This book provides the first wide-ranging account of the impact of the COVID-19 pandemic in two contrasting island regions - the Caribbean and the Pacific - and in several islands and island states. It traces the complexity of effects and responses, at different scales, through the first critical year. Written by a range of scholars and practitioners working in the region the book focuses on six key themes: public health; the economies (notably the collapse of tourism, the revival of local agriculture and fishing, and the rebirth of self-reliance, and even barter); the rescue by remittances; social tensions and responses; public policy; and future 'bubbles' and regional connections. Even with marine borders that excluded the virus all island states were affected by COVID-19 because of a considerable dependence on tourism – prompting urgent challenges for governance, economic management and development, as small states sought to balance lives against livelihoods in search of revitalisation or even a 'new normal'.