global levels and minimising the need or requirements in the arms race, especially in nuclear weaponry systems, at least on a temporary basis. Thus, war fear could be minimised in certain regions. This may in turn influence international terrorism and its supply chain networks.15.New ideological constructions in many critical subject disciplines, such as medicine, economics, political science, sociology, psychology, robotic sciences, religious and humanistic sciences. Hence, research and development activities will expand in every country.16.Developments in sociological tool-kits and social engineering skills to deliver efficient services through supply chain networks and management of patients and general public.17.People getting used to do some optional analysis and adapt to follow optimum use of resources, economising resources, and sustainable approaches to satisfy their need structure. These trends may reorganise the supply chain networks in national and regional levels.18.General public may develop some positive altitudes over the special duties performed by various essential services in society, especially, health workers, social workers, police and armed forces who are involved in quarantine processes, etc. However, there should be very efficient supply chains to maintain these services in optimum operation when necessary to society, particularly, in South Asia.19.Reduction in plastic and polythene use at the domestic level, thus reducing the environmental pollution. As a whole, it may contribute to global environmental protection efforts. Especially, it may temporarily reduce greenhouse gases due to the minimum use of vehicles and industries in the world. Perhaps, there may be some climate changes in the environment.20.Reduction in the environmental pollution in the world, regional and national contexts. Mainly, air, sound, and water pollution will be reduced. There are some studies conducted, and they reveal that the pollution level is reduced drastically in all these three sectors.21.Possible formation of further philanthropic ideas amongst the upper hierarchy segments in society. Thus, the domestic supply chain networks should capture these demands effectively.22.If the government is successful in managing the COVID-19 instead of developing a pandemic situation, it can lead to a stable political order in society. Perhaps, the incumbent government could win another term in power as the pandemic situation has provided a great opportunity to compare each country and its skills in the governance of their political regimes.23.Reduction in crimes such as drug addiction, alcoholism, gambling, prostitution or commercial sex, violence and suicide. Again, the supply chain networks in commercial sex, illicit drugs, etc. may change.24.Some countries may amend or introduce specific legislation based on their experiences in the management of COVID-19 pandemic situations. Particularly, trading pacts amongst regional countries may change whilst new pacts may also be formulated.25.Some countries may review policy gaps and take action for policy updates. Sri Lanka needs a policy on indigenous medicine (traditional medicine) which is not covered by the existing health policy in Sri Lanka. It is the right time to respond to the court decision and request a new pharmacopeia with a list of codes.26.More utilisation of the internet for sharing ideas, new knowledge, filtering knowledge gaps, news messages, etc. This may open up more avenues to reduce the stress level of the people.27.Return migrants who are having strong financial resources may invest in Sri Lanka if the socio-economic and political stability established after complete control and management of COVID-19 in Sri Lanka.28.Returning migrants with less or poor financial resources may seek jobs in the apparel sector or plantation sector. Therefore, there will be a high supply in the labour market in the country. This situation may impact the new formation of production and supply chain networks.29.There will be more research on COVID-19, particularly discovering a vaccine and medical strategies which are more effective in patient management. If any new vaccinations are discovered, there will be a massive demand from each country and new supply chain networks will emerge within the health sector.Therefore, positive impacts are relatively high and some impacts are short term and most others are long term. This situation depends on the early stage of April 2020 and the shape could change due to several global socio-economic and political factors. So far, COVID-19 is in a rapid spread tendency in most countries, and there are no sufficient health and socio-economic facilities, especially supply chain networks to address the need structure of the pandemic situation in these countries. When the Indian scenario is analysed, the COVID-19 impacts will be the most painful here when compared to other countries. The social system prevailing in India is not simple in terms of managing the pandemic situation. It is very clear that any society which has a high social disparity may have to face the most negative impacts.The negative impacts towards the family, communities, nations, regions and the world push them backward in any sector or socio-economic and political spheres. Several elements which cause negative impacts can be identified as illnesses or COVID-19, pandemic situation, deaths, social distancing, curfew and the lock-down of the entire functional mechanism of a single society and the global network in production, trade, supply chain networks, transportation, social networking and political network. Therefore, this paper has given similar attention to the negative impacts of COVID-19 at the local, regional and global contexts based on the situation in early April 2020. They are given in the following:1.The pandemic situation has spread as a global pandemic disease which is creating fear, stress, stigma, minimising social networks, etc.2.Health and medical systems, especially biomedical systems, have taken their maximum effort but the healthcare system itself is affected due to various conditions in nature. Thus, there are many deaths reported though the biomedical system has made an enormous effort.3.High rate of deaths due to various illnesses or complications of diseases occurring amongst the patients, especially the elderly who are affected by COVID-19.4.Impossible tasks and challenges to the medical staff, supporting staff, social workers and health administrators at local, domestic and/or global levels. The World Health Organisation (WHO) is the primary entity followed by other United Nations (UN) agencies which are responsible during a regional and/or global pandemic situation.5.Some countries such as Italy, Spain, USA and China and a few other European countries are facing a much higher disintegration in all subsystems of society. Thus, the social system needs a complete reorganisation and integration to survive.6.Dismantling the family relationship and intimate relationships with relatives, neighbours, various communities, etc. These conditions may lead to interpersonal conflicts and domestic violence in the family.7.Losing the knowledge, experience, and services of the elderly would mean that the next generation would not be able to share them for their betterment.8.Downward trends of family economic conditions and several lower hierarchy social classes facing unbearable economic hardships due to lack of daily or monthly earnings. Though there are market accessibility and supply chain network even under the limitation of social mobility, they do not possess the purchasing power.9.Disruptions of schools, universities and vocational education segments where they have to seek certain optional strategies to cover up their educational goals. Especially, they may face some irreversible gaps in their education. All supply chain networks in the education field have been interrupted.10.Some people may face various kinds of stress, social stigma and depression conditions due to the malfunction of the social system.11.Possible social conflicts or conflicts of interests in the subsystems and this may lead towards the social system. Some institutions and organisations may not possess sufficient capacities to find remedial solutions to fill the gaps and issues.12.Decline in religious belief systems and practices in all religions and people may not believe in superstitious powers, in god and other divine and invisible elements in society.13.If the government and its subordinate authorities face some inadequate workable decisions or binding decisions and poor policy applications, it may lead to political instability in society. These conflicts of interests may cause political changes in society.14.Social unrest, stress and social stigma amongst the family members due to their detachment from family as a result of local and international migration. This may get aggravated further through the suspension of continental air transportation under lock-down situations.15.Disruptions in the productions of primary and secondary items in the society. Especially, issues in the production of primary items may lead to social unrest in society. Less demand and lack of proper supply chain networks may aggravate the existing unrest level.16.There are many people who are losing their jobs and incomes in the formal and informal sectors in the society.17.Service providers’ (supply chain networks) inability to continue the day-to-day supply of commodities and other services due to the lack of profit margins. It may lead to detachments from such entities or services, and some people may find alternative solutions. Thus, there may be some temporal decline in supply chains in society.18.People might depend on rumours and other informal channels of information if there is a chaotic condition in formation channels or the dissemination of information. Especially, if there are some loop halls in supply chain networks, these rumours may work rapidly with different social and economic impacts.19.Certain social classes may display their egoistic ideologies at the time of accumulating primary or essential goods and services. This may cause some negative attitudes amongst other social classes by creating conflict of interests.20.Global economic recession and increase in poverty level in society. This may lead to financial crises such as a decline in monetary values, share market values and businesses, changes in supply chain networks, and purchasing power of the people.21.The country has to take alternative action to maintain a stable economy. The developing countries and poor countries may get more loans and grants for their economy to survive. Thus, there will be more economic and political dependency in these countries. As a result of this condition, countries in the hegemonic circle may directly or indirectly fulfil their hidden agendas in the territories of such dependent countries. Being South Asian countries, there are certain common social and economic characteristics that need to be safeguarded during the pandemic situation.22.The pandemic situation will directly influence the Sustainable Development Goals (SDGs) defined to be achieved by 2030, since some countries may not allocate financial resources to meet the country-specific targets.23.Internal fragmentation may occur in global hegemonic countries, particularly in the USA and they may attempt to regain the hegemonic power through various economic and political strategies. Perhaps, they may go for direct war strategies with other countries or accelerate existing intervention in the Middle-East region.24.Sri Lankans who have been employed in foreign countries may return home and future foreign revenues may reduce. It is one of the major revenue in Sri Lanka, especially the migrant workers in the Middle-East, Europe and East Asian countries made a significant contribution to the Sri Lankan economy. This may cause some effects in supply chain networks in Sri Lanka as well as South Asian countries.25.If the government of Sri Lanka does not engage the returning migrants fruitfully, they may get frustrated and thus cause some vulnerability in the informal sectors of society.When these positive and negative impacts are considered, it is very clear that COVID-19 has caused more positive impacts to the nations, regions and the world, particularly to South Asian countries. However, some countries such as Italy, Spain, the USA, and China and several European countries have suffered a lot. At the time of writing this article, COVID-19 has infected 5,306,928 persons worldwide (when the article was finalised for publication, the number has increased up to 15,947,291). Comparatively, these positive and negative impacts are valid for these countries too, irrespectively of the level of the spread of COVID-19.The proposed future action plan or COVID-19 recovery action plan mainly focuses on the socio-economic, environment and political spheres and not on the medical and technical spheres. Table 1 illustrates this categorically.Table 1 COVID-19 recovery action plan related to socio-economic, environment and political domainsFull size tableWhen these different domains or spheres are looked at, it becomes very clear that there are higher numbers of actions identified under social domains. It implies that COVID-19 is a pandemic situation and it has more critical aspects in the social domain which needs to be looked at through a sociological rather than administrative or political perspective. Furthermore, all responsible officers as well as the public could provide at least a minimum input than all actions highlighted in Table 1. Moreover, most of the proposed actions are focused on short-term and medium-term actions. However, there are some significant actions identified under long-term actions which are related to individual and group level attitudes.All these analyses done and elaborated in different subsections of the paper highlight that there is a pivotal role to be played by the supply chain networks and management clusters in every society. In South Asian countries, the situation in supply chain networks and management is more specific than in other parts of the world because all these countries maintain a dual mode of economy—subsistence and commercial. Particularly, end users and consumers are engaged in some domestic or cottage production systems. If they have a surplus, then they share it with their relatives and neighbours as a cultural habit. Thus, they are not totally dependent on the market system. Some of them sell these domestic products to boutiques. Sometimes they give some value addition as cottage products and try to sustain a stable supply chain network. This situation is seen in many South Asian countries. Therefore, sustainability in supply chain networks in South Asian countries is highly volatile. However, it is obvious that the supply chain networks are influential and of paramount importance under the COVID 19 pandemic situation in South Asian countries.Especially, if the authorities focus on this COVID 19 recovery action plan, it will help protect the family, environment and the nation. Therefore, we need to have an attitudinal change towards a more sustainable control of the pandemic situation in our country. The entire analysis of this paper is mainly based on the researcher’s Sri Lankan and other South Asian countries’ experience, particularly in development planning. The insight will help to manage and control the COVID-19 pandemic situation in South Asian countries. If we are able to adapt to the situation as explained, this approach will help us to maintain a stable and sustainable development programme for these countries, particularly for Sri Lanka.When compared to several historical experiences in managing pandemic situations, this COVID-19 pandemic situation can be used as a development opportunity to enjoy a much higher take-off with a new set of attitudes in the process of development.