The COVID‐19 crisis and complexity: A soft systems approach

A systematic review of the case findings, testing and management of COVID-19

Background: Mass testing and adequate management are essential to terminate the spread of coronavirus disease 2019 (COVID-19). This testing is due to the possibility of unidentified cases, especially ones without COVID-19 related symptoms. This review aimed to examine the outcome of the existing studies on the ways of identifying COVID-19 cases, and determine the populations at risk, symptom and diagnostic test management of  COVID-19.

Methods: The articles reviewed were scientific publications on the PubMed, Science Direct, ProQuest, and Scopus databases. The keywords used to obtain the data were COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and case detection, case management or diagnostic test. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Population, Intervention, Control and Outcomes (PICO) approaches.

Results: A total of 21 articles from 13 countries met the inclusion criteria and were further analyzed qualitatively. However, 62% of the articles used a rapid antibody test for screening rather than a rapid antigen test. According to the rapid antigen test, 51.3% were positive, with men aged above 50 years recording the highest number of cases. Furthermore, 57.1% of patients were symptomatic, while diagnostic tests' sensitivity and specificity increased to 100% in 14 days after the onset.

Conclusions:  Real-time polymerase chain reaction (RT-PCR)  is recommended by the World Health Organization for detection of COVID-19. Suppose it is unavailable, the rapid antigen test is used as an alternative rather than the rapid antibody test. Diagnosis is expected to be confirmed using the PCR and serological assay to achieve an early diagnosis of COVID-19, according to disease progression, gradual rapid tests can be used, such as rapid antigen in an earlier week and antibody tests confirmed by RT–PCR and serological assay in the second week of COVID-19.

Understanding and strengthening wildlife and zoonotic disease policy processes: A research imperative

The COVID-19 pandemic highlights the urgency and importance of monitoring, managing and addressing zoonotic diseases, and the acute challenges of doing so with sufficient inter-jurisdictional coordination in a dynamic global context. Although wildlife pathogens are well-studied clinically and ecologically, there is very little systematic scholarship on their management or on policy implications. The current global pandemic therefore presents a unique social science research imperative: to understand how decisions are made about preventing and responding to wildlife diseases, especially zoonoses, and how those policy processes can be improved as part of early warning systems, preparedness and rapid response. To meet these challenges, we recommend intensified research efforts towards: (i) generating functional insights about wildlife and zoonotic disease policy processes, (ii) enabling social and organizational learning to mobilize those insights, (iii) understanding epistemic instability to address populist anti-science and (iv) anticipating evolving and new zoonotic emergences, especially their human dimensions. Since policy processes for zoonoses can be acutely challenged during the early stages of an epidemic or pandemic, such insights can provide a pragmatic, empirically-based roadmap for enhancing their robustness and efficacy, and benefiting long-term decision-making efforts.

What are we saving? Tracing governing knowledge and truth discourse in global COVID-19 policy responses

As the world went suddenly into lockdown due to the COVID-19 pandemic, sending individuals to their homes and shutting businesses and institutions, the closing of schools posed big problems. The majority of the world's children were out of school, leading to the longest sustained period of school closures in history. We saw educators turning towards responses not aimed at collegial and community-engaged strategies for education in an emergency but at online learning cast as education/business as usual. This study explores the logic driving this global response through analyses of the documents released by three key global education actors: (1) the OECD and its paper A Framework to Guide Education Response to the COVID-19 Pandemic of 2020; (2) UNESCO's Global Education Coalition #LearningNeverStops; and (3) the World Bank's Guidance Note on Education Systems' Response to COVID-19; and Guidance Note: Remote Learning and COVID-19. The authors of this article draw on Carol Bacchi's approach to poststructural policy analysis to make visible the key concepts and binaries used within policy texts and to understand the "technologies of saving" that were invoked in each policy response, locating the education programmes, activities and actors within knowledge practices in educational reform. This article explores the World Bank, OECD and UNESCO responses using an analysis of knowledge harmonisation and difference among these institutions as well as their location as key norm-setters and governing actors in the field of education. The authors argue that all three responses privilege private-sector providers of digital technology. The consequence of these responses is that technologies of saving have centred on privatised, corporate edu-business and edu-tech aimed at online education delivery, bringing significant risks for the erasure of local knowledges. The authors' study suggests that local policymakers, including community-based and national actors, must be invited into the discussion to envision other possibilities and to name the potential destructiveness embedded in the international organisations' actions.