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Review

Consequences of COVID-19 on Health, Economy, and Tourism in Asia: A Systematic Review

by
Kumpol Saengtabtim
1,
Natt Leelawat
1,2,*,
Jing Tang
2,3,
Anawat Suppasri
4 and
Fumihiko Imamura
4
1
Department of Industrial Engineering, Faculty of Engineering, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand
2
Disaster and Risk Management Information Systems Research Unit, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand
3
International School of Engineering, Faculty of Engineering, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand
4
International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai 980-8572, Japan
*
Author to whom correspondence should be addressed.
Sustainability 2022, 14(8), 4624; https://doi.org/10.3390/su14084624
Submission received: 13 March 2022 / Revised: 10 April 2022 / Accepted: 11 April 2022 / Published: 12 April 2022
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Abstract

:
Since the beginning of the COVID-19 situation, academic and disaster-related organizations have focused on the severity of COVID-19 and how to prevent the infection. The side effects of COVID-19 also created serious impacts on human lives from multiple perspectives. This study primarily aims to conduct a systematic review on the COVID-19 impacts from the aspects of health, economy, and tourism, focusing on Asia. We use the preferred reporting items for systematic reviews and meta-analyses as the main tool in conducting the systematic review analysis. The keywords related to the focused aspect are searched based on the two prominent academic journal databases: Web of Science and PubMed. In each aforementioned aspect, the consequences and the main stakeholders who were directly and indirectly affected are explained. Moreover, the connection between the three aspects based on the impact of COVID-19, which still continues to intensify, and strategies to prepare for future pandemic situation are also presented.

1. Introduction

Since the end of 2019, the coronavirus disease, or COVID-19, has affected many people worldwide. The World Health Organization (WHO) played a critical role in managing the situation and providing policies for each country to cope with the situation. On 11 March 2020, WHO announced COVID-19 as a pandemic [1]. As of December 2021, more than 260 million people were infected by the disease, and more than five million people succumbed to death during this pandemic [2], which affected all countries. In this regard, the effect of the pandemic varies per country: some countries were greatly affected, whereas others were not. Currently, each country’s government copes and mitigates the COVID-19 situation by announcing the appropriate responses and measures. Most of these responses and measures involve collaboration among the stakeholders, such as citizens, governments, and business sectors. Lockdown and social distancing are examples of these measures [3]. These strategies can prevent COVID-19 spread by prohibiting people’s gathering and reducing contact rates [4].
In addition, the impact of COVID-19 is apparent in multiple business sectors. Apart from the health sectors, economic and tourism sectors were also affected by COVID-19 [5]. From an economic perspective, many countries in Asia are vulnerable to COVID-19 [6]. Some scholars estimated the decline in the regional gross domestic product (GDP) to be >10% for the Asia and Pacific region [7]. The economic impact is more pronounced in South Asia [8], which can be described from multiple perspectives: stock and commodity market, supply chain, and agriculture. Accordingly, in 2020, most stock markets in Asia are declining significantly. Some businesses stopped operating due to the lack of consumer demand, especially the tourism businesses. Not only the tourism business but also the real estate sector was severely impacted by COVID-19 owing to lower demand and price reductions [9,10]. Even established companies were unable to handle the scenario because COVID-19 was deemed as a “black swan” or an unexpected situation [11]. In particular, the tourism industry has been impacted by the COVID-19 and government restriction policies. Most people were anxious to go outside because no treatment was available yet during the beginning phase of the COVID-19. Meanwhile, the restriction policies, such as lockdown and social distancing, caused the restaurant to close earlier and avoid dine-in customers. Moreover, the airline industry and healthcare were severely impacted by these policies. Healthcare accessibility for COVID-19 patients was one of the biggest concerns due to the excess number of patients per healthcare worker. Additionally, the ways to prevent COVID-19 were limited, thus raising concern about people’s safety. The mental health of the people was a huge concern regarding health impact. Various studies have focused on analyzing the impact of COVID-19 on people’s mental health. Moreover, patients who need immediate care for curing their disease also had difficulty accessing the healthcare system.
Since the beginning of the COVID-19 situation, various studies have focused on the impact of COVID-19 in multiple aspects, such as the number of individuals affected and deaths, stock market failure, and mental health issues. However, analysis for identifying the connection between impacts of the COVID-19 situation was still limited. The present study conducts a systematic review for identifying the COVID-19 impact on economic, health, and tourism aspects in Asia based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Additionally, the advantage of COVID-19 related to the tourism aspect is mentioned in this research. This research comprises five main parts: introduction, methodology, result, discussion, and conclusion.

2. Methodology

This section explains the main methodology for the systematic review. Additionally, the selection and exclusion criteria are explained.

2.1. Systematic Review

Currently, much research has focused on the use of systematic review as the main part. The literature review section is considered the traditional way of summarizing previous related research on the focused topic. However, some contents of the literature review might not be specific and contain some bias, thus producing errors. Accordingly, the systematic review approach or research synthesis [12] was defined as the structural, hierarchical, and systematic approach to summarize the keys and knowledge from the focused field of studies [13]. Selecting the research articles for the systematic review should be symmetrical. All selected studies must be filtered until the most suitable ones are obtained. Therefore, the approach for a systematic review is different from a traditional systematic review [13]. The PRISMA provides the structural method for a good systematic review. The current trend for systematic reviews applies to healthcare-related topics [14]. However, systematic reviews have also been used in other fields, such as disaster management [15] and disaster impact analysis [16,17]. Overall, the concept of the systematic review has a common output, which is to describe the current situation systematically. Based on the PRISMA concept, 27 checklists and 4 steps are necessary for a systematic review analysis. The main flow of the PRISMA includes four main processes: identification, screening, eligibility, and inclusion. The selected research will be filtered according to the PRISMA concept and reasonable points from each phase. For the full detail of the PRISMA, Moher et al. [14] described the information. In this research, the key impact of COVID-19 on different aspects such as health, economics, and tourism can be identified based on the systematic review approach. Additionally, a discussion regarding the link between the three aspects is also explained.
The traditional literature review was considered the unstructured and unsystematic process of identifying and narrating studies about a specific topic [12]. In this case, the systematic review concept is used as the main methodology for analyzing and systematically identifying reliable articles. Additionally, the PRISMA criteria shape the analysis to be more systematic and well defined [18]. Many review studies have attempted to narrate the COVID-19 situation from multiple perspectives. For instance, Behrmann et al. [18] tried conducting a systematic review based on the mental health status of people with attention deficit hyperactivity disorder during the lockdown period. From the psychological impact perspective, Hooper et al. [19] tried determining the psychological interventions for healthcare workers during the disaster periods including the COVID-19 situation. Accordingly, COVID-19 had some effects on people’s daily life; thus, mental health and health issues are the main concern for the academic field. In addition, the economic and tourism industries were also severely affected. Therefore, this research attempts to provide useful content related to the COVID-19 impacts from the perspective of health, economy, and tourism through a systematic review analysis using the PRISMA criteria. Accordingly, the workflow of the PRISMA concept for this research can be summarized as shown in Figure 1.

2.2. Reviewing Design and Criteria

We conducted the systematic review according to the PRISMA concepts: identification, screening, eligibility, and inclusion phases.

2.2.1. Query Terms

As aforementioned, the COVID-19 impacts are identified using the systematic review and categorized into three aspects: economic, health, and tourism. Additionally, this research focused on Asian countries. Therefore, the query terms are (“COVID-19” OR “nCoV” OR “Coronavirus”) AND (“Asia”) AND (“Impact” OR “Crisis”) AND (“Economic” OR “Health” OR “Business” OR “Tourism”). The first set of query terms identifies the topic related to the COVID-19 situation, including various COVID-19-related terms. The second set identifies the focused area: Asia. The third set of query terms identifies the key indicators of the query results, which are related to impacts and crises. Lastly, the topics related to the research focus are selected.

2.2.2. Focused Database for Querying

The following databases contain research articles: Scopus, Google Scholar, PubMed, and Web of Science (WOS). This study uses PubMed and WOS for performing the systematic review analysis. The advantage of these two databases, especially the WOS, is obtaining more informative data and the option for performing citation analysis [20]. Citation analysis includes the journal summarization, ranking of citation, and publication country. Meanwhile, we used PubMed because of its ease of usage and fast query process. Additionally, Bramer et al. [21] indicated that a good systematic review analysis requires at least Embase, MEDLINE, WOS, and Google Scholar databases [21].

2.2.3. Inclusion and Exclusion Criteria

For the inclusion criteria, the articles included are based on the search result from WOS and PubMed. This criterion is applied in the identification phase. After that, the exclusion criteria will be applied to remove the unrelated articles in the screening, eligibility, and inclusion phase. The exclusion process started in the screening phase wherein the articles are scanned based on the title and abstract. The following articles were removed: duplicated articles from the two databases and the unrelated articles based on the title and abstract. Subsequently, the authors read the whole articles remaining; those articles with contents unrelated to the research theme, that is, the impact of the COVID-19 based on the economic, health, and tourism aspect, are excluded. Finally, the remaining article will be summarized and included in the systematic review analysis.

3. Results

We conducted a systematic review analysis. First, the selected articles were analyzed based on the general information (e.g., article type, publish place, and journal type). Next, the keywords from the selected articles are examined to determine the linkage. Finally, the analyzed result from the systematic review will be concluded based on each aspect.

3.1. Overall Result from the Systematic Review

We conducted a descriptive analysis of the 51 selected articles. The WOS’s tool for analyzing the citation allows us to easily identify the articles based on the country or region using the institutional affiliations [22], type of journal, type of article field, and publication year.
The country based on the institutional affiliations for the selected article can be identified according to the origin country or region of the authors and co-authors of the published journal article. Table 1 presents the result.
Table 1 shows the number of authors and co-authors for the selected articles separated by country and region. Next, the selected articles can also be summarized according to the research areas of the published journal. The results are summarized in Table 2.
Table 2 shows the related fields of the studies included in this review. The results are summarized on the basis of the WOS core collection. The top research areas cover most of the research focuses related to the economic and health aspects. However, most of them are included in other related fields, such as social science and transportation.
Furthermore, the analysis result is also summarized according to its publication year. Thirty of the selected articles were published in 2021 and 21 were published in 2020. This indicates the shift of the academic focus from the origin and causes of the COVID-19, which are the main theme in the first phase [23], to the impact of the COVID-19 situation in the later phase, which involves 2021.
Finally, from 51 selected articles, we retrieved keywords to perform the analysis using co-occurrence network analysis. The main objective of the co-occurrence network analysis performed by KH-Coder is to identify the main theme from a set of texts [24]. However, we excluded four articles that lack the provided keywords. The analysis was performed using KH-Coder 3 program [25]. Accordingly, Figure 2 presents the result of the co-occurrence network analysis.
The co-occurrence network analysis result shows an overview of the selected articles in this research. The result also shows the value of the correlation coefficient between each keyword, which can be identified by the intensity and value of the connected line (edge) [25]. The co-occurrence network color (Node color) indicates the 8 groups of keywords that seem to have a close relationship among them; the circle size indicates the number of terms or, the frequency, such as the number of times that the specific keywords appeared in the analysis. In conclusion, the co-occurrence network analysis can define as the main theme and connectivity property for the selected group of words. Based on this, the result covers most of the research focus, including the impact of the economic, health, and tourism aspects. For the health aspect, most of the keywords are related to psychological issues, such as depression, anxiety, and mental. One of the vital groups of people in Figure 2 is the healthcare workers. Accordingly, healthcare workers are deemed to play a vital role in mitigating the impact of the COVID-19. Meanwhile, For the economic aspect, keywords, such as delay, demand, damage, value, chain, and financial, are the main key contents to illustrate the economic consequence of COVID-19. This implies some consequences of the COVID-19 on the financial sector and value chain. As shown in Figure 2, the linkage between economic and tourism consequences may be found in the following keywords: air, inbound, trade, tourist, frustration, and transport, among others. This can imply that the economic consequence is closely related to the tourism consequence. Additionally, the key terms, such as recovery and management, can indicate the research trend focused on the COVID-19 management for dealing with health and tourism consequences.

3.2. Health Aspects

The current COVID-19 situation in most countries is worse due to the increasing rate of infected people and deaths. However, results of the systematic review analysis reveal that the physical impacts of the COVID-19 pandemic are not mentioned frequently; rather, most studies were focused on the psychological impacts. This assumption also matches Hughes et al.’s [16] study. Thus, the selected articles based on health aspects are summarized in Table 3, including the authors’ names, field, and overall contents. According to the selected 24 articles, two main fields have been defined to be focused on the consequence from the health aspect, which are psychological and mental health impact and health accessibility and treatment.

3.2.1. Psychological and Mental Consequences

The analysis of the health aspect reveals that most articles mentioned the psychological impact, which mainly focused on anxiety and depression from multiple perspectives. The main points for the psychological impact based on the results of the systematic reviews are from two main causes: the COVID-19 impact and the restriction policy from the government. The articles in this aspect analyzed the psychological situation based on the field surveys, questionnaire surveys, demographic, and health-related data. Research based on the psychological and mental consequences has two main types: the analysis based on the group of people and the analysis based on the country. The healthcare workers, such as doctors and nurses, experienced the mental consequences of this pandemic [17,47]. The pressure from the impact of the COVID-19 situation and the overload job that they must do are the main reason for the mental consequences [32,34,39]. Apart from the frontline healthcare workers, the junior healthcare workers and the students’ mental health are also impacted by the COVID-19 situation [39]. Furthermore, the obstacle of wearing personal protective equipment for healthcare workers is also a main factor for the mental impact. The other group of people who experienced the impact based on the mental consequences is those working under pressure, such as athletes [38]. Moreover, healthcare workers who have to treat people experienced the psychological impact of the COVID-19 situation. Similarly, the mental health of some people, especially informal caregivers, who are taking care of patients needing close care, such as those with dementia [16], was also impacted due to unpaid bills [16]. Additionally, pregnant women experienced both direct and indirect effects of the COVID-19 situation, thereby creating mental consequences to this group of patients [26]. Some studies also mentioned the mental health effect of COVID-19 based on the comparison among the focused areas. Most of these types of research focused on the comparison between the countries with different economic situations, such as the upper and lower-income countries [41], among the middle-income countries in Asia [40]. Meanwhile, some studies adopted the measurement methods, such as the Impact of Event Scale-Revised (IES-R) and Depression, Anxiety, and Stress Scale (DASS-21), to measure the impact on the people, including the clinical and non-clinical cases [40,41]. Especially for the case of DASS-2, this value indicates the impact level based on the depression and the sample’s depression level [40]. In conclusion, most studies on the psychological and mental consequences are under the health aspect. Therefore, the government and related organizations must pay attention to people’s mental health, including regular individuals, patients, and healthcare workers. We can take the lesson from the mental health consequence of the past pandemic, such as severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) [29]. Accordingly, the situation can be mitigated by providing healthcare support [28], encouragement, and useful information based on the current COVID-19 situation to alleviate the stress and anxiety of the people [27].

3.2.2. Health Accessibility and Treatment Consequence

Health accessibility for the people is said to be a goal for Sustainability Development Goals. Thus, the government must provide equal accessibility and treatment to all [44]. Based on the filtered research related to health accessibility and treatment consequence, most studies have tried analyzing the needs of the people requiring the treatment but experienced obstacles due to the COVID-19, thereby preventing them from entering the healthcare system. Cancer is said to be a disease that needs close-up care for treatment. Based on this, during the COVID-19 situation, the needs for treating the disease are also high, requiring immediate attention [43,46]. Degeling et al. [42] summarized that the impact of the COVID-19 situation also decreased the survival rate for the patient with this disease. Both cancer patients and outpatients from the caring system were affected by COVID-19 [42]. Apart from the patient needing close-up care, the less developed community also needs much care to provide accessibility to the healthcare system [45].

3.3. Economic Aspects

From this perspective, the analysis of the impact based on the economic aspects was conducted. After filtering out the unrelated research, 19 research articles were left to analyze the impact of the economic aspects deeply. Initially, we try separating the field into stock, commodity-related, and supply chain, business, and consumption related based on the research objective. Table 4 summarizes the contents in the respective field.

3.3.1. Stock and Commodity Markets Consequences

Since the beginning of the COVID-19 situation, most economic-related businesses were negatively impacted, especially the stock and commodity markets. Marobhe [47] suggested that one of the main reasons for this negative impact was the announcement from WHO, which confirmed the pandemic status of the COVID-19 situation. Thus, the impact of the COVID-19 situation has a varied level. Olakojo et al. [48] examined that the lower-income country had a lower impact than the higher-income country. Apart from the COVID-19 impact, false news and information can also increase the impact on the stock market [49]. Additionally, the commodity market was severely affected. Accordingly, the commodities, such as fossil fuels, were severely impacted by COVID-19 [54], which is observed from the reduction in the returns [52]. In contrast, the commodity, such as gold, was positively affected by the COVID-19 situation because its price increased. Additionally, gold has been used as a tool to mitigate the negative impact of the COVID-19 situation [53]. Meanwhile, the COVID-19 situation also produced good effects based on the stock market. Marobhe [47] suggested that the logistic stock did not significantly impact the COVID-19 situation due to the higher shipping demand based on medical products. Moreover, the stock investors gained some advantages when the COVID-19 situation was alleviated [50].

3.3.2. Supply Chain, Business, and Consumption Consequences

The severity of the COVID-19 symptoms greatly impacted people. However, it also created many impacts on most businesses in many industries. Most businesses need much adaptation to survive the COVID-19 impacts. For the business side, the production and management plan needed to be mostly concerned with handling the COVID-19 effects. Hoeft [55] stated that an agile concept in the automotive industry has been used to handle unprecedented events like the COVID-19 situation through immediate market findings. The airline industry is one of the most affected industries. Gudmundsson et al. [64] and Abate et al. [56] specified that the aviation-related industry, including the tourism-related businesses, was severely affected by COVID-19 which can also create bankruptcy in their business. The studies also expressed the government’s big concern to support the businesses in this industry based on the overview perspective by focusing on the business linkage. Additionally, the Asia-Pacific region is also estimated to take a shorter period for recovering this industry than other global regions based on the historical data [64]. Similarly, the agriculture-related business industry was also affected. Moreover, the demand and supply for poultry and crops were severely affected by multiple aspects, such as climate change [60,65] and food safety [59]. Additionally, the value chain related to production in multiple businesses also got many effects from the COVID-19 situation due to the stuck from the suppliers [58,61,62]. Pahl et al. stated that the global value chain (GVC) that depends on multiple countries is likely to be more affected than the GVC involving small country groups [58,63]. Additionally, Or et al. [57] stated that COVID-19 has many impacts on the consumer attitude, especially for the international products.

3.4. Tourism Aspects

In this research, eight studies were categorized as tourism-related aspects according to the result of the filtering out process using PRISMA. The authors’ names and the overall contents are presented in Table 5.
Regarding the journal from the filtering process in PRISMA concepts, the results showed many impacts on the tourism industry, especially in Asian countries. Gallego and Font [68] found that even Europe experienced a 30% reduction in people’s desire for traveling, but Asia had dropped significantly by 50%. Additionally, for Japan, about an 80% reduction in inbound travelers from Asia, Europe, America, and Oceania was recorded when compared with the period before the COVID-19 situation [73]. Therefore, the impact of the COVID-19 situation on the tourism industry also significantly affected the economic industry [66]. Furthermore, Yang et al. [67] mentioned the impact of the tourism industry based on the different scales of city. The results from the study showed a higher impact based on the cities with a well-developed economy and less for otherwise. Some governments in Asia also try using enforcement to control and stabilize the situation. For example, in the case of Macau, Wong, and Lai [70] showed that the laws and enforcement by the government to control the COVID-19 situation are not only used for controlling the COVID-19 situation but also satisfied the people concerning the government enforcement. Meanwhile, Baum and Hai [72] found that the hospitality sector was also impacted by the COVID-19 situation, and this led to the question about the right of the people to participate in not only the tourism industry but also the hospitality sectors. Although most articles were focusing on the impact of the COVID-19 situation on tourism, some have mentioned the good point of the COVID-19 situation. Examples of the positive viewpoints are the adaptation of the tourism business for merging [69,71], overtourism, and climate change recovery [72].

4. Discussion

Although some people were not infected by the COVID-19, they can still feel the impacts from multiple aspects. This study analyzed the impact of the COVID-19 situation based on the systematic review analysis. The impacts are widely spread from each focused aspect to affect many stakeholders and the involved organizations. For the health aspect, both patients and healthcare workers were impacted by COVID-19 directly and indirectly. For the direct effect, due to the COVID-19 situation, the accessibility to the healthcare system was hard to access. This can affect both patients and healthcare workers who regularly meet for some treatments. For the indirect effect, the COVID-19 situation also created much impact on the mental health of both patients and healthcare workers due to the lockdown policy and the reduction of health workers’ resting time. The health aspect had a great impact due to the COVID-19 situation, but the economic and tourism aspects suffered too. The policies for controlling and the severity of the COVID-19 situation affected both the economic and tourism industries. Before the COVID-19 situation, the tourism industry worldwide has received many investments and witnessed substantial growth. Many businesses tried expanding their businesses due to the higher demand. However, if the COVID-19 situation intensifies again, many businesses will need to cease operations or change their management system to adapt to the situation. The noticeable things that can indicate the COVID-19 impacts are the declining stocks and commodity markets in many countries and the reduction in the number of travelers worldwide, affecting multiple sectors, such as the tourism industry and aviation industry. Therefore, the impact of the COVID-19 situation on human life is inevitable.
Even though each focused aspect in this research has different impacts on the related stakeholders, these three aspects are somewhat connected. First, the initial causes of the three aspects are the same. Both COVID-19 prevention policies and the severity of the COVID-19 are the main cause for creating the impact based on the three aspects. Next, the economic and tourism impacts are clearly to be seen due to the viewpoint of the decrease in the demand of the consumers. The relationship between the economic and tourism aspects is still hard to match with the health aspects because the result of the systematic review is mainly focused on the mental health caused by the COVID-19 situation. However, this point can be connected based on the presence of some resilience of the COVID-19 severity. By the end of 2021, many ways were implemented to prevent and protect human lives from the COVID-19 based on the health aspect. COVID-19 vaccine is the main tool for preventing the sickness from the COVID-19 [74]. Many vaccines, such as the viral vector vaccine and mRNA vaccine, played a vital role in reducing the COVID-19 effects [75]. Therefore, after the resilience from the COVID-19 severity, multiple sectors, including the tourism industry, can also recover. Regarding this, the preliminary causal loop diagram can be created to show the connectedness among the three aspects, including how each effect is related to each other based on the focused aspects (Figure 3).
According to the proposed causal loop diagram shown in Figure 3, each effect is connected to other effect by the relationship arrow which can be identified by positive and negative symbol [76]. The positive arrow indicates the positive relationship between the two effects. In contrast, the negative arrow is for the negative relationship between the two effects. The closed loop with odd number of negative relationships is the Balancing loop (B) [76]. In this case, there are three main balancing loops—the impact of the COVID-19 based on the three aspects and the effect that can reduce the intensity of the COVID-19. Moreover, the Reinforcing loop (R) can be identified by the closed loop with even number of negative relationships [76]. There is only one reinforcing loop in the causal loop diagram. It is the reinforcing outcome from the overtourism problem and the number of flight and tourists. Therefore, it can be determined that all three aspects have some connectivity based on functions and effects. The intensity level of COVID-19 is the main factor influencing all the focused aspects. However, the implementation of government and COVID-19 restriction policies, such as lockdown and travel restrictions, lead to a reduced impact on all focused aspects. One of the main reasons for impact reduction is a business adaptation in the supply chain and tourism sector. As a result, it can be demonstrated that the impact of COVID-19 on all three aspects reported in this study are connected to one another. Thus, the study findings are consistent with that of Purcell et al. [77], wherein the health and economic crises caused by COVID-19 show a negative impact on the travel and hospitality sectors. Additionally, the study of Purcell et al. [77] explained the relationship among the three consequences, which are health, economy, and tourism, using the sustainability concept; this concept was used to determine the approach to “Build Back Better” for all the three aspects. Furthermore, Sharma et al. [78] presented the resilience-based framework, which outlined how to transform the tourism and economic sectors that were severely impacted by the COVID-19 pandemic.
From the selected articles in the systematic review analysis, many studies have focused on using the previous pandemic with similar impacts to the COVID-19 situation as the base case for identifying COVID-19 impacts from multiple perspectives. SARS pandemic statistics reveal that around 8000 people were affected and less than 100 died in 29 countries [52]. Chang et al. [52] specified the impact of the previous pandemic situation, such as SARS, including some of the global financial crises to the commodity market, including fossil fuel and renewable energy. The analysis results indicate both the positive and negative effects on the fuel markets during these crisis periods. Additionally, Trans et al. [66] indicated the impact of the SARS on the tourism industry. The result of the analysis shows the substantial effects on the tourism industry during the SARS pandemic based on the reduction of 1.2% for the international arrival. Moreover, the result also shows that Asia’s region and the Pacific got higher effects than other regions. Based on this, even the effects of the SARS pandemic are lower than the impact of the COVID-19 pandemic. A reason for COVID-19’s greater impact than the previous pandemic is the globalization or the expansion of the global economies and population [79]. Accordingly, it can show some signs of the possible effects of the future pandemic that might happen soon by using the previous pandemic, such as SARS and COVID-19, as the base cases.
Currently, most research and the government from many countries attempt to shift the focus from the phase of protecting to be the resilience phase, or from the response phase to the recovery phase according to the step of the disaster management cycle [80]. Based on this, the future trends for the COVID-19 consequence articles will be more about the approach to recover the economic, healthcare, and tourism situation together with the consequence modeling due to a large amount of data and information that keep increasing. The selected article provides many insights into the possible way to recover society, including the business, from the COVID-19 situation. Health aspects were one of the most remarkable concerns of the consequence of the COVID-19 situation because it can have a direct effect on the human body, which might cause deadliness. In this research, most of the focused articles mentioned the psychological consequence of the COVID-19 situation. The main causes of the mental health effects for both patients and healthcare workers are the number of workloads from the healthcare systems with the COVID-19 preventive policies from the government. Thus, to enter the recovery process, stakeholders must have some tradeoffs for compromising the restriction of the policy, but the COVID-19 effects can be long-term. Based on this, encouragement and good support for these people are the main keys to mitigating the mental health problem during the COVID-19 situation [27]. From the tourism perspective, most of the aforementioned recovery processes were focused on the adaptation of the business to handle the possible pandemic events by changing the way to conduct the business during a pandemic. Accordingly, a small amount of the research has tried focusing on how to eliminate the risk of another pandemic occurs because of its direct effects on the tourism industry [81]. Like the tourism perspective, the economic aspect also faced the direct effects of the COVID-19 situation, especially the business related to transportation (e.g., the aviation industry). One possible tool to avoid facing the direct hit of the COVID-19 situation is to adopt a new approach to conducting the business by focusing on how to conduct the business in the unexpected events that might happen in the future as the case of the automotive industry [55]. Additionally, the stock market had some brightness in the dark during the time of the disasters. Some commodities, such as gold, were also a good hedging tool to mitigate the impact of the COVID-19 [53].
Even though most of the current research trends related to the COVID-19 consequence focused on the response phase, the COVID-19 situation in December 2021 was still a concern of many countries due to the emerging COVID-19 new variants. Regarding this, most countries still paid attention to the consequence of the COVID-19, especially for health-related issues. Based on this, some countries were trying to tradeoff between increasing and reducing the level of the COVID-19 control policies that can create a good outcome for the health aspect if the level of the COVID-19 control policy is increased, but it might cause bad outcomes for the economic aspect.

5. Conclusions

This research analyzed the consequences and impacts of the COVID-19 situation based on the systematic review analysis. The impact of the COVID-19 situation created a more widespread effect on multiple sectors than expected. The severity of the COVID-19 itself caused much harm due to the significant increase in the number of affected and death cases. In the 2 years that COVID-19 created drastic effects on human life, the consequence and impact on health, economy, and tourism aspects are analyzed together with the stakeholders and businesses affected by the COVID-19. Moreover, the approach and methods that have been used for reducing the impact of the COVID-19 are also defined. This study’s results provide insight into the interesting perspective of the COVID-19 consequences based on the academic articles’ overall focus. The results of the systematic review show a different viewpoint of the COVID-19 impacts based on the health aspect: the studies did not focus on the direct impact on people’s health, but most of them focused on the indirect mental health effect on both healthcare workers and patient. In addition, most research articles also mentioned the positive side of the COVID-19 situation. For example, the problem of overtourism was clearly solved in many countries, and there emerged a new viewpoint of the management system to be used during similar situations in multiple business sectors.
This research finding reveals the impact of COVID-19 on health, economy, and tourism. As the impact of COVID-19 has been continuing throughout the first quarter of 2022, there is still scope for future research. The research trend such as the analysis based on business transformations to survive in the post-COVID-19 era is still viable based on the concept of sustainability (“Build Back Better”). Furthermore, in addition to determining the impact of COVID-19 on health, economics, and tourism, an analysis to synthesize the lessons learned from the COVID-19 pandemic may be undertaken to determine the strengths and weaknesses of COVID-19 controlled policies.
The articles selected in this research are not fixed based on the point of time. The COVID-19 situation had created a massive impact for almost two years since 2020, and its impact on human from multiple perspectives is magnified. At the end of 2021, the new variant of the COVID-19 called B.1.1.529 or Omicron started to spread in many countries and caused the re-implementation of the COVID-19 prevention policy in many countries. WHO first announced this variant on 26 November 2021 [82]. Therefore, the impact of the COVID-19 can create other future impacts apart from those mentioned in this study. In addition, many new published studies are still not included in this systematic review analysis due to the limited fixed research period. Lastly, the summary of consequences and impacts of the COVID-19 analyzed in this research can benefit policymakers who want to understand the current stage of the COVID-19 situation and the future pandemic.

Author Contributions

Conceptualization, N.L. and J.T.; Formal analysis, K.S.; Funding acquisition, N.L.; Investigation, K.S., N.L. and J.T.; Methodology, K.S.; Project administration, N.L.; Supervision, N.L., J.T. and A.S.; Validation, N.L. and J.T.; Writing—original draft, K.S. and N.L.; Writing—review & editing, K.S., N.L., A.S., F.I. and J.T. All authors have read and agreed to the published version of the manuscript.

Funding

This research is funded by Thailand Science Research and Innovation Fund Chulalongkorn University CU_FRB65_dis (22)_147_21_13; and the COVID-19 related research by IRIDeS, Tohoku University, and UCL-Tohoku University Strategic Partner Funds.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Acknowledgments

We would like to thank the support of The Second Century Fund (C2F), Chulalongkorn University.

Conflicts of Interest

The authors declare no conflict of interest.

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Figure 1. Retrieval workflow and overall progress of the systematic review.
Figure 1. Retrieval workflow and overall progress of the systematic review.
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Figure 2. Keywords co-occurrence network.
Figure 2. Keywords co-occurrence network.
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Figure 3. Proposed causal loop diagram based on the connectedness of the three aspects.
Figure 3. Proposed causal loop diagram based on the connectedness of the three aspects.
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Table
Table 1. Descriptive results for selected articles by country and institutional affiliations.
Table 1. Descriptive results for selected articles by country and institutional affiliations.
CountryRecord Count (Authors/Co-Authors)
China14
England12
United States of America10
India6
Malaysia6
Spain6
Thailand6
Pakistan5
Philippines5
Singapore5
Others (37 Countries)
Table
Table 2. Descriptive results for the selected articles by research areas.
Table 2. Descriptive results for the selected articles by research areas.
Research AreasOverall Contents
Business Economics9
Public Environmental Occupational Health9
Psychiatry8
Social Sciences Other Topics8
Science Technology Other Topics4
Food Science Technology3
Environmental Sciences Ecology2
General Internal Medicine2
Geriatrics Gerontology2
Neurosciences Neurology2
Others17
Table
Table 3. Overall summary for the selected journal based on the health aspect.
Table 3. Overall summary for the selected journal based on the health aspect.
Author(s)FieldOverall Contents
Ghazanfarpour et al. [26]Psychological and mental health impactThis meta-analysis research tried finding the impact of COVID-19 based on the mental health of pregnant women.
Castaldelli-Maia et al. [27]Psychological and mental health impactThe analysis to understand people’s anxiety and depression during the COVID-19.
Kılınçel et al. [28]Psychological and mental health impactThis research analyzed the effect of the home-quarantine policy during COVID-19 and whether it causes anxiety and loneliness among young people.
Mukaetova-Ladinska and Kronenberg [29]Psychological and mental health impactThis research analyzed the short- to long-term mental health of the people during the COVID-19 situation.
Suen et al. [30]Psychological and mental health impactThis research analyzed the mental health of Lesbian, Gay, Bisexual, Transgender (LGBTQ) during the COVID-19 situation.
Marzo et al. [31]Psychological and mental health impactThis research analyzed individuals’ psychological consequences during the COVID-19 situation based on multiple countries, including Asian countries.
Aisa et al. [32]Psychological and mental health impactThe research for identifying the stress and mental health of the healthcare workers who take care of the COVID-19 patients.
Salari et al. [33]Psychological and mental health impactResearch identifying the mental issues during the COVID-19 situation.
Thatrimontrichai et al. [17]Psychological and mental health impactThe analysis to identify the psychological stress for healthcare personnel during the COVID-19 situation.
Shrestha et al. [6]Psychological and mental health impactAnalysis identifying psychological distress among the people in the community during the COVID-19 in the context of Nepal.
Saeed et al. [34]Psychological and mental health impactThe analysis examines the mental health of healthcare workers during the COVID-19 situation for the focus case of South Asia.
Marzo et al. [35]Psychological and mental health impactThe analysis to examine the psychological distress of aging people during the COVID-19 situation is based on the focus case of Bangladesh.
Tee et al. [36]Psychological and mental health impactThe analysis identifies the mental health of people in the Philippines during the early phase COVID-19 situation.
Sepúlveda-Loyola et al. [37]Psychological and mental health impactThe analysis to examine the mental health of aging people during the COVID-19 situation.
Leguizamo et al. [38]Psychological and mental health impactThe analysis to identify the mental health of high-performance athletes during the COVID-19 situation.
Htay et al. [39]Psychological and mental health impactThe analysis to study the mental health of healthcare workers during the COVID-19 situation based on multiple countries, including the Asian country.
Wang et al. [40]Psychological and mental health impactThis study analyzed the mental health of Asian people during the COVID-19 situation based on the seven middle-income countries.
Hughes et al. [16]Psychological and mental health impactThe study explained the impact of COVID-19 on the mental health of the caregivers for individuals suffering from dementia during the COVID-19 pandemic.
Tee et al. [41]Psychological and mental health impactThe analysis compared the impact of COVID-19 on the psychological and mental between the Chinese and Filipino people.
Teoh et al. [42]Health accessibility and treatmentThe analysis to understand the impact of the COVID-19 based on the urological patient care worldwide, including in Asia.
Degeling et al. [43]Health accessibility and treatmentThe research analyzed the effect of the COVID-19 situation on treatment delays, which resulted in a high mortality rate during the COVID-19 pandemic.
Singh et al. [44]Health accessibility and treatmentThis research examined health service issues during the COVID-19 situation.
Ahmed et al. [45]Health accessibility and treatmentThis study analyzed the healthcare accessibility for the country that has a slum community during the COVID-19 situation based on the case of Bangladesh.
De Guzman and Malik [46]Health accessibility and treatmentThe study analyzed the impact of COVID-19 on cancer patients who required treatment in the Asia-Pacific region during the COVID-19 pandemic.
Table
Table 4. Overall summary for the selected journal based on the economic aspect.
Table 4. Overall summary for the selected journal based on the economic aspect.
Author(s)FieldOverall Contents
Marobhe [47]Stock and commodityThe research analyzed the variation of the logistic and cargo-related stock in the area of Europe, North America, and Asia.
Olakojo et al. [48]Stock and commodityThe analysis to find the impact of the stock market of the oil-producing countries in the multiple continents including Asia.
Tan [49]Stock and commodityThe study of the early phase of the COVID-19 based on the impact of the effects of news and information on the Stock market.
He et al. [50]Stock and commodityThe study analyzed the impact of the stock market based on the COVID-19 situation in the cases of the various countries from the multiple continents including Asia.
Liu et al. [51]Stock and commodityThe analysis shows the effect of the COVID-19 situation that impact on 21 stock markets including some of the stock markets in Asia, such as Singapore and Korea.
Chang et al. [52]Stock and commodityThe analysis to find the impact for the energy sectors in the perspective of stock based on the COVID-19 situation.
Mezghani et al. [53]Stock and commodityThe study determined the impact based on the financial market and commodity market with the strategy to mitigate the risk from these markets during the COVID-19.
Yu et al. [54]Stock and commodityThe analysis examined the impact of COVID-19 on the energy market and consequential effects that are related to the supply chain system.
Hoeft [55]Supply chain, business, and consumptionThe analysis to find the impact on the Automobile industry based on the crisis management during the COVID-19 situation.
Abate et al. [56]Supply chain, business, and consumptionThe research analyzed the impact of the COVID-19 situation based on the aviation industry based on the perspective of the support from the government.
Or et al. [57]Supply chain, business, and consumptionThe research analyzed the impact of the COVID-19 situation on the trade preference and demand of the consumer in Asia.
Pahl et al. [58]Supply chain, business, and consumptionThe estimating of the GDP consumption and the global value chain impact is based on the case COVID-19 situation based on Africa, Latin America, and Asia.
Amjath-Babu et al. [59]Supply chain, business, and consumptionThe measuring for the impact on food industry related including the logistics for agricultural products during the COVID-19 situation based on the cases of Bangladesh.
Rasul [60]Supply chain, business, and consumptionThe analysis for finding the impact on agricultural industry based on the effects of the COVID-19 situation and climate change in the area of South Asia.
Biswal et al. [61]Supply chain, business, and consumptionThis research studied the impact based on the Poultry businesses in India’s case based on the COVID-19 and government policy.
Nordhagen et al. [62]Supply chain, business, and consumptionThe analysis to find the impact from the food supply chain industry focused on the lower- and middle-income countries including the country in Asia.
Lenzen et al. [63]Supply chain, business, and consumptionThe analysis to find the impact of the COVID-19 from multiple perspective including economic, social, and environmental aspects.
Gudmundsson et al. [64]Supply chain, business, and consumptionThe analysis analyzed the result based on the air transport industry during the COVID-19 situation based on multiple continents including Asia.
Jaacks et al. [65]Supply chain, business, and consumptionThe analysis to find the effect of the COVID-19 on agricultural sector in India, especially for the effects on farmers activity which resulted in the uncontrolled price of agricultural products.
Table
Table 5. Overall summary for the selected journal based on the tourism aspect.
Table 5. Overall summary for the selected journal based on the tourism aspect.
Author(s)Overall Contents
Tran et al. [66]This research analyzes the impact of tourism based on the two groups of countries (already have experience with pandemic (SARS) and no experience with the pandemic) in Asia and Oceania continents.
Yang et al. [67]This research analyzes the impact of the tourism industry on the COVID-19 situation from different city perspectives based on the case of a city in China.
Gallego and Font [68]This research analyzes the impact of the tourism industry on multiple continents, including Asia based on the uses of big data on flight data.
Cheung et al. [69]The exploring for understanding the psychological need for tourism of the travelers in Japan, China, and South Korea based on the period before, during, and post COVD-19 situation.
Wong and Lai [70]This research analyzes the impact of the tourism industry based on the government using law enforcement to control the COVID-19 situation in the Macau case.
Zhong et al. [71]The research for finding the impact of the COVID-19 situation on tourism industry based on the investigation in China with the focusing on future situation for the tourism industry.
Baum and Hai [72]The investigation for finding the impact of the COVID-19 situation on the tourism industry and hospitality sectors globally including in Asia.
Tang [73]The study for finding the impact of the Japanese inbound tourism from the COVID-19 situation together with the analysis for the trade facilitating impact on tourism industry in Japan and COVID-19.
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MDPI and ACS Style

Saengtabtim, K.; Leelawat, N.; Tang, J.; Suppasri, A.; Imamura, F. Consequences of COVID-19 on Health, Economy, and Tourism in Asia: A Systematic Review. Sustainability 2022, 14, 4624. https://doi.org/10.3390/su14084624

AMA Style

Saengtabtim K, Leelawat N, Tang J, Suppasri A, Imamura F. Consequences of COVID-19 on Health, Economy, and Tourism in Asia: A Systematic Review. Sustainability. 2022; 14(8):4624. https://doi.org/10.3390/su14084624

Chicago/Turabian Style

Saengtabtim, Kumpol, Natt Leelawat, Jing Tang, Anawat Suppasri, and Fumihiko Imamura. 2022. "Consequences of COVID-19 on Health, Economy, and Tourism in Asia: A Systematic Review" Sustainability 14, no. 8: 4624. https://doi.org/10.3390/su14084624

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