Impact of the COVID-19 Pandemic on Stem Education and Skills: A Case Study Approach

1.1. STEM EDUCATION FOR THE 21ST CENTURY

Globalization has changed the way societies function today [1] and new social, technological and scientific conditions make the future unpredictable, as natural disasters and infections can easily change the balance [2]. Because of these unprecedented conditions, the problems that arise are complex and difficult to manage [3]. Another characteristic of these situations is that they have never happened before, so the conditions are unknown [4]. At the same time, there are not a few cases where the required solutions must be provided in a short time and be efficient [3]. This is the context in which the COVID-19 pandemic is studied in this article, i.e. as an everyday problem to which innovative solutions [5,6,7,8] and integrated strategies [9] had to be provided in a short time [5,6,7,8] .

The COVID-19 pandemic represented a new condition of everyday life, affecting not only health systems around the world, but also other aspects [6,8,9,10,11,12,13] such as international transport, supply chains [8,6], education [8,11,13], the global economy [12,13,14] and social activities in general [13]. The complexity, speed [15,16] and uncertainty that characterised the early stages of the crisis destabilised society and its structures [15]. To manage the crisis, health systems and governments were forced to implement innovative practices that had not been tried before [6,17,18].

21st century skills are defined as the cognitive [3,19,20] and interpersonal [20] abilities that enable individuals to cope and adapt to the demands of the workplace and the global economy [4] κοινωνιών [1]. In the process of problem solving, individuals act responsibly [21], following principles such as ethics, humanism and sustainability [22].

In order to acquire these skills, individuals should have started to cultivate them from their school days through the education system [23], so they should be at the heart of curricula [4].

There is no precise definition of 21st century skills. This article focuses on some of them, namely innovation, critical thinking, collaboration, communication [4,24] , adaptability [4,25] , digital literacy [4,21] and leadership [4].

Innovation is defined as the use of new technologies and technology derivatives that contribute to improving the use of technology [7].

With the acquisition of critical thinking, the individual is able to analyse, synthesise, evaluate and apply the available information [26,27,28,29,30,31,32] in order to decide what to use to solve a problem [33] or what to believe. More specifically, it is the evaluation of information that helps individuals to separate the information they have into correct and incorrect information [26,29,34,35,36], thus reducing the likelihood of falling victim to misinformation [37].

The problems that arise in today's world, precisely because of their complexity, usually require solutions from many different areas of knowledge. It is impossible for any one person to possess all the necessary knowledge, so in order to solve the problem he or she will have to collaborate with professionals from other fields [19]. A prerequisite for achieving the goal is the possibility of cooperation between members of different fields and the possibility of communication [19]. Communication is related to the exchange of opinions, knowledge and the exchange and explanation of the thoughts of each team member [38], while cooperation is related to the complex of those processes related to the team effort to achieve a goal [39]. Communication and cooperation lead to the achievement of the goal [38,40].

The leader of a group is defined as the person who has the knowledge as well as the experience from everyday life [41] to guide his/her group towards the desired outcome [41,42], which is a common goal [42,43,44]. Key characteristics of a leader are the ability to collaborate and communicate [40] . He is also the one who has the vision [42,44,45] and motivates the team [42,45].

Adaptability is the ability to understand, in a short time, the constraints involved in solving a problem and to work on solving it without stress and emotional outbursts [46]. Taking into account new and specific circumstances increases his productivity [20] and helps him to cope with changes that will occur in the future [47].

As the acronym STEM suggests, it is the name given to an education that combines the principles of the natural sciences (physics, chemistry, biology, geology), technology, mathematics and engineering. In this type of education, students approach each problem to be solved in an interdisciplinary way. This allows them to develop multiple skills in the process. The ultimate goal of STEM education is to create multi-skilled professionals who are trained to find innovative solutions by combining knowledge from different fields [48].

At the heart of STEM education is the acquisition of skills that can equip students for successful careers [49]. Key features of STEM education are the ability to address complex problems of everyday life through the use of interdisciplinary methods [25,30,50,51] and outcomes characterised by innovation [30]. It is also associated with the development of the aforementioned 21st century skills of critical thinking, collaboration and innovation [50] and the ability to rise to any challenge [51]. The objectives of STEM education are fully aligned with the acquisition of 21st century skills [25]. It is worth noting that more recent trends include the contribution of non-STEM fields of knowledge to solving a problem, so we move from STEM education to STEAM, so we include the contribution of disciplines such as sociology, psychology, philosophy, etc. [52].

The active citizen has also mastered many of the 21st century skills such as critical thinking [27]. They are also constantly alert to keep themselves informed and to distinguish between authoritative and non-authoritative sources [53]. The skills an individual masters after engaging in STEM contribute to the development of an active citizen personality that can support the development of the global economy [50].

1.1. COVID 19 CRISIS

The most recent public health crisis faced by humanity was that caused by SARS-CoV-2, widely known as COVID-19. It was officially declared a pandemic by the World Health Organization (WHO) on 11 March 2020 [11,54,55,56] and ended on 5 [57] May 2023 [57,58], although this does not mean that the virus no longer poses a threat to global public health [6,57]. Transmission of the virus to the first patient was from an animal [9], which places this virus and viruses of the same family [9] in the category of zoonotic diseases [9,59]. One of the main reasons for the rapid spread and difficulty in containing the virus was the fact that in today's world short and long distance travel is more accessible than in the past, increasing the risk of transmission [54].

In the midst of this crisis, many individual problems arose that required immediate and effective solutions. One of the main and initial difficulties was the fact that this disease has two characteristics that make it difficult to diagnose:

There are asymptomatic patients, i.e. patients who carry and transmit the virus but have no symptoms.

The most common symptoms, such as cough, malaise and fever, are similar to those of influenza [6,59].

Therefore, diagnosis can only be made with specific screening tests, those using a nasal sample are reliable and those using saliva are mainly used in children and people with mild symptoms [59]; such as the polymerase chain reaction (PCR) test [60,61,62], which is time-consuming, expensive [60,62] and requires qualified personnel to perform and interpret the result [62].

The development of a vaccine was the first goal of the scientific community, as this would prevent the virus from entering the host organism. A second issue related to unexpected barriers that arose was the reluctance or refusal of the general population to be vaccinated. The main concerns about whether a person is available for vaccination are related to side effects, long-term effects and, more generally, whether the vaccine is safe [10]. The same concerns were expressed by participants in a survey conducted in Kampala, Uganda [56]. At the same time, the rapid development of the vaccine and its country of origin create barriers to its introduction [10]. In these situations, appropriate information, direct and honest communication, and promotion of vaccine safety data can help to overcome hesitancy [10]. At the same time, educating the general public about the testing process that takes place before a vaccine is available for general use and presenting scientific developments can have a positive effect on reducing vaccine hesitancy [10]. The administration of vaccines to the general population undoubtedly contributed to the emergence from the crisis [14,54,57,58], both in terms of the severity of symptoms and in limiting transmission [57].

During the pandemic, a great deal of information, both accurate and inaccurate, was disseminated to the public [10,12,55,63,64,65,66,67,68,69,70]. This made it more difficult to overcome the health crisis [11,13,55,63,69,71], as misinformation led to mistrust of health authorities, non-cooperation with instructions from health officials and even risky behaviour [11,55,63]. As a result, individuals do not receive valid information and their decisions are influenced by the misinformation they receive, leading to an increase in cases and deaths [72]. It is worth noting that false information about the virus will continue to be spread until the end of 2024. On Twitter, 3% of users are responsible for spreading this information [73]. A fact that confirms the ease with which all kinds of information can be disseminated.

The use of the Internet and social media by a large part of the world's population has contributed to the rapid spread of false information to a large part of the population [7,11,12,13,63,64,67,73,74,75] [76,77,78]. Social media in particular, with their large number of users but easy way of transmitting information, have been an easy channel for the transmission of false information in a short period of time [11,13,67,71,78]. The use of algorithms or bots used by social media to replicate posts, often containing fake news [55,67,75,76], has also contributed to this. They work by creating filters that allow information to reach users only from sources that agree with their views and reject those that do not [75]. Citizens have used information that in many cases comes from the scientific community but has not been peer-reviewed [69]. It was also found that users of social networking sites were strongly influenced by receiving positive feedback from other users for sharing information, rather than whether the information was accurate [68].

Some of the information related to unsubstantiated treatments [63,74,75,76], such as that the use of vitamins can help treat the virus [63], that the virus is transmitted via the 5G network [13,66,77], and the use of inappropriate drugs to treat the disease, such as hydroxychloroquine [12,66,70] or the formulation ivermectin [11,55,66], which is used as a parasiticide in animals [55]. In another case, the misconception was spread that alcohol could cure the virus [7,77]. With regard to hydroxychloroquine, Mutlu et al. reported in [12] on the contribution of Twitter to its use. But also in characterising good practices such as the use of masks [55,63,69], , the use of screening diagnostic tests in case of symptoms, social isolation [69] as incorrect [55,63,69].

As a result, part of the population was influenced by this information and did not follow preventive practices [13,64,70,71], putting public health at risk [71,74,75,77]. People who fell victim to misleading information put their physical [11,13,55,75,78] and mental health at risk [11,13,77,78], and the information caused negative emotions such as fear, sadness and anxiety [74]. Fake news also destabilises society and undermines democracy [78]. At the same time, there is a lack of trust in any preventive measures taken to protect public health [75]. In the same context, Bangladesh warned of an increase in deaths during the monsoon due to the combination of the virus and dengue, a scenario that did not materialise but caused fear among the public [69]. Misinformation has even hampered doctors' ability to care for COVID19 patients [70].

In many cases, prominent figures such as politicians [14,55,71], religious leaders [55,71], carnies [55,77], and even state officials [13] have contributed to disinformation by communicating their personal, unfounded views to their audiences [55,77]. On the other hand, distrust of political figures and political polarisation hindered the implementation of government measures to prevent and respond to the pandemic [75].

Factors influencing how individuals process the information they receive include prejudice [63,78],digital literacy [63,64,79], health education [63,64,79], η παιδεία σχετικά με την υγεία [10,55,63,78,79] and social segregation [63]. Bombarding citizens with scientifically accurate and verified information alone may not produce the desired results [75].

In many cases, misinformation has led to refusal of vaccination [10,13,55,56,57,63,64,66,75,76,77] and to the promotion of poor practices in response to the crisis, which has contributed to its prolongation [63]. A questionnaire distributed in Kampala, Uganda, shows that misinformation had an impact on individuals' willingness to be vaccinated, with 55% of the sample stating that they did not want to be vaccinated, citing misinformation as the reason [56]. It is worth noting that the same study found that individuals' desire to be vaccinated was higher prior to exposure to misinformation [56]. In many cases, misinformation was even associated with anti-vaccine conspiracy theories [7,10,55,64,66,71,75,77], which were believed because in times of crisis it is easier for individuals to believe in such theories due to the frustration they experience [55,66]. Scenarios in which vaccines were used by governments to implant microchips in citizens so that they could be traced [66,71], and the alteration of human genetic material and fertility [71] became credible. The existence of vaccine side effects, although rare, affects the public's willingness to be vaccinated [10,57,58,80], despite the fact that the overall benefits of mass vaccination far outweigh the side effects [58]. Similarly, personal experiences of the vaccine shared by social media users appeared to influence some of the public more than the results of scientific studies [75].

Reducing misinformation can begin with the education of physicians of different specialties, who can help the pro-vaccination campaign by creating a supportive environment in which patients' concerns are allayed and by providing personalised advice [57].

RESEARCH AIM

This unprecedented health crisis was an example of a real-life problem that placed society, health professionals, national leaders and science and technology workers in general in an unprecedented and urgent situation. The solutions to both the pandemic problem and other problems that arose during the pandemic had to be provided in a short time and be efficient.

The main purpose of this paper is to conduct a case study of the pandemic in order to identify the contribution of 21st Century Skills and STEM education fields to the management of the crisis. As the latter focus on solving everyday problems and mastering 21st century skills, the COVID-19 pandemic is a representative example of a complex everyday problem. In this way, the development of 21st century skills is supported so that future professionals will be able to provide solutions to any other everyday problem that may arise.

METHODOLOGY

PRISMA was chosen as the method for the meta-analysis of the data. Literature sources were searched in three databases: PubMED, SCOPUS, GOOGLE SCOLAR. The search was complex, using the operators shown in Table 1, and was carried out on 22/11/2024 in all three databases. The following criteria were set by the authors for the inclusion of sources

• Articles published between 01/11/2024 and the day of the search were selected.
• Articles only, not book chapters or conference proceedings.
• Articles written in English.
• Articles with free access for all.

After the first search, a total of 579 articles were found, 374 in PubMED, 16 in SCOPUS and 189 in GOOGLE SCOLAR. Of these, 122 remained after removing articles that were not relevant to the queries. The titles and DOIs of the 122 articles were kept in a Word file so that they could be retrieved during the study. Of the 122 articles, 8 duplicates were removed, leaving 114 for the study. The inventory is shown in Table 2.

The scholars read the 114 articles one by one and then discussed and argued about which articles to include and which to reject. In the end, 56 articles were included. Table 3 lists the articles that were included and their main conclusions, while Table 4 lists the articles that were rejected and the reason for rejection; it should be noted that an additional rejection criterion was applied, i.e. all articles that referred to the treatment of specific patient groups during the pandemic were rejected.

Figure 1 shows the number and corresponding percentage of articles examined that referred to the contribution of each of the 21st century skills on which the article focused.

Figure 2 shows the number of articles and the corresponding percentage of the total number of articles studied that refer/refer to the contribution of STEM fields and the interdisciplinary approach to crisis management and exit from crisis.

Figure 3 analyses the articles referring to the contribution of technology and identifies the specific technologies mentioned.

Figure 4 analyses the articles examined in terms of the direction taken to emerge from the crisis.

In Figure 5, the articles are analysed by the country of the higher education institution to which the researchers belong.

The articles studied come from 44 different scientific journals and newspapers and 2 platforms whose purpose is to disseminate accurate information. The journals can be divided into eight different categories according to their field of interest; the number of articles per category and the corresponding percentage are shown in Figure 6.

The analysis of the sources leads to the following initial conclusions:

• In terms of 21st century skills, collaboration and critical thinking have been studied more extensively in the literature reviewed.
• In terms of STEM, technology is the most relevant.
• Many of the studies were carried out by teams of researchers whose institutions are located on different continents, which reinforces the need for collaboration and communication between the scientific community in order to carry out research.
• The articles came from newspapers and journals in many different scientific fields, demonstrating that the pandemic was a problem that required an interdisciplinary approach to solve.

THE CONTRIBUTION OF 21ST CENTURY SKILLS TO CRISIS MANAGEMENT

4.1. ADAPTABILITY

The way out of this unprecedented crisis was to identify the points where there were gaps and to find solutions to each new problem that arose [81]. Thus, operational planning of the response to the crisis was central [81], and planning had to be adapted to the new data.

Country leaders [15] and primary health care systems [82] were called upon to adapt to the new conditions. Even pro-vaccination strategies had to be adapted [10,83,84], as vaccine hesitancy is related to socioeconomic, cultural and demographic factors [10,83], which had to be taken into account when designing a strategy.

4.2. COLLABORATION

The emergence from the health crisis was the result of collaboration at many different levels. In each case, the goals achieved were different and the benefits to society were multiple.

The multifaceted and multidimensional problems that emerged during the crisis required collaboration between professionals from many different scientific fields [6,8,12,16,62,81,82,83,85]. The global nature of the crisis also required cooperation between countries [81,86]; common policies, but also the exchange of good practices, brought positive results. At another level, scientists, society, politicians, agencies such as ministries, non-governmental organisations and the WHO worked together at national, regional and international levels to achieve their common goal of overcoming the crisis [81], [7,61,81,83,86]. Collaboration at multiple levels was also required to limit misinformation, with WHO re-opening channels of collaboration with political leaders [71,75], , social media leaders [75] and technology companies [13,70,75,79]. Collaboration between local leaders and the community [10], but also between health professionals and citizens [76], develops a sense of trust [10,15,76,81] that leads to positive outcomes [10] and even limits the phenomenon of misinformation [76].

Some of the positive results of collaboration have been the distribution of vaccines and efforts to be fair [14], the development and implementation of diagnostic tests [81], but also the limitation of misinformation [13,70,71,75,79].

Table 5 lists cases of collaboration from the reviewed bibliography.

4.3. COMMUNICATION

Another 21st century skill that was used and contributed greatly to overcoming the crisis was communication. Communication played an important multidimensional role in managing the crisis.

Communication between those involved in crisis management was essential to make strategic decisions [16] . The dissemination of information about health advice and the vaccination campaign played an important role in crisis management, highlighting the need for communication between leaders and citizens [82,83], between health professionals and citizens [70,83], and between health professionals and governments [81,82].

Communication was also emphasised in relation to access to scientifically valid and up-to-date data on the virus. At the same time, data should be easily accessible and transparent [81,87].

Communication between health professionals and the general public can increase trust between the parties involved [70,83]. Given the reluctance of the population to accept vaccination [10,14,57], it is important to improve the communication skills of health professionals to strengthen their arguments and to provide valid and timely information to patients so that they can receive the necessary vaccinations [10,57]. Such methods also yield better results in ethnic minority communities [70].

In these unprecedented circumstances, health workers needed to be constantly and promptly informed about government policies and guidelines for patient care and to ask questions [81,82].

Table 6 lists cases of communication from the literature review.

4.4. LEADERSHIP

Different decisions taken by policymakers around the world have resulted in different rates of recovery [5], demonstrating that the outcome of crises depends largely on how they are managed.

Governments around the world have implemented measures such as lockdowns, quarantines [8,15,81,83], mandatory masks in public [8,81,83], social distancing and mass vaccination [8,83], COVID-19 clinics, mass vaccination centres and mobile testing stations [82] . The implementation of preventive measures has been shown to be effective in significantly reducing the likelihood of transmission from an infected person to a healthy person [84] . Efforts to increase vaccination coverage have used a variety of tactics. These tactics have included

• making vaccination a condition of employment
• requiring proof of vaccination when entering public places and when travelling
• Providing financial incentives for those who had been vaccinated, either through gift vouchers or raffles of large sums of money [89].

Equally important were the decisions required of those with leadership roles in health care structures, as they influenced policy decisions on resource allocation, treatment protocols, management of health care workers, and communication with citizens [15]. Decision-making required immediate access to valid information and a critical review of the prevailing epidemiological situation [81]. Leadership was also considered critical to the success of the vaccination campaign in each country [14].

Table 7 lists examples of leadership from the literature reviewed.

4.5. CRITICAL THINKING

Misinformation has been one of the main obstacles to overcoming the public health crisis. One of the main methods of managing misinformation is to gather data from many different and valid sources that are consistent with each other [81]. As the search for, dissemination of, and discussion of health-related information among community members increases during a health crisis, information management becomes even more important [79]. It was also important to disseminate information about symptoms and protective measures through many different mechanisms in different languages to increase accessibility [81]. Technology has helped to find innovative solutions to reduce such phenomena.

The term infodemic has been developed to describe the large amount of information that citizens have to deal with during a pandemic, including false, redundant and misleading information [7,13,55,66,70,71,75,76,77,78,79]. The term predates the COVID-19 pandemic, but has received more attention since [70]. The main axes of combating disinformation during the pandemic are listed in Infodemic Management [63,70,79] and are as follows

• Monitoring the transmission of information and the impact of disinformation
• Strengthening the critical thinking of the general population by increasing their digital and scientific literacy.
• Fact-checking and peer-reviewing information.
• Valid and accurate transfer of knowledge to avoid its distortion by commercial or political interests [63].

It is clear that in the fight against disinformation, the existence of critical thinking can help individuals to rely only on valid information. Limiting the spread of disinformation can to a large extent be based on educating the public to distinguish reliable information from non-information [10,63,67,68], i.e. strengthening their critical thinking [67,75]. The large amount of information, but also the easy access to it, has led countries to develop strategies to teach citizens how to distinguish false information [7,11,70].

Table 8 lists cases of leadership from the literature reviewed.

4.6. INNOVATION

Innovation is at the heart of 21st century skills and problem solving. Because of the unprecedented conditions that prevailed during the pandemic, innovation was important, as any solution to unknown conditions is considered innovative when combined with principles such as justice and humanity.

Even the preventive measures implemented and the measures to support the vaccination campaign can be described as innovative, as they had not been implemented on such a scale in the past [8,15,81,82,83,88]. While innovative solutions have also been implemented to combat misinformation [55] , patient care [5,7]. It should be noted that an account of the innovative applications and technologies used to manage the crisis will be analysed in detail in a later section of the article.

Table 9 lists the innovations implemented during the crisis.

5. THE CONTRIBUTION OF STEM PROFESSIONS TO OVERCOMING THE CRISIS

5.1. THE NEED FOR A MULTIDISCIPLINARY APPROACH.

As mentioned above, the crisis was multidimensional and affected many different aspects of daily life. The problems that professionals were called upon to solve required an interdisciplinary approach [6,8,9,12,60,62,72,79,81,83]. The interdisciplinary approach, consistent with collaboration between scientists from different fields, was necessary to solve many individual problems, such as monitoring epidemiological risk [9], mitigating misinformation [55,71,75], , finding diagnostic tools [62], creating applications on mobile devices [60], and even using AI in medicine [72]. In particular, professionals in molecular biology, engineering and data analysis have worked together to improve diagnostic tools. STEM professionals have been asked to work together to limit misinformation [55], and the contribution of the social sciences has been requested in the same direction [71]. Collaboration between scientists, industry and IT specialists is emphasised in [12], and between combat medics and programmers in [54].

Table 10 lists the data from sources related to the interdisciplinary approach.

5.2. THE CONTRIBUTION OF SCIENCE

The contribution of the natural sciences to the management of the crisis was crucial. As the problem was primarily medical, biology contributed to the knowledge gathered on how to deal with the virus [6]. While both biology and chemistry contributed to the identification of those therapeutic methods that were suitable for treating the virus [6]. While physics and chaos theory can contribute to finding a transmission model and thus to designing prevention and public health protection strategies [91].

Table 11 provides data on the contribution of positive sciences to overcoming the crisis.

5.3. CONTRIBUTION OF TECHNOLOGY

The contribution of technology to overcoming the health crisis has been multidimensional, as it has helped to solve problems in many different areas. More specifically, it has helped to

• Monitoring the epidemiological situation [60,72,85]
• Making decisions on policy formulation [16]
• Finding and producing vaccines [14,58,80],
• Supporting the vaccination campaign [57,80],
• Identify and produce drugs [6,54,90].
• Find and develop diagnostic tests [61,62,81],
• Support diagnosis [6,60],
• Finding treatments [58],
• Support telemedicine [5,15,60,72,81,82,92,93]
• Keeping health professionals informed about constantly changing conditions [6,18,81,82,83]
• Limiting misinformation [7,12,13,54,65,67,68,78],
• Collecting and disseminating valid information [5,7,67,79,80,87,88],
• Providing psychological support to citizens [7,90],
• Production of personal protection equipment [6],
• Gathering citizens' opinions on the burning issues of the time [79].

In order to achieve the above objectives

• Technology - new technologies [5,6,14,58,60,61,80,82,83,92],
• Digital tools [7,18,57,72,79,81,82,85,88],
• Applications [5,7,16,60,72],
• Digital portals- websites-databases- platforms [7,67,70,72,80,87,88] [87],
• Computer science [72,79,93],
• Telecommunications [72,93],
• Nanotechnology [6],
• Software [16] ,
• Immersive technologies [90],
• Artificial intelligence [72],
• Machine learning [62],
• Electronic Systems [81],
• NPL [7,54,65,67,78] ,
• Software [16],
• Programming languages [87].

Table 12 lists the technologies that were used during the pandemic to help manage the crisis.

The applications developed are associated with a number of innovations, such as personalised advice, daily reminders, notification of COVID-19 test results, recommendation of quarantine in case of symptoms, notifications in case of contact with a sick person, etc. [5]. The contribution of such applications was significant in terms of detecting outbreaks, monitoring the spread of the disease and checking the effectiveness of preventive measures [82]. Their effectiveness during the pandemic [5] highlights the fact that in an uncertain environment, technology, science and creativity can contribute to finding a solution to any problem [5]. Diagnostic applications require the use of interdisciplinary methods, as the analysis of nasal swabs requires the integration of a biosensor and the use of WiFi or Bluetooth for data transfer [60].

Table 13 lists the applications mentioned in the reviewed literature.

In addition to the use of apps, telemedicine was widely used during the pandemic [15,72,81,92,93], which, unlike apps, is an integrated system of care [72,93]. Telemedicine existed before the public health crisis, but during the crisis it was rapidly integrated into care systems [82,92], while in countries such as the United Kingdom its use became universal [93]. Its use helped to contain the disease during the pandemic, as video calls allowed the doctor to examine the patient and assess whether they needed further hospital care or could remain in isolation [72]. In this way, health professionals came into contact with fewer infected people [72]. After the pandemic, citizens continued to use telemedicine, recognising its benefits in terms of saving resources and time, as it does not require travel [92]. It was used in many cases of chronic diseases mentioned in [92] and will not be analysed further as it is beyond the scope of this article.

The digital environment created during the implementation of telemedicine has the potential to promote health while creating strong bonds between health professionals and users [7]. As both applications and telemedicine require the use of the internet, and in order to reduce the gap between those who have access and those who do not, Wi-Fi hotspots have been created so that even more people can access health applications and telemedicine platforms [82].

Artificial intelligence (AI) has contributed to addressing this global crisis through its use in various innovative applications [6,8,54,60,65,72,90,94,95]. Machine learning, deep learning and neural network techniques can use data sets related to critical factors in pandemic response, such as

• Disease progression and population movement [8,60,65,72],
• decision making [54,94],
• disease diagnosis [8,54,60,65,72,95]
• Building predictive models [8,54,65,95],
• Limiting the spread of fake news and promoting the spread of accurate news [11,13,57,63,65,67,75,77,79],
• limiting the spread of the virus [12],
• supporting the implementation of preventive measures [8,65],
• in patient care [8,12,54,60,64,65,72,95],
• Classification of virus data [8,65,95],
• in identifying and reducing negative emotions such as anxiety, depression, and psychological support in both healthcare workers and the general population [72,95]
• in vaccine discovery [65]

Systems based on machine learning, deep learning [11,13,67,77,78], artificial intelligence [11] and innovative [77] hybrid models [67,77] have been used against disinformation [11] .

Table 14 lists the use of artificial intelligence, deep learning, machine learning and neural networks in crisis management.

In response to the pandemic and the need for immediate and innovative solutions, immersive technologies such as Virtual Reality (VR), Augmented Reality (AR), Mixed Reality (MR), Extended Reality (XR) [90] were put at the service of healthcare. These technologies attempted to provide solutions to problems that arose during the pandemic; the review in [90] lists 53 platforms, applications, games and smart objects that were used in different areas and contributed in their own way to the management of the pandemic. While [57], mentions the contribution of virtual reality environments combined with motivational interviewing to increase vaccination rates.

Social media have also been used in pandemic management in the following areas

• Communication between the community and scientists [66,84]
• Sharing scientific data [66],
• Dissemination of accurate information [64,66,75,79,84]
• Limiting misinformation [11,12,55,63,64,66,67,73,75]
• Pro-vaccination [83]

Table 15 reports on the contribution of social media during the pandemic.

5.4. THE CONTRIBUTION OF MATHEMATICS

Mathematics as a positive science contributed to the way out of the crisis through the use of

• mathematical models [12,16,60,64,70,91]
• Algorithms [11,13,60,63,67,72,73,76,77] [13]
• Datasets [13,17,67,78] ,
• deterministic models [16]

While the areas of the crisis to which they contributed were

• Predicting the spread of the virus [16,60,91],
• Patient care [17],
• Decision making [16],
• Monitoring compliance with preventive measures [76].
• in limiting misinformation [11,13,55,63,64,67,70,76,78],
• in identifying fake news [76], [67,73,77], [13,67,73,76,77],
• Communicating accurate information [67],
• providing psychological support, limiting negative emotions [67].

Table 16 provides a detailed description of the contribution of mathematics to crisis management.

CONCLUSIONS

The COVID19 pandemic, along with the individual problems that emerged during it, was a problem of everyday life that sought quick and innovative solutions not only regarding the virus but also regarding the other problems that emerged.

Through the method of data meta-analysis, the authors of the article demonstrated that the exit from the crisis was supported by people who possessed the skills of the 21st century. Professionals in all fields collaborated, communicated, used their critical thinking, their leadership skills, but they also had to adapt to the new conditions. From the perspective of scientific fields, the approach was interdisciplinary, a multitude of sciences from different scientific fields collaborated in order to provide solutions to the problems that arose. Professionals from Natural Sciences, Technology, Engineering and Mathematics worked in order to provide solutions.

In more detail, scientists were called upon to collaborate with each other, with local communities, with political leaders, with policymakers, with local-national and international bodies. The collaboration between the parties mentioned also required communication between the two sides. Their leadership skills were used by heads of states, agencies, and health units in order to be able to coordinate the implementation of the required actions and to handle situations. On the other hand, due to the dimensions that the phenomenon of misinformation took during the pandemic, the development of critical thinking among health professionals and citizens was often put in focus. Given that the vaccine was at the heart of the solution to the problem, the reduction of hesitancy or refusal to vaccinate required the development of critical thinking and brought to the surface the need to separate information into valid and invalid. Adaptability was another of the basic skills that helped to emerge from the crisis as those involved in crisis management had to adapt their decisions to the new data and citizens had to adapt in a short period of time to the instructions given to them each time.

The contribution of the STEM fields and the corresponding scientists is obvious. From the field of natural scientists, doctors, biologists, chemists, physicists worked both at the research level and at the industrial level in order to produce vaccines, medicines. They also contributed to the development of models for monitoring the epidemiological situation. Specialists in technology and information technology contributed greatly to the development of applications which in turn helped to monitor the situation, support patient care, and limit misinformation. Engineers contributed to the development of industrial products. While Mathematicians contributed to data analysis and the development of algorithms in order to achieve goals such as finding fake news, patient care, data categorization. While, the contribution of social sciences mainly in issues of psychological support and citizen management has been significant.

Throughout this process, the solutions provided were innovative, as new practices and applications emerged in order to provide solutions.

The COVID19 pandemic was an unprecedented situation, the exit of the global community from this large-scale health crisis was partly the result of the use of 21st century skills but also of the interdisciplinary approach.