We use qualitative interviews to study subsistence consumers confronting the global, pervasive and extended challenges of COVID‐19, encompassing literally all realms of daily life. For subsistence consumers whose circumstances are filled with day‐to‐day uncertainty and a small margin of error to begin with, the pandemic has led to manifold uncertainties and a disappearing margin of error, with potentially lethal consequences. Their constraints to thinking and lack of self‐confidence arising from both low income and low literacy are magnified in the face of the complex, invisible pandemic and the fear and panic it has caused. Characteristic relational strengths are weakened with social distancing and fear of infection. Yet, subsistence consumers display humanity in catastrophe, and confront the uncontrollable by reiterating a higher power. Consumption is reduced to the very bare essentials and income generation involves staying the course versus finding any viable alternative. We derive implications for consumer affairs.

A bottom-up approach grounded in micro-level understanding of low income and associated low literacy has important implications in the health arena. This paper draws from two decades of social science research on low-income settings, with particular emphasis on subsistence marketplacesmarketplaces "where consumers and entrepreneurs … live at or near subsistence" 1-to derive implications for health policy for low-income patients in the United States. The Subsistence Marketplaces Initiative at the University of Illinois has combined basic research and educational innovations along with communitybased outreach through marketplace literacy to tens of thousands of low-income individuals in seven countries. It has taken a bottom-up approach grounded in micro-level understanding of the thinking, feeling, behavioral and social aspects of living with low income and associated low literacy, to understand and improve interactions in the marketplace. By considering broader life circumstances and concomitant factors such as literacy, this approach unpacks poverty not only in terms of the material but in terms of the cognitive, the affective, the behavioral, and the social. What we have learned about marketplace interactions in subsistence marketplaces has relevance for United States healthcare, with the patient as the customer of the health provider. Lessons from subsistence marketplaces can inform innovations in medical education, design and delivery of healthcare for low-income patients, outreach education, and future micro-level research at the human-healthcare interface. At the outset, we note that our learning can be summarized in one phrase-"the things we take for granted!" Those of us fortunate enough to have a good education sometimes do not even devote conscious thought to mundane shopping activities that can overwhelm low-literate, low-income consumers. These activities include locating a product at a store, finding a price, understanding product information (such as nutrition information and expiry of medicine), computing the cost of different quantities, figuring final price based on discounts, gauging price-size trade-offs, forming a judgment of value (as in give ver

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