Democracy, Capacity, and Coercion in Pandemic Response: COVID-19 in Comparative Political Perspective

Justifications and acceptability of coercive public health measures in the COVID-19 response in South Africa: a case study of the jurisprudence of human rights cases

South Africa implemented a comprehensive response to COVID-19 comprising of several coercive public health measures. As in many countries, COVID-19 measures were subject to a number of legal challenges on the grounds that these measures infringed on individual rights and liberties. Here, courts were required to assess the extent to which these limitations were justifiable against the state's imperative to improve public health. Consequently, the acceptability of different justifications of coercive public health measures during the COVID-19 pandemic in South Africa may be understood and assessed through the lens of its jurisprudence. This paper seeks to outline the approach to allowing, or disallowing, coercive public health measures as adopted by the judiciary as arbiters of allowable human rights infringements and thus permitting or prohibiting the state from exercising coercive powers. Specifically, this analysis aims to identify the principles underpinning the decisions with an expressly ethical lens with a view to providing content for the operationalisation of justifications for coercive state action such as the harm principle, reciprocity, least restrictive means in relation to the promotion of public health and the limitation of individual liberty.

Information Seeking and Avoidance in the COVID-19 Pandemic as a Function of Political Ideology and National Context: A Survey Comparing the US and Germany

The COVID-19 pandemic sparked a globally heightened need for scientific information. At the same time, the abundance of information led to tendencies of media fatigue and information avoidance. Both information seeking and avoidance are embedded in a specific national context, in which conditions of and measures against the pandemic may differ dramatically. In addition, the pandemic quickly became entangled with political ideology. Using the Risk Information Seeking and Processing Model (RISP) as a theoretical background, we investigate the role of national context and political ideology for information seeking and avoidance in a comparative survey in the U.S. and Germany during the early phase of the pandemic. Results show that the factors predicting information behavior are effective in both countries with only few differences: In both countries, perceived hazard characteristics, information norms and perceived information gathering capacity were related to higher information seeking and lower information avoidance. Ideology too is an important influence: Right-leaning ideology was associated with lower levels of information norms in both countries; but only in the US was right-leaning ideology connected to less perceived hazard characteristics and less negative affective responses. Results are discussed regarding their implications for the RISP model.

State capacity impact on COVID-19 mortality in Brazil

This study addresses the State's capacity to combat the COVID-19 pandemic and contributes to the literature on crisis management in health care. We analyzed whether the capacity level impacted the State response to COVID-19 in Brazilian healthcare regions in 2020 using a set of statistical analysis techniques and public health impact analysis, including propensity score matching (PSM). Results revealed that a low COVID-19 mortality was associated with participation in municipal health consortia, schooling level of municipal health managers and the resources allocated by the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ). Conversely, the number of intensive care units (ICU) and life-sustaining equipment available were associated with higher mortality, as locations with a larger population concentrated operational capacity to treat the most severe cases. In conclusion, the different levels of State capacity in health regions led to different outcomes in combating the pandemic. This reinforces the importance of discussing State capacity and crisis management, since the COVID-19 confrontation in Brazil related to the level of existing resources concerning health system capacity, bureaucratic capacity and participation in consortia for sharing inputs and ensuring the provision of health services to the population.

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.

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.

Social and Psychological Effects of COVID-19 Pandemic on Adolescents' and Young Adults' Mental Health: A Cross-Cultural Mediation Study

The ongoing pandemic has dramatically disrupted daily life, increasing the risk of developing psychiatric disorders and poor mental wellbeing. The compound effects of social, political and psychological stressors have increased psychological symptoms among adolescents and young people, with worries about COVID-19 playing a central role in the clinical course of their mental health problems caused by the pandemic. The aim of this cross-cultural study was to examine the social psychological effects of COVID-19 on adolescents' and young people's mental health and wellbeing in Ibero-American population. Participants involved 6,283 adolescents and young adults from five different Spanish-Speaking countries (83.7% female) aged between 12 and 30 years (M = 18.79; SD = 3.48). Participants completed the Worries about COVID-19 and its Consequences Scale (W-COV), the Satisfaction with Life Scale (SWLS), and the Depression, Anxiety and Stress Scale (DASS-21). Descriptive analyses, multivariate ANOVAs and Pearson correlations were performed, as well as Structural Equation Modelling (SEM) testing a mediational model. The results indicate cross-cultural difference in COVID-19 related worries, emotional symptoms and life satisfaction. Results from SEM confirmed the overall indirect effects of COVID-19 cases, political response and participants' conditions during lockdown on depression, anxiety, stress and life satisfaction mediated by COVID-19 related worries. These findings suggest that the social psychological factors underlying psychological symptoms could be partly explained by increased worries about COVID-19 and its personal, social, economic and political consequences, which may offer guidance to policy makers and health services for safeguarding youth mental well-being.

Increasing compliance with international pandemic law: international relations and new global health agreements

Across multiple pandemics, global health governance institutions have struggled to secure the compliance of states with international legal and political commitments, ranging from data sharing to observing WHO guidance to sharing vaccines. In response, governments are negotiating a new pandemic treaty and revising the International Health Regulations. Achieving compliance remains challenging, but international relations and international law research in areas outside of health offers insights. This Health Policy analyses international relations research on the reasons why states comply with international law, even in the absence of sanctions. Drawing on human rights, trade, finance, tobacco, and environmental law, we categorise compliance mechanisms as police patrol, fire alarm, or community organiser models. We show that, to date, current and proposed global health law incorporates only a few of the mechanisms that have shown to be effective in other areas. We offer six specific, politically feasible mechanisms for new international agreements that, together, could create compliance pressures to shift state behaviour.

COVID-19 and democracy: a scoping review

BACKGROUND

The resilience of democracy is tested under exogenous shocks such as crises. The COVID-19 pandemic has recently tested the resilience of democratic institutions and practices around the world.

AIM

The purpose of this article is to scope the early research literature that discusses democracy and the COVID-19 pandemic. We review scientific journal articles published during the first two years of the pandemic. We ask three research questions in scoping this body of literature: (1) what are the key topic areas of all published research that associates itself with both democracy and COVID-19, (2) what kinds of conceptual and theoretical contributions has research literature that more specifically discusses democracy under the pandemic produced, and (3) what are the impacts of democracy to the pandemic and vice versa according to empirical research?

METHODS

The scoping review methodology draws on systematic literature search strategies, computational methods, and manual coding. The systematic Web of Science search produced 586 articles for which we conducted a Correlated Topic Model. After technical and manual screening, we identified 94 journal articles that were manually coded.

RESULTS

The early research on democracy and the COVID-19 pandemic offers a versatile body of scholarship. The topic modeling shows that the scholarship discusses issues of crises, governance, rights, society, epidemiology, politics, electorate, technology, and media. The body of papers with conceptual and theoretical contributions has offered new insights on the difficulties, possibilities, and means to maintain democracy under a pandemic. Empirical research on democracy's impact on the COVID-19 pandemic and vice versa varies in terms of methodology, geographical scope, and scientific contributions according to the direction of influence studied. Democracy appears to have a significant impact on some aspects of policy responses and epidemiological characteristics of the pandemic. In most parts of the world, the scope, franchise, and authenticity of democracy narrowed down due to the pandemic, albeit in most cases only temporarily.

CONCLUSIONS

A significant number of papers show that the pandemic has accentuated democratic backsliding but is unlikely to have undermined established democracies that have proved resilient in face of the pandemic. But empirical research has also made visible some weak signals of antidemocratic tendencies that may become more accentuated in the longer run.

Individualism, economic development, and democracy as determinants of COVID-19 risk information on 132 government websites

Little is known about how governments transparently communicate about COVID-19. This study conducted a content analysis of 132 government COVID-19 websites to identify the salience of health messages (i.e., perceived threat, perceived efficacy, and perceived resilience) and cross-national determinants of information provision. Multinomial logistic regression was used to estimate the relationship between country-level predictors (i.e., economic development, democracy scores, and individualism index) and information salience. The numbers of deaths, discharged patients, and daily new cases were prevalent on the main webpages. Subpages provided information about vulnerability statistics, government responses, and vaccination rates. Less than 10% of governments included messages that may instill self-efficacy. Democratic countries had higher chances of providing threat statistics on subpages, including daily new cases (Relative Risk Ratio, RRR = 1.66, 95% CI: 1.16-2.37), mortalities (RRR = 1.69, 95% CI: 1.23-2.33), hospitalizations (RRR = 1.63, 95% CI: 1.12-2.37), and positivity rates (RRR = 1.55, 95% CI: 1.07-2.23). On subpages, democratic governments emphasized information about perceived vulnerability (RRR = 2.36, 95% CI: 1.50-3.73), perceived response efficacy (RRR = 1.48, 95% CI: 1.06-2.06), recovery numbers (RRR = 1.84, 95% CI: 1.31-2.60), and vaccinations (RRR = 2.14, 95% CI: 1.39-3.30). Developed countries reported the number of daily new cases, perceived response efficacy, and vaccination rates on their COVID-19 main pages. Individualism scores predicted the salience of vaccination rates on main pages and the omission of information related to perceived severity and perceived vulnerability. Democracy levels were more predictive of reporting information about perceived severity, perceived response efficacy, and perceived resilience on subpages of dedicated websites. Improving public health agencies' communication about COVID-19 is warranted.

HIV policy legacies, pandemic preparedness and policy effort to address COVID-19

That the world was unprepared for a major infectious disease outbreak is now readily apparent to all credible observers. However, some countries were more prepared than others and we have seen a variety of responses to COVID-19 emerge across nations. While recognizing that the sources of variation in country responses to COVID-19 are many and varied, in this study we seek to examine how policy legacies from national responses to HIV have influenced countries' responses to COVID-19. The aim of this study was to examine whether countries with a more conducive HIV policy environment were better prepared for COVID-19 and have therefore had more preemptive and rights-based responses. Using data from the Oxford Covid-19 Government Response Tracker, we develop measures of country effort to respond to COVID-19 including early containment and closure policies, prevention policies, economic policies, and health system policies. We combine this with data from the HIV Policy Lab and correlate overall and disaggregated country HIV Policy scores with COVID-19 Policy scores. We find that the COVID-19 Containment and Closure Measures Index was negatively correlated with supportive social policies related to HIV in the early stages of the pandemic, but the association did not persist as time went on. The COVID-19 Economic Support Measures had prolonged positive associations with supportive social policies related to HIV and negative association with clinical and treatment policies. Countries with stronger structural responses to HIV have been less inclined towards involuntary measures and more prepared for the social and economic elements of COVID-19 pandemic response.

Local implementation of public health policies revealed by the COVID-19 crisis: the French case

BACKGROUND

Improving health system performance depends on the quality of health policy implementation at the local level. However, in general, the attention of researchers is mainly directed towards issues of health policy design and evaluation rather than implementation at the local level. The management of the COVID-19 crisis, especially in Europe, has particularly highlighted the complexity of implementing health policies, decided at the national or supranational level, at the local level.

METHODS

We conducted 23 semi-structured interviews with the main stakeholders in the management of the COVID-19 crisis in the second largest French region in order to identify the different actors and modes of coordination of the local implementation of health policies that this crisis management illustrates in a very visible way. Our methodology is complemented by a content analysis of the main guidelines and decisions related to this implementation.

RESULTS

The analysis of these data allows us to identify three levels of implementation of health policies at the local level (administrative, organizational and operational). Interviews also reveal the existence of different types of coordination specific to each of these levels of local implementation of health policies. These results then make it possible to identify important managerial avenues for promoting global coordination of these three levels of implementation.

CONCLUSIONS

Although research on health services emphasizes the existence of several levels of local implementation of health policies, it offers little in the way of definition or characterization of these levels. The identification in this study of the three levels of local implementation of health policies and their specific forms of coordination contribute to a more precise characterization of this implementation in order to promote, in practice, its global coordination.

Priming COVID-19's consequences can increase support for investments in public health

Can messaging that emphasizes the costs of COVID-19 increase popular support for more proactive public health policies? People who experience disasters often become more supportive of policies to address their underlying causes, and the pandemic may have similar spillover effects for public opinion. To test this idea, the study implements a survey experiment in Italy, Germany, and the United States in which half of the respondents were randomly assigned to a prime about the impact of the pandemic prior to answering questions about their support for public health policies. The results show that respondents who received the prime became more favorable toward increased government spending on domestic and foreign public health programs alike. These treatment effects were consistent across countries, across two different surveys in the United States conducted at different points in time, and across partisan subgroups. However, the treatment did not consistently increase support for more active and intrusive government policies to address specific public health challenges like smoking or HIV/AIDS. The results suggest that public health advocates may benefit from messaging that connects COVID-19 to the need for public health funding beyond the context of the pandemic.

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.

Political Psychological and Sociocultural Determinants of Compliance with COVID-19 Emergency Measures Among Waste Pickers in an Iranian Sub-urban Slum Community

In the context of the coronavirus disease 2019 (COVID-19) pandemic, compliance with government regulations is a tremendous challenge in the effort to curb the viral transmission. The fact that specific communities and people across the world continue to ignore government regulations of COVID-19 is a crucial issue to address. Researchers sought to examine the political psychological and sociocultural determinants of adherence to COVID-19-related law and policy measures among waste pickers in a sub-urban slum community in Iran. A cross-sectional survey of 362 waste pickers from two municipalities in the countryside of Tehran, Iran, was conducted between January and May 2022. Multiple regression analysis was used to predict the significant difference between the direct or indirect effects of political psychological and sociocultural variables on compliance with COVID-19 emergency measures. Confidence intervals were estimated using the bootstrap method. The findings supported the proposed model. The results indicated that political ideology (β = - 0.13, 95% CI - 0.29 to 0.02), individualism worldview (β = - 0.14, 95% CI - 0.32 to 0.07), fatalism (β = - 0.18, 95% CI - 0.40 to 0.04), health literacy (β = 0.16, 95%CI - 0.05 to 0.37) and prosociality (β = 0.09, 95%CI 0.03-0.13) exert an indirect effect on compliance with the COVID-19 emergency measures through both trust in government and trust in science and scientific community. This study has implications for authorities in ensuring adherence to governmental orders for COVID-19 outbreak. A democracy-based and human rights-based approach and a flexible framework for proceeding more equitable COVID-19 legal and government regulations is critical to an effective and acceptable health response to COVID-19. Instituting slum emergency planning committees, incorporating the informal providers into all pandemic response plans in every urban informal settlement and providing an immediate guarantee of payments to waste packers will be indispensable.

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.

Populism and health. An evaluation of the effects of right-wing populism on the COVID-19 pandemic in Brazil

What are the effects of right-wing populism in the struggle against COVID-19? We explore data from Brazil, a country whose populist radical right-wing president was among the prominent denialists regarding the effects of the pandemic. Using cross-sectional and weekly-panel data for 5,570 municipalities during 2020, we present evidence that social distancing was weakened, and the number of cases and deaths were higher in places where the president had received greater electoral support during the 2018 presidential elections. Placebo tests using traditional right-wing vote and data on Severe Acute Respiratory Syndrome (SARS) before the pandemic outbreak indicate that the former does not correlate with health outcomes, and the populist share of the vote does not correlate with the latter. Hence, we find strong indications that right-wing populism relates to a poor response to the disease.

International taxation sentiment and COVID-19 crisis

Investigating public sentiment regarding tax policy during the COVID-19 pandemic could be useful for understanding the experiences across societies. Using Linguistic Inquiry and Word Count to investigate and quantitatively measure the pandemic's effect-from January 25 to April 9, 2020-on the sentiment regarding possible tax policies throughout the world, thereby determining that, overall, taxation sentiment is reduced as the number of confirmed COVID-19 cases grows. Further investigation reveals that, as COVID-19 spreads, the sentiment for raising taxes decreases and that for reducing taxes increases, and this effect is mitigated by countries' democracy. We further find that news sentiment in unofficial media and in countries with low social trust is more significantly affected by COVID-19. Robustness tests performed using different subsamples of developed and developing countries and different pandemic circumstances validate our findings. This research has crucial implications for policy evaluation and development.

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.

Measuring the Impact of Future Outbreaks? A Secondary Analysis of Routinely Available Data in Spain

Background: As of 7 January 2022, it is estimated that 5.5 million people worldwide have died from COVID-19. Although the full impact of SARS-CoV-2 (COVID-19) on healthcare systems worldwide is still unknown, we must consider the socio-economic impact. For instance, it has resulted in an 11% decrease in the GDP (Gross Domestic Product) in the European Union. We aim to provide valuable information for policymakers by analysing widely available epidemiological and socioeconomic indicators using Spanish data. Methods: Secondary analysis of routinely available data from various official data sources covering the period from 1 March 2020 to 31 March 2021. To measure the impact of COVID-19 in the population, a set of epidemiological and socioeconomic indicators were used. The interrelationships between these socioeconomic and epidemiological indicators were analysed using Pearson's correlation. Their behaviour was grouped according to their greater capacity to measure the impact of the pandemic and was compared to identify those that are more appropriate to monitor future health crises (primary outcome) using multivariate analysis of canonical correlation for estimating the correlation between indicators using different units of analysis. Results: Data from different time points were analysed. The excess of mortality was negatively correlated with the number of new companies created during the pandemic. The increase in COVID-19 cases was associated with the rise of unemployed workers. Neither GDP nor per capita debt was related to any epidemiological indicators considered in the annual analysis. The canonical models of socioeconomic and epidemiological indicators of each of the time periods analysed were statistically significant (0.80-0.91 p < 0.05). Conclusions: In conclusion, during the COVID-19 pandemic in Spain, excess mortality, incidence, lethality, and unemployment constituted the best group of indicators to measure the impact of the pandemic. These indicators, widely available, could provide valuable information to policymakers and higher management in future outbreaks.

Everyday capabilities were a path to resilience during COVID-19: a case study of five countries

COVID-19 demanded urgent responses by all countries, with wide variations in the scope and sustainability of those responses. Scholarship on resilience has increasingly emphasized relational considerations such as norms and power and how they influence health systems' responses to evolving challenges. In this study, we explored what influenced countries' national pandemic responses over time considering a country's capacity to test for COVID-19. To identify countries for inclusion, we used daily reports of COVID-19 cases and testing from 184 countries between 21st January 2020 and 31st December 2020. Countries reporting test data consistently and for at least 105 days were included, yielding a sample of 52 countries. We then sampled five countries representing different geographies, income levels and governance structures (Belgium, Ethiopia, India, Israel and Peru) and conducted semi-structured key informant interviews with stakeholders working in, or deeply familiar with, national responses. Across these five countries, we found that existing health systems capacities and political leadership determined how responses unfolded, while emergency plans or pandemic preparedness documents were not fit-for-purpose. While all five countries were successful at reducing COVID-19 infections at a specific moment in the pandemic, political economy factors complicated the ability to sustain responses, with all countries experiencing larger waves of the virus in 2021 or 2022. Our findings emphasize the continued importance of foundational public health and health systems capacities, bolstered by clear leadership and multisectoral coordination functions. Even in settings with high-level political leadership and a strong multisectoral response, informants wished that they-and their country's health system-were more prepared to address the pandemic and maintain an effective response over time. Our findings challenge emergency preparedness as the dominant frame in pandemic preparedness and call for a continued emphasis on health systems strengthening to respond to future health shocks and a pandemic moving to endemic status.

The Continuity of the Social Sciences During COVID-19: Sociology and Interdisciplinarity in Pandemic Times

I argue that the COVID-19 pandemic presents an opportunity for sociologists and other social scientists to focus their scholarship on this apparently new event, while applying theoretical and methodological traditions that were established during pre-pandemic times. I substantiate this argument by critically reviewing published sociological research on COVID-19, especially as it developed early on during the pandemic, in the light of the historical development and original ambitions of sociology and other social sciences. Evaluating these contributions, I make a case for the value of a collaborative notion of interdisciplinarity to analyze the multi-dimensional dynamics of the COVID-19 pandemic from the viewpoint of various disciplines. On the basis of sociological work on celebrity culture during the pandemic, I argue that this task can be accomplished without resorting to all too readily made judgments concerning the unprecedented nature of the pandemic. Studying the multiple dimensions of the pandemic, each of the social sciences can usefully contribute to interdisciplinary research by relying on the proven perspectives of their respective disciplinary orientations and specialty areas.

Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward

A series of aggressive restrictive measures were adopted around the world in 2020-2022 to attempt to prevent SARS-CoV-2 from spreading. However, it has become increasingly clear the most aggressive (lockdown) response strategies may involve negative side-effects such as a steep increase in poverty, hunger, and inequalities. Several economic, educational, and health repercussions have fallen disproportionately on children, students, young workers, and especially on groups with pre-existing inequalities such as low-income families, ethnic minorities, and women. This has led to a vicious cycle of rising inequalities and health issues. For example, educational and financial security decreased along with rising unemployment and loss of life purpose. Domestic violence surged due to dysfunctional families being forced to spend more time with each other. In the current narrative and scoping review, we describe macro-dynamics that are taking place because of aggressive public health policies and psychological tactics to influence public behavior, such as mass formation and crowd behavior. Coupled with the effect of inequalities, we describe how these factors can interact toward aggravating ripple effects. In light of evidence regarding the health, economic and social costs, that likely far outweigh potential benefits, the authors suggest that, first, where applicable, aggressive lockdown policies should be reversed and their re-adoption in the future should be avoided. If measures are needed, these should be non-disruptive. Second, it is important to assess dispassionately the damage done by aggressive measures and offer ways to alleviate the burden and long-term effects. Third, the structures in place that have led to counterproductive policies should be assessed and ways should be sought to optimize decision-making, such as counteracting groupthink and increasing the level of reflexivity. Finally, a package of scalable positive psychology interventions is suggested to counteract the damage done and improve humanity's prospects.

Resources or trust: What matters more in the vaccination strategies of high-income liberal democracies?

Objectives

This paper presents an overview of the vaccination policy responses to the COVID-19 pandemic in Denmark, Canada, and the United States until September 1, 2021. The article seeks to understand the reasons for vaccination differences among high-income, liberal democracies.

Methods

The country cases were selected based on tiers of population-level vaccination uptake within six months after vaccines became broadly available (for high-income countries). We conducted a rapid review of primary data for each country case. Through a graphical and descriptive analysis, we evaluated common patterns as well as significant divergences in the vaccination rollout across countries and its relationship with COVID-19 health outcomes, government policy responses, resource constraints, and socio-political factors. This inductive analysis provides a sense of how resource constraints compare with current political contexts in each country case that may influence the public's response to a national vaccination strategy.

Results

Resources, socio-economic factors, and health outcomes related to COVID-19 do not ensure vaccination policy success as the case of the United States makes clear. Instead, trust in government and health systems appear to promise a higher vaccination uptake and maintained support for measures during a pandemic. Trust in government can be defined as the confidence citizens have that governmental actions will do what is right and perceived as fair.

Conclusion

Denmark, the United States, and Canada are high-income liberal democracies with very different vaccine strategies and subsequently different vaccination outcomes across their populations. What appears to be critical to successful vaccination outcomes is high trust in government or health officials, along with the depoliticization of the COVID-19 pandemic among the country's political parties.

Professional regulation, profession-state relations and the pandemic response: Australia, Canada, and the UK compared

The COVID-19 pandemic provoked a surge in demand for health services. To help meet this demand, governments and health profession regulators implemented regulatory policy change to enhance professional availability and flexibility. Some nations may have been better positioned to make such changes due to their systems of healthcare profession regulation. More specifically, countries like Australia and the United Kingdom with their national regulatory structures could be more adaptable than Canada with its provincial system of regulation. To determine if this is the case, and guided by Abbott's (1988, 2005) ecological approach, we conducted a policy analysis. We find few differences in regulatory policy changes in terms of what was done, with the exception of scope of practice changes, which were implemented in Canadian provinces, but were not necessary in Australia and the United Kingdom. Instead, in the latter two countries practitioners were asked to bear responsibility for their own scopes. Additional content analysis of medical journals explored what professionals thought about policy responses, finding that Australian professionals were more positive than others. Moreover, government responses were regarded more favourably when they were perceived to be collaborative. Although there is little evidence that one regulatory system is better than another in facilitating crisis responses, regulatory structures do shape the nature of regulatory policy change.

Pandemic preparedness systems and diverging COVID-19 responses within similar public health regimes: a comparative study of expert perceptions of pandemic response in Denmark, Norway, and Sweden

BACKGROUND

National responses to the COVID-19 pandemic depend on national preparedness systems that must be understood as components of global public health emergency preparedness systems, governed and coordinated through the World Health Organization's 2005 International Health Regulations. The pandemic has raised the question of why countries belonging to similar public health regimes, coordinated through the same global system, responded differently to the same threat. Comparing the responses of Denmark, Sweden and Norway, countries with similar public health regimes, the paper investigates to what degree national differences in COVID-19 policy response reflect significant differences in the policy preferences of national expert groups.

RESULTS

We employ a structured case comparison of Denmark, Norway, and Sweden to analyze their' politico-administrative pandemic preparedness systems and policy responses during the first wave of the COVID-19 pandemic. We use the results of an interdisciplinary expert survey completed in 2020 to analyze expert perceptions in two ways. First, we analyze expert perceptions of COVID-19 responses while controlling for national COVID-19 trajectories and experts' characteristics. Second, we analyze the distribution and effect of dominant global expert-held ideas across countries, showing the importance of dominant ideas for experts' perceptions and preferences for COVID-19 response.

CONCLUSION

The study finds no evidence indicating that COVID-19 policy variation between the most similar cases of Denmark, Norway, and Sweden are the result of differences in the policy preferences of national expert groups. Instead, our study highlights the importance of other factors than cross-national expert dissensus for explaining variation in pandemic response such as the politico-administrative organization of pandemic preparedness systems. Further, we find that expert support for dominant ideas such as a 'focused protection strategy' is associated with consistent policy preferences across locational, disciplinary, and geographic affiliations. Recognition of the latter should be a part of future discussions about how global ideas of pandemic preparedness are diffused transnationally and embedded in national politico-administrative systems.

COVID-19 Point Blank: Language, Migration, and the Pandemic as a Political Issue

The current pandemic is sustained in dichotomies and distancing, as most of us awkwardly have recently experienced. Moreover, COVID-19 has definitely put the spotlight on social inequalities that are underpinning our society and it has highlighted the escalation of the state surveillance capability and new forms of oppression too. The discrimination ingrained in our societies, built on a historically defined regime of racialized oppression and structural disadvantage of racialized citizens and migrants, was produced well before the coronavirus, but it is now casting a different shade, reinforcing forms of exclusions, highlighting the pandemic as a political issue. Hence, this paper addresses a range of political perspectives of the lived experiences in and through social space with examples of narratives in language which capture the everyday political experiences of the pandemic within Europe. The kind of language used and its profound effect on the growing discourse regarding COVID-19 is the main focus in this paper. I here explore the intertwining of language and politics during the pandemic and bring out the countervailing narratives that seem to be in constant tension. I then ask where this takes us, not only in terms of scholarship and expansion of knowledge, but also with a pragmatic edge to it, trying to figure out how is it possible for us to achieve some sort of cognitive shift in our approach in order to learn from this challenge and from this new perspective. Methodologically, as well as looking at existing data, references to attitudes in general are made. A theoretical discussion on migration and language, and the kind of intersection between them, is offered, from the point of view of critical theory, before pointing to the metaphors used, the implications they allow, and how all these fit together, in the form of a concluding discussion. Metaphor or not, the power of language in its ramifications of articulations about the pandemic and the idea of distance underlines COVID-19 as a deeply political issue.

Perceived Changes in Sexual Interest and Distress About Discrepant Sexual Interest During the First Phase of COVID-19 Pandemic: A Multi-Country Assessment in Cohabiting Partnered Individuals

Due to COVID-19 pandemic, different restrictive measures in terms of physical distancing and lockdowns have been introduced in most European countries, affecting all facets of social life. Currently, little is known about how partnered individuals perceive changes in their sexual life during this complex emergency. This study explored retrospectively assessed changes in sexual interest for one's partner and levels of distress related to perceived sexual interest discrepancy during the first phase of the pandemic in a large-scale online sample of partnered individuals (n = 4813; Mage = 38.5 years, SD = 10.74) recruited between May and July 2020 in seven European Union countries and Turkey. We also examined the possible role of approach/avoidance motives for sex in reported changes in sexual interest and associated distress. Most participants (53%) reported no change in their sexual interest during the pandemic, followed by those who reported an increase (28.5%). The pattern was similar across the eight countries. Distress about discrepant sexual interest, which was only weakly related to changes in sexual interest, was significantly associated with relationship quality and emotional closeness with a partner, coping with and worrying about the pandemic, and specific motivation for sex. In contrast to avoidant and relationship-focused approach motivation, ego-focused approach motivation was related to stable sexual interest during the pandemic. The current study contributes to the understanding of the link between sexual interest and complex emergencies. Considering that the COVID-19 pandemic continues, the reported experiences and perceptions are prone to change.

COVID-19 pandemic, global spread, issues, and challenges

COVID-19 pandemic undoubtedly has a long-term implication for various aspects of governance. The coupled impacts of COVID-19 pandemic and natural hazards in global perspectives provided the opportunities to researchers, academicians, decision-makers, and practitioners to opening up new research avenues and policy requirements. Integrated assessment to quantify the societal consequences of the pandemic is the need of the hour to develop a comprehensive global response and recovery plan to regain the unprecedented impacts to global governance. The book is an attempt to conduct the assessment for regaining global phenomena; it is important to understand the cutting-edge vulnerability and deprivation to address inequalities between countries and shifting modality in risk governance. The case studies of COVID-19 pandemic impacts, governance, and consequences have been analyzed from various perspectives at the local, national, and regional levels.

Coping with Denialism: How Street-Level Bureaucrats Adapted and Responded to COVID-19 in Tanzania

CONTEXT

This article aims to highlight challenges and adaptations made by local health officials in Tanzania in working to contain and manage COVID-19.

METHODS

The study takes an inductive approach, drawing on the reported experiences of 40 officials at different levels of government across four purposefully selected regions in July 2020. Interviewees were asked about the guidance they received to contain COVID-19, the source of that guidance, their challenges and successes in implementing the guidance, and if and how they adapted the guidance to their particular setting.

FINDINGS

The interviews depict considerable challenges, including a lack of supplies and resources for implementing infection control, surveillance, and mitigation practices and dealing with fear and stigma. At the same time, they also provide evidence of innovation and adaptation among street-level bureaucrats. Respondents overwhelmingly praised the president, whose limited national response is seen as helpful for reducing fear and stigma.

CONCLUSIONS

Other scholars have highlighted the potential dangers of street-level discretion if local officials "make policy" in ways that contradict their agencies' stated goals. In contrast, our study suggests benefits of autonomy at the street level-particularly in contexts where the central state was relatively weak and/or acting against the public interest.

Using hierarchical clustering analysis to evaluate COVID-19 pandemic preparedness and performance in 180 countries in 2020

OBJECTIVE

To rank and score 180 countries according to COVID-19 cases and fatality in 2020 and compare the results to existing pandemic vulnerability prediction models and results generated by standard epidemiological scoring techniques.

SETTING

One hundred and eighty countries' patients with COVID-19 and fatality data representing the healthcare system preparedness and performance in combating the pandemic in 2020.

DESIGN

Using the retrospective daily COVID-19 data in 2020 broken into 24 half-month periods, we applied unsupervised machine learning techniques, in particular, hierarchical clustering analysis to cluster countries into five groups within each period according to their cumulative COVID-19 fatality per day over the year and cumulative COVID-19 cases per million population per day over the half-month period. We used the average of the period scores to assign countries' final scores for each measure.

PRIMARY OUTCOME

The primary outcomes are the COVID-19 cases and fatality grades in 2020.

RESULTS

The United Arab Emirates and the USA with F in COVID-19 cases, achieved A or B in the fatality scores. Belgium and Sweden ranked F in both scores. Although no African country ranked F for COVID-19 cases, several African countries such as Gambia and Liberia had F for fatality scores. More developing countries ranked D and F in fatality than in COVID-19 case rankings. The classic epidemiological measures such as averages and rates have a relatively good correlation with our methodology, but past predictions failed to forecast the COVID-19 countries' preparedness.

CONCLUSION

COVID-19 fatality can be a good proxy for countries' resources and system's resilience in managing the pandemic. These findings suggest that countries' economic and sociopolitical factors may behave in a more complex way as were believed. To explore these complex epidemiological associations, models can benefit enormously by taking advantage of methods developed in computer science and machine learning.

The institutional capacity of the Health Sector and the response to COVID-19 in a global perspective

This study approaches the Global Health Security Index (GHSI) according to the responses to the first cycle of the COVID-19. The GHSI ranks countries' institutional capacity to address biological risks. We analyzed data regarding the spread of COVID-19 pandemic in 50 countries to assess the ability of GHSI to anticipate health risks. The lack of vaccination determined the spread of the COVID-19 in the first cycle of the pandemic in 2020. Country indicators are correlated and demonstrated by descriptive statistics. The clustering method groups countries by similar age composition. The main restriction that can be attributed to the GHSI concerns the preference of biomedical variables for measuring institutional capacity. Our work shows that the pandemic had a significant impact on better-prepared countries, according to the GHSI, to control the spread of diseases and offer more access to health care in 2020. This paper points out that the health sector depended on the cooperation of governments in the adoption of social distancing during the first cycle of the pandemic. The GHSI failed to consider the role of political leaders who challenge severe health risks by vetoing social distancing.

Privacy lost: Appropriating surveillance technology in China's fight against COVID-19

China's unprecedented measures to mobilize its diverse surveillance apparatus played a key part in the country's successful containment of the ongoing coronavirus pandemic. Critics worldwide believe these invasive technologies, in the hands of an authoritarian regime, could trample the right to privacy and curb fundamental civil and human rights. However, there is little domestic public resistance in China about technology-related privacy risks during the pandemic. Drawing on academic research and a semantic network analysis of media frames, we explore the contextual political and cultural belief systems that determine public support for authorities' ever-expanding access to personal data. We interrogate the longer-term trajectories-including the guardian model of governance, sociotechnical imagination of technology, and communitarian values-by which the understanding of technology and privacy in times of crisis has been shaped. China's actions shed light on the general acceptance of the handover of personal data for anti-epidemic purposes in East Asian societies like South Korea and Singapore.

The Language of Pandemic Leaderships: Mapping Political Rhetoric During the COVID-19 Outbreak

This article maps political rhetoric by national leaders during the COVID-19 pandemic. We identify and characterize global variations in major rhetorical storylines invoked in publicly available speeches (N = 1201) across a sample of 26 countries. Employing a text analytics or corpus linguistics approach, we show that state heads rhetorically lead their nations by: enforcing systemic interventions, upholding global unity, encouraging communal cooperation, stoking national fervor, and assuring responsive governance. Principal component analysis further shows that country-level rhetoric is organized along emergent dimensions of cultural cognition: an agency-structure axis to define the loci of pandemic interventions and a hierarchy-egalitarianism axis which distinguishes top-down enforcement from bottom-up calls for cooperation. Furthermore, we detect a striking contrast between countries featuring populist versus cosmopolitan rhetoric, which diverged in terms of their collective meaning making around leading over versus leading with, as well as their experienced pandemic severity. We conclude with implications for understanding global pandemic leadership in an unequal world and the contributions of mixed-methods approaches to a generative political psychology in times of crisis.

Political regime, data transparency, and COVID-19 death cases

The COVID-19-the worst pandemic since the Spanish flu-has dramatically changed the world, with a significant number of people suffering from and dying of the disease. Some scholars argue that democratic governments are disadvantaged in coping with the current pandemic mainly because they cannot intervene in their citizens' lives as aggressively as their authoritarian counterparts. Other scholars, however, suggest that possible data manipulation may account for the apparent advantage of authoritarian countries. Taking such a possibility seriously, this paper analyzes the relationship between political regimes, data transparency, and COVID-19 deaths using cross-national data for over 108 countries, obtained from Worldometer COVID-19 Data, Polity V Project, Variety of Democracy (V-Dem) Project, HRV Transparency Project among other sources. Regression analyses indicate that authoritarian countries do not necessarily tend to have fewer COVID-19 deaths than their democratic counterparts after controlling for other factors, especially data transparency. The transparency variable itself, on the other hand, is positively correlated with the number of death cases more consistently (P <0.05). Overall, the estimation results point to the possible data manipulation, not the nature of regime characteristics itself, as a more significant source for the seemingly low casualty rates in authoritarian countries.

Compliance with recommendations limiting COVID-19 contagion among university students in Sweden: associations with self-reported symptoms, mental health and academic self-efficacy

AIMS

The COVID-19 containment strategy in Sweden uses public health recommendations relying on personal responsibility for compliance. Universities were one of few public institutions subject to strict closure, meaning that students had to adapt overnight to online teaching. This study investigates the prevalence of self-reported recommendation compliance and associations with self-reported symptoms of contagion, self-experienced effects on mental health and academic self-efficacy among university students in Sweden in May-June 2020.

METHODS

This was a cross-sectional 23 question online survey in which data were analysed by multinomial regression, taking a Bayesian analysis approach complemented by null hypothesis testing.

RESULTS

A total of 4495 students consented to respond. Recommendation compliance ranged between 70% and 96%. Women and older students reported higher compliance than did men and younger students. Mild to moderate COVID-19 symptoms were reported by 30%, severe symptoms by fewer than 2%; 15% reported being uncertain and half of the participants reported no symptoms. Mental health effects were reported by over 80%, and changes in academic self-efficacy were reported by over 85%; in both these areas negative effects predominated. Self-reported symptoms and uncertainty about contagion were associated with non-compliance, negative mental health effects, and impaired academic self-efficacy.

CONCLUSIONS

Students generally followed public health recommendations during strict closure of universities, but many reported considerable negative consequences related to mental health and academic self-efficacy. Digital interventions should be developed and evaluated to boost coping skills, build resilience and alleviate student suffering during the pandemic and future similar crises.

Macro level factors influencing strategic responses to emergent pandemics: A scoping review

BACKGROUND

Strategic planning is critical for successful pandemic management. This study aimed to identify and review the scope and analytic depth of situation analyses conducted to understand their utility, and capture the documented macro-level factors impacting pandemic management.

METHODS

To synthesise this disparate body of literature, we adopted a two-step search and review process. A systematic search of the literature was conducted to identify all studies since 2000, that have 1) employed a situation analysis; and 2) examined contextual factors influencing pandemic management. The included studies are analysed using a seven-domain systems approach from the discipline of strategic management.

RESULTS

Nineteen studies were included in the final review ranging from single country (6) to regional, multi-country studies (13). Fourteen studies had a single disease focus, with 5 studies evaluating responses to one or more of COVID-19, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), Influenza A (H1N1), Ebola virus disease, and Zika virus disease pandemics. Six studies examined a single domain from political, economic, sociological, technological, ecological or wider industry (PESTELI), 5 studies examined two to four domains, and 8 studies examined five or more domains. Methods employed were predominantly literature reviews. The recommendations focus predominantly on addressing inhibitors in the sociological and technological domains with few recommendations articulated in the political domain. Overall, the legislative domain is least represented.

CONCLUSIONS

Ex-post analysis using the seven-domain strategic management framework provides further opportunities for a planned systematic response to pandemics which remains critical as the current COVID-19 pandemic evolves.

Macro level influences on strategic responses to the COVID-19 pandemic - an international survey and tool for national assessments

BACKGROUND

Variation in the approaches taken to contain the SARS-CoV-2 (COVID-19) pandemic at country level has been shaped by economic and political considerations, technical capacity, and assumptions about public behaviours. To address the limited application of learning from previous pandemics, this study aimed to analyse perceived facilitators and inhibitors during the pandemic and to inform the development of an assessment tool for pandemic response planning.

METHODS

A cross-sectional electronic survey of health and non-health care professionals (5 May - 5 June 2020) in six languages, with respondents recruited via email, social media and website posting. Participants were asked to score inhibitors (-10 to 0) or facilitators (0 to +10) impacting country response to COVID-19 from the following domains - Political, Economic, Sociological, Technological, Ecological, Legislative, and wider Industry (the PESTELI framework). Participants were then asked to explain their responses using free text. Descriptive and thematic analysis was followed by triangulation with the literature and expert validation to develop the assessment tool, which was then compared with four existing pandemic planning frameworks.

RESULTS

928 respondents from 66 countries (57% health care professionals) participated. Political and economic influences were consistently perceived as powerful negative forces and technology as a facilitator across high- and low-income countries. The 103-item tool developed for guiding rapid situational assessment for pandemic planning is comprehensive when compared to existing tools and highlights the interconnectedness of the 7 domains.

CONCLUSIONS

The tool developed and proposed addresses the problems associated with decision making in disciplinary silos and offers a means to refine future use of epidemic modelling.

Public willingness to adhere to COVID-19 precautionary measures in Sudan: an application of the Health Belief Model

INTRODUCTION

coronavirus disease (COVID-19) is a highly infectious disease caused by the novel coronavirus (SARS-CoV-2). Several public health and social protective measures that may prevent or slow down the transmission of COVID-19 were introduced. However, these measures are unfortunately being neglected or deliberately ignored by some individuals.

METHODS

a cross sectional online based survey was conducted to identify possible factors influencing public willingness to adhere to precautionary measures and preventive guidelines against COVID-19 during the lockdown periods in Sudan. The questionnaire was used to collect socio-demographic data of study participants, their health beliefs and willingness regarding adherence to precautionary measures against COVID-19 based on the constructs of the Health Belief Model.

RESULTS

a total of 680 respondents completed and returned the online questionnaire. Significant predictors of the willingness to adhere to the precautionary measures against COVID-19 were gender (β= 3.34, P<0.001), self-efficacy (β= 0.476, P<0.001), perceived benefits (β= 0.349, P<0.001) and perceived severity (β= 0.113, P=0.005). These factors explained 43% of the variance in respondents' willingness to adhere to COVID-19 precautionary measures. Participants who were female, confident in their ability to adhere to the protective measures when available, believing in the benefits of the protective measures against COVID-19 and perceiving that the disease could have serious consequences were more likely to be willing to adhere to the protective measures.

CONCLUSION

female respondents and respondents having higher self-efficacy, higher perceived benefits and higher perceived severity were more likely to be willing to adhere to the protective measures against COVID-19 in Sudan.

Why is repositioning public health innovation towards a social paradigm necessary? A reflection on the field of public health through the examples of Ebola and Covid-19

Health innovations are generally oriented on a techno-economic vision. In this perspective, technologies are seen as an end in themselves, and there is no arrangement between the technical and the social values of innovation. This vision prevails in sanitary crises, in which management is carried out based on the search for punctual, reactive, and technical solutions to remedy a specific problem without a systemic/holistic, sustainable, or proactive approach. This paper attempts to contribute to the literature on the epistemological orientation of innovations in the field of public health. Taking the Covid-19 and Ebola crises as examples, the primary objective is to show how innovation in health is oriented towards a techno-economic paradigm. Second, we propose a repositioning of public health innovation towards a social paradigm that will put more emphasis on the interaction between social and health dimensions in the perspective of social change. We will conclude by highlighting the roles that public health could play in allowing innovations to have more social value, especially during sanitary crises.

Malawi at the Crossroads: Does the Fear of Contracting COVID-19 Affect the Propensity to Vote?

The new coronavirus disease (COVID-19) has paralysed many sectors of human life, including economic, social-cultural and political processes. In the political arena, several countries have postponed elections due to the COVID-19 pandemic. Other countries, including Malawi, went ahead with their planned elections. Malawi held a presidential election at a time when the number of COVID-19 cases was increasing rapidly. In this paper, we assess the effect of the perceived risk of catching COVID-19 on willingness to vote in the Malawi presidential election that was held on 23 June 2020. Turn out in this election was ten percentage points lower than in the general elections that were held a year earlier. The paper draws on a nationally representative survey of adult Malawians (n = 1155). In our main analysis, we use instrumental variables to account for potential endogeneity. We find that nearly two thirds of Malawians thought that they were likely to catch COVID-19 at some point. Notwithstanding the COVID-19 risk, 86% of the country's citizens were willing to vote. Our analysis shows that an individual's perceived risk of catching COVID-19 is associated with a lower likelihood of voting (β = - 0.096; p < 0.05). This suggests that voter turnout in Malawi's fresh presidential election may have been highly affected by the perceived risk of catching COVID-19. The policy implication is that instituting and enforcing primary preventive measures may help reduce the perceived risk of catching COVID-19 and mitigate voter apathy.

Life under lockdown: Illustrating tradeoffs in South Africa's response to COVID-19

This research note sheds light on the first three months of the COVID-19 outbreak in South Africa, where the virus has spread faster than anywhere else in the region. At the same time, South Africa has been recognized globally for its swift and efficient early response. We consider the impact of this response on different segments of the population, looking at changes in mobility by province to highlight variation in the willingness and ability of different subsets of the population to comply with lockdown orders. Using anonymized mobile phone data, we show that South Africans in all provinces reduced their mobility substantially in response to the government's lockdown orders. Statistical regression analysis shows that such mobility reductions are significantly and negatively associated with COVID-19 growth rates two weeks later. These findings add an important perspective to the emerging literature on the efficacy of shelter-in-place orders, which to date is dominated by studies of the United States. We show that people were particularly willing and able to act in the provinces hit hardest by the pandemic in its initial stages. At the same time, compliance with lockdown orders presented a greater challenge among rural populations and others with more precarious livelihoods. By reflecting on South Africa's inequality profile and results of a recent survey, we demonstrate how the country's response may deepen preexisting divides. This cautionary tale is relevant beyond South Africa, as much of the continent - and the world - grapples with similar tradeoffs. Along with measures to contain the spread of disease, governments and other development focused organizations should seriously consider how to offset the costs faced by already marginalized populations.

Aspects About Science in the Context of Production and Communication of Knowledge of COVID-19

In the context of the COVID-19 pandemic, and given the huge volume of information available for the general population (being part of them fake news), there is a clear need to foster people's understanding of the meaning of science, of how scientific knowledge is produced, communicated, and used. As one of the main aims of science education is the promotion of students' scientific literacy, one of the issues focused on teaching should be aspects of nature of science (NOS) - which can be introduced from discussions in socioscientific contexts. In this paper, we analyse the context of the COVID-19 pandemic in order to identify and discuss aspects of NOS involved in the production and communication of knowledge about it. We analyse selected scientific publications and reports from the general media, mainly focused on three broad topics about the production and validation of knowledge: (i) the characterisation of the virus, and (ii) the treatments and vaccines for COVID-19, and (iii) the communication of knowledge produced from the characterisation of scientific literature itself in the pandemic period. The analysis was carried out from a model that presents a broad and complex view of science, as it addresses several areas of knowledge and specific aspects of each of them and proposes the generation of one's view of science from an integration of some of its distinct areas and/or aspects. The results show the current pandemic is a rich socioscientific context whose discussion of social, political, economic, and ethical aspects may support students' learning of nature of science, thus fostering scientific literacy.

Como a comunidade internacional da medicina de precisão tem se posicionado diante dos desafios impostos pela pandemia da COVID-19?

Medicina de precisão pode ser definida como um movimento de transformação da biomedicina contemporânea que orienta a atividade de pesquisa acadêmica, modelos de negócios e o desenvolvimento de produtos e serviços de saúde desenhados individualmente para o usuário, baseado em informações genéticas e outros marcadores biomédicos dos pacientes. Ao longo dos últimos anos, essa comunidade tem sido bastante atuante no cenário científico internacional. No entanto, durante a pandemia da COVID-19 ainda não ficou claro quais posicionamentos ou estratégias têm sido adotadas por esses grupos para o enfrentamento da crise sanitária. O objetivo deste artigo é compreender como a comunidade internacional da medicina de precisão está reagindo à pandemia da COVID-19, e em que estão baseadas as suas abordagens e potenciais soluções sugeridas para a mitigação dos efeitos negativos causados pelo aumento das infecções pelo novo coronavírus. Para tanto, foi feita pesquisa documental em 28 documentos provenientes de 18 fontes selecionadas, em que analisou-se as narrativas difundidas pelos profissionais da medicina de precisão em artigos científicos, editoriais, comentários, perspectivas, notícias de jornais e boletins e conferência virtual da Coalizão de Medicina Personalizada (PMC, em inglês). Com isso, buscou-se compreender como esses grupos imaginam uma nova configuração sociotécnica para o enfrentamento da pandemia e de seus efeitos.

The value proposition of the Global Health Security Index

Infectious disease outbreaks pose major threats to human health and security. Countries with robust capacities for preventing, detecting and responding to outbreaks can avert many of the social, political, economic and health system costs of such crises. The Global Health Security Index (GHS Index)-the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries-recently found that no country is sufficiently prepared for epidemics or pandemics. The GHS Index can help health security stakeholders identify areas of weakness, as well as opportunities to collaborate across sectors, collectively strengthen health systems and achieve shared public health goals. Some scholars have recently offered constructive critiques of the GHS Index's approach to scoring and ranking countries; its weighting of select indicators; its emphasis on transparency; its focus on biosecurity and biosafety capacities; and divergence between select country scores and corresponding COVID-19-associated caseloads, morbidity, and mortality. Here, we (1) describe the practical value of the GHS Index; (2) present potential use cases to help policymakers and practitioners maximise the utility of the tool; (3) discuss the importance of scoring and ranking; (4) describe the robust methodology underpinning country scores and ranks; (5) highlight the GHS Index's emphasis on transparency and (6) articulate caveats for users wishing to use GHS Index data in health security research, policymaking and practice.

Antibiotic Resistance: Moving From Individual Health Norms to Social Norms in One Health and Global Health

Antibiotic resistance is a problem for human health, and consequently, its study had been traditionally focused toward its impact for the success of treating human infections in individual patients (individual health). Nevertheless, antibiotic-resistant bacteria and antibiotic resistance genes are not confined only to the infected patients. It is now generally accepted that the problem goes beyond humans, hospitals, or long-term facility settings and that it should be considered simultaneously in human-connected animals, farms, food, water, and natural ecosystems. In this regard, the health of humans, animals, and local antibiotic-resistance-polluted environments should influence the health of the whole interconnected local ecosystem (One Health). In addition, antibiotic resistance is also a global problem; any resistant microorganism (and its antibiotic resistance genes) could be distributed worldwide. Consequently, antibiotic resistance is a pandemic that requires Global Health solutions. Social norms, imposing individual and group behavior that favor global human health and in accordance with the increasingly collective awareness of the lack of human alienation from nature, will positively influence these solutions. In this regard, the problem of antibiotic resistance should be understood within the framework of socioeconomic and ecological efforts to ensure the sustainability of human development and the associated human-natural ecosystem interactions.