Mobilizing Policy (In)Capacity to Fight COVID-19: Understanding Variations in State Responses

Political determinants of COVID-19 restrictions and vaccine rollouts: The case of regional elections in Italy and Spain

The COVID-19 pandemic is one of the most significant public health crises in modern history, with considerable impacts on the policy frameworks of national governments. In response to the pandemic, non-pharmaceutical interventions (NPIs) and mass vaccination campaigns have been employed to protect vulnerable groups. Through the lens of Political Budget Cycle (PBC) theory, this study explores the interplay between incumbent electoral concerns and political dynamics in influencing the implementation of NPIs and vaccination rollout within the administrative regions of Italy and Spain during the period spanning June 2020 to July 2021. The results reveal that incumbents up for the next scheduled election are 5.8 % more likely to increase the stringency of containment measures than those that face a term limit. The findings also demonstrate that the seats of the incumbent and coalition parties in parliament and the number of parties in the coalition have a negative effect on both the efficiency of the vaccination rollout and the stringency of NPIs. Additionally, the competitiveness of the election emerges as an important predictor of the strictness of NPIs. Therefore, our results suggest that incumbents may strategically manipulate COVID-19 policy measures to optimize electoral outcomes. The study underscores the substantive influence of political incentives, competitive electoral environments, and government coalitions on policy formulation during health emergencies.

Mixed methods approach to examining the implementation experience of a phone-based survey for a SARS-CoV-2 test-negative case-control study in California

OBJECTIVE

To describe the implementation of a test-negative design case-control study in California during the Coronavirus Disease 2019 (COVID-19) pandemic.

STUDY DESIGN

Test-negative case-control study.

METHODS

Between February 24, 2021 - February 24, 2022, a team of 34 interviewers called 38,470 Californians, enrolling 1,885 that tested positive for SARS-CoV-2 (cases) and 1,871 testing negative for SARS-CoV-2 (controls) for 20-minute telephone survey. We estimated adjusted odds ratios for answering the phone and consenting to participate using mixed effects logistic regression. We used a web-based anonymous survey to compile interviewer experiences.

RESULTS

Cases had 1.29-fold (95% CI: 1.24-1.35) higher adjusted odds of answering the phone and 1.69-fold (1.56-1.83) higher adjusted odds of consenting to participate compared to controls. Calls placed from 4pm to 6pm had the highest adjusted odds of being answered. Some interviewers experienced mental wellness challenges interacting with participants with physical (e.g., food, shelter, etc.) and emotional (e.g., grief counseling) needs, and enduring verbal harassment from individuals called.

CONCLUSIONS

Calls placed during afternoon hours may optimize response rate when enrolling controls to a case-control study during a public health emergency response. Proactive check-ins and continual collection of interviewer experience(s) and may help maintain mental wellbeing of investigation workforce. Remaining adaptive to the dynamic needs of the investigation team is critical to a successful study, especially in emergent public health crises, like that represented by the COVID-19 pandemic.

Why do democracies respond differently to COVID-19? A comparison of the United States and South Korea

Background

COVID-19 has posed severe challenges to crisis management in democracies. Different democracies respond to the crisis differently. This article proposes an analytical framework to explain why democracies respond differently to the public health crisis and how different contextual factors affect crisis response in democracies.

Methods

By comparing COVID-19 responses in the US and South Korea, this article conducts a comparative case study with a most similar system design. The two countries have been selected as cases because they are both developed democracies with a robust healthcare system. However, different contextual factors in the two countries have created different crisis responses by shaping different crisis leadership and political and social solidarity. This study collected data from different sources, including government documents, official websites, leaders' speeches, research reports, academic articles and news media. We tried to enhance the reliability of the data by comparing different data sources.

Results

We found that individual, institutional and cultural dimensions of contextual factors can influence different crisis responses of democratic countries by shaping crisis leadership and political and social solidarity. On the individual and institutional dimensions, leadership style and governance structure shape crisis leadership (sense making, decision making and coordinating, and meaning making), which in turn influences crisis management. On the cultural dimension, political and social solidarity measured by political polarization and social cooperation are shaped by cultural and social norms.

Conclusion

Our findings indicate that democracies require strong crisis leadership and a high degree of political and social solidarity to tackle public health crises. A centralized and coordinated system, as well as a political elite leadership style shaped by rich crisis response experience, expertise and high sensitivity to crises are conducive to crisis management. Fostering a cultural and social norm that facilitates state-society collaboration can promote crisis management. These findings provide valuable insights for decision-makers to effectively respond to future pandemics.

Study on the logic and effectiveness of crisis learning in the promotion policy adjustment: an observation based on the adjustment of COVID-19 prevention policy in China

Background

As the impact of COVID-19 on normal production and living conditions diminishes, this serious emergency is come to an end. China's policy framework has facilitated positive adjustment over the past 3 years by timely modifying its emergency response to changes in viruses and epidemics. This paper aims to explore the logic of China's policy framework that promoted policy adjustment through crisis learning during COVID-19.

Methods

By gathering and classifying China's epidemic prevention policies throughout the past 3 years, integrating policy texts, and analyzing key events, this article examines the process of supporting policy adjustment through crisis learning in the policy system during COVID-19.

Results

The Chinese government's COVID-19 policy adjustment process can be divided into four stages, namely 'The period of stress response', 'The period of COVID-19 prevention and control', 'The period of regular prevention and control', and 'The period of overall adjustment'. The policy adjustments in each stage demonstrate the logic and effectiveness of crisis learning in the promotion policy adjustment. The study has determined that the motivational logic comprises three crucial elements: security requirements, accountability pressure, and reputation management. The institutional logic encompasses both the organizational and resourceful environments, and the institutional and cultural environment. Additionally, the behavioral logic of policy adaptation aligns with the strategy of crisis learning. Meanwhile, the logical framework of 'crisis learning-policy adjustment' can be verified using the Chinese government's policy adjustment in COVID-19 as an example.

Conclusion

Establishing an effective post-crisis learning system is crucial to improving the effectiveness of crisis response. There is a logical link between crisis learning and policy adjustment. The implementation of policy adjustment needs to be based on the results of crisis learning. Government departments are essential for crisis learning and policy adjustment.

Towards understanding policy design through text-as-data approaches: The policy design annotations (POLIANNA) dataset

Despite the importance of ambitious policy action for addressing climate change, large and systematic assessments of public policies and their design are lacking as analysing text manually is labour-intensive and costly. POLIANNA is a dataset of policy texts from the European Union (EU) that are annotated based on theoretical concepts of policy design, which can be used to develop supervised machine learning approaches for scaling policy analysis. The dataset consists of 20,577 annotated spans, drawn from 18 EU climate change mitigation and renewable energy policies. We developed a novel coding scheme translating existing taxonomies of policy design elements to a method for annotating text spans that consist of one or several words. Here, we provide the coding scheme, a description of the annotated corpus, and an analysis of inter-annotator agreement, and discuss potential applications. As understanding policy texts is still difficult for current text-processing algorithms, we envision this database to be used for building tools that help with manual coding of policy texts by automatically proposing paragraphs containing relevant information.

State Capacity and COVID-19: Targeted versus Population-Wide Restrictions

CONTEXT

During the COVID-19 pandemic, governments varied in their implementation of social distancing rules. Some governments were able to target their social distancing requirements toward specific segments of the population, whereas others had to resort to more indiscriminate applications. This article will argue that state capacity crucially affected the manner in which social distancing rules were applied.

METHODS

Using data from the Oxford COVID-19 Government Response Tracker, the author performed a series of ordered logistic regressions to examine whether state capacity increased the likelihood of more targeted applications of each social distancing rule.

FINDINGS

Given the same level of infectivity, more capable states were indeed more likely to resort to targeted applications of each social distancing restriction. Interestingly, the size of state capacity's effect varied by the type of restriction. State capacity had a stronger influence on face-covering requirements and private-gathering restrictions than it had on school closures, workplace closures, and stay-at-home orders.

CONCLUSIONS

The way in which social distancing rules are applied is endogenous to state capacity. Effective governance is a precursor to more targeted and nuanced applications of social distancing rules.

Alcohol policy framing in South Africa during the early stages of COVID-19: using extraordinary times to make an argument for a new normal

INTRODUCTION

Public health and alcohol industry actors compete to frame alcohol policy problems and solutions. Little is known about how sudden shifts in the political context provide moments for policy actors to re-frame alcohol-related issues. South Africa's temporary bans on alcohol sales during the COVID-19 pandemic offered an opportunity to study this phenomenon.

METHODS

We identified Professor Charles Parry from the South African Medical Research Council as a key policy actor. Parry uses a Twitter account primarily to comment on alcohol-related issues in South Africa. We harvested his tweets posted from March 18 to August 31, 2020, coinciding with the first two alcohol sales bans. We conducted a thematic analysis of the tweets to understand how Parry framed alcohol policy evidence and issues during these 'extraordinary times.'

RESULTS

Parry underlined the extent of alcohol-related harm during 'normal times' with scientific evidence and contested industry actors' efforts to re-frame relevant evidence in a coherent and well-constructed argument. Parry used the temporary sales restrictions to highlight the magnitude of the health and social harms resulting from alcohol consumption, particularly trauma, rather than the COVID-19 transmission risks. Parry portrayed the sales ban as a policy learning opportunity (or 'experiment') for South Africa and beyond.

CONCLUSIONS

Crisis conditions can provide new openings for public health (and industry) actors to make salient particular features of alcohol and alcohol policy evidence.

Exempting the state and responsibilizing individuals during pandemic governance: Analyzing the health minister's responses to the Covid-19 pandemic in Turkey

The COVID-19 pandemic pushed the governments of the world to implement different regulative and protective measures. Although these measures required serious re-considerations of public health strategies, they were still grounded on pre-existing contexts of countries' health systems, namely the "new public health" paradigm. Turkey's neoliberal health reforms since 2003 coincide with the principles of this paradigm's trends toward marketizing services and responsibilizing individuals; yet the Turkish context of the pandemic also stands out due to its mixed and unique form of governance. Utilizing the tweets of the Turkish Health Minister between March 13th and October 1st, 2020, we conducted a thematic qualitative analysis investigating the Turkish state's response to the COVID-19 pandemic. Our analysis revealed that state responsibility was framed around building new pandemic hospitals, informing the public, and building trust. Conversely, his tweets assigned Turkish individuals an active role in shaping pandemic outcomes through their "informed" and "empowered" agency. Finally, he coined "togetherness," referring to the sum of individual actions, as an indispensable goal in assuring public compliance with precautions. The Minister's tweets reflect the unique nature of pandemic governance in Turkey with a relatively imposing and swift response of centralized power but a primary focus on "responsibilized" individuals' collective actions.

Covid-19 Policy Convergence in Response to Knightian Uncertainty

Domestic policy responses to COVID-19 were remarkably consistent during the early days of the pandemic. What explains this policy convergence? Our formal model suggests that the novel character of COVID-19 produced a period of maximum policy uncertainty, incentivizing political actors to converge on a common set of policies to minimize their exposure to electoral punishment. This convergence is likely to break down as policy feedback produces opinion divergence among experts and the public and as politicians recalculate the costs and benefits of various policy responses and under some conditions facing incentives to adopt extreme policies.

Britain's COVID-19 battle: The role of political leaders in shaping the responses to the pandemic

This article introduces an analytical framework to trace and compare leaders' different types of behaviours to the health crisis posed by COVID-19, following the analytical benefits of Leadership Trait Analysis. It examines Boris Johnson's and Nicola Sturgeon's diverging initial responses to the pandemic's onset. We employ the Leadership Trait Analysis to shed light on three main differences in their respective leadership styles: risk-proneness versus risk-aversion; flexibility versus rigidity and rule advocacy versus rule ambivalence. Crises are one of the more fruitful situations in which to study leaders as their personal characteristics become central to the decision-making process. Thus, we employ an agent-centred and political psychology approach to analyse leaders' behaviour and make sense of their divergent management styles. The results show that the differences between these leaders' approaches to handling this global health crisis can be partly explained by their level of openness to information and their task versus relationship focus.

Vulnerability, neglect, and collectivity in Brazilian favelas: Surviving the threats of the COVID-19 pandemic and the state's necropolitics

The COVID-19 pandemic has deepened existing inequities and injustices in Brazil, seen in the disproportionately detrimental impacts on favelas. State policy responses to the pandemic have disregarded favela residents' experiences. Recommendations such as 'shelter-in-place' ignore the reality of over 11.4 million favela residents who cannot work from home or afford to stop working, nor practise physical distancing from others. This study investigates the discourse of community organisations in favelas as they respond to the threats of the COVID-19 pandemic and the state's necropolitics. Community organisations in favelas have taken action to protect their residents from the virus, unemployment and hunger. I assess organisations' (1) justification to act as a collective in their communities, and (2) stances about the government's responses to the crisis. Through content analysis of social media, websites and media appearances of eight favela organisations and collectives in São Paulo and Rio de Janeiro, this study finds three main themes through which organisations justify their actions: vulnerability, neglect, and collectivity and care. More than survival strategies, the actions of favela organisations are counter-political acts as they oppose the decrepit necropolitics of the state by collectively enduring in the Brazilian context of the COVID-19 pandemic. Understanding favela organisations' actions in response to the pandemic is fundamental. It further illuminates the impact of public health emergencies in the lives of informal settlements' residents and the governance of public health emergencies in these communities.

One Pandemic, Two Solutions: Comparing the U.S.-China Response and Health Priorities to COVID-19 from the Perspective of "Two Types of Control"

After three years of global rampage, the COVID-19 epidemic, the most serious infectious disease to occur worldwide since the 1918 influenza pandemic, is nearing its end. From the global experience, medical control and social control are the two main dimensions in the prevention and control of COVID-19. From the perspective of "two types of control", namely medical control and social control, this paper finds that the political system, economic structure, and cultural values of the United States greatly limit the government's ability to impose social control, forcing it to adopt medical control to fight the virus in a single dimension. In contrast, China's political system, economic structure, and cultural values allow its government to adopt stringent, extensive, and frequent social control, as well as medical control to fight the virus. This approach departs from the traditional pathway of fighting the epidemic, i.e., "infection-treatment-immunization", thereby outpacing the evolution of the virus and controlling its spread more rapidly. This finding helps explain why the Chinese government adopted a strict "zeroing" and "dynamic zeroing" policy during the first three years, at the cost of enormous economic, social, and even political legitimacy. It was not until late 2022, when the Omicron variant with the waning virulence became prevalent, that China chose to "coexist" with the virus, thus avoiding a massive epidemic-related death. While the United States adopted a pulsed-style strategy at the beginning of the epidemic, i.e., "relaxation-suppression-relaxation-suppression", and began to "coexist" with the virus in just one year, resulting in a large number of excess deaths associated with the epidemic. The study contributes to explaining the difference in the interplay between public health priorities and COVID-19 response strategies in China and the United States, based on the specific public health context and the perspective of "medical control" and "social control".

COVID-19 vaccination and governance in the case of low, middle and high-income countries

BACKGROUND

Global crises, regardless of the place where they started to spread or of the factors that triggered them, require a comprehensive approach, primarily based on good communication, cooperation and mutual support. No individual and no institution should remain indifferent to crises but, on the contrary, be fully aware that any involvement in curbing them matters. Although humanity can be affected by various types of crises, in this paper we refer to the one related to COVID-19 pandemic. There are certain reasons that come to justify our choice: first of all, being a shock with a strong impact on people, its analysis should be performed from several angles; this may bring to light an image with its disparate propagation and measures to counteract it both in developed countries, and especially in those with a shortage of resources. Secondly, in the context of the emergence of vaccines against COVID-19, it is helpful to have an overview of COVID-19 through the lens of the relationship between the vaccination process and the elements that characterize governance, with a differentiated dashboard by country categories worldwide: low, middle and high-income countries. Our study is far from capturing the complexity arising from such social problem, but rather aims to outline the defining role of governance when it comes to providing firm reactions to the COVID-19 crisis.

METHODS

Given that our sample consists of a large number of countries, namely 170, first, examined all together, and then, split into three groups (high, middle and low-income), it is challenging to address governance in association with COVID-19 vaccination, in order to see how much they interact and how each of the six aggregate governance indicators of the World Bank (Worldwide Governance Indicators) is reflected in this process. Even if they do not oscillate strongly over relatively short periods of time, reporting on health issues requires a sequential inventory, considering closer time intervals, so as to be able to act promptly. Thus, to better distinguish how the COVID-19 vaccination process evolved in low, middle and high-income countries, but also how it was imprinted by governance, we present the situation quarterly (March, June, September and December), in 2021, the year when the immunization campaigns were the most intense at the global level. Regarding the applied methods, we mention both OLS regressions with robust estimators and a panel model, used to investigate the determinants of COVID-19 vaccination, some of them describing the good governance, as well as other dimensions.

RESULTS

The findings point out that the influence of governance on COVID-19 vaccination differs depending on whether a country belongs to high, middle or low-income typology: the strongest determinism of governance on vaccination is encountered in high-income countries, and the weakest in low-income ones; in some cases, governance does not matter significantly. However, exploring the three groups of states included in the research, it is observed that the most relevant factors in this relationship are government effectiveness, regulatory quality and control of corruption.

CONCLUSIONS

Besides the order of importance of governance indicators on COVID-19 vaccination, our study indicates that, overall, governance positively shapes the vaccination rate at the level of the chosen sample. In normative terms, these findings can be translated particularly by the fact that they can serve as information to raise awareness on the relevance of the existence of an institutional framework that allows the formulation of strategies according to the patterns of each country, especially since the actionable tools depend on the available resources. As a general conclusion, public policies should be designed in such a way as to strengthen trust in vaccination regulations and in governments, to reduce the multifaceted negative effects of this health crisis and to hope for its total end.

Impact of policy response on health protection and economic recovery in OECD and BRIICS countries during the early stages of the COVID-19 pandemic

OBJECTIVES

During the early stages of the COVID-19 pandemic, the full reopening of the economy typically accelerated viral transmission. This study aims to determine whether policy response could contribute to the dual objective of both reducing the spread of the epidemic and revitalising economic activities.

STUDY DESIGN

This is a longitudinal study of Organization for Economic Cooperation and Development (OECD) and Brazil, Russia, India, Indonesia, China, and South Africa (BRIICS) from the first quarter (Q1) of 2020 to the same period of 2021.

METHODS

From a health-economic perspective, this study established a framework to illustrate the following outcomes: suppression-prosperity, outbreak-stagnancy, outbreak-prosperity and suppression-stagnancy scenarios. Multinomial logistic models were used to analyse the associations between policy response with both the pandemic and the economy. The study further examined two subtypes of policy response, stringency/health measures and economic support measures, separately. The probabilities of the different scenarios were estimated.

RESULTS

Economic prosperity and epidemic suppression were significantly associated with policy response. The effects of policy response on health-economic scenarios took the form of inverse U-shapes with the increase in intensity. 'Leptokurtic', 'bimodal' and 'long-tailed' curves demonstrated the estimated possibilities of suppression-prosperity, outbreak-prosperity and suppression-stagnancy scenarios, respectively. In addition, stringency/health policies followed the inverted U-shaped pattern, whereas economic support policies showed a linear pattern.

CONCLUSIONS

It was possible to achieve the dual objective of economic growth and epidemic control simultaneously, and the effects of policy response were shaped like an inverse U. These findings provide a new perspective for balancing the economy with public health during the early stages of the pandemic.

Media representations of China amid COVID-19: A corpus-assisted critical discourse analysis

Although there has been an increasing number of studies investigating media representations of the COVID-19 outbreak around the world, less international attention has been given to Chinese media outlets’ coverage of the COVID-19 outbreak than that of their western counterparts. This study employs corpus-assisted critical discourse analysis to investigate how China is linguistically represented in a state-run English-language news media. The analysis reveals that China is respectively represented as a victim, a fighter, and a cooperative/supportive country with ideological implications for global solidarity and humanitarianism. This study sheds light on the effective use of discursive strategies in promoting international cooperation and building a national image amid a global health crisis. The value of using corpus-assisted critical discourse analysis to examine national image is also highlighted.

Indigenous peoples and the COVID-19 pandemic: a systematic scoping review

Past influenza pandemics including the Spanish flu and H1N1 have disproportionately affected Indigenous Peoples. We conducted a systematic scoping review to provide an overview of the state of understanding of the experience of Indigenous peoples during the first 18 months of the COVID-19 pandemic, in doing so we capture the state of knowledge available to governments and decision makers for addressing the needs of Indigenous peoples in these early months of the pandemic. We addressed three questions: (a) How is COVID-19 impacting the health and livelihoods of Indigenous peoples, (b) What system level challenges are Indigenous peoples experiencing, (c) How are Indigenous peoples responding? We searched Web of Science, Scopus, and PubMed databases and UN organization websites for publications about Indigenous peoples and COVID-19. Results were analyzed using descriptive statistics and content analysis. A total of 153 publications were included: 140 peer-reviewed articles and 13 from UN organizations. Editorial/commentaries were the most (43%) frequent type of publication. Analysis identified Indigenous peoples from 19 different countries, although 56% of publications were centered upon those in Brazil, United States, and Canada. The majority (90%) of articles focused upon the general adult population, few (<2%) used a gender lens. A small number of articles documented COVID-19 testing (0.04%), incidence (18%), or mortality (16%). Five themes of system level challenges affecting exposure and livelihoods evolved: ecological, poverty, communication, education and health care services. Responses were formal and informal strategies from governments, Indigenous organizations and communities. A lack of ethnically disaggregated health data and a gender lens are constraining our knowledge, which is clustered around a limited number of Indigenous peoples in mostly high-income countries. Many Indigenous peoples have autonomously implemented their own coping strategies while government responses have been largely reactive and inadequate. To 'build back better' we must address these knowledge gaps.

A qualitative descriptive study of the impact of the COVID-19 pandemic on staff in a Canadian intensive care unit

PURPOSE

We sought to explore the lived experiences of a professionally diverse sample of healthcare workers (HCWs) in a single intensive care unit (ICU) serving a large and generalizable Canadian population. We aimed to understand how working during the COVID-19 pandemic affected their professional and personal lives, including their perceptions of institutional support, to inform interventions to ameliorate impacts of the COVID-19 and future pandemics.

METHODS

In this qualitative descriptive study, 23 ICU HCWs, identified using convenience purposive sampling, took part in individual semistructured interviews between July and November 2020, shortly after the first wave of the pandemic in Ontario. We used inductive thematic analysis to identify major themes.

RESULTS

We identified five major themes related to the COVID-19 pandemic: 1) communication and informational needs (e.g., challenges communicating policy changes); 2) adjusting to restricted visitation (e.g., spending less time interacting with patients); 3) staffing and workplace supports (e.g., importance of positive team dynamics); 4) permeability of professional and personal lives (e.g., balancing shift work and childcare); and 5) a dynamic COVID-19 landscape (e.g., coping with constant change). The COVID-19 pandemic contributed to HCWs in the ICU experiencing varied negative repercussions on their work environment, including staffing and institutional support, which carried into their personal lives.

CONCLUSION

Healthcare workers in the ICU perceived that the COVID-19 pandemic had negative repercussions on their work environment, including staffing and institutional support, as well as their professional and personal lives. Understanding both the negative and positive experiences of all ICU HCWs working during the COVID-19 pandemic is critical to future pandemic preparedness. Their perspectives will help to inform the development of mental health and wellbeing interventions to support staff during the COVID-19 pandemic and beyond.

Global border restrictions in 2020-2021: Adherence and the effectiveness in long-term COVID-19 epidemic control

BACKGROUND

Restrictions on international travel were widely applied to contain cross-border COVID-19 diffusion, while such applications varied globally, and little was known about their impacts on the long-term epidemic progression.

METHODS

We explored the global diversity in maintaining border policies classified to four levels (screening, quarantine, ban on regions and total border closure) using data of 185 countries and regions between 01 January 2020 to 31 December 2021. By using Ordinary least squares (OLS) regression and quantile regression (QR) models, we examined the relationship between total COVID-19 incidence and the cumulative duration of each policy level in 2020-2021, and the heterogeneity of such association across different transmission severity countries.

RESULTS

Firstly, "ban on regions" was the most durable policy applied in high-income countries, while in low-income countries, less stringent measures of screening and quarantine arrivals were applied the longest. Secondly, the cumulatively longer maintenance of the border quarantine was significantly associated with lower infections (log) in COVID-19 high-prevalent countries (75th QR, coefficient estimates [β] = -0.0038, 95% confidence interval: -0.0066 to -0.0010). By contrast, in medium and high transmission severity countries, those with longer duration of imposing bans on regions showed no suppressing effects but significantly higher COVID-19 incidence (OLS regression, β = 0.0028, 95% CI: 0.0009-0.0047; 75th QR, β = 0.0039, 95% CI: 0.0014-0.0063). No other significant results were found.

CONCLUSION

From the long-term perspective, inbound quarantine was effective in mitigating severe epidemics. However, in countries with medium or high COVID-19 prevalence, our findings of ban on regions highlighted its ineffectiveness in the long-term epidemic progression.

Navigating the dual dilemma between lives, rights and livelihoods: COVID-19 responses in China, Singapore, and South Korea

The COVID-19 pandemic has created a dual dilemma for governments worldwide: between the protection of lives and of individual rights, and more long-term between safeguarding lives and preserving livelihoods. Taking a dynamic approach, this paper asks how different regime types have navigated this dual dilemma by adjusting their pandemic-response strategies over the course of time. Three case studies from East Asia are selected to represent different regime types—autocratic China, hybrid Singapore, and democratic South Korea—that share experience with previous coronavirus episodes. Comparing the three cases between late 2019 to mid-2022, remarkable differences are found in the adaptability of response strategies. China’s authoritarian regime appeared to be at a clear strategic advantage due to its indifference toward individual rights during the first COVID-19 wave. In the longer run, however, the picture has changed substantially. While China has exclusively prioritized the protection of lives, fixating on its “Zero-COVID” strategy, Singapore has attached at least equal weight to sustaining livelihoods, experiencing a drawn-out zigzagging before pivoting to a “Living with COVID” strategy. Among the three cases, only South Korea has made consistent efforts to protecting individual rights while gradually recalibrating lives and livelihoods. Over time, the high degree of responsiveness of South Korea’s democratic regime has allowed for a relatively smooth transition to coexisting with the virus. The paper concludes with some lessons that European democracies might learn from pandemic responses in East Asia in a longitudinal perspective.

E-government, political system and COVID-19 in Africa: lessons for future disruptive shocks

Purpose

This study aims to explore the role of mobile tracing applications as part of e-government services in combating the COVID-19 pandemic effects in Africa by analyzing the moderating role of sustainable development. This study also investigated the role of the political and economic systems in mitigating the negative consequences of COVID-19 and how e-government interacts in this relationship.

Design/methodology/approach

This study included the COVID-19 performance index for 94 countries belonging to different regions, including 20 African countries. Multiple linear regression was used for data analysis via Stata software. The study was conducted from the start of the pandemic to March 13, 2021.

Findings

The results show that less economically and technologically developed countries with generally authoritarian political systems, including African countries, could limit the spread of the pandemic better than some democratic, economically and technologically developed countries in the first wave of the pandemic. The promotion of sustainable development goals moderates the relationship between mobile tracing applications as part of the e-government service and the fight against COVID-19.

Originality/value

This study provides insight into the role of mobile application technology as an e-governance service in mitigating the negative consequences of the COVID-19 pandemic in a context characterized by economic limitations, fragile public health infrastructure and relatively high political instability, especially in Africa. The findings shed light on some of the difficulties African countries may face in incorporating technology into their development projects.

How insights from the field of information behavior can enrich understanding of knowledge mobilization

PURPOSE

The authors review the literature on information behavior, an autonomous body of work developed mainly in library studies and compare it with work on knowledge mobilization. The aim is to explore how information behavior can contribute to understanding knowledge mobilization in healthcare management.

DESIGN/METHODOLOGY/APPROACH

The authors conducted a narrative review using an exploratory, nonkeyword "double-sided systematic snowball" method. This is especially useful in the situation when the two traditions targeted are broad and relies on distinct vocabulary.

FINDINGS

The authors find that the two bodies of work have followed similar trajectories and arrived at similar conclusions, with a linear view supplemented first by a social approach and then by a sensitivity to practice. Lessons from the field of information behavior can be used to avoid duplication of effort, repeating the same errors and reinventing the wheel among knowledge translation scholars. This includes, for example, focusing on sources of information or ignoring the mundane activities in which managers and policymakers are involved.

ORIGINALITY/VALUE

The study is the first known attempt to build bridges between the field of information behavior and the study of knowledge mobilization. The study, moreover, foregrounds the need to address knowledge mobilization in context-sensitive and social rather than technical terms, focusing on the mundane work performed by a variety of human and nonhuman agents.

Impact of the COVID-19 on electricity consumption of open university campus buildings - The case of Twente University in the Netherlands

Since the COVID-19 outbreak, the restrictive policies enacted by countries in response to the epidemic have led to changes in the movement of people in public places, which has had a direct impact on the use and energy consumption of various public buildings. This study was based on electricity consumption data for 25 on-campus public buildings at 1-hour intervals between January 2020 and June 2022 at Tewnte University in the Netherlands, and after the data were climate-corrected by multiple regression analysis, the changes in EU and EUI for various types of buildings were compared for different restriction periods using ANOVA, LSD and t-tests. And additionally, further analyzed the changes and reasons for the electricity consumption of various public buildings on campus and customers' electricity consumption behavior in a period of time after the lifting of the epidemic restriction policy. The results of ANOVA analysis show that the restriction policy has a significant effect on teaching, sports, and cultural buildings, and the electricity intensity of the three types of buildings is reduced by 0.28, 0.09, and 0.07 kwh/m²/day respectively under the strict restriction policy; The t-test results show that during the restriction period, all building types, except for living and academic buildings, show a significant decreasing trend, with the teaching buildings having the greatest energy saving potential, with an average daily EU reduction of 1088kwh/day and an EUI reduction of 0.075kwh/ m²/day. The above findings provide a case study of a complete cycle of energy consumption changes in university buildings under similar epidemic restriction policies before and after the epidemic restriction, and inform the electricity allocation policies of university and government energy management authorities.

COVID-19 vaccines, mobility, and pandemic bureaucracies: Undocumented migrants' perspectives from Italy's Alpine border

While scholars have noted the deeply unequal effects of the pandemic containment, there has been limited attempt to map the socio-political lives of vaccination policies, particularly from the perspective of undocumented persons moving at state margins. This paper explores how undocumented migrants, who were predominantly male travellers attempting to cross Italy's Alpine borders, encountered Covid-19 vaccines and contemporary legislation. Based on ethnographic observations and qualitative interviews with migrants, doctors, and activists at safehouses both on the Italian and French sides of the Alpine border, we trace how mobility centred decisions to accept or reject vaccines were significantly shaped by exclusionary border regimes. We move beyond the exceptional focus of the Covid-19 pandemic to show how centring visions of health connected to viral risk diverted attention from migrants' wider struggles to move to obtain safety. Ultimately, we argue for a recognition of how health crises are not merely unequally experienced, but may result in the reconfiguration of violent governance practices at state borders.

A saúde em tempos de crise: lições a partir da Covid-19

Resumo: A pandemia da Covid-19 trouxe desafios à gestão pública de todo o mundo, sendo frequentes os debates sobre quais seriam as ações mais assertivas para o seu enfrentamento. Diante disso, este estudo teve como objetivo compreender os elementos que influenciaram no resultado do enfrentamento à pandemia por meio de uma revisão integrativa sistematizada de artigos nacionais e internacionais. Os resultados evidenciaram diversas tipologias de condicionantes do enfrentamento à Covid-19, que poderiam ser agregados em três categorias inter-relacionadas: conjuntura local, contexto organizacional e capacidades estatais. Estes elementos se concentram de forma dispersa ao longo dos territórios, ensejando estratégias, parcerias e instrumentos de cooperação para minimização dos danos à população. Os resultados do estudo avançam na literatura ao desvendar a complexidade do gerenciamento de crises desta magnitude, contribuindo para a criação de aprendizado e para a gestão do conhecimento em benefício do enfrentamento de crises de saúde futuras.

Learning lessons from the COVID-19 pandemic

This study examines the literature on learning lessons from the coronavirus disease 2019 (COVID-19) pandemic to make a conceptual and empirical contribution. The conceptual contribution suggests a simplified policy transfer framework for learning lessons from the proliferation of approaches involving an expanding and confusing mix of hypotheses, questions, criteria, domains, constructs, factors and criteria. This is then used to review the literature of lessons from COVID-19. This fuses the three reasons for transfer failure and the context-mechanism- outcome configuration of realist approaches to suggest three simple criteria of informed transfer (outcomes); complete transfer (mechanisms); and appropriate transfer (context). The empirical contribution suggests that it is difficult to learn lessons from the existing literature. The conceptual framework suggests that lessons about successful transfer involve a clear idea of policy success, understanding how the policy instrument or mechanism links with success in the original context, and how 'fungible' it is to the new context. Put another way, the 'COVID lessons industry' may itself need to learn that lessons about policy transfer should be informed, complete and appropriate.

Community Resilience and COVID-19: A Fuzzy-Set Qualitative Comparative Analysis of Resilience Attributes in 16 Countries

The COVID-19 pandemic has caused massive disruptions to governments and societies across the world. While public healthcare systems have come under immense pressure, public trust in governments and institutions are also in decline. In this paper, we seek to assess the resilience of policy systems and processes in 16 countries during the COVID-19 pandemic through the use of fuzzy-set Qualitative Comparative Analysis (fsQCA). We focus specifically on robustness, preparedness, social capital, and institutional strength as key attributes of community resilience at city-level. Our analysis of the data reveals that COVID-19 resilience is dependent on a combination of factors, with a multi-factorial approach to policy design and governance necessary for effective pandemic and disaster recovery.

Policy and Guideline Review of Vaccine Safety for COVID-19 in Pregnant Women in Southern Africa, with a Particular Focus on South Africa

Pregnant and lactating mothers have historically been excluded from clinical trials. To understand the shift from excluding to including this population in COVID-19 vaccine trials, we conducted a review of guidance issued by countries in southern Africa over the last three years. We conducted a review of documents and official statements recorded on Ministries of Health websites, and social media platforms, the World Health Organisation website, the COVID-19 Maternal Immunisation tracker and the African Union official webpage. Search terms included COVID-19 vaccination policies, guidelines for pregnant and lactating women, COVID-19 vaccination trials and pregnant women. We retrieved and reviewed policies, guidelines, and official statements from 12 countries. We found inconsistencies and incomplete guidance in respect to the inclusion of pregnant and lactating mothers in COVID-19 vaccine trials from the selected countries. Of the twelve countries reviewed, Namibia and South Africa had clear guidance on vaccination plans and implementation for pregnant women, and their inclusion in COVID-19 vaccine trials. Explicit and clear guidelines are critical in communicating changes in policy towards those deemed vulnerable for them to participate in vaccine trials. This review provides lessons for future pandemics on managing changes in guidance towards those groups historically excluded from vaccine and clinical trials.

Institutional Network Relationship of Chinese Public Crisis Governance System-Based on the Quantitative Comparative Analysis of Policies during SARS and COVID-19

After experiencing many public crisis events, such as SARS in 2003 and COVID-19 in 2020, the Chinese public crisis governance system has been improved from its initial state. The distribution structure and cooperation network among various government departments in China have become more complex. How to accurately clarify the relationship between the various departments in the existing governance system has become an important issue of the Chinese public crisis governance system. Based on the perspective of networked research, this article examines the network relationship between institutions in the Chinese public crisis governance system from the two dimensions of network centrality and network density. Using the bibliometric method to use public policies released in 2003 and 2020 as data samples and the two large-scale institutional reforms in 2003 and 2018 as the time nodes, this paper conducts a comparative analysis of the institutional network relationship of the Chinese public crisis governance system during different periods. The research shows that the network relationship among institutions in the Chinese public crisis governance system has changed from a centralized type to a diverse type; there is a trend of expansion in network relations; the legalization of governance networks is strengthened and the core of the network is transformed into the direct leadership of the Party Committee; and the overall network structure is experiencing a rational evolution.

Changes in Online Illegal Drug Buying during COVID-19: Assessing Effects due to a Changing Market or Changes in Strain using a Longitudinal Sample Design

This research uses longitudinal data to investigate if illegal online drug purchases changed over time during the COVID-19 pandemic, and if these changes were primarily driven by users adjusting to market conditions or by a heightened level of pandemic-induced strain that could drive a greater demand for drugs. Data were collected across four waves between fall 2019 and fall 2021 using an online survey. Data showed an increase in reported online drug purchases across the waves, but the online drug purchases remained consistent for the first year of the pandemic, but increased by approximately 44% between the fall 2020 and fall 2021 when over 13 percent of the sample admitted to buying illegal drugs online. Strain was also related to buying illegal drugs online as those respondents who made illegal online purchased had an average of 5.2 strain events in the past 12 months compared to only 2.4 events among those who did not report purchasing illegal drugs online. However, the influence of strain on online purchases remained consistent across time. These results suggest that the increase in online drug purchases was primarily driven by users adapting to changing market conditions rather than the cumulative strains associated with the pandemic producing a greater effect on purchases. Policy implications are also discussed.

Administrative characteristics and timing of governments' crisis responses: A global study of early reactions to COVID-19

In a crisis, fast reaction is key. But what can public administration tell us about this? This study develops a theoretical framework explaining how administrative characteristics, including fragmentation, capacities, legacies and learning, affect governments' response timing. The COVID-19 pandemic is exploited as a unique empirical setting to test this framework and its scope conditions. Region fixed-effects models and survival analysis of partly hand collected data for more than 150 national governments confirm some limited predictive power of administrative structures and traditions: Especially in developing countries, governments with a separate ministry of health adopted binding containment measures faster. Countries with hierarchical administrative traditions, for example, socialist, adopted some interventions like school closures faster than more liberal traditions, for example, Anglo-American. These characteristics increase threat perception and availability of a response, respectively. Results also suggest that intracrisis and intercrisis learning supply governments with response options. The study advances comparative public administration and crisis research.

Governance and planning in a 'perfect storm': Securitising climate change, migration and Covid-19 in Sweden

The article describes and reflects upon how multi-level governance and planning in Sweden have been affected by and reacted upon three pending major challenges confronting humanity, namely climate change, migration and the Covid-19 pandemic. These 'crises' are broadly considered 'existential threats' in need of 'securitisation'. Causes and adequate reactions are contested, and there are no given solutions how to securitise the perceived threats, neither one by one, no less together. Government securitisation strategies are challenged by counter-securitisation demands, and plaguing vulnerable groups in society by in-securitising predicaments. Taking Sweden as an example the article applies an analytical approach drawing upon strands of securitisation, governance and planning theory. Targeting policy responses to the three perceived crises the intricate relations between government levels, responsibilities, capacities, and actions are scrutinized, including a focus upon the role of planning. Overriding research questions are: How has the governance and planning system - central, regional and local governments - in Sweden responded to the challenges of climate change, migration and Covid-19? What threats were identified? What solutions were proposed? What consequences could be traced? What prospects wait around the corner? Comparing crucial aspects of the crises' anatomies the article adds to the understanding of the way multilevel, cross-sectional, hybrid governance and planning respond to concurrent crises, thereby also offering clues for action in other geopolitical contexts. The article mainly draws upon recent and ongoing research on manifestations of three cases in the Swedish context. Applying a pragmatic, methodological approach combining elements of securitisation, governance and planning theories with Carol Lee Bacchi's 'What is the problem represented to be' and a touch of interpretive/narrative theory, the study reveals distinct differences between the anatomies of the three crises and their handling. Urgency, extension, state of knowledge/epistemology, governance and planning make different imprints on crises management. Sweden's long-term climate change mitigation and adaptation strategies imply slow, micro-steps forward based on a combination of social-liberal, 'circular' and a touch of 'green growth' economies. Migration policy displays a Janus face, on the one hand largely respecting the UN refugee quota system on the other hand applying a detailed regulatory framework causing severe insecurity especially for minor refugees wanting to stay and make their living in Sweden. The Covid-19 outbreak revealed a lack of foresight and eroded/fragmented responsibility causing huge stress upon personnel in elderly and health care and appalling death rates among elderly patients, although governance and planning slowly adapted through securitising policies, leading to potential de-securitisation of the issue. The three crises have caused a security wake-up among governments at all levels and the public in general, and the article concludes by discussing whether this 'perfect storm' of crises will result in a farewell to neoliberalism - towards a neo-regulatory state facing further challenges and crises for governance, planning and the role of planners. The tentative prospect rather indicates a mixture of context-dependent 'hybrid governance', thus also underlining the crucial role of planners' role as 'chameleons' in complicated governance processes of politics, policy and planning.

Tracking changes in SARS-CoV-2 transmission with a novel outpatient sentinel surveillance system in Chicago, USA

Public health indicators typically used for COVID-19 surveillance can be biased or lag changing community transmission patterns. In this study, we investigate whether sentinel surveillance of recently symptomatic individuals receiving outpatient diagnostic testing for SARS-CoV-2 could accurately assess the instantaneous reproductive number R(t) and provide early warning of changes in transmission. We use data from community-based diagnostic testing sites in the United States city of Chicago. Patients tested at community-based diagnostic testing sites between September 2020 and June 2021, and reporting symptom onset within four days preceding their test, formed the sentinel population. R(t) calculated from sentinel cases agreed well with R(t) from other indicators. Retrospectively, trends in sentinel cases did not precede trends in COVID-19 hospital admissions by any identifiable lead time. In deployment, sentinel surveillance held an operational recency advantage of nine days over hospital admissions. The promising performance of opportunistic sentinel surveillance suggests that deliberately designed outpatient sentinel surveillance would provide robust early warning of increasing transmission.

SARS-CoV-2 and COVID-19: A Narrative Review

The World Health Organisation has reported that the viral disease known as COVID-19, caused by SARS-CoV-2, is the leading cause of death by a single infectious agent. This narrative review examines certain components of the pandemic: its origins, early clinical data, global and UK-focussed epidemiology, vaccination, variants, and long COVID.

Resilience of Health Systems: Understanding Uncertainty Uses, Intersecting Crises and Cross-level Interactions Comment on "Government Actions and Their Relation to Resilience in Healthcare During the COVID-19 Pandemic in New South Wales, Australia and Ontario, Canada"

The coronavirus disease 2019 (COVID-19) pandemic has created opportunities to study resilience in multiple, interrelated societal systems while considering the institutional, community and individual level. We aim to discuss critical, yet underrepresented, issues in resilience discourses which are fundamental to advance theories, concepts and measurement of health system resilience. These relate to a better understanding of (i) how government's handle and use uncertainties to facilitate or impede change, including the role of negotiation and conflicts, (ii) the intersections of health with multiple, co-occurring crises (systemic intersections), and (iii) cross-level interactions, ie, the interrelation between individual-level resilience, the collective resilience of groups and communities, and the resilience of a system as a whole (and vice versa). Analyses of these aspects can help to "contextualize" our understanding of resilience in complex adaptive systems. However, conceptual clarity is needed whether resilience is considered an underlying feature, outcome, or intermediate determinant of a (health) system's performance.

Exploring the relationship between national governance indicators and speed of initial government response to COVID-19 in low- and middle-income countries

Objectives

This study aimed to explore the relationship between national governance and country response to the COVID-19 pandemic in low- and middle-income countries, to support preparedness for the next pandemic. We conducted a statistical analysis of 116 countries, examining the relationship between speed of initial response and measures of national governance.

Study design

Observational study, with individual countries as the unit of analysis.

Methods

We used logistic regression to look for associations between quicker initial government response and four national governance indicators: Government Effectiveness, Political Stability and Absence of Violence/Terrorism, Voice and Accountability, and Corruption Perceptions Index.

Results

A quicker initial government response was associated with countries with higher Government Effectiveness (OR 13.92 95% CI 3.69-52.48, p < 0.001) and lower Political Stability and Absence of Violence/Terrorism (OR 0.23, 95% CI 0.09-0.57, p = 0.002). There was no relationship observed between speed of initial government response and Voice and Accountability or Corruption Perceptions Index. Other factors associated with quicker initial response were small population size, experiencing first COVID-19 case after the pandemic declaration, not having previous experience with SARS-CoV1 or MERS and not being an island nation.

Conclusions

This study shows that having higher state policy and implementation capacity, and lower political stability was associated with a quicker initial pandemic response. Limitations of this study include the use of crude national level indicators and broad categorisations of countries into quicker and slower responders. Deeper enquiry into the early decision-making processes taken at the national executive level within individual countries may help clarify the observed associations further.

How did the COVID-19 pandemic impact the wellbeing of family care-givers? A longitudinal study of older adults in Germany

Previous research was not able to identify an effect of the COVID-19 pandemic on family care-givers' wellbeing due to cross-sectional data structures, care-giver-specific samples or non-probability sampling designs. In this article, by drawing on longitudinal data from a random and representative sample of the German population aged 40 and older, we overcome methodological limitations of previous research. We examine the impact of the COVID-19 pandemic on the wellbeing (life satisfaction, depressive symptoms, loneliness) of different groups of family care-givers (new care-givers, continuous care-givers, past care-givers) and non-care-givers in Germany. We derived a balanced sample of n = 3,875 individuals aged 43–97 (mean = 66.5 years, standard deviation = 10.2 years) from the German Ageing Survey (DEAS) to explore changes in wellbeing between 2017 (pre-pandemic) and June/July 2020 (pandemic). Using a first-difference approach, we found that the pandemic has a negative impact on both non-care-givers' and family care-givers' wellbeing, with increased levels of depressive symptoms and loneliness compared to pre-pandemic times. Changes in depressive symptoms of family care-givers did not significantly deviate from non-care-givers. However, continuous care-givers showed more pronounced increases in loneliness compared to non-care-givers. Our results suggest that family care-givers' wellbeing merits particular attention when considering the long-term consequences of the COVID-19 pandemic on individuals' wellbeing.

Analysis of factors influencing public employees' work cognition under a public health crisis: A survey of China's response to COVID-19

The work cognition of public employees lays importance on tackling an escalating health crisis situation. At the micro-level and macro-level, different factors contribute to different degrees of public employees' work cognition. However, there are limited studies examining the work cognition of public employees and its influencing factors, particularly in situations such as a public health crisis. Our research takes China's response to COVID-19 as an example. The data have been taken from six Chinese provinces, Hunan, Hubei, Jiangsu, Shanxi, Henan, and Shandong, through a total of 738 questionnaires and telephonic interviews. Furthermore, this study used a logistic multiple regression model to analyze the factors that influenced the public employees' work cognition when working under a public health crisis. The results of our study showed that at a micro-level, the educational background, attitudes, and actions (initiative, responsibility, administrative capacity, and timeliness of feedback), and their level of concern with work influenced the work cognition of the public employees. At a macro-level, we found that it was the anti-epidemic measures that most influenced public employees' work cognition. Our findings provide important policy implications for emergency preparedness and handling of major emergencies, and have important reference value for the management of public employees and the improvement of national governance capabilities under similar major challenges in the future.

How Policy Mix Choices Affect the COVID-19 Pandemic Response Outcomes in Chinese Cities: An Empirical Analysis

Since January 2020, the COVID-19 pandemic has caused millions of deaths and has posed a major public health threat worldwide. Such a massive and complex crisis requires quick and comprehensive policy responses. We developed an empirical dataset of policy mixes that included 4915 policies across 36 Chinese cities and investigated the relationships between the policy design choices and the COVID-19 pandemic response outcomes of a city. Using topic modeling and ordinary least squares regression analysis, we found considerable variation among cities in the compositions and design features of their policy mixes. Our analysis revealed that restriction measures did not significantly influence limiting the spread of the pandemic, but they were negatively correlated with the economic growth rate. By contrast, health protection measures greatly contributed to controlling viral spread. Intensive socioeconomic support reduced the occurrence of secondary disasters. The most effective policy strategy to deal with the COVID-19 pandemic appears to be a comprehensive policy design with a mix of restrictions, health protection measures, and socioeconomic support policies accompanied by a timely lockdown. Our empirical findings can help to improve pandemic policy design and contribute to generating broader lessons for how local governments should deal with similar crises in the future.

The imperative of state capacity in public health crisis: Asia's early COVID-19 policy responses

Preexisting political institutions influence governments' responses to public health crises in different ways, creating national variations. This article investigates how state capacity, a country's fundamental ability to organize bureaucracy and allocate societal resources, affects the timing and configuration of governments' COVID-19 policy responses. Through comparative case study analysis of five of China's neighboring countries early in the COVID-19 crisis, the paper shows that more-capable states (Singapore, South Korea, Taiwan) initiated crisis response faster, mobilized national resources more extensively, and utilized diverse policy tools when the virus risk level was still low. In contrast, low-capacity states (Thailand and Indonesia) were more reactive in handling the crisis, limited their focus to border-related measures, and were more constrained in the types of tools they could employ. The paper points to the importance of studying the COVID-19 response process rather than the outcome (i.e., confirmed cases/deaths) when unpacking the impacts of political institutions in public health crises.

Effects of COVID-19 restriction measures in Indonesia: A comparative spatial and policy analysis of selected urban agglomerations

With higher densities, urban agglomerations account for the fastest rates of COVID-19 transmission. In Indonesia, one of the most rapidly urbanizing regions in the world, the national government issues overall policy on the pandemic. However, implementation is often contingent on local governments. Many policies aim to stem the spread of infection by controlling people's mobility or regulating their daily activities. Urban agglomerations are a strategic site of investigation in this light, because they consist of interconnected communities governed by various levels and jurisdictions. This paper analyzes the effects of policy interventions relative to confirmed cases in the seven major urban agglomerations in Indonesia (totaling 30 municipal/district governments). Data were collected from confirmed and fatality trends from March to mid-October 2020, which were contrasted with corresponding policies for each jurisdiction. By sorting the indicators of the spread of the pandemic and its corresponding control measures, we reach conclusions about which dimensions served to curb or trigger the surge of COVID-19 clusters. The analysis unsurprisingly shows that within each agglomeration, the main cities continue to represent the highest number of confirmed cases despite variations between them. This study also highlights two key findings. First, the effectiveness of distancing measures depends considerably on the capacity of governments to implement restrictions. For example, budget limitations resulted in uneven implementation of national mandates by decentralized authority. Facilities and services at different locations also influence our understanding of disease transmission. Second, people's ability and willingness to engage with a policy regime is contingent upon personal values or economic constraints. The study shows that viewing the spatial distribution of COVID-19 at the scale of urban agglomerations helps to explain key aspects of transmission and policy, pointing to recommendations about pursuing certain protocols. Nevertheless, key challenges remain to meet the full potential of this analytical approach, due to relatively low levels of testing and inadequate data collection measures in Indonesia.

Does Governance Quality Matter for the Selection of Policy Stringency to Fight COVID-19?

Independent of different national conditions, an indisputable fact is that the worldwide governments should play a role in fighting the ongoing COVID-19. To make clear the determinants of government response to tackle COVID-19, I investigate the impact of governance quality. To do so, I newly create an overall governance index based on six dimensions of Worldwide Governance Indicators (WGI) from the World Bank to proxy governance quality. I regress the overall governance index with controls on the stringency index from the Oxford COVID-19 Government Response Tracker database. Using pooled and panel data models with individual and time fixed effects, I find that the relationship between governance quality and policy stringency for 339 days across 163 countries is significantly nonmonotonic. Countries with middle governance quality select a high level of policy stringency in contrast to those with high and low governance quality. I also find that policy stringency significantly increases when daily new cases increase. The findings highlight the role of governance quality in deciding the stringency level of public health policies.

Developing a mental health index using a machine learning approach: Assessing the impact of mobility and lockdown during the COVID-19 pandemic

Governments worldwide have implemented stringent restrictions to curtail the spread of the COVID-19 pandemic. Although beneficial to physical health, these preventive measures could have a profound detrimental effect on the mental health of the population. This study focuses on the impact of lockdowns and mobility restrictions on mental health during the COVID-19 pandemic. We first develop a novel mental health index based on the analysis of data from over three million global tweets using the Microsoft Azure machine learning approach. The computed mental health index scores are then regressed with the lockdown strictness index and Google mobility index using fixed-effects ordinary least squares (OLS) regression. The results reveal that the reduction in workplace mobility, reduction in retail and recreational mobility, and increase in residential mobility (confinement to the residence) have harmed mental health. However, restrictions on mobility to parks, grocery stores, and pharmacy outlets were found to have no significant impact. The proposed mental health index provides a path for theoretical and empirical mental health studies using social media.

The "Inherent Vices" of Policy Design: Uncertainty, Maliciousness, and Noncompliance

Policy designs must not only "work" in the sense of accomplishing their goals but must also work in their intended fashion. Most research to date has focused on the former topic and dwells on the technical aspects of how various tools and instruments could be utilized to achieve the aims and goals of policymakers. This branch of research tends to underemphasize the difficulties inherent to policy making including policy contexts that are often highly uncertain, policymakers who fall short of an idealized version of high capacity, well-intentioned decisionmakers grappling with relevant public problems, and policy-takers who fail to comply with government wishes. These "inherent vices" of policy making are factors which contribute to policy volatility or the risk of policy failure. The paper stresses the need for improved risk management and mitigation strategies in policy formulation and policy designs to take these risks into account. It sets out and develops an approach borrowed from product failure management (in manufacturing) and portfolio management (in finance) to help better assess and manage these risks.

Public perceptions during the first wave of the COVID-19 pandemic in Canada: a demographic analysis of self-reported beliefs, behaviors, and information acquisition

Introduction

We explored associations between sociodemographic factors and public beliefs, behaviors, and information acquisition related to the coronavirus disease 2019 (COVID-19) to identify how the experiences of subpopulations in Canada may vary.

Methods

We administered a national online survey through Ipsos Incorporated to adults residing in Canada. Sampling was stratified by population age, sex, and regional distributions. We used descriptive statistics to summarize responses and test for differences based on gender, age, educational attainment, and household income using chi-squared tests, followed by weighted logistic regression.

Results

We collected 1996 eligible questionnaires between April 26th and May 1st, 2020. Respondents mean age was 50 years, 51% were women, 56% had a post-secondary degree, and 72% had a household income <$100,000. Our analysis found differences within the four demographic groups, with age effects most acutely evidenced. Respondents 65 years and older were more likely to perceive the pandemic as very serious, less likely to report declines in overall health, and more likely to intend to get vaccinated, compared to 18–29 year olds. Women overall were more likely to report negative outcomes than men, including stress due to the pandemic, and worsening social, mental/emotional, and spiritual health. Respondents 45 and older were more likely to seek and trust information from traditional Canadian news sources, while 18-29 year olds were more likely to seek and trust information on social media; overall, women and respondents with a post-secondary degree were more likely to access and trust online information from public health sites.

Conclusion

This study found important demographic differences in how adults living in Canada perceived the COVID-19 pandemic, the impacts on their health, and their preferences for information acquisition. Our results highlight the need to consider demographic characteristics in tailoring the format and information medium to improve large scale acceptance and uptake of mitigation and containment measures.

In trust we trust: The impact of trust in government on excess mortality during the COVID-19 pandemic

The COVID-19 pandemic has brought forward myriad challenges to public policy, central of which is understanding the different contextual factors that can influence the effectiveness of policy responses across different systems. In this article, we explore how trust in government can influence the ability of COVID-19 policy responses to curb excess mortality during the pandemic. Our findings indicate that stringent policy responses play a central role in curbing excess mortality. They also indicate that such relationship is not only influenced by systematic and structural factors, but also by citizens' trust in government. We leverage our findings to propose a set of recommendations for policymakers on how to enhance crisis policymaking and strengthen the designs of the widely used underlying policy learning processes.

Water Quality and Water Pollution in Time of COVID-19: Positive and Negative Repercussions

On 11 March 2020, the World Health Organization declared the new COVID-19 disease a pandemic. Most countries responded with a lockdown to reduce its effects, which brought beneficial consequences to the environment in many regions, but the pandemic also raised a series of challenges. This review proposes an assessment of the COVID-19 pandemic positive and negative impacts on water bodies on different continents. By applying a search protocol on the Web of Science platform, a scientific bank of 35 compatible studies was obtained out of the 62 open-access articles that were initially accessible. Regarding the positive impacts, the SARS-CoV-2 monitoring in sewage waters is a useful mechanism in the promptly exposure of community infections and, during the pandemic, many water bodies all over the world had lower pollution levels. The negative impacts are as follows: SARS-CoV-2 presence in untreated sewage water amplifies the risk to human health; there is a lack of adequate elimination processes of plastics, drugs, and biological pollution in wastewater treatment plants; the amount of municipal and medical waste that pollutes water bodies increased; and waste recycling decreased. Urgent preventive measures need to be taken to implement effective solutions for water protection.

Dynamic governance of the first wave of Covid-19 in Tunisia: An interoperability analysis

This study proposes an interoperability index of the measures taken by the Tunisian government during the first wave of the coronavirus disease 2019 (COVID‐19) pandemic. In the first part, we present the process of decision making as a revised and adjusted process in continuous upgrading, based on the dynamic governance process in times of crisis. In the second part, we estimate an index that records the strictness of government policies in each subperiod and the degree of interoperability between the Tunisian pandemic responses against COVID‐19 using subperiod instantiations. Our empirical findings show that the pandemic management strategy in Tunisia during the first wave was adjusted by incorporating new pandemic policies and changing the stringency levels over time. After estimating the interoperability index, we found that the measures taken early in a subperiod interact directly with the next successive subperiod in the decision process, but they interact indirectly with other successive subperiods.

The pandemic management strategy in Tunisia during the first wave has been adjusted by incorporating new pandemic policies and changing the stringency levels over time.

Tunisia has reached the highest level of the strictness of government policies, after 18 days of initial responses taken during the first wave in a stepwise manner.

The measures taken early in a subperiod interact directly with the next successive subperiod in the decision‐making process, but they interact indirectly with other successive subperiods.

Pandemic crisis cannot be managed or defeated with a single measure or policy, even at the highest stringency level. Instead, it is managed with several policy responses that interreact together over time.

The establishment of a dynamic and flexible decision‐making process can be useful in managing a future health crisis in countries whose public health systems suffer from several shortcomings.

Characterizing the Dynamic Evolution of Interagency Collaborative Decision-Making Networks in Response to COVID-19 in China: A Policy Document Analysis

Collaborative decision-making across multiple government agencies is considered a critical and effective strategy to combat public health crisis; however, we know little about how the collaborative decision-making works and evolves during periods of crisis. To fill this lacuna, this study uncovers the structure and evolving dynamics of the network by employing a policy document analysis. Based on the policy documents, jointly issued by the agencies of Chinese central government in four phases regarding COVID-19 control, we first constructed a co-occurrence matrix of policy-issuing agencies to outline the network structure, then drew a breadth–depth matrix to identify the role evolution of agencies, and lastly built a two-mode network consisting of policy topics and agencies to determine the evolution mechanisms of policy attentions for each agency. It was found that the network structure of interagency collaboration involves three forms: discrete structure in the early phase, subgroup structure in the middle phase, and connected structure in the latter phase. Agencies embedded in the network can be categorized into three types: leading agencies, key agencies, and auxiliary agencies, with their constituent members changed as the pandemic risks are gradually becoming under control. Furthermore, each type has its own primary policy attentions, but shares some common foci in all four phases and shifts attention in the emergency management process. This study contributes to shedding light on the formation of and variations in collaborative networks in health emergencies and provides policy implications for other countries that have struggled against COVID-19.

Depressive symptoms in higher education students during the COVID-19 pandemic: the role of containment measures

Background

Students are a vulnerable group for the indirect impact of the COVID-19 pandemic, particularly their mental health. This paper examined the cross-national variation in students’ depressive symptoms and whether this can be related to the various protective measures implemented in response to the initial stage of the COVID-19 outbreak.

Methods

Student data stem from the COVID-19 International Student Well-being Study, covering 26 countries during the first wave of the COVID-19 pandemic. Country-level data on government responses to the COVID-19 pandemic were retrieved from the Oxford COVID-19 Tracker. Multilevel analyses were performed to estimate the impact of the containment and economic support measures on students’ depressive symptoms (n = 78 312).

Results

School and workplace closures, and stay-at-home restrictions were positively related to students’ depressive symptoms during the COVID-19 pandemic, while none of the economic support measures significantly related to depressive symptoms. Countries’ scores on the index of these containment measures explained 1.5% of the cross-national variation in students’ depressive symptoms (5.3%). This containment index’s effect was stable, even when controlling for the economic support index, students’ characteristics, and countries’ epidemiological context and economic conditions.

Conclusions

Our findings raise concerns about the potential adverse effects of existing containment measures (especially the closure of schools and workplaces and stay-at-home restrictions) on students’ mental health.