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

Is society caught up in a Death Spiral? Modeling societal demise and its reversal

Just like an army of ants caught in an ant mill, individuals, groups and even whole societies are sometimes caught up in a Death Spiral, a vicious cycle of self-reinforcing dysfunctional behavior characterized by continuous flawed decision making, myopic single-minded focus on one (set of) solution(s), denial, distrust, micromanagement, dogmatic thinking and learned helplessness. We propose the term Death Spiral Effect to describe this difficult-to-break downward spiral of societal decline. Specifically, in the current theory-building review we aim to: (a) more clearly define and describe the Death Spiral Effect; (b) model the downward spiral of societal decline as well as an upward spiral; (c) describe how and why individuals, groups and even society at large might be caught up in a Death Spiral; and (d) offer a positive way forward in terms of evidence-based solutions to escape the Death Spiral Effect. Management theory hints on the occurrence of this phenomenon and offers turn-around leadership as solution. On a societal level strengthening of democracy may be important. Prior research indicates that historically, two key factors trigger this type of societal decline: rising inequalities creating an upper layer of elites and a lower layer of masses; and dwindling (access to) resources. Historical key markers of societal decline are a steep increase in inequalities, government overreach, over-integration (interdependencies in networks) and a rapidly decreasing trust in institutions and resulting collapse of legitimacy. Important issues that we aim to shed light on are the behavioral underpinnings of decline, as well as the question if and how societal decline can be reversed. We explore the extension of these theories from the company/organization level to the society level, and make use of insights from both micro-, meso-, and macro-level theories (e.g., Complex Adaptive Systems and collapsology, the study of the risks of collapse of industrial civilization) to explain this process of societal demise. Our review furthermore draws on theories such as Social Safety Theory, Conservation of Resources Theory, and management theories that describe the decline and fall of groups, companies and societies, as well as offer ways to reverse this trend.

Consequences of the Early Phase of the COVID-19 Pandemic for Home-Healthcare Recipients in Norway: A Nursing Perspective

Municipal home-healthcare services are becoming increasingly important as growing numbers of people are receiving healthcare services in their home. The COVID-19 pandemic represented a challenge for this group, both in terms of care providers being restricted in performing their duties and care receivers declining services for fear of being infected. Furthermore, preparedness plans were not always in place. The purpose of this study is to investigate the consequences for recipients of home healthcare in Norway of the actual level of COVID-19 infection spread in the local population, as observed by licensed nurses working in home-healthcare services. Approximately 2100 nurses answered the survey. The most common adverse consequences for home-healthcare recipients were increased isolation and loneliness, increased health concerns, and the loss of respite care services. An increased burden for relatives/next of kin and fewer physical meetings with service providers were frequently observed and reported as well. This study shows that there were more adverse consequences for service users in municipalities with higher levels of contagion than in those with lower levels of contagion. This indicates that the municipalities adapted measures to the local rate of contagion, in line with local municipal preparedness strategies.