Nordic welfare states-still standing or changed by the COVID-19 crisis?

The knowns and unknowns of long COVID-19: from mechanisms to therapeutical approaches

The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been defined as the greatest global health and socioeconomic crisis of modern times. While most people recover after being infected with the virus, a significant proportion of them continue to experience health issues weeks, months and even years after acute infection with SARS-CoV-2. This persistence of clinical symptoms in infected individuals for at least three months after the onset of the disease or the emergence of new symptoms lasting more than two months, without any other explanation and alternative diagnosis have been named long COVID, long-haul COVID, post-COVID-19 conditions, chronic COVID, or post-acute sequelae of SARS-CoV-2 (PASC). Long COVID has been characterized as a constellation of symptoms and disorders that vary widely in their manifestations. Further, the mechanisms underlying long COVID are not fully understood, which hamper efficient treatment options. This review describes predictors and the most common symptoms related to long COVID's effects on the central and peripheral nervous system and other organs and tissues. Furthermore, the transcriptional markers, molecular signaling pathways and risk factors for long COVID, such as sex, age, pre-existing condition, hospitalization during acute phase of COVID-19, vaccination, and lifestyle are presented. Finally, recommendations for patient rehabilitation and disease management, as well as alternative therapeutical approaches to long COVID sequelae are discussed. Understanding the complexity of this disease, its symptoms across multiple organ systems and overlapping pathologies and its possible mechanisms are paramount in developing diagnostic tools and treatments.

Income and Career Concerns Among Emerging Adults From Finland, Sweden, and the United Kingdom During COVID-19

In this study, we examine the prevalence of income and career concerns among emerging adults in three different welfare states during COVID-19: Finland (n = 309), Sweden (n = 324), and the United Kingdom (n = 343). This study also delves into how factors such as one's self-perceived financial situation, generalized mistrust, loneliness and socio-demographics are related to emerging adults' income and career concerns. Results showed that individuals from the United Kingdom were more likely to experience increased income and career concerns than those in Finland and Sweden. Our results also suggest that income concerns were associated with one's current financial situation, future financial situation, childhood financial situation, and loneliness. Also, career concerns were related to generalized mistrust, loneliness, and age. For both country-specific and general analyses, loneliness emerged as the most important for increased income and career concerns for emerging adults in all three countries.

Handling Public's Well-being during the COVID-19 Crisis: An Empirical Study with Municipalities' Representatives in Sweden

BACKGROUND

COVID-19 had a significant impact on the public's health and well-being due to infections and restrictions imposed during the crisis. Recreational activities are important for the public's well-being, however comes in second in relation to the public's safety from the COVID-19 virus. In Sweden, a country with a decentralized public health and welfare system relied on less stringent approaches for handling the crisis. The limited restrictions of Sweden allowed the recreational activities to take place despite the pandemic, which could be attributed to considerations for the public's well-being.

OBJECTIVE

The objective of this study is to investigate municipal approaches for handling and supporting recreational activities during the COVID-19 crisis.

METHODS

We conducted an empirical study (qualitative and quantitative), using an online survey for data collection, with 23 participants. They were representatives holding mostly managerial roles, from 18 distinct municipalities (of 18 counties). A thematic analysis was conducted to analyze open-ended responses, and descriptive statistics was used as a method to summarize the close-ended responses.

RESULTS

In this study, we report on the status of municipalities during the COVID-19 pandemic. The highlighted results show a significant impact on the municipalities as a result of COVID-19, where 78.3% of participants state significant changes due to the pandemic. 88.9% indicate efforts and approaches for supporting recreational activities during COVID-19. Following national guidelines for public's health and safety is indicated by 78.3%. Information and Communications Technologies (ICTs) were considered significant for dealing with COVID-19 as per 87% of participants. Our qualitative results further show details of public's health and safety considerations, efforts to support recreational activities particularly for youth, and ICTs role and requirements. Challenges relating to the usability of ICTs were also highlighted.

CONCLUSIONS

Despite the critique of Sweden's lenient strategy of handling the COVID-19 crisis, our results show significant considerations for both the public's safety and well-being by the municipalities (additionally on a regional and local levels) in this study. Trusting the public with safety guidelines in addition to efforts for publics' safety, supporting public's well-being with approaches for maintaining recreational activities, and giving special care to youth, was the Swedish approach to handling the crisis. Despite having technological solutions in place, challenges using digital solutions and requirements for future development are noted.

CLINICALTRIAL

None.

Exploring the Process of Policy Overreaction: The COVID-19 Lockdown Decisions

Policy overreaction is a common phenomenon, especially in complex and emergency situations where politicians are led to make decisions fast. In these emergency decisions, emotions run generally high and cognitive processes are often impaired. The conditions of policy overreaction are in place as emotions overwhelm decision makers' rational processes. Drawing on the response patterns of three countries to the COVID-19 pandemic, we develop a process model of policy overreaction which describes the effects of negative emotions and institutional isomorphism on policy decision-making. Our model highlights four critical stages: negative emotions buildup, propagation of fear, isomorphic decision-making, and leading to an intractable crisis. This article shows precisely how the cascading effect of negative emotions, particularly fear, is contagious and spreads to generate crowd effects, which bend considerably policy makers' ability to make rational decisions. Our theory provides a better understanding of the process by which policy overreaction takes place.

Laws, Policies, and Collective Agreements Protecting Low-wage and Digital Platform Workers During the COVID-19 Pandemic

In the context of the COVID-19 pandemic, this commentary describes and compares shifting employment and occupational health social protections of low-wage workers, including self-employed digital platform workers. Through a focus on eight advanced economy countries, this paper identifies how employment misclassification and definitions of employees were handled in law and policy. Debates about minimum wage and occupational health and safety standards as they relate to worker well-being are considered. Finally, we discuss promising changes introduced during the COVID-19 pandemic that protect the health of low-wage and self-employed workers. Overall, we describe an ongoing “haves” and a “have not” divide, with on the one extreme, traditional job arrangements with good work-and-health social protections and, on the other extreme, low-wage and self-employed digital platform workers who are mostly left out of schemes. However, during the pandemic small and often temporary gains occurred and are discussed.

The Nordic governments' responses to the Covid-19 pandemic: A comparative study of variation in governance arrangements and regulatory instruments

Government responses to the Covid-19 pandemic in the Nordic states-Denmark, Finland, Iceland, Norway, and Sweden-exhibit similarities and differences. This article investigates the extent to which crisis policymaking diverges from normal policymaking within the Nordic countries and whether variations between the countries are associated with the role of expertise and the level of politicization. Government responses are analyzed in terms of governance arrangements and regulatory instruments. Findings demonstrate some deviation from normal policymaking within and considerable variation between the Nordic countries, as Denmark, Finland, and to some extent Norway exhibit similar patterns with hierarchical command and control governance arrangements, while Iceland, in some instances, resembles the case of Sweden, which has made use of network-based governance. The article shows that the higher the influence of experts, the more likely it is that the governance arrangement will be network-based.

Who spends more to combat COVID-19 social risks and why?

COVID-19 has gone beyond a public health crisis and poses a serious threat to people's livelihoods. In response to the growing employment and income crisis, most OECD countries have introduced various policies and programs to alleviate rapidly rising social risks and stabilise people's livelihoods. However, these measures vary, with some governments spending only 1% of GDP in 2020, while others spent more than 10%. We conducted a multiple regression analysis to examine factors associated with the level of additional social spending in 31 OECD countries. The results indicate that lower generosity of unemployment benefits was associated with additional social policy spending. However, contrary to the hypothesis, higher additional spending was found among countries with higher levels of government debt. We ended with policy recommendations.

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans’ social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.

Ideological Dilemmas Actualised by the Idea of Living Environmentally Childfree

Over the past decade, the choice of living childfree has increasingly been viewed as a pro-environmental behaviour. Recent research has investigated statistical relations between environmental concern and reproductive attitudes, as well as exploring the processes around actually deciding to live environmentally childfree. Based on increased public attention about the phenomenon, this article employs Michael Billig’s notion of ideological dilemmas to analyse the media coverage of choosing to live environmentally childfree, attempting to answer how these dilemmas influence whether living childfree is perceived as a relevant pro-environmental behaviour. Thirty-one news items were analysed using a synthesis of critical discursive psychology and thematic analysis. The analysis identified five ideological concepts: liberalism, sustainable development, globalism, biologism and humanism. Each of these concepts contains positions supporting and opposing the idea of living environmentally childfree in Norway. These ideological dilemmas seem to weaken the perceived relevance of living environmentally childfree, as the topic is easily dismissed or framed as irrelevant. I therefore conclude that the discourse of living environmentally childfree is analogous to how society generally relates to solutions to the environmental crises.

Social policy in the face of a global pandemic: Policy responses to the COVID-19 crisis

How have welfare states responded to the coronavirus pandemic? In this introductory article, we provide a synopsis of papers that comprise this special issue on social policy responses to COVID-19, an overview of some of the key questions they raise, and some provisional answers to these questions. Our conclusions are threefold: first, these social policy responses, while entailing new developments in many countries, nonetheless reflect, at least in part, existing national policy legacies. Second, these responses can be understood as a form of "emergency Keynesianism," which is characterized by the massive use of deficit spending during economic crises, with the aim of to supporting rather than challenging core capitalist institutions. Third, there are clear differences in terms of the nature of the reforms enacted during the initial phase of the COVID-19 crisis as compared to reforms enacted as a response to the 2008 financial crisis.

How did Sweden Fail the Pandemic?

Sweden has since the start of the pandemic a COVID-19 mortality rate that is 4 to 10 times higher than in the other Nordic countries. Also, measured as age-standardized all-cause excess mortality in the first half of 2020 compared to previous years Sweden failed in comparison with the other Nordic countries, but only among the elderly. Sweden has large socioeconomic and ethnic inequalities in COVID-19 mortality. Geographical, ethnic, and socioeconomic inequalities in mortality can be due to differential exposure to the virus, differential immunity, and differential survival. Most of the country differences are due to differential exposure, but the socioeconomic disparities are mainly driven by differential survival due to an unequal burden of comorbidity. Sweden suffered from an unfortunate timing of tourists returning from virus hotspots in the Alps and Sweden's government response came later and was much more limited than elsewhere. The government had an explicit priority to protect the elderly in nursing and care homes but failed to do so. The staff in elderly care are less qualified and have harder working conditions in Sweden, and they lacked adequate care for the clients. Sweden has in recent years diverged from the Scandinavian welfare model by strong commercialization of primary care and elderly care.